Archive for the ‘research’ Category

Tularemia in Minnesotan Ticks

https://www.liebertpub.com/doi/abs/10.1089/vbz.2018.2388

Prevalence of Francisella tularensis in Dermacentor variabilis Ticks, Minnesota, 2017

Tory Whitten, Courtney Demontigny, Jenna Bjork, Mandy Foss, Molly Peterson, Joni Scheftel, Dave Neitzel, Maureen Sullivan, and Kirk Smith
Published Online:https://doi.org/10.1089/vbz.2018.2388

Introduction: The prevalence of Francisella tularensis in Minnesota ticks is unknown. Ticks collected at seven sites were tested to determine the infection prevalence of F. tularensis in Dermacentor variabilis in Minnesota.

Materials and Methods: Ticks were collected from two properties at an epizootic site and at five long-term tick research sites. Ticks were pooled by species, sex, date, and site with a maximum of 10 ticks per pool. Ticks were bisected and homogenized; DNA from supernatant was extracted and tested by real-time PCR (RT-PCR). Twice, additional ticks were collected for bacterial culture and isolation of F. tularensis. Proportion of positive pools and minimum infection rate (MIR) were calculated.

Results: A total of 3527 ticks were tested for F. tularensis including 1601 male D. variabilis and 1926 female D. variabilis. Across all sites, 128 (34%) of 378 pools were RT-PCR positive for F. tularensis. Of 128 positive pools, F. tularensis from 96 (75%) was identified as type A; F. tularensis from 32 pools was unable to be subtyped. The overall MIR was 3.6%. The MIR was significantly lower at the epizootic site compared with Morrison County 1 (3.9% vs. 7.2%; p = 0.02) but did not differ between the epizootic site and Pine County 1 (3.9% vs. 2.1%; p = 0.49). Within the epizootic site, the MIR was significantly higher at Washington County 2 compared with the adjacent property (5.7% vs. 2.3%; p < 0.001). F. tularensis was cultured from 6 (15%) of 40 pools.

Conclusions: F. tularensis was found in ticks at a majority of sites tested. The MIR of F. tularensis in D. variabilis ticks in Minnesota varied geographically. Our findings support the hypothesis that D. variabilis plays an important role in the natural history of tularemia in Minnesota. Further ecologic studies are needed to fully understand the importance of tick species in the maintenance and transmission of F. tularensis in Minnesota.

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**Comment**

The Dermacentor variabilis tick is a hard bodied tick, also known as the American Dog tick or Wood tick and is widely known.  It transmits Rocky Mountain spotted fever (RMSF) and tularemia to humans as well as canine tick paralysis to dogs.  http://edis.ifas.ufl.edu/in781

LyraEDISServlet-2

Dorsal view of American dog ticks, Dermacentor variabilis (Say), with male on left, and female on right.  Credit: J.F. Butler, University of Florida

It was been suggested that adult ticks move to the edge of the roads and trails in an attempt to find a host, or “quest.” Some have hypothesized that because many animals typically follow trails, they leave an odor that attracts these ticks causing them to move toward and quest alongside trails in attempts to find a host (Mcnemee et al. 2003).

More on Tularemia:  https://madisonarealymesupportgroup.com/2016/10/25/of-rabbits-and-men/ 

https://madisonarealymesupportgroup.com/2018/09/28/after-tularemia-death-experts-stress-education/

https://madisonarealymesupportgroup.com/2018/08/07/tularemia-hunting-dogs-as-possible-vectors/

https://madisonarealymesupportgroup.com/2018/02/27/tularemia-infected-ticks-found-on-sorrento-valley-trail-in-ca/

https://madisonarealymesupportgroup.com/2018/03/07/hantavirus-tularemia-warnings-issued-in-san-diego-county/

https://madisonarealymesupportgroup.com/2018/09/19/glandular-tularemia/

Normally thought of as inhabiting areas east of the Rocky Mountains, the Wood tick is obviously defying entomology maps and traipsing all over – from Minnesota to Missouri, California, and most probably everywhere in-between.

I remember hearing Timothy Lepore, MD, FACS, surgeon at Nantucket Cottage Hospital, at a Lyme conference.  He explained that Tularemia is also a disease of those who work with the land such as landscapers and farmers, as well as those who get bit by a tick. There are cases reported in every state but Hawaii, and many other wild and domestic animals can be infected. The highest rates of infection are in Arkansas.  Please see this link for more details but know that this is a bioweaponized pathogen:  https://madisonarealymesupportgroup.com/2016/10/25/of-rabbits-and-men/  The WHO estimates that an aerosol dispersal of 50 kg of F. tularensis over an area with 5 million people would result in 25,000 incapacitating casualties including 19,000 deaths.

Transmission: Transmission can occur through the skin or mucous membranes when handling infected animals as well as through tick bite, contact with fluids from infected deer flies, mosquitoes or ticks, handling or eating undercooked rabbit, drinking contaminated water, inhaling dust from contaminated soil, and handling contaminated pelts or paws of animals. It can also be inhaled from infected hay, grain, or soil. Dr. Lepore had patients who contracted it from their pet dog who shook rain water on them after chewing on a dead rabbit, as well as from folks eating road kill, a person who held sick animals, and a gentleman who slept with his pet bunny.

Another reminder – don’t sleep with pets!
The fact that 35% of Minnesotan ticks are infected with Tularemia is concerning.  Spread the word.

 

 

 

 

Impact of Pre-operative Antimicrobial Treatment on Microbiological Findings From Endocardial Specimens in Infective Endocarditis

https://www.ncbi.nlm.nih.gov/pubmed/30680557

2019 Jan 24. doi: 10.1007/s10096-018-03451-5. [Epub ahead of print]

Impact of pre-operative antimicrobial treatment on microbiological findings from endocardial specimens in infective endocarditis.

Abstract

Treatment of infective endocarditis (IE) should be initiated promptly. This might hamper the chances to identify the causative organism in blood cultures. Microbiological sampling of infected valve in patients undergoing surgery might identify the causative organism. The impact of pre-operative antimicrobial treatment on the yield of valve samples is not known. This study evaluated the impact of the duration of the pre-operative antibiotic treatment on valve culture and 16S rRNA PCR findings from resected endocardial samples. Patients meeting the modified Duke criteria of definite or possible IE and undergoing valve surgery due to IE during 2011-2016 were included from Southern Finland. Eighty-seven patients were included.

In patients with shorter than 2 weeks of pre-operative antimicrobial treatment, PCR was positive in 91% (n = 42/46) and valve culture in 41% (n = 19/46) of cases. However, in patients who had 2 weeks or longer therapy before operation, PCR was positive in 53% (n = 18/34) and all valve cultures were negative. In 14% of patients, PCR had a diagnostic impact. In blood-culture negative cases (n = 13), PCR could detect the causative organism in ten patients (77%). These included five cases of Bartonella quintana, one Tropheryma whipplei, and one Coxiella burnetii. Long pre-operative antimicrobial treatment was shown to have a negative impact on microbiological tests done on resected endocardial material. After 2 weeks of therapy, all valve cultures were negative, but PCR was positive in half of the cases. PCR aided in diagnostic work-up, especially in blood culture negative cases.

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**Comment**

The dilemma “to treat or not to treat” because of hampered ability to subsequently test for organisms is real; however, the risk for not treating is potentially death.

The big point for Lyme/MSIDS patients; however, is the fact they found Bartonella and Coxiella burnettii, also known as Q-fever in patients with infective carditis.

https://www.columbia-lyme.org/q-fever  Those working with farm animals are at greater risk through inhalation or ingestion of soil or animal waste particles; however, ticks do transmit it.

Signs and Symptoms

Symptoms include high fever, headache, sore throat, malaise, nausea, diarrhea, chest pain, nonproductive cough, pneumonia, and hepatitis. Neurological manifestations occur in about one percent of patients and could develop into meningitis, encephalitis, myelitis and/or peripheral neuropathy. Endocarditis, infection of the heart valves, is the most serious manifestation. However, it is usually found in patients with preexisting valvular disease. Unfortunately, the mortality rate is increasingly high, currently at 65 percent.

Go here for a nifty table with the various coinfections, vectors, causative agent, endemic area, and symptoms: https://www.lymedisease.org/lyme-basics/co-infections/other-co-infections/

You will note that the brown dog tick, Rocky Mountain Wood tick, and the Lone Star Tick are all vectors and Q-fever is endemic throughout the U.S.  Treatment is doxycycline.

https://www.wrair.army.mil/Documents/TropMed/(18)%20Lyme%20and%20Rickettsial%20Disease_LTC%20Waterman.pdf  This document states endocarditis caused by Q fever may be chronic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88923/  Interestingly, even as far back as the 30’s, Q fever was noted to have properties of both viruses and rickettsiae. This document states Q fever may occur in patients without any animal contact due to it’s ability to be spread by wind.  The same document states human Q fever cases have occurred in the following:

  • An OB after an abortion on an infected woman
  • transplacental transmission
  • autopsies
  • intradermal inoculation
  • blood transfusion
  • tick bite
  • sexually in infected mice
  • possibly from infected dogs
  • infected cats

The real kicker on that last one was the 1984 report of 13 people who developed febrile respiratory disease by playing poker in a room where a cat had delivered kittens.  Abstract here:

Kosatsky T. Household outbreak of Q-fever pneumonia related to a parturient cat. Lancet. 1984;ii:1447–1449. [PubMed]

Symptoms were:

  • bradycardia (slow heart rate)
  • fever
  • palatal petechiae (red or purple spots on mouth palate)
  • rapidly enlarging bilateral pulmonary infiltrates (fluid in both lungs)

 

 

 

 

 

Study Shows Ticks PCR Positive for Bartonella and Two Strains of Borrelia

https://www.sciencedirect.com/science/article/abs/pii/S1877959X18302942

Regional prevalences of Borrelia burgdorferi, Borrelia bissettiae, and Bartonella henselae in Ixodes affinis, Ixodes pacificus and Ixodes scapularis in the USA

Abstract

The objective of this work was to determine the prevalence of Borrelia and Bartonella species in Ixodes spp. ticks collected from 16 USA states. Genus PCR amplification and sequence analysis of Bartonella and Borrelia16SsRNA-23SsRNA intergenic regions were performed on DNA extracted from 929 questing adult ticks (671 Ixodes scapularis, 155 Ixodes affinis, and 103 Ixodes pacificus).

Overall, 129/929 (13.9%) Ixodes ticks were PCR positive for Borrelia burgdorferi sensu stricto, 48/929 (5.1%) for B. bissettiae whereas 23/929 (2.5%) were PCR positive for a Bartonella henselae. Borrelia bissettiae or B. burgdorferi s.s. and B. henselae co-infections were found in I. affinis from North Carolina at a rate of 4.5%; in a single I. scapularis from Minnesota, but not in I. pacificus. For both bacterial genera, PCR positive rates were highly variable depending on geographic location and tick species, with Ixodes affinis (n = 155) collected from North Carolina, being the tick species with the highest prevalence’s for both Borrelia spp. (63.2%) and B. henselae (10.3%). Based on the results of this and other published studies, improved understanding of the enzootic cycle, transmission dynamics, and vector competence of Ixodes species (especially I. affinis) for transmission of Borrelia spp. and B. henselae should be a public health research priority.

________________

**Comment**

One of the most understated studies yet.  Research on transmission and vector competence is screaming to be done – especially for Bartonella as mainstream medicine still thinks it’s a simple disease caused by the scratch of a cat that only affects immunocompromised people.  They also insist the black-legged tick is the sole perp for Lyme.  Both of these tenets are being shattered on a daily basis.

https://madisonarealymesupportgroup.com/2018/07/10/bartonella-henselae-neuroretinitis-in-patients-without-cat-scratch/

https://madisonarealymesupportgroup.com/2019/01/23/chest-imaging-of-cat-scratch-disease-in-2-year-old-immunocompetent-baby-with-no-history-of-cat-contact/

https://madisonarealymesupportgroup.com/2018/07/05/cat-scratch-disease-in-a-1-5-year-old-girl-case-report/  A 1.5-year-old girl who was seen in hospital for the sparing use of her left arm when crawling.  Tested positively for Bartonella henselae.

https://madisonarealymesupportgroup.com/2018/04/03/encephalopathy-in-adult-with-cat-scratch-disease/  Case of a 53-year-old healthy man, presenting with confusion.  Serology confirmed Bartonella henselae infection.

https://madisonarealymesupportgroup.com/2019/01/09/transverse-myelitis-guillain-barre-associated-with-bartonella/  Healthy 10 year old girl had coexisting transverse myelitis and Guillain-Barré syndrome (GBS) related to infection with Bartonella henselae.

https://madisonarealymesupportgroup.com/2018/11/05/skull-infection-due-to-bartonella/  A 3-year-old female with a recent history of typical CSD involving lymph nodes who developed osteomyelitis of the skull.

https://madisonarealymesupportgroup.com/2019/01/02/bartonella-langerhans-cell-histiocytosis-cancer/

 

https://madisonarealymesupportgroup.com/2018/11/16/study-shows-lyme-in-15-species-of-canadian-ticks-6-of-which-bite-humans-numerous-new-bird-species-acting-as-hosts/  Overall, 1,265 ticks consisting of 27 tick species belonging to four genera were collected.  Of the 18 tick species tested, 15 species (83%) were positive for Bbsl and, of these infected ticks, 6 species bite humans.

Two ticks species known to be transmitters of disease (I. affinis and I. minor) were transported into Canada and are actually more important vectors of Bbsl in the southeastern U.S. than the blacklegged tick.

THESE FINDINGS UNDERSCORE THE FACT PEOPLE DO NOT HAVE TO GO AN ENDEMIC AREA TO CONTRACT LYME DISEASE AND ASSOCIATED TICK-BORNE DISEASES. 

 

 

 

 

Mitral Valve Endocarditis: A Supposed Rare Manifestation of Lyme Disease

https://www.ncbi.nlm.nih.gov/m/pubmed/30690018/

Mitral Valve Endocarditis: A rare Manifestation of Lyme Disease.

Haddad O, et al. Ann Thorac Surg. 2019.

Abstract

Valvular involvement in Lyme disease is rare. Confirmation of Borrelia species as the causative agent by Polymerase Chain Reaction (PCR) was done in a few cases in Europe and the US. We describe a case of mitral regurgitation with a preoperative diagnosis of myxomatous mitral valve degeneration. During surgery, the surgeon suspected infective rather than degenerative; etiology; tissue cultures were negative. However, universal bacterial PCR on explanted valve tissue detected Borrelia burgdorferiDeoxyribonucleic Acid(DNA). If a surgeon suspects infective endocarditis at the time surgery, appropriate specimens should be sent for histopathology, culture, and PCR.

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**Comment**

If I’ve said it once, I’ve said it 1,000 times:  researchers need to obstain from using the word “rare” in anything they write about MSIDS.  Nobody has a clue about numbers.  Testing misses over half of all cases and this study is a perfect example in that it proves tissue cultures can be negative yet a person can still be infected with Lyme.  Lyme experts have talked about seronegativity for decades yet mainstream medicine continues to deny it exists.  This must change.

Lyme/MSIDS causes all sorts of heart issues:  

https://madisonarealymesupportgroup.com/2018/08/14/vermont-resident-dies-of-rare-lyme-disease-complication-that-isnt-rare/

https://madisonarealymesupportgroup.com/2018/09/17/lyme-carditis-heart-block-other-complications-of-ld/

https://madisonarealymesupportgroup.com/2018/11/16/advanced-heart-block-in-children-with-lyme-disease-2/

https://madisonarealymesupportgroup.com/2017/08/23/video-dr-neil-spector/

https://madisonarealymesupportgroup.com/2018/06/03/heart-problems-tick-borne-disease/

https://madisonarealymesupportgroup.com/2018/10/10/lyme-carditis-presenting-with-atrial-fibrillation/

https://madisonarealymesupportgroup.com/2017/06/10/lyme-carditis-with-complete-heart-block/

https://madisonarealymesupportgroup.com/2018/04/04/correlation-of-natural-autoantibodies-heart-disease-related-antibacterial-antibodies-in-pericardial-fluid-mycoplasma-bb-chlamydia/

https://madisonarealymesupportgroup.com/2019/01/30/13-common-infections-that-can-raise-your-heart-attack-risk-including-lyme-msids/

https://madisonarealymesupportgroup.com/2018/09/28/bartonella-infective-endocarditis-with-dissemination-a-case-report-literature-review/

https://madisonarealymesupportgroup.com/2017/01/04/endocarditis-consider-bartonella/

https://madisonarealymesupportgroup.com/2018/02/20/babesia-and-heart-issues/

Does this look rare to you?

Industry-Sponsored Doctors: New Study Shows Depth of Commercial Influence

http://www.greenmedinfo.com/blog/industry-sponsored-doctors-new-study-shows-depth-commercial-influence?

Industry-Sponsored Doctors: New Study Shows Depth of Commercial Influence

“© [2/7/19] GreenMedInfo LLC. This work is reproduced and distributed with the permission of GreenMedInfo LLC. Want to learn more from GreenMedInfo? Sign up for the newsletter here http://www.greenmedinfo.com/greenmed/newsletter.”

Professional education events are heavily sponsored by drug companies promoting their products as the solution. This widely used coercive and misinformation technique where drug risks are exaggerated and side effects minimized was exposed in a recent BMJ Open study. 

The online medical journal BMJ Open recently published a retrospective cohort study titled Does industry-sponsored education foster overdiagnosis and overtreatment of depression, osteoporosis and over­active bladder syndrome? An Australian cohort study. Looking at publicly reported industry-sponsored events in Australia from October 2011 to September 2015, the researchers focused on three conditions subject to over diagnosis and over treatment: depression, osteoporosis and overactive bladder.

Over the 4-year study period 3,132 events were identified consisting of approximately 96,660 attendees. These events were attended by primary care doctors more often than sponsored events without a focus on the three conditions identified in the study. The researchers found a strong concentration of sponsorship among just a few companies. Two companies sponsored over 70% of depression events; another two companies over 80% of overactive bladder events.

The researchers concluded the following:

“…primary care clinicians were often targeted, dinner was often provided and that a few companies sponsored most events. In most cases, sponsors’ products are not cost-effective choices for the specified condition.”

The researchers initially hypothesized that company’s marketing treatments for each condition would sponsor related events and that target audiences would mainly work in primary care, reflecting a broad patient population. What they found was in alignment with their hypothesis. The results from the study showed the following:

“Servier, which markets agomelatine and AstraZeneca (quetiapine) sponsored 51.2% and 23.0% of depression events, respectively. Amgen and GlaxoSmithKline, which co-market denosumab, sponsored 49.5% of osteoporosis events and Astellas and Commonwealth Serum Laboratories (CSL) (mirabegron and solifenacin) sponsored 80.5% of overactive bladder events.”

The study highlights the need for professional education to be free of commercial sponsorship. Medical professionals are continually influenced, both directly and indirectly, by pharmaceutical and commercial interests which can have negative, real-world consequences for their patients.

While the recent Australian study highlights the problem of industry-sponsored influence, another more insidious method may be just as alarming. The fraudulent and selective nature of industry-sponsored research often captures the intellectual and regulatory pillars of medicine. For example, in 2015 the BMJ published Restoring Study 329, a decade-long effort by researchers to uncover the truth about the health risks and treatment value of an antidepressant approved for use by adolescents. Using the same data GlaxoSmithKline used to market their blockbuster antidepressant Paxil, researchers doing the restorative study 14 years later found that,

 “Neither paroxetine nor high-dose imipramine demonstrated efficacy for major depression in adolescents, and there was an increase in harms with both drugs.”

Meanwhile, a 2012 Cochrane systematic review found that AstraZeneca’s antipsychotic quetiapine, highlighted in the recent BMJ Australian study, had limited efficacy evidence for depression.

Industry influence upon the knowledge base, prescribing habits and beliefs of medical professionals often renders natural remedies and true healing solutions to depression, osteoporosis and overactive bladder invisible. Modalities with less potential for serious side effects too often become the casualties with the net effect seeing the patient shouldering the burdens of risk and substandard results.

How bad can it get? A look back at the past twenty-years reveals a cautionary tale of a racing American opioid epidemic caused in part by the combination of both industry-sponsored education and fraudulent research.

Dr. David Kessler, U.S. Food and Drug Administration (FDA) commissioner when Purdue Pharma’s opioid OxyContin, the drug that kicked off the American epidemic, won the agency’s green light in 1995 acknowledged,

“No doubt it was a mistake. It was certainly one of the worst medical mistakes, a major mistake.”

It was the first opioid to win the stamp of approval from the FDA, despite the lack of testing and demonstrated proof of the drugs safety and efficacy. Purdue then went on to sent a promotional video to approximately 15,000 doctors who were told OxyContin was “less than 1 percent addictive” — a figure subsequent studies proved false.

Once the overwhelming evidence of devastation from the opioid crisis began to be spotlighted by the media, then-president Richard Sackler of Purdue wrote in a confidential email,

“…we have to hammer on the abusers in every way possible. They are the culprits and the problem. They are reckless criminals.”

Established medicine appears to be at the beginning stages of confronting its industry-sponsored blindspots. As more in the profession began escaping their myopic pharmaceutical shackles in search of true healing, it is essential for patients to empower themselves alongside this awakening become active participants in their individual healing journeys. Please use the GreenMedInfo research dashboard to access over 10,000+ evidence-based topics related to natural and integrative medicine. And share the resource, and this article and others to friends and family, who can subscribe to our complimentary newsletter here.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of GreenMedInfo or its staff.

Bias #8. News Media Blackout: Blackout on Ebola when White House asked the AP to stop reporting on it. It took De Niro’s pulling “VAXXED” from a film festival for the media to report on vaccines even though it was produced by a reputable producer, had two celebrity doctors who did a 180 on their stance on vaccines as well as a vaccine whistleblower who showed the CDC “sanitized” results. Weiler also shows how Andrew Wakefield’s study was retracted after a reporter, not a scientist, alleged impropriety in the study design approval.The CDC whistleblower states this is what the CDC does all the time.

https://madisonarealymesupportgroup.com/2017/12/11/levels-of-evidence-media-liability-double-standards-zika-vs-aluminum/

https://madisonarealymesupportgroup.com/2018/11/09/cochrane-no-longer-a-collaboration/