Archive for the ‘Testing’ Category

Woman Develops Lyme Disease Symptoms After Giving Birth, But Baby Doesn’t – Yet

https://danielcameronmd.com/woman-develops-lyme-disease-symptoms-after-giving-birth/

WOMAN DEVELOPS LYME DISEASE SYMPTOMS AFTER GIVING BIRTH

In their article, “An Unusual Case of Serologically Confirmed Post-Partum Lyme Disease Following an Asymptomatic Borrelia burgdorferi Infection Acquired during Pregnancy and Lacking Vertical Transmission in Utero,” Pavia et al. describe the case of a young woman who developed symptoms of Lyme disease immediately following the birth of her child. [1]

By 

A 23-year-old woman, who lived in Brooklyn, NY, had visited her primary care doctor complaining of bilateral knee swelling and pain. Three days prior, she had delivered a healthy baby girl.

The pain was reported as 8/10 in severity and was exacerbated by walking, according to the authors.

When the woman was 6 months pregnant, she experienced similar knee pain briefly but never sought treatment.

“Interestingly, except for a brief 2-day period where she experienced knee pain, she remained symptom-free for Lyme disease for the remainder of the pregnancy.”

During her pregnancy the woman had taken several trips to wooded areas in upstate New York.

She denied any known exposure to ticks or the development of any rash.

Testing for Lyme disease was positive by Western blot with several reactive bands including: 18, 23, 28, 33, 41,43, 58, 66, and 93 kDa.

The woman was treated successfully with a 3-week course of doxycycline.

Her newborn was symptom-free at birth and has never shown any of the usual signs or symptoms of active disease well into early childhood and beyond, the authors state.

According to the authors, “There was no evidence for congenital or perinatal transmission of this pathogen at any point pre-term or postnatally.”

Related Articles:

No complications with Lyme disease and pregnancy
Can Lyme disease impact pregnancy outcome?
Podcast: Pregnancy, breast feeding and Lyme disease

References:
  1. Pavia CS, Plummer MM, Varantsova A. An Unusual Case of Serologically Confirmed Post-Partum Lyme Disease Following an Asymptomatic Borrelia burgdorferi Infection Acquired during Pregnancy and Lacking Vertical Transmission in Utero. Pathogens. 2024 Feb 20;13(3):186. doi: 10.3390/pathogens13030186. PMID: 38535530; PMCID: PMC10976031.

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**Comment**

This, of course, will be used ad nauseam to push the myth that congenital transmission is rare or doesn’t occur.  FALSE!  Further, it is widely known that the immune system often keeps the infection in check until a trigger sets it off.

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Category:

Lyme, Pregnancy, research, Testing, Transmission, Treatment

Antibodies to Borrelia Burgdorferi and Bartonella Species in Serum and synovial fluid From People With Rheumatic Diseases

https://www.researchgate.net/publication/378974250_Antibodies_to_Borrelia_burgdorferi_and_Bartonella_species_in_serum_and_synovial_fluid_from_people_with_rheumatic_diseases

Antibodies to Borrelia burgdorferi and Bartonella species in serum and synovial fluid from people with rheumatic diseases

March 2024

Microbiology Spectrum 12(4):e0165323

DOI:10.1128/spectrum.01653-23

License  CC BY 4.0

Authors:
Lisa Kim
Erin Lashnits
Edward B Breitschwerdt
Amanda Elam

Abstract and Figures

Vector-borne infections may underlie some rheumatic diseases, particularly in people with joint effusions. This study aimed to compare serum and synovial fluid antibodies to B. burgdorferi and Bartonella spp. in patients with rheumatic diseases. This observational, cross-sectional study examined paired synovial fluid and serum specimens collected from 110 patients with joint effusion between October 2017 and January 2022. Testing for antibodies to B. burgdorferi (using CDC criteria) and Bartonella spp. via two indirect fluorescent antibody (IFA) assays was performed as part of routine patient care at the Institute for Specialized Medicine (San Diego, CA, USA). There were 30 participants (27%) with positive two-tier B. burgdorferi serology and 26 participants (24%) with IFA seroreactivity (≥1:256) to B. henselae and/or B. quintana. Both B. burgdorferi IgM and IgG were detected more frequently in synovial fluid than serum: 27% of patients were either IgM or IgG positive in synovial fluid, compared to 15.5% in serum (P = 0.048). Conversely, B. henselae and B. quintana antibodies were detected more frequently in serum than synovial fluid; overall only 2% of patients had positive IFA titers in synovial fluid, compared to 24% who had positive IFA titers in serum (P < 0.001). There were no significant associations between B. burgdorferi or Bartonella spp. seroreactivity with any of the clinical rheumatological diagnoses. This study provides preliminary support for the importance of synovial fluid antibody testing for documenting exposure to B. burgdorferi but not for documenting exposure to Bartonella spp.
IMPORTANCE This study focuses on diagnostic testing for two common vector-borne diseases in an affected patient population. In it, we provide data showing that antibodies to B. burgdorferi, but not Bartonella spp., are more commonly found in synovial fluid than serum of patients with joint effusion. Since Lyme arthritis is a common—and sometimes difficult to diagnose—rheumatic disease, improving diagnostic capabilities is of utmost importance. While our findings are certainly not definitive for changes to practice, they do suggest that synovial fluid could be a useful sample for the clinical diagnosis of Lyme disease, and future prospective studies evaluating this claim are warranted.
For more:

Category:

Bartonella, Lyme, research, Testing

I’ve Got Lyme Disease And You May Have It Too

https://fishrise.substack.com/p/lyme-disease

Lyme Disease: Running Riot

I’ve got it, you may have it too.

By Richard Wilson
MAR 16, 2024

Science Photo Library

Article Excerpts:

Ticks are the original muggers. They lurk on the tips of grass fronds, often in and around woodland, waiting for an unwitting victim to brush past. They’re looking for a free meal which, for us, turns into a lose-lose transaction. The tick gets our blood and we get Lyme Disease, a bacterial infection with very unpleasant consequences.

I’ve been paying attention to this because I’ve just been diagnosed with Lyme. Worse, I’ve had it untreated for about 8 years, which is why I can also say that most doctors wouldn’t recognize it even if they caught it, and that I wouldn’t wish it on anyone.

There are two basics to understand about Lyme Disease, and they come hand-in-glove: An early diagnosis is both essential and very hard to get. Speed is everything because, given the chance, there’s no organ in your body or corner of your central nervous system that the Lyme bacteria won’t vandalise.

(See link for article)

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**Comment**

The article starts with the unfortunate pervasive propaganda about warmer/wetter weather causing ticks to proliferate

This is patently FALSE.

For more:

For tick prevention:

Category:

Activism, Prevention, Testing, Ticks

New Testing Approach Improves Detection of Rare But Emerging Powassan Virus Spread by Deer Ticks

https://www.umass.edu/news/article/new-testing-approach-improves-detection-rare-emerging-powassan-virus-spread-deer-ticks

NEW TESTING APPROACH IMPROVES DETECTION OF RARE BUT EMERGING POWASSAN VIRUS SPREAD BY DEER TICKS

UMass Amherst-based NEWVEC developed method to monitor and prevent potentially deadly infections

Researchers at the New England Regional Center of Vector-Borne Diseases at the University of Massachusetts Amherst have come up with a new, more accurate method for detecting in ticks the emerging Powassan virus, which can cause life-threatening neuroinvasive disease, including encephalitis and meningitis.

This robust, real-time approach reduces the incidence of false negative test results, the NEWVEC researchers found. The team describes the study in a special issue of the journal Viruses, titled “Tick-borne Viruses: Transmission and Surveillance.”

“Powassan has been a growing concern in New England for the past several years and false negatives can confound efforts to surveil,” says vector-borne disease expert Stephen Rich, professor of microbiology at UMass Amherst and principal investigator and executive director of NEWVEC. “The development of sensitive detection methods for diagnostics and surveillance is critical.”

Named after the town in Ontario, Canada, where it was first identified in 1958 in a 5-year-old boy who died from encephalitis, Powassan virus is a flavivirus related to West Nileand other mosquito-borne viruses.

Though still rare, Powassan virus is drastically increasing in incidence in the U.S., predominantly in the Northeast and Great Lakes region. More than 10% of the record 290 U.S. cases reported in 2022 (compared to only one case per year from 2004 to 2006) resulted in death, and half of the survivors suffered long-term neurological damage. The virus is transmitted to humans primarily by Ixodes scapularis, the same blood-sucking deer ticks that transmit Lyme disease, babesiosis and other tick-borne illnesses.

The team at NEWVEC – which brings together academic communities, public health practitioners and residents and visitors across the Northeast in an effort to reduce diseases spread by ticks and mosquitoes – developed a triplex real-time PCR test for the simultaneous and quantitative detection of the Powassan virus and Powassan virus lineage II (deer tick virus) in Ixodes scapularis, or deer ticks. (The prototype Powassan virus is found mostly in Ixodes cookei and Ixodes marxi ticks that feed almost exclusively on woodchucks in their burrows and rarely bite humans or human pets.)

The NEWVEC team conducted a tick survey in coastal and offshore Massachusetts, focusing on 13 sites from the highly endemic regions of tick-borne diseases in Cape Cod and Martha’s Vineyard. They tested the ticks for Powassan virus, comparing  their new triplex PCR method to the standard, commercially available Luminex xMap technology.

“The good news is that ours works as well as the other one. So, in other words, everything that the other one could detect, we could detect,” Rich explains. “The great news is that we also overcame the problem of false negatives, which is what happens when a sample is not of sufficient quality that any test would ever be able to detect the virus in it.”

The new triplex method accomplishes a reduction in false negatives by using a “clever” quality control. Both tests seek to detect the presence of Powassan virus RNA. “But we also had a paired search for the RNA from the tick, which is present in every tick regardless of whether it has the virus or not,” Rich says. “And what that tells us is, if we can amplify tick RNA, then we have some hope of being able to detect the virus RNA. If we don’t detect the tick DNA, then we have no hope of being able to detect the virus RNA.

“And before we developed that method, people would be left to wonder – if they were inquisitive – whether a negative result meant that the virus wasn’t there or that the sample wasn’t testable. So, we’ve ruled out that latter possibility. And now we know with some assurance that when a tick tests negative, it’s a true negative. It’s not that the sample just isn’t good enough.”

In the areas surveyed, “We found pockets of high incidence of this virus,” Rich says.

Powassan virus was detected at four of six sites in Cape Cod and two of seven sites in Martha’s Vineyard. Of 819 ticks collected, 33 (4.03%) tested positive for Powassan virus and 752 tested as Powassan negative, using the new triplex method. Thirty-four ticks (4.15%) failed the quality control tick RNA test. That showed that the standard Luminex method underestimated the overall prevalence of Powassan virus because those 34 ticks were found Powassan negative. And only 30 ticks tested positive using the Luminex method, demonstrating that the triplex technique has a higher sensitivity to detect the virus RNA.

Infection rates reached as high as 10.43% at one site in Truro on Cape Cod, and were completely absent at seven other sites. All the ticks that tested positive for the Powassan virus also were positive for the lineage II deer tick virus.

The researchers say they hope this improved triplex PCR test will be useful in transmission studies and as a tool to monitor and prevent Powassan virus infections in Massachusetts and other areas where the virus has been reported.

“Powassan virus is only a threat to people through the bite of tick,” Rich says. “That’s why these highly accurate and sensitive tests of the tick are so valuable in assessing where and when risk of exposure is highest.”

Correction: A previous version of this story mistakenly used the term “false positives” instead of “false negatives” in multiple instances, including in the quote by Stephen Rich. These errors have been corrected.

March 26, 2024

CONTACT

Patty Shillington

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**Comment**

It’s been a while since I’ve seen information on Powassan; however, one thing I know: it’s not rare.

For more:

Category:

research, Testing, Ticks, Transmission, Viruses

Adaptive Immune Response Investigation in Lyme Borreliosis

https://pubmed.ncbi.nlm.nih.gov/38165616/

Adaptive Immune Response Investigation in Lyme Borreliosis

Mihail Pruteanu 1, Armin Schwarzbach 2, Markus Berger 2

Abstract

To diagnose Lyme Borreliosis, it is advised to use an enzyme-linked immunosorbent test to check for serum antibodies specific for Lyme and all tests with positive or ambiguous enzyme-linked immunosorbent assay (ELISA) results being confirmed by immunoblot. This method of measuring the humoral immunity in human fluids (e.g., by ELISA) has provided robust and reproducible results for decades and similar assays have been validated for monitoring of B cell immunity. These immunological tests that detect antibodies to Borrelia burgdorferi are useful in the diagnosis of Borreliosis on a routine basis. The variety of different Borrelia species and their different geographic distributions are the main reasons why standards and recommendations are not identical across all geographic regions of the world. In contrast to humoral immunity, the T cell reaction or cellular immunity to the Borrelia infection has not been well elucidated, but over time with more studies a novel T cell-based assay (EliSpot) has been developed and validated for the sensitive detection of antigen-specific T cell responses to B. burgdorferi. The EliSpot Lyme assay can be used to study the T cell response elicited by Borrelia infections, which bridges the gap between the ability to detect humoral immunity and cellular immunity in Lyme disease. In addition, detecting cellular immunity may be a helpful laboratory diagnostic test for Lyme disease, especially for seronegative Lyme patients. Since serodiagnostic methods of the Borrelia infection frequently provide false positive and negative results, this T cell-based diagnostic test (cellular assay) may help in confirming a Lyme diagnosis. Many clinical laboratories are convinced that the cellular assay is superior to the Western Blot assay in terms of sensitivity for detecting the underlying Borrelia infection. Research also suggests that there is a dissociation between the magnitude of the humoral and the T cell-mediated cellular immune responses in the Borrelia infection. Lastly, the data implies that the EliSpot Lyme assay may be helpful to identify Borrelia infected individuals when the serology-based diagnostic fails to do so. Here in this chapter the pairing of humoral and cellular immunity is employed to evaluate the adaptive response in patients.

For more:

Category:

Lyme, research, Testing