The author of today’s piece is a senior NIH official who wished to remain anonymous to protect themselves from reprisals.
As someone who works directly with the NIH Director’s office, I am dismayed by the disingenuous coverage of NIH in places like the New York Times and Science Magazine. Very little of what I read comports with my own experience and I am worried that scientists and the general public are getting a false view of the real problems inside the world’s largest funder of biomedical research.
Every large institution is fraught with palace politics, but today’s NIH is suffering from a deeply entrenched senior leadership in the director’s office that is plagued by enmity, distrust and isolation. The NIH Director works in Building 1 and oversees 27 other Institutes that research various diseases—the one most people have heard of is the National Cancer Institute. But to most of these institute directors, Building1 is a dark hole they both fear and despise. If you’re a running a research lab in Wisconsin this probably doesn’t matter to you; if you’re bed ridden with an undiagnosed, complex neurological disease—a life put on hold—why would you care?
But at every level today NIH’s management is distanced further away from its overall mission to advance science that improves health.
NIH scientists are quite busy with their research and don’t always read news about NIH scandals. I don’t, because I don’t really have time, nor do I care. But turmoil from the recent election has caused me to read about the retirement of Dr. Lawrence Tabak, who served as Principal Deputy Director, the number two position at NIH. I have worked with and observed Dr. Tabak’s ascent to this commanding position at NIH, from which he weaponized systems and processes to harm those who disagreed with his views or decisions. (See link for article)
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Important quotes:
NIH is not a merit-based system. It’s a cabal where people appoint their loyalists and contrive to manipulate our public agency to their personal advantage.
NIH labs and research programs get reviewed by scientists at prestigious research universities to ensure they publish excellent studies. But these university scientists are, at the same time, beholden to the NIH for grants to fund their own studies. This conflict of interestensures that the reviews are biased to favor NIH labs, because no professor wants to anger the agency that funds his own grants.
Right out of the horse’s mouth.
And this, right here, is why we haven’t seen a shred of helpful research in Lymeland in over 40 years. These cabal loyalists know they must repeat the accepted narrative or be left in the dust.
Prof. Holly Ahern’s Lyme disease comments to Australian Senate
2/5/25
The Australian Senate has launched an inquiry into the access to diagnosis and treatment for people in Australia with tick-borne diseases. Professor Holly Ahern of the United States recently submitted the following written comments and was also asked to give verbal remarks. (See video at end of this article.)
Dear Committee Members:
I am a scientist, professor of microbiology, and co-founder of a Lyme disease advocacy organization in New York State. I am also the Scientific Advisor for the Focus on Lyme Foundation in Arizona, which has funded research on several projects directed at improving the state of diagnostic testing for Lyme disease and other tick-borne illnesses.
I have served on several state and federal committees convened to address the growing problem of tick-borne diseases in the United States, most recently the 2022 Dept. of Health and Human Services, Tick Borne Disease Working Group (TBDWG).
But most of all, I am mother of a daughter who went from a record setting collegiate All American swimmer to bed bound and disabled over the course of only a few weeks. She lost years of her life as a result of flawed medical guidelines that prioritize care for patients early in the infection, while providing only minimal guidance for the diagnosis and care of patients in later stages of the disease.
In my daughter’s case, we saw the tick bite but she developed no rash. Fever, profound fatigue, widespread pain, and other symptoms began months later, and were attributed to a viral illness. The difficulties we faced in getting her illness diagnosed and appropriately treated in 2010 match those of hundreds of thousands of other people with Lyme disease in the United States and Europe, and also in Australia.
Biologically complex organism
Lyme disease is a bacterial infection caused by a microbe with global distribution. They are transmitted to humans by several species of tick. The bacteria are biologically complex. They adapt and survive in environments that would kill most other bacteria.
During human infection, some subgroups (genospecies) of these bacteria linger in the bloodstream, while others disseminate to connective tissue-rich areas of the body. Regardless, infection triggers profound immune system and other physiological events, leading to a wide range of symptoms that vary significantly among patients and can be quite severe.
The standard medical definition implies that the overwhelming majority of Lyme borreliosis (Lyme disease) patients are infected with the same bacteria and have the same uniform disease presentation, which is straightforward to diagnose and treat. As defined, Lyme disease is caused by only a few specific genospecies of Borrelia (now named Borreliella). Several other genospecies of Borrelia are associated with diseases collectively referred to as “Relapsing Fever borreliosis.”
Differences between the two diseases are subtle. Relapsing Fever Borrelia fail to produce the skin manifestation (erythema migrans or “bull’s-eye” rash) that is noted in Lyme disease; however, other symptoms are very similar. Existing diagnostic tests for Lyme disease don’t detect infections caused by Relapsing Fever Borrelia.
Thus, a patient may be bitten by a tick and infected with a Relapsing Fever Borrelia, such as B. miyamatoi, show all the symptoms that a patient with Lyme disease would have, but may not be diagnosed or treated for the infection because the EM rash did not appear and/or the standard lab tests for Lyme disease were negative. (See link for article)
Progressively Growing Extra Costs Tagged to Research Grants Cut Back to 15%
Feb 16, 2025
By Peter A. McCullough, MD, MPH
I talked to someone today who has recently received a coveted NIH RO1 grant. Instead of being happy she said she is terrified. Why? Recently, Elon Musk and the Department of Government Efficiency (DOGE) has trimmed back “indirects” universities and hospitals slap on top of the direct research funded projects. This rate has grown from 15% over decades to >50% at many prestigious medical centers. The current indirect rate at Harvard is69%. (See link for article)
MEDICAL DETECTIVE: The complex role of Bartonella in chronic illness, part 1
This article was originally posted on Dr. Richard Horowitz’s Medical Detective Substack. It is Part 1 of a 5-part series. You can find more helpful content by subscribing here.
Bartonella is the third “B” of the triad found in the vast majority of my chronically ill patients who suffer from chronic Lyme disease/PTLDS, along with Borrelia and Babesia.
A gram-negative intracellular bacteria, it’s controversial and misunderstood and has been throwing a monkey wrench into my treatments for decades.
I barely remember learning about it in medical school, except when they were teaching me about cat scratch fever in children that would cause small, localized rashes (papules) at the site of the scratch with swollen lymph nodes and fevers.
It would be treated with a short course of antibiotics like azithromycin. These images show classical cat scratch disease before and after treatment when the lesions are starting to crust up.
[From: Mazur-Melewska K, Mania A, Kemnitz P, Figlerowicz M, Służewski W. Cat-scratch disease: a wide spectrum of clinical pictures. Postepy Dermatol Alergol. 2015 Jun;32(3):216-20. doi: 10.5114/pdia.2014.44014. Epub 2015 Jun 15. PMID: 26161064; PMCID: PMC4495109.]
Unfortunately, Bartonella infections rarely resemble this one particular manifestation, or the general medical community would be diagnosing and treating it a lot more often.
It is a very tricky bacteria, and, like Lyme disease, has found a way to not only avoid immune recognition, but change its clinical characteristics so it resembles a broad range of other diseases.
Immune Evasion by Bartonella
Bartonella is referred to as a “stealth bacteria” because it evades the immune system by living inside red blood cells (intraerythrocytic persistence), blood vessel walls (inflaming them, causing vasculitis), endothelial cells, fibroblasts, epithelial cells of the skin (causing the classic Bartonella rashes described below), macrophages (immune cells that play a critical role of initiating and maintaining an inflammatory response, as well as potentially resolving inflammation) and bone marrow cells.
So it can hide throughout the body in areas where the immune system doesn’t easily penetrate and recognize the bacteria, not to mention, it can exist under biofilms in persister forms like Borrelia. Biofilms protect the bacteria from immune recognition and the effects of antibiotics.
Bartonella can manipulate host cell interactions to hide from immune detection by altering its surface proteins to avoid recognition (like Lyme disease), and possesses unique fat and sugar molecules (lipopolysaccharides) that minimize immune response activation; this often leads to prolonged, asymptomatic infections that can be difficult to diagnose with standard tests (it can hide in the body for years in some patients without symptoms), and then reactivate under certain conditions.
The patient below was in remission for one year after doing an 8-week course of double dose dapsone combination therapy (DDDCT), and then reactivated after being treated with antibiotics for a skin infection. This skin rash emerged when he got treated for cellulitis, which had nothing to do with his initial Lyme infection. You can see the classical Bartonella “stretch marks.”
[From: Horowitz, R.I.; Fallon, J.; Freeman, P.R. Comparison of the Efficacy of Longer versus Shorter Pulsed High Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome with Bartonellosis and Associated Coinfections. Microorganisms 2023, 11, 2301. https://doi.org/10.3390/microorganisms11092301%5D
Reactivation often happens when the immune system is unable to control the infection, due in part to the immunosuppressive nature of the bacteria.
I’ve found multiple species of Bartonella in our sickest patients leading to chronic variable immune deficiency (CVID), just as I’ve found Borrelia causing immune suppression, along with mold toxicity and Long Covid affecting immune functioning.
The multisystemic nature of Bartonella infections
When we see patients with Bartonella, as I mentioned, it has no resemblance whatsoever with the classical cat-scratch disease I learned about in medical school. Bacteria like Bartonella cause similar symptoms to those seen in chronic Lyme disease, presenting as a “great imitator.”
It can result in chronic fatiguing, musculoskeletal, cardiopulmonary, neuropsychiatric illness and can cause fevers, chills, fatigue, headaches, muscle/joint and nerve pain, cognitive difficulties, insomnia, depression, anxiety, and cause inflammation in every body system imaginable, just like Lyme disease, Borrelia burgdorferi, does.
There can also be inflammation in the eyes (optic neuritis, conjunctivitis, uveitis, arterial and venous occlusions); the brain, surrounding structures and spinal cord (meningitis, encephalitis, transverse myelitis, seizure disorders), with associated Bartonella “rage” and psychosis (Bartonella, like Lyme disease, can cause a broad range of psychiatric manifestations, including but not limited to severe depression, anxiety, Obsessive Compulsive Disorder, Bipolar disorder and schizophrenia with psychosis).
It also can cause inflammation in the muscles (myalgias), joints (arthritis, osteomyelitis), nerves (neuropathy) and blood vessels (vasculitis), as well as the heart valves (endocarditis, including culture negative endocarditis), heart muscle (myocarditis), and sac surrounding the heart (pericarditis) causing chest pain with masses in the chest (mediastinum) and lymph nodes resembling non-Hodgkins lymphoma.
Even the gastrointestinal tract can be affected (nausea, vomiting, weight loss, bleeding), as can the liver (hepatitis), spleen (splenitis, enlargement), and skin, which oftentimes shows signs of inflammation (stretch marks, i.e. striae; granulomas, hard fibrous areas over the knuckles, elbows, and Bacillary angiomatosis, which are tumor-like masses, raised dark areas, papules, nodules, and lesions in the skin, bones, and organs).
Bartonella is a frequently found infection in those suffering from chronic Lyme disease—I’ve seen it in up to 80-90% of all of my chronically ill patients these days and should be considered in any and all cases of FUO (fever of unknown origin).
[From: Cheslock, M.A.; Embers, M.E. Human Bartonellosis: An Underappreciated Public Health Problem? Trop. Med. Infect. Dis. 2019, 4, 69. https://doi.org/10.3390/tropicalmed4020069%5D
Transmission of Bartonella
Part of the reason Bartonella has been a controversial topic in the Lyme community–at least among certain physicians and researchers–is because there has only been one study to date regarding tick transmission of the bacteria, and this was in European species of deer ticks (Ixodes ricinus) with one species, called Bartonella birtlesii.
The bacteria is, however, being found in ticks throughout the world, and other studies have shown the bacteria in different ticks and in chronic Lyme disease patients.
When I was co-chair of the HHS Tick-borne Disease Working Group (TBDWG) back in 2018, I had to fight to get Bartonella included as a co-infection of importance; whether all species are able to be transmitted by ticks or not, makes no difference.
Why? To date, the number of species able to transmit Bartonella keeps increasing over the years, and most of us are exposed to these vectors on a regular basis. The most common vectors transmitting the bacteria are fleas, mites, lice, keds (not the sneakers!), spiders, red ants, ticks (probable), sand flies, black and yellow flies, and mosquitoes.
Bartonella is showing up in a broad range of vectors, so it’s possible to get exposed from many different sources. That is why the vast majority of my sick patients are testing positive for it. In fact, for most of us living on this planet, I daresay we’ll all likely be exposed to Bartonella at some point during our lives. How we handle it, and whether we get symptoms, will depend on how our immune system is functioning.
Testing for multiple Bartonella species
The table below shows some of the most common species of Bartonella seen in human disease. This is not comprehensive, as there are now at least 45 species of Bartonella, and 18 of them or more are pathogenic [capable of causing disease].
Some of the most common ones are: B. henselae (Cat scratch disease, CSD; endocarditis, neuroretinitis, lymphadenopathy), B. quintana (Trench fever, endocarditis, bacillary angiomatosis [BA]), B. clarridgeiae (bacteremia, endocarditis, CSD, chest wall abscess), B. elizabethae (endocarditis, neuroretinitis), B. bacilliformis (Carrion’s disease), B. koehlerae (endocarditis, including culture negative endocarditis), B. vinsonii subsp (bacteremia, endocarditis, fevers, neurological symptoms), B. berkhoffi (endocarditis, bacteremia, neurological symptoms), and B. grahamii (neuroretinitis).
[From: Rebekah L. Bullard, Emily L. Olsen, Mercedes A. Cheslock, Monica E. Embers, Evaluation of the available animal models for Bartonella infections, One Health, Volume 18, 2024,100665, ISSN 2352-7714, https://doi.org/10.1016/j.onehlt.2023.100665.%5D
How do we test for Bartonella?
As you can see from the above table, testing for just one species makes no sense, because we can be exposed to a broad range of Bartonella species during our lifetime. I started to test for Bartonella over two decades ago. This is from an abstract I presented at the 16th International Scientific Conference on Lyme disease in 2003:
You can see from this abstract, even 22 years ago, by just testing for Bartonella henselae, one of the most common species, we found that using an ELISA and IFA (Immunofluorescent Assay) was positive in less than 50% of patients–but using DNA analysis with a PCR (Polymerase Chain Reaction) in the blood, we found 53% were positive when standard antibody assays were negative.
Which means the rule of thumb when testing for Bartonella is go as broad as you can. It is fine to start with local lab testing.
Level 1 testing
Using local labs like Quest, Labcorp, or Bioreference, you can send off antibody titers to B. henselae, B. quintana and B. bacilliformis, as well as PCRs and even a VEGF (vascular endothelial growth factor), an indirect marker of Bartonella exposure, indicating inflammation in the blood vessels (vasculitis). Often, however, you’ll want to use several specialty labs to prove infection.
Level 2 testing
If the above testing is negative, as it usually is, but you clinically suspect Bartonella, move on to the next level of tests. The three specialty labs include IgeneX laboratory (Bartonella IgM/IgG Immunoblots, Bartonella FISH [Fluorescent In-Situ-Hybridization test, an RNA test], T Labs (Bartonella FISH) with confocal microscopy, and Galaxy Laboratories, using their 4 species IFA antibody panel (for the most common species), and their ddPCR (direct droplet PCR) tests. The Bartonella Digital ePCR™ platform combines highly sensitive ddPCR technology with culture enrichment (BAPGM™).
I usually start with IgeneX laboratory and find that most of my patients have indeterminate or positive Immunoblots. Many times a negative Bartonella FISH test will turn positive later on during treatment, after the bacteria has been flushed out from the intracellular compartments where it’s been hiding.
I follow VEGF levels over time, as an indirect marker of Bartonella, when reactivation of infection is suspected. Keep in mind VEGF can be positive for other reasons (including Long Covid or cancer with metastases).
Level 3 testing
Skin biopsies can be done of the classical Bartonella rashes. Dr. Marna Ericson from T Labs has done this for me several times, and she found positive Bartonella in the skin, under biofilms, when it couldn’t be found through other methods.
I suspected Bartonella in two of my patients, but despite all classical testing, couldn’t prove exposure. The Bartonella fluoresces red under the microscope with this technique. I don’t suggest it as first level testing, but it can be very useful if you have looked for Bartonella using any and all of the above laboratories and methodologies.
Stay tuned for parts 2, 3, 4 and 5
In Part 2, I’ll discuss more about establishing a diagnosis as well as an overview of how other co-infections may overlap and affect Bartonella symptoms. Part 3 will discuss effective treatments, and Parts 4 and 5 go into more detail about these treatments.
Dr. Richard Horowitz has treated 13,000 Lyme and tick-borne disease patients over the last 40 years and is the best-selling author of How Can I Get Better? and Why Can’t I Get Better? You can subscribe to read more of his work on Substack or join his Lyme-based newsletter for regular insights, tips, and advice
I am pleased to report about the new peer-reviewed research paper published on the use of hydroxychloroquine in the treatment of COVID-19 by Professor Christian Perronne’s research group. The corresponding author is Dr. Alexis Lacout affiliated with the Surgical Medical Center of Tronquieres in Aurillac, France. This is a review paper, so no new results are presented. However it puts together a definitive compendium of the available evidence in favor of the use of hydroxychloroquine based multidrug protocols for the treatment of COVID-19. Xavier Azalbert, one of the paper’s co-authors, gave an informative interview about this work with John Davidson.
The authors review in detail the early evidence available in favor of hydroxychloroquine from China and the mechanisms of action that made it plausible that it would be an effective treatment for COVID-19. They also give a brief overview of the flawed studies that followed, which purported to discredit the use of hydroxychloroquine in COVID-19 treatment. The authors then review the cardiac safety of the medication, and discuss blatantly fraudulent studies attempting to discredit hydroxychloroquine, that were subsequently retracted. The paper concludes with a review of the positive evidence in support of the prophylactic use of hydroxychloroquine to prevent symptomatic COVID-19 infection, and other studies supporting the efficacy of hydroxychloroquine in preventing hospitalizations and deaths.
This paper does not cover the same ground as my shorter comment publication that was published last year in the Tasman Medical Journal, focusing on the analysis Dr. Zev Zelenko’s early data of his triple drug hydroxychloroquine-based protocol which enhanced Dr. Didier Raoult’s protocol with the addition of zinc. Also not mentioned was the early meta-analysis by Dr. Raphael Stricker in support of the prophylactic use of hydroxychloroquine based on several early studies on Indian health workers. Nevertheless, this paper stands its ground on its own, and perfectly complements my work and the work by Dr. Stricker.
Although ivermectin-based protocols, such as the one by Dr. Jackie Stone, have proven themselves to be superior, ivermectin does have some limitations, e.g. it cannot be used with pregnant women, and during 2021 the community standard of care advocated by Dr. Zelenko combined both medications. That being said, this is an important paper for educating the Neanderthals that have not yet realized that they were lied to by the powers that be about hydroxychloroquine. With the worst of the pandemic in the rearview mirror, the persecution of pioneering doctors like Dr. Didier Raoult has intensified. The guilty understand that they are wrong and are now trying to erase history. They want their sins forgotten. This must never be allowed to happen.
Madison Area Lyme Support Group 