Archive for the ‘Rocky Mountain Spotted Fever’ Category

“Super-Fast” Lone Star Ticks Showing up in New Places

https://www.lymedisease.org/lyme-sci-super-fast-lone-star-ticks-are-showing-up-in-new-places/

LYME SCI: “Super-fast” lone star ticks are showing up in new places

March 30, 2022

By Lonnie Marcum

The lone star tick (Amblyomma americanum) has been rapidly expanding its range, from the Southern United States into the Northeast and Midwest.

This tick is a major vector of several viral, bacterial, and protozoan pathogens affecting humans, pets, livestock, birds and other wild animals in the United States. In some Midwestern states, it is commonly known as the “turkey tick” due to its association with wild turkeys. (Childs and Paddock, 2003)

Currently, the lone star tick is known to transmit human ehrlichiosis, tularemia, Heartland virus, Bourbon virus, Southern tick-associated rash illness (STARI) and rarely Rocky Mountain spotted fever—one of the deadliest tick-borne diseases in the US.

People bitten by a lone star tick may also develop alpha-gal syndrome—a severe allergy to meat and meat-related products.

A recent crowdsourced science project has documented the largest increase of the lone star tick in decades. Researchers documented new tick encounters in over 300 counties—including six new counties in western states—where these ticks had not been documented before.

TickSpotters program evaluates photos

In a study published in the Journal of Medical Entomology, researchers at the University of Rhode Island (URI) evaluated over 9,500 photos submitted between 2014-2019 to the TickSpotters surveillance program.

To document the changes, researchers first identified the ticks in the submitted photos, then logged the county each was reported from. They used this method to plot the geographic ranges of three medically important U.S. tick species: Amblyomma americanum, Ixodes scapularis and Ixodes pacificus. The last two are the vectors for Lyme disease.

More than 5,000 photographs of the lone star tick were received from over 1,000 counties across the US. Of those, 341 counties had no previous record of lone star ticks. The largest expansion of the lone star tick was seen in Illinois, Indiana, Kentucky, and Ohio.

In addition, the lone star tick was reported in several counties in the western US, a region not typically associated with these ticks. Notably, it was found in six new counties in California, four counties in Colorado and one new county each in Idaho, Oregon and Utah.

“The causative drivers of these upturns are complex, but have a lot to do with increased host availability, warming temperatures, and moisture availability,” researcher Heather L Kopsco, PhD, told Entomology Today,

Female lone star ticks are identifiable by a single silvery-white spot on the center of their back (scutum.) The male lone star tick is slightly smaller, with varied white streaks or spots around the margins of its body.

Finding Heartland virus in Georgia

Another recent study published in the CDC journal “Emerging Infectious Diseases” found lone star ticks infected by Heartland virus in Georgia. The article points out several major knowledge gaps and the complexity of diseases carried by the lone star tick. (Romer et al, 2022)

“Heartland is an emerging infectious disease that is not well understood,” says Emory University’s Gonzalo Vazquez-Prokopec PhD, senior author of the study.

Interestingly, the genetic analysis of the Heartland virus from Georgia shows that it is 2%-5% different from previous genetic sequences of the virus.

“These results suggest that the virus may be evolving very rapidly in different geographic locations, or that it may be circulating primarily in isolated areas and not dispersing quickly between those areas,” Vazquez-Prokopec says.

The Heartland virus wasn’t officially named until 2009. However, the CDC has since found evidence of it in wild animals in at least 13 states, including stored samples from deer dating back to 2001. (Clark et al, 2018)

Because the initial symptoms of these tick-borne viruses resemble the flu, and tests for it are not readily available, it is likely being undetected and underreported in humans.

Quick and aggressive

The lone star tick moves quickly and aggressively, says Thomas Mather, PhD, Director of the TickEncounter Resource Center and co-author of the URI study.

“It is super-fast. It can move from below your knees to the top of your head in a matter of seconds.” Mather says it is the tick most frequently found attached to humans in the South.

The greatest risk of being bitten by the adults exists in early spring through fall. Lone star ticks are found mostly in woodlands with dense undergrowth and around animal resting areas, where they will quest on tall grass and low hanging branches.

Nymphal ticks quest lower to the ground but also move fast. If you encounter a patch of larvae, you’ll find they may latch on by the hundreds. Tick Encounters recommends using sticky duct tape to remove these larvae as soon as possible.

Expanding range

The range of the lone star tick in North America has increased dramatically over the past 30 years. Large numbers have been recorded as far to the northeast as Maine, as far to the southeast as Florida, as far south as Mexico and as far west as Colorado. Recently, patchy encounters have also been noted in Canada and the West coast.

Diseases carried by lone star ticks

The following is a list of symptoms of diseases caused by the bite of the lone star tick per the CDC.

Alpha-gal Syndrome (AGS)

Reactions can include:

  • Rash
  • Hives
  • Nausea or vomiting
  • Heartburn or indigestion
  • Diarrhea
  • Cough, shortness of breath, or difficulty breathing
  • Drop in blood pressure
  • Swelling of the lips, throat, tongue, or eye lids
  • Dizziness or faintness
  • Severe stomach pain

Symptoms commonly appear 2-6 hours after eating meat or dairy products, or after exposure to products containing alpha-gal (for example, gelatin-coated medications). Personal products that use ingredients containing “hydrolyzed protein,” lanolin, glycerin, collagen, or tallow are particularly problematic.

AGS reactions can differ from person to person and range from mild to severe. Anaphylaxis (a potentially life-threatening allergic reaction involving multiple organ systems) may need urgent medical care.

People may not react after every alpha-gal exposure.

Seek immediate emergency care if you are having a severe allergic reaction.

Bourbon Virus

Scientists are still learning about possible symptoms caused by this virus.

People diagnosed with Bourbon virus disease had symptoms including:

  • fever
  • tiredness
  • rash
  • headache
  • other body aches
  • nausea, and

Patients with Bourbon virus will have low blood counts for cells that fight infection and help prevent bleeding.

There is no medicine to treat Bourbon virus disease. Doctors can only treat the symptoms. For example, some patients may need to be hospitalized and given intravenous fluids and treatment for pain and fever. Antibiotics don’t work against viruses.

Ehrlichiosis

Signs and symptoms of ehrlichiosis typically begin 1-2 weeks after the bite of an infected tick. Left untreated, ehrlichiosis can be fatal. Early treatment with doxycycline is highly effective.

Early signs and symptoms (the first 5 days of illness) are usually mild or moderate and may include:

  • Fever, chills
  • Severe headache
  • Muscle aches
  • Nausea, vomiting, diarrhea, loss of appetite
  • Confusion
  • Rash (more common in children)

About a third of people with ehrlichiosis report a rash, which can look like red splotches or pinpoint dots. This typically develops five days after the fever begins.

Early treatment can reduce your risk of developing severe illness, which can include:

  • Damage to the brain or nervous system (e.g. inflammation of the brain and surrounding tissue (called meningoencephalitis))
  • Respiratory failure
  • Uncontrolled bleeding
  • Organ failure
  • Death
Heartland Virus
  • Most people infected with Heartland virus experience fever, fatigue, decreased appetite, headache, nausea, diarrhea, and muscle or joint pain. Many require hospitalization.
  • Some people also have lower than normal counts of white blood cells (cells that help fight infections) and lower than normal counts of platelets (which help clot blood). Sometimes, liver enzymes are elevated.
  • It can take up to two weeks for symptoms to appear after an infected tick bite.
Rocky Mountain Spotted Fever

Early signs and symptoms are not specific to RMSF. However, the disease can rapidly progress to a life-threatening illness.

Signs and symptoms can include:

  • Fever
  • Headache
  • Rash
  • Nausea
  • Vomiting
  • Stomach pain
  • Muscle pain
  • Lack of appetite

While almost all patients with RMSF will develop a rash, it often does not appear early in illness, which can make RMSF difficult to diagnose. RMSF rash usually develops 2-4 days after fever begins. The appearance of the rash can vary widely. Some rashes look like red splotches and some look like pinpoint dots.

Some patients who survive severe RMSF may be left with permanent damage, including amputation of arms, legs, fingers, or toes (from damage to blood vessels in these areas); hearing loss; paralysis; or mental disability.

Southern tick-associated rash illness (STARI)

It is not known whether antibiotic treatment is necessary or beneficial for patients with STARI. Nevertheless, because STARI resembles early Lyme disease, physicians will often treat patients with oral antibiotics.

The rash of STARI is a red, expanding “bull’s-eye” lesion that develops around the site of a lone star tick bite. The rash usually appears within seven days of the tick bite and expands to a diameter of three inches or more. The rash should not be confused with much smaller areas of redness and discomfort that can occur commonly at the site of any tick bite.

Patients may also experience fatigue, headache, fever, and muscle pains. The saliva from lone star ticks can be irritating; redness and discomfort at a bite site does not necessarily indicate an infection.

Tularemia

The signs and symptoms of tularemia vary depending on how the bacteria enter the body. Illness ranges from mild to life-threatening. All forms are accompanied by fever, which can be as high as 104 °F.

“Ulceroglandular” is the most common form of tularemia and usually occurs following a tick or deer fly bite or after handing an infected animal. A skin ulcer appears at the site where the bacteria entered the body. The ulcer is accompanied by swelling lymph glands, usually in the armpit or groin.

LymeSci is written by Lonnie Marcum, a Licensed Physical Therapist and mother of a daughter with Lyme. She serves on a subcommittee of the federal Tick-Borne Disease Working Group. Follow her on Twitter: @LonnieRhea  Email her at: lmarcum@lymedisease.org.

References

Childs JE, Paddock CD. (2003) The ascendancy of Amblyomma americanum as a vector of pathogens affecting humans in the United States. Annu Rev Entomol. 48:307-37. doi: 10.1146/annurev.ento.48.091801.112728. Epub 2002 Jun 4. PMID: 12414740.

Clarke, L. L., Ruder, M. G., Mead, D. G., & Howerth, E. W. (2018). Heartland Virus Exposure in White-Tailed Deer in the Southeastern United States, 2001-2015. The American journal of tropical medicine and hygiene, 99(5), 1346–1349. https://doi.org/10.4269/ajtmh.18-0555

Guzmán-Cornejo C et al (2011) The Amblyomma (Acari: Ixodida: Ixodidae) of Mexico: identification keys, distribution and hosts. Zootaxa 2998:16–38

Kopsco HL, Duhaime RJ, Mather TN. (2021) Crowdsourced Tick Image-Informed Updates to U.S. County Records of Three Medically Important Tick Species. J Med Entomol.  11:tjab082. doi: 10.1093/jme/tjab082. Epub ahead of print. PMID: 33973636.

Monzón, J. D., Atkinson, E. G., Henn, B. M., & Benach, J. L. (2016). Population and Evolutionary Genomics of Amblyomma americanum, an Expanding Arthropod Disease Vector. Genome biology and evolution, 8(5), 1351–1360. https://doi.org/10.1093/gbe/evw080

Riemersma KK, Komar N. (2015) Heartland Virus Neutralizing Antibodies in Vertebrate Wildlife, United States, 2009-2014. Emerg Infect Dis. 21(10):1830-3. doi: 10.3201/eid2110.150380. PMID: 26401988; PMCID: PMC4593439.

Romer, Y., Adcock, K., Wei, Z., Mead, D. G., Kirstein, O., Bellman, S….Vazquez-Prokopec, G. M. (2022). Isolation of Heartland Virus from Lone Star Ticks, Georgia, USA, 2019. Emerging Infectious Diseases, 28(4), 786-792. https://doi.org/10.3201/eid2804.211540.

Springer YP, Eisen L, Beati L, James AM, Eisen RJ. (2014) Spatial distribution of counties in the continental United States with records of occurrence of Amblyomma americanum (Ixodida: Ixodidae). J Med Entomol. Mar;51(2):342-51. doi: 10.1603/me13115. PMID: 24724282; PMCID: PMC4623429.

Steinke J, Platts-Mills T, Commins, S. (2015) The alpha-gal story: lessons learned from connecting the dots. J Allergy Clin Immunol. 135(3): 589-96.

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**Comment**

Great, informative article.  I disagree with the notion that the climate is causing tick movement and proliferation of disease – here’s why:

Ticks will be the last species on the planet besides the IRS.

New Guidance for Treatment of Lyme & Other TBD in Pregnancy

https://www.lymedisease.org/lyme-pregnancy-guidance/

New guidance for treatment of Lyme and other TBD in pregnancy

Oct. 27, 2021

from the Lyme Disease Association website:

In a recently published review article,* authors provide a comprehensive summary of treatment options for pregnant patients with less common bacterial, fungal, and viral infections, including several tick-borne diseases (Lyme disease, ehrlichiosis, human granulocytic anaplasmosis, human monocytic ehrlichiosis, babesiosis, and Rocky Mountain spotted fever).

This review provides guidance to clinicians based on the most recently published evidence-based research and expert recommendations.

The review included a search of MEDLINE (inception to March 2021); clinical practice guidelines (both national and international); the CDC website; and additional references from bibliographies of noteworthy articles. The review also provides a list of medications on the WHO Essential Medications List that are used to treat the above infections (*Alyssa P. Gould et al., Drugs in Context-peer reviewed).

A summary of key treatment recommendations from the review article for several tick-borne diseases during pregnancy are as follows:

Lyme disease:

  • Treatment of gestational Lyme disease is essential to reduce adverse outcomes in pregnancy. The data shows adverse outcomes in treated pregnancy is (11–16%) compared to untreated disease (50–60%).
  • Doxycycline should not routinely be used in pregnancy for Lyme disease in order to avoid adverse side effects including transient suppression of bone growth and staining of developing teeth, especially with proven alternatives.
  • Amoxicillin is the preferred treatment in the absence of neurological manifestations or atrioventricular heart block.
  • Ceftriaxone is typically reserved for patients with severe neurological or cardiac manifestations.
  • One study noted a non-significant increase in adverse pregnancy outcomes, such as pregnancy loss, among orally treated (31.6%) compared to parenterally treated (12.1%) pregnant patients.
  • Alternative oral therapy is cefuroxime axetil and parenteral therapies include penicillin G or cefotaxime.
  • Late Lyme disease (often manifesting as Lyme arthritis) may be managed with oral or parenteral β-lactams.

Ehrlichiosis & Anaplasmosis:

  • If infections with anaplasmosis or ehrlichiosis is suspected, treatment should be initiated due to the likelihood of complications and potential for vertical transmission of disease.
  • Rifampin has shown in vitro activity against ehrlichia and has been used successfully in limited case reports of pregnant women with anaplasmosis.
  • Doxycycline has been used successfully to treat ehrlichiosis.
  • Due to a lack of data, these pregnant patients should be closely monitored for resolution of disease.
  • The addition of amoxicillin or cefuroxime is suggested if coinfection with Lyme disease is suspected, as rifampin does not have activity against B. burgdorferi.

Babesiosis:

  • Patients with suspected babesiosis should be treated due to potential complications, including possible vertical transmission to the fetus.
  • Combination therapy is preferred with clindamycin plus quinine.
  • Longer treatment courses or retreatment may be needed in cases with symptoms and/or parasitaemia persisting >3 months. Resolution of parasitaemia should be used to determine treatment course.

Rocky Mountain spotted fever (RMSF):

  • RMSF cases are associated with poor outcomes for the fetus, regardless of the treatment.
  • Prevention is crucial for pregnant patients, and treatment should be provided within 3–5 days of exposure.
  • Doxycycline is the preferred therapy. Treatment course is typically 5–7 days or 3 days after fever resolution.
  • Chloramphenicol is a proposed alternative treatment; but there are concerns for significant adverse effects, including myelosuppression, aplastic anaemia, and grey baby syndrome, specifically at or near birth, and it is associated with higher mortality in RMSF. (chloramphenicol is not available orally in the US).

Read the full review article here.

Read other LDA articles regarding treatment here

Study Shows American Dog Ticks in Western U.S. Are a Separate Species

https://entomologytoday.org/2021/08/25/american-dog-ticks-western-new-species-dermacentor-similis/

Study Shows American Dog Ticks in Western U.S. Are a Separate Species

Dermacentor similis, male

Researchers have split the medically important American dog tick into two species: the existing Dermacentor variabilis in eastern states and the newly described Dermacentor similis west of the Rocky Mountains. An adult male D. similis tick is shown here. (Photo courtesy of Paula Lado, Ph.D.)

By Melissa Mayer

Melissa Mayer

Melissa Mayer

Rocky Mountain spotted fever spreads when Rickettsia rickettsia bacteria pour into a bite wound while an American dog tick takes a blood meal. Unlike some other tick-borne diseases, which require a longer bite to transmit, Rocky Mountain spotted fever infection may take place within the first 30 minutes of the tick bite.

The distribution of the American dog tick (Dermacentor variabilis) in the United States is a wide yet broken one. It’s mostly found throughout the central and eastern parts of the country—with a few western populations all the way on the other side of the Rocky Mountains. But are these widely separated populations really the same species?

In a study published this month in the Journal of Medical Entomology, a team of researchers at Ohio State University used an integrative taxonomy approach—looking at both physical and genetic evidence—to determine that the ticks formerly known as Dermacentor variabilis in the west are a new species, which they’ve named Dermacentor similis.

Wild, Wild West

Paula Lado, Ph.D.

Paula Lado, Ph.D.

“We were working on other aspects related to Dermacentor evolution and phylogenetics, and our results consistently showed a separation between populations from the western states and all other locations eastern of the Rockies,” says lead author Paula Lado, Ph.D., who is now with the Center for Vector-Borne Infectious Diseases at Colorado State University. “And that had been shown in other studies in the past, so we decided to explore the topic in depth.”

Dermacentor tick collection locations

(See link for article)

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**Comment**

The study also found that ticks from Wisconsin and Michigan formed a small subcluster in the eastern group, which means there’s probably some variation there.

The difference between these ticks is in the minutia.  They both will happily infect you. While taxonomy considers this a “win” it’s just more research that doesn’t help patients at all. A tick is a tick is a tick.  All suck your blood and have the potential of transmitting life-altering pathogens into the human and animal body.

Important quotes:

And, because the American dog tick transmits the bacteria that cause Rocky Mountain spotted fever as well as other pathogens, describing a new species like D. similis means taking a close look at which diseases these ticks can carry and how well they do it, which is called vector competency.

“Splitting D. variabilis into two species may mean that they could be vectors for different pathogens,” Lado says. “In my opinion, it is crucial to determine the vector competency of the new species, D. similis. That will allow for us to know what pathogens are transmitted by both Dermacentor species.”

A word of warning on those quotes: all of these variables have been proven over time to be short-sighted as ticks can acquire the ability to transmit things they never used to transmit.  They have also been found in places they never were before.  Doctors looking at entomology maps have been misdiagnosing people for decades as the information is constantly changing, limited, and imperfect. Please see: The Confounding Debate Over Lyme in the South (Speilman’s maps)

Transmission times have been hotly contested for over 40 years. Mainstream medicine and conflict-riddled researchers and public health ‘authorities’ continue to doggedly state the party line that Lyme transmission takes at least 24-48 hours, whereas reality paints a far different picture, showing the potential transmission of Lyme (and other pathogens) can occur within a few hours.  It must also be remembered that minimum transmission time has never been determined, and some coinfections like Powassan virus can be transmitted within minutes. There’s also the sticky issue of partially fed ticks being able to transmit much sooner.

There is an absolute dearth of research on the issue of coinfected ticks and coinfected patients.  Does coinfection alter transmission times?  The coinfection issue remains in the Dark Ages, leaving patients and the doctors who dare to treat them muddling blindly through the process.  But, hey now we know some worthless information about the undersides of ticks!

Again, the only box Lyme/MSIDS fits into is “Pandora’s.” Trying to put a lid on this thing is completely futile.

For more:

Below is a picture of a tick, without food or water for days, and the thousands of eggs it laid.

Tick eggs

Ticks aren’t picky, and can show up in the wildest of places:

IMG_2121

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Tickborne Illnesses in Finland

https://www.lymedisease.org/ticks-finland-2/

TOUCHED BY LYME: Tick-borne illnesses in Finland

April 28, 2021

Guest blogger C.M. Rubin interviews two European scientists about the prevalence of Lyme disease and other tick-borne infections in Finland.

The Global Search for Education: Finland — Ticks

by C M Rubin as featured in the Huffington Post

Lyme disease is caused by a bacterium transmitted to humans via a tick bite. The CDC (Center for Disease Control) claims that Lyme Borreliosis is the most common and fastest growing infectious illness in the United States. The disease can cause a variety of flu-like symptoms such as fever, achy joints, fatigue and headache. Additionally, Anaplasmosis/Ehrlichiosis, Babesiosis, Rocky Mountain Spotted Fever, Bartonella, Tularemia, and more recently, Borrelia Miyamotoi (a distant relative of Lyme Borreliosis) are other recognized tick-borne infectious diseases in the United States.

Experts have been unable to agree for decades on whether a case definition called chronic Lyme disease exists. Yet, some Lyme victims, even after taking the standard treatment of antibiotics, continue to suffer from long-term and often serious health problems for years after they first contract the disease. Does chronic Lyme disease exist, or is the condition which some patients experience an autoimmune or nervous system response triggered by the infection, or indeed is it a bit of both? These are some of the major questions researchers are trying to figure out as they take on the enormous challenges of identifying better Lyme diagnostic tools and treatment plans for what is becoming a growing global public health crisis.

Today in The Global Search for Education, I take a look at tick-borne illnesses in Finland. I am joined by Docent Jarmo Oksi, Finland’s leading researcher in the field of Lyme disease, who is based at the University of Turku in Finland. In addition, I welcome Markku Kuusi, Chief Medical Officer from Finland’s National Institute for Health and Welfare.

2013-04-25-cmrubinworldticks1400.jpg“The weakness of the Finnish surveillance system is that we don’t collect any clinical information on patients, we only get notifications from laboratories.” — Markku Kuusi
What is the annual incidence of Lyme disease in Finland and in Europe at large?Jarmo: Laboratory reports on Lyme Borreliosis cases (based on positive serology) have doubled in 10 years and are now about 1,500. The estimated number of Lyme Borreliosis infection cases is about four times this number — i.e. estimated incidence in Finland is 5,000-6,000 annually (population 5.5 million), which is about 100 per 100,000 inhabitants per year. However there are areas in the Southwestern Archipelago with incidence of 1000 per 100,000 inhabitants per year.

Markku: Based on the National Infectious Disease Register, the incidence of Lyme disease in Finland has been about 30/100,000 during the past few years. In terms of the annual incidence in other Nordic countries, in Norway it has been about 6/100,000 and in Denmark, 1 – 2/100,000. It is hard to believe that there is such a difference in actual incidence, so that is why I believe the diagnostic criteria are truly different. The weakness of the Finnish surveillance system is that we don’t collect any clinical information on patients, we only get notifications from laboratories; so it is difficult to say whether the symptoms of our cases really are compatible with Lyme Borreliosis.

Would you comment on the annual incidence of any of the other tick-borne illnesses which are endemic in Finland in addition to Lyme.

Markku: Tick-borne Encephalitis (TBE) is another important tick-borne disease in Finland. The incidence has been particularly high on Aland Island and therefore TBE vaccination is included in the national immunization program. Before the vaccination program, the annual incidence was up to 100/100,000 population. Now it has decreased substantially. It seems that in other parts of Finland (apart from Aland Island), the incidence is increasing, and therefore other areas may also be included in the immunization program in the near future (for example, the Archipelago around the city of Turku).

Do you believe that chronic Lyme disease exists or that it is a misnomer for other diseases triggered by Lyme disease?

Markku: This is a difficult question. I think it is clear that some patients have a prolonged course of the disease which may last several months. The most experienced clinicians in Finland think that a continuing Borrelia infection is possible if the patient has not received adequate treatment for the illness, resulting in disseminated infection. Even after adequate treatment, some patients have symptoms due to immunological mechanisms, but it is very hard to say whether these symptoms are related to Borrelia infection or to some other causes.

2013-04-25-cmrubinworldlabra_182.JPG_3420500.jpg“The most experienced clinicians in Finland think that a continuing Borrelia infection is possible if the patient has not received adequate treatment for the illness, resulting in disseminated infection.”— Markku Kuusi
If you believe in chronic Lyme disease, what do you believe are the most effective ways to treat it?Jarmo: If you mean chronic infection, I think that this entity after standard antibiotic therapy is very very seldom (I see about one case in five years). However, if detected –e.g. with cultivation or PCR (the most specific way to detect), the treatment I give is individual antibiotic treatment — maybe double the length compared to the initial treatment.

What do you believe is the most effective way to treat symptoms triggered by the infection, e.g. chronic auto-immune reaction?

Jarmo: During the first months I wait for gradual improvement. If there is no improvement after six to 12 months, I then start low-dose corticosteroid treatment for a certain subset of patients. Some other subsets may get help from, for example, amitriptyline, which raises the threshold for pain sensation.

What tests currently available to the general public, other than the Western Blot test, do you believe provide a better degree of certainty?

Jarmo: PCR (and culture) are useful in some situations (culture only in research settings), but even PCR is not sensitive enough to detect all cases — e.g. in CSF (cerebrospinal fluid) of neuroborreliosis cases. Besides Western Blots, ELISA tests based on C6 peptide are generally good as confirmatory tests.

2013-04-25-cmrubinworld_P6Q5372.JPG_198500.jpg“We are currently enrolling patients into a study on neuroborreliosis: comparison of IV Ceftriaxone for 3 weeks vs. oral Doximycin for 4 weeks. Hopefully this study will give us new knowledge on markers of how to identify patients with reactive symptomatology triggered by Lyme neuroborreliosis.”— Jarmo Oksi
Are you aware of any other promising tests in development?Markku: Last year, a Finnish group reviewed the diagnostic tests in our country. It is my understanding that right now there are not unfortunately any new reliable tests available. So we shall have to wait awhile for them.

To what research do you believe scientists around the world must give priority in order to overcome the challenges the public faces with finding a cure for Lyme disease?

Markku: I think it is important to better understand the mechanism behind the sequelae of acute borreliosis. Therefore, we need more research on the immunology of the disease. In other words, how does the bacteria actually cause joint symptoms or neurologic symptoms. I think this will help us to develop better diagnostic tests and hopefully better drugs. I believe antibiotics are not the only solution.

What is the focus of your research and how does it relate to the challenges of identification and cure of Lyme disease and diseases triggered by Lyme?

Jarmo: We are currently enrolling patients into a study on neuroborreliosis: comparison of IV Ceftriaxone for three weeks vs. oral Doximycin for four weeks. Hopefully this study (with control CSF specimens) and long follow-ups of patients also will give us new knowledge on markers of how to identify patients with reactive symptomatology triggered by Lyme neuroborreliosis.

How can technology help us find a cure for Lyme disease faster?

Markku: This is not really a field in which I am knowledgeable, but I believe that better molecular and immunological methods may give possibilities for new diagnostics and for the development of new drugs. What I really hope is that there will be better and more specific laboratory tests for Lyme Borreliosis in the future. I think that one of the key issues is to harmonize the laboratory methods so that we can get a better understanding of the epidemiology of Lyme disease in Finland.

C M Rubin is a child and family health and education advocate.  She is the author of a number of award winning books as well as the widely read online series THE GLOBAL SEARCH FOR EDUCATION.

Follow C. M. Rubin on Twitter: www.twitter.com/@cmrubinworld

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**Comment**

I disagree with two tenets in this paper:

  • Chronic Lyme is rare.  I personally, as well as my husband, and most I deal with have improved immensely or even reached remission with lengthy treatment utilizing numerous antimicrobials and other modalities.  As they say, “The proof is in the pudding.”  Lyme spirochetes have been found in the autopsied brain despite treatment.  There are also extensive global research showing the persistence of the organism in 700 peer-reviewed papers (as well as coinfections that often come with Lyme): Peer-Reviewed Evidence of Persistence of Lyme:MSIDS copy  Please keep in mind that everything is rigged against reporting chronic infection. Globally, doctors work under the CDC/IDSA’s myopic focus on the acute phase and frank denial of persistent infection.  It doesn’t surprise me at all that a Finnish researcher also cow-tows to this thinking.  It’s rampant.
  • That we need yet more research on the acute phase of Lyme.  Frankly, that’s about all we have.  We desperately need researchers to quit myopically focusing on this phase of the illness and study the thousands upon thousands with chronic/persistent symptoms who often do to not test positive on the abysmal CDC 2-tiered testing, which is rigged to not pick up chronic infection, and do not have the “classic” EM rash.  These two variables have kept the sickest patients from being studied.

Know Your Ticks

https://www.globallymealliance.org/tick-table/

Know your ticks

Easy to read table shows the most common ticks found in the U.S. that transmit pathogens to humans.
Note: only a partial list. To learn more about tick-bite prevention and how to be Tick AWARE, click here

Click here to download the Tick Table

Tick Table

For more:

Remember, in Wisconsin, ticks are found in every county in the state. Researchers are also finding them in bright, open, mowed lawns.