Archive for the ‘Testing’ Category

Advanced Heart Block in Children With Lyme Disease

https://link.springer.com/article/10.1007%2Fs00246-018-2003-8

Advanced Heart Block in Children with Lyme Disease

Meena Bolourchi, Eric S. Silver, Leonardo Liberman

First Online:

 

Abstract

Background

The clinical course of children with advanced heart block secondary to Lyme disease has not been well characterized.

Objective

To review the presentation, management, and time to resolution of heart block due to Lyme disease in previously healthy children.

Methods

An IRB approved single-center retrospective study was conducted of all patients < 21 years old with confirmed Lyme disease and advanced second or third degree heart block between 2007 and 2017.

Results

Twelve patients (100% male) with a mean age of 15.9 years (range 13.2–18.1) were identified. Six patients (50%) had mild to moderate atrioventricular valve regurgitation and all had normal biventricular function. Five patients had advanced second degree heart block and 7 had complete heart block with an escape rate of 20–57 bpm. Isoproterenol was used in 4 patients for 3–4 days and one patient required transvenous pacing for 2 days. Patients were treated with 21 days (n = 6, 50%) or 28 days (n = 6, 50%) of antibiotics. Three patients received steroids for 3–4 days. Advanced heart block resolved in all patients within 2–5 days, and all had a normal PR interval within 3 days to 16 months from hospital discharge.

Conclusion

Symptomatic children who present with new high-grade heart block from an endemic area should be tested for Lyme disease. Antibiotic therapy provides quick and complete resolution of advanced heart block within 5 days, while steroids did not appear to shorten the time course in this case series. Importantly, no patients required a permanent pacemaker.

_________________

 

**Comment**

Yes, go ahead and test but realize testing misses half of all cases.  

Since 3rd degree heart block can be fatal, this is a big deal.  Don’t let fear of antibiotics keep you from treating these poor kids.  They say 5 days of antibiotics does the trick, but these patients need follow-up.  Coinfections also need to be taken into consideration as certain antibiotics will not work on all pathogens.  If they have Babesia, for instance, they need anti-malarials.

There are many out there giving “natural” protocols and dissing the use of antibiotics.  This study on serious heart issues is a prime example of the fact that Lyme can kill & time is of the essence.  

More on heart issues with Lyme/MSIDS:  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/2018/09/17/lyme-carditis-heart-block-other-complications-of-ld/

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

https://madisonarealymesupportgroup.com/2018/07/02/new-uva-study-tentatively-links-ticks-to-heart-disease/

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

 

 

Category:

Heart Issues, Lyme, research, Testing, Treatment

Study Shows Lyme in 15 Species of Canadian Ticks – 6 of which Bite Humans. Numerous New Bird Species Acting As Hosts

Scott et al., 2018, Canada-wide tick-host-pathogen study, Bbsl

Healthcare 2018, 6, 131; doi:10.3390/healthcare6040131

John D. Scott, Kerry L. Clark, Janet E. Foley, John F. Anderson, Bradley C. Bierman, and Lance A. Durden

Abstract:

Lyme disease, caused by the spirochetal bacterium, Borrelia burgdorferi sensu lato (Bbsl), is typically transmitted by hard-bodied ticks (Acari: Ixodidae).  Whenever this tick-borne zoonosis is mentioned in medical clinics and emergency rooms, it sparks a firestorm of controversy.  Denial often sets  in, and healthcare practitioners dismiss the fact that this pathogenic spirochetosis is present in their area.  For distribution of Bbsl across Canada, we conducted a 4-year, tick-host study (2013-2016), and collected ticks from avian and mammalian hosts from Atlantic Canada to the West Coast.  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.  Overall, 13 of the 18 tick species tested are human-biting ticks.  Our data suggest that a 6-tick, enzootic maintenance cycle of Bbsl is present in southwestern B.C., and five of these tick species bite humans.  Biogeographically, the groundhog tick, Ixodes cookei, has extended its home range from central and eastern Canada to southwestern British Columbia (B.C.).  We posit that the Fox Sparrow, Passerella iliaca  is a reservoir-competent host for Bbsl.  The Bay-breasted Warbler, Setophaga castanea, and the Tennessee Warbler, Vermivora peregrina, are new host records for the blacklegged tick, Ixodes scapularis.  We provide the first report of a Bbsl-positive Amblyomma longirostre larva parasitizing a bird; this bird parasitism suggests that a Willow Flycatcher is a competent reservoir of Bbsl.  Our findings show that Bbsl is present in all provinces, and that multiple tick species are implicated in the enzootic maintenance cycle of this pathogen.  Ultimately, Bbsl poses a serious public health contagion Canada-wise.

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**Comment**

This study highlights the fact that it’s not just the blacklegged tick transmitting pathogens.

Six tick species capable of transmitting to humans have been found in Canada.

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. 

Amblyomma longirostre ticks are typically in countries of South, Central and North America.  The fact one was  found in Canada is quite telling.  The fact it was infected with Borrelia burgdorferi – even more telling.  They’re known to transmit Rickettsia.  The larvae are found on birds, while nymphs are reported as parasitizing songbirds and mammals. The adult stages are typically found on mammals such as rodents.

This study supports the fact that birds are the major transporters of ticks, and that mice aren’t the largest concern in tick propagation:  https://madisonarealymesupportgroup.com/2018/11/07/ticks-on-the-move-due-to-migrating-birds-and-photoperiod-not-climate-change/

https://madisonarealymesupportgroup.com/2017/08/17/of-birds-and-ticks/

The 13 ticks in Canada found to be able to potentially infect humans are:

  1. Amblyomma longirostre*
  2. Dermacentor albipictus*
  3. Haemaphysalis leporispalustris*
  4. Ixodes affinis* 
  5. Ixodes angustus
  6. Ixodes banksi*
  7. Ixodes brunneus* 
  8. Ixodes cookei
  9. Ixodes muris
  10. Ixodes pacificus
  11. Ixodes spinipalpis 
  12. Ixodes scapularis
  13. Ixodes texanus*

Of note:  previously Ixodes dentatus were positive for Bbsl (Scott et al, 2012).  In addition, Ixodes urrae can transmit Bbsl to humans as well.

*rarely transmits to humans

The four year study found a number of new bird hosts of importance as well.  

In sum:

  1. Birds are transiting ticks worldwide, with the exception of the arctic and antarctic.  This study blows holes in the climate change theory, as does this study:  https://madisonarealymesupportgroup.com/2018/08/13/study-shows-lyme-not-propelled-by-climate-change/
  2. Throw the maps away.  Maps have been used against patients for decades.
  3. Numerous species of ticks are transmitting diseases.  There’s no such thing as a “good tick.”
  4. Ticks are nature’s dirty syringes with the capability of infecting humans with numerous pathogens.  The following link is another study that corroborates this: https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/  For the first time, Garg et al. show a 85% probability for multiple infections including not only tick-borne pathogens but also opportunistic microbes such as EBV and other viruses.  Yet, 83% of all commercial tests focus only on Lyme (borrelia).
  5. Bbsl is present in ALL Canadian provinces.  
  6. Tick-borne illness is a crisis.
  7.  Doctors desperately need tick-borne illness education:  https://madisonarealymesupportgroup.com/2018/02/19/calling-all-doctors-please-become-educated-regarding-tick-borne-illness-heres-how/, and  https://madisonarealymesupportgroup.com/2018/06/06/lyme-education-for-healthcare-professionals/

The denial of Lyme/MSIDS must end.  The data keeps pouring in and it’s not going to get better with time.  Patients have been ill for decades but denied medical treatment.  Many have needlessly died.  Stop the madness.  Do your part by spreading the correct information in your sphere of influence.  

Category:

Lyme, research, Rickettsia, Testing, Ticks, Transmission

Thirty Percent Finnish Ticks Carry at Least One Pathogen & Candidas Rickettsia Tarasevichiae Found for the First Time

https://www.ncbi.nlm.nih.gov/pubmed/30355331

Parasit Vectors. 2018 Oct 24;11(1):556. doi: 10.1186/s13071-018-3131-y.

Tick-borne pathogens in Finland: comparison of Ixodes ricinus and I. persulcatus in sympatric and parapatric areas.

Laaksonen M1, Klemola T2, Feuth E3, Sormunen JJ2, Puisto A2, Mäkelä S2, Penttinen R4, Ruohomäki K2, Hänninen J4, Sääksjärvi IE4, Vuorinen I4, Sprong H5, Hytönen J3, Vesterinen EJ4,6.

Abstract
BACKGROUND:
Almost 3500 tick samples, originally collected via a nationwide citizen science campaign in 2015, were screened to reveal the prevalence and distribution of a wide spectrum of established and putative tick-borne pathogens vectored by Ixodes ricinus and I. persulcatus in Finland. The unique geographical distribution of these two tick species in Finland allowed us to compare pathogen occurrence between an I. ricinus-dominated area (southern Finland), an I. persulcatus-dominated area (northern Finland), and a sympatric area (central Finland).
RESULTS:
Of the analysed ticks, almost 30% carried at least one pathogen and 2% carried more than one pathogen. A higher overall prevalence of tick-borne pathogens was observed in I. ricinus than in I. persulcatus: 30.0% (604/2014) versus 24.0% (348/1451), respectively. In addition, I. ricinus were more frequently co-infected than I. persulcatus: 2.4% (49/2014) versus 0.8% (12/1451), respectively. Causative agents of Lyme borreliosis, i.e. bacterial genospecies in Borrelia burgdorferi (sensu lato) group, were the most prevalent pathogens (overall 17%). “Candidatus Rickettsia tarasevichiae” was found for the first time in I. ricinus ticks and in Finnish ticks in general. Moreover, Babesia divergens, B. venatorum and “Candidatus Neoehrlichia mikurensis” were reported for the first time from the Finnish mainland.
CONCLUSIONS:
The present study provides valuable information on the prevalence and geographical distribution of various tick-borne pathogens in I. ricinus and I. persulcatus ticks in Finland. Moreover, this comprehensive subset of ticks revealed the presence of rare and potentially dangerous pathogens. The highest prevalence of infected ticks was in the I. ricinus-dominated area in southern Finland, while the prevalence was essentially equal in sympatric and I. persulcatus-dominated areas. However, the highest infection rates for both species were in areas of their dominance, either in south or north Finland.

________________

**Comment**

Candidatus Rickettsia tarasevichiae:

Causes human disease and is a new species of rickettsiae of the spotted fever group.  https://www.nejm.org/doi/full/10.1056/NEJMc1303004

Symptoms:

  • hospitalized with fever
  • asthenia (weakness)
  • anorexia
  • nausea
  • headache
  • eschar (dead tissue that falls off healthy skin)
  • lymphadenopathy (swollen lymph nodes)
  • meningitis-like manifestations: vomiting, neck stiffness, and Kernig’s sign.
  • Coma, renal dysfunction, respiratory acidosis then developed, and the patient died 4 days after admission to the hospital.
  • Laboratory tests showed a slight increase in the leukocyte count
  • elevated level of aspartate aminotransferase
  • proteinuria
  • increase in the level of cerebrospinal fluid protein and leukocyte count
  • Since none of the patients presented with rash, which is considered to be a typical sign of infections with species of rickettsiae of the spotted fever group their conditions were initially misdiagnosed, and they received penicillin G, leading to a prolonged hospitalization for approximately 20 days.
Babesia venatorum

Causes human disease: https://wwwnc.cdc.gov/eid/article/20/5/pdfs/12-1034.pdf  B. venatorum was first known as Babesia sp. EU1 and was named after the Latin word for hunter because the first reported infected patients were 2 occupational hunters from Austria and Italy.

Symptoms:

  • irregular fever (38.6°C–41.0°C) for 12 days
  • anemi
  • malaise
  • myalgia
  • fatigue
  • progressive weakness
  • shortness of breath
Candidatus Neoehrlichia mikurensis:

Causes human disease:  https://jcm.asm.org/content/48/5/1956.full, and is an uncultured emerging bacterium that is in the family of Anaplasmosis. It’s close relatives Ehrlichia chaffeensis and Anaplasma phagocytophilum selectively infect the professional phagocytes monocytes/macrophages and neutrophilic granulocytes, which suggests that “Ca. Neoehrlichia mikurensis” may display tropism for leukocytes also.  Until now, no one has been able to grow “Ca. Neoehrlichia mikurensis”, which explains why  blood cultures remain negative. 

https://www.sciencedirect.com/science/article/pii/S2052297518300027

Symptoms:

  • immunosuppressive conditions
  • haematologic neoplasia
  • fever
  • myalgia (muscle pain)
  • arthralgia (joint pain)
  • Vascular events such as deep vein thrombosis, thromboembolic events, aneurysm and transitory ischemic accidents
  • skin manifestations, such as erythema nodosum or erysipelas-like rashes
  • elevated C-reactive protein levels
  • leukocytosis (neutrophilia) 
  • anemia

Ixodes ricinus tick, a.k.a castor bean tick, or sheep tick info:  http://www.cfsph.iastate.edu/Factsheets/pdfs/ixodes_ricinus.pdf  I. ricinus can also transmit a number of pathogens including Babesia divergens (babesiosis), louping ill virus, tick-borne encephalitis virus, Borrelia burgdorferi (Lyme disease) and Anaplasma phagocytophila (tick-borne fever of ruminants, human granulocytic anaplasmosis).  Add to this growing list “Candidatus Rickettsia tarasevichiae,” a new species of rickettsiae of the spotted fever group.

Ioxodes persulcatus tick, a.k.a. Taiga tick info:  http://www.bristoluniversitytickid.uk/page/Ixodes+persulcatus/25/#.W-mzZREeteI  Transmits Russian Spring-Summer encephalitis and Lyme disease.

Babesia divergens, B. venatorum and “Candidatus Neoehrlichia mikurensis” were reported for the first time from the Finnish mainland.

This article demonstrates why many in “Lyme land” remain ill.

You can’t diagnose what you can’t see, grow, and test for.

Authorities have absolutely no idea what is infecting everyone, and Lyme is only the tip of the ice-berg.

 

 

 

 

 

 

 

Category:

Babesia, Lyme, research, Rickettsia, Testing, Ticks

GLA – What the “Man on the Street” Knows About Lyme Disease

Global Lyme Alliance (GLA) and Matthew Morrison (from Glee) take to the streets of NYC to find out what people really know about #Lymedisease.

  1.  While ticks are the accepted transmitters of Lyme/MSIDS, there are other ways to contract it including congenitally & via breast milk.  There is also data suggesting other bodily fluids including semen, vaginal secretions, and urine – not to mention mosquitoes, biting flies, and other biting bugs.

WE NEED GOOD, UNBIASED, RESEARCH IN THIS AREA.

  1. The better question to ask is, “What can you lose with Lyme?” and the answer  – potentially – everything.
  2. Interestingly, Lyme has been around forever:  https://madisonarealymesupportgroup.com/2018/02/12/the-persistent-spiral-the-ancient-history-of-lyme-disease-and-tick-borne-infections/ and was found in Otzi, the oldest European mummy.
  3. Lyme disease is a PANDEMIC.  And it’s not going away.
  4. While dogs are “tick taxi’s,” cats, along with about every single mammal carry Bartonella, a huge player in Lyme/MSIDS.  I predict much more on Bart will be discovered shortly.
  5. Education needs to emphasize that ticks carry numerous pathogens.  The symbiotic relationship between them is one reason many remain ill:  https://madisonarealymesupportgroup.com/2018/10/30/study-shows-lyme-msids-patients-infected-with-many-pathogens-and-explains-why-we-are-so-sick/  The one germ, one drug paradigm does not work here.
  6. While tick testing is an interesting and educational endeavor, you should be seen immediately by a Lyme literate doctor if you ever find an attacked tick. Please do not take the CDC’s “wait and see” approach.  It’s not worth the risk. Few states have free tick testing and it typically costs $50 or more per tick. If it were me, I’d demand prophylactic treatment.  Trust me.  You don’t want this.

 

 

 

Category:

Activism, Lyme, Testing, Ticks

Study Finds Increased Lyme Test Sensitivity With Additional Antigens

https://www.ncbi.nlm.nih.gov/pubmed/30344068

Diagn Microbiol Infect Dis. 2018 Oct 3. pii: S0732-8893(18)30435-8. doi: 10.1016/j.diagmicrobio.2018.09.012. [Epub ahead of print]

Evaluation of in vivo expressed Borrelia burgdorferi antigens for improved IgM serodiagnosis of early Lyme disease.

Brandt KS1, Ullmann AJ1, Molins CR1, Horiuchi K1, Biggerstaff BJ1, Gilmore RD2.

Abstract
Improved serologic tests are needed for accurate diagnosis and proper treatment of early stage Lyme disease. We evaluated the 3 antigens currently used for 2-tiered IgM immunoblot testing (FlaB, OspC, and BmpA) in combination with 3 additional antigens (BBA65, BBA70, and BBA73) and measured the sensitivity and specificity against a serum repository of positive and negative controls. Using 3 statistical methods for positivity cutoff determinations and scoring criteria, we found increased sensitivities for early Lyme disease when 2 of 6 antigens were positive as compared with the 2 of 3 antigen IgM criteria currently used for second-tier immunoblot scoring. Specificities for negative controls were comparable or superior to using 2 of 3 antigens. These results indicate that IgM sensitivity and specificity of serological testing for Lyme disease in the early stages of illness can be improved by employing antigens that target the initial host antibody responses.

 

Category:

Lyme, research, Testing