HHS Announces Final Conscience Rule Protecting Health Care Entities and Individuals
The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced today the issuance of the final conscience rule that protects individuals and health care entities from discrimination on the basis of their exercise of conscience in HHS-funded programs. Just as OCR enforces other civil rights, the rule implements full and robust enforcement of approximately 25 provisions passed by Congress protecting longstanding conscience rights in healthcare.
The final rule fulfills President Trump’s promise to promote and protect the fundamental and unalienable rights of conscience and religious liberty, a promise he made when he signed an executive order in May 2017 protecting religious liberty. In October 2017, the Department of Justice issued guidance encouraging other Departments, including HHS, to implement and enforce all relevant religious freedom laws.
As a result, in January 2018, following the launch of its new Conscience and Religious Freedom Division, HHS announced the proposed conscience rule. OCR received over 242,000 public comments, and analyzed and carefully considered all comments submitted from the public on the proposed conscience regulation before finalizing it.
This final rule replaces a 2011 rule that has proven inadequate, and ensures that HHS implements the full set of tools appropriate for enforcing the conscience protections passed by Congress. These federal laws protect providers, individuals, and other health care entities from having to provide, participate in, pay for, provide coverage of, or refer for, services such as abortion, sterilization, or assisted suicide. It also includes conscience protections with respect to advance directives.
The final rule clarifies what covered entities need to do to comply with applicable conscience provisions and requires applicants for HHS federal financial assistance to provide assurances and certifications of compliance. The rule also specifies compliance obligations for covered entities, including cooperation with OCR, maintenance of records, reporting, and non-retaliation requirements.
“Finally, laws prohibiting government funded discrimination against conscience and religious freedom will be enforced like every other civil rights law.” said OCR Director Roger Severino. “This rule ensures that healthcare entities and professionals won’t be bullied out of the health care field because they decline to participate in actions that violate their conscience, including the taking of human life.Protecting conscience and religious freedom not only fosters greater diversity in healthcare, it’s the law,” Severino concluded.
Click here – PDF to read the Final Conscience Rule.
Click here – PDF to read the Final Conscience Rule Factsheet.
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*This HHS-approved document is being submitted to the Office of the Federal Register (OFR) for publication and has not yet been placed on public display or published in the Federal Register. This document may vary slightly from the published document if minor editorial changes are made during the OFR review process. The document published in the Federal Register is the official HHS-approved document.
*People using assistive technology may not be able to fully access information in these files. For assistance, please email OCR at OCRMail@hhs.gov or contact the OCR Call Center at (800) 368-1019.
Rickettsiales in Ticks Removed from Outdoor Workers, Southwest Georgia and Northwest Florida, USA
Elizabeth R. Gleim1 , L. Mike Conner, Galina E. Zemtsova, Michael L. Levin, Pamela Wong, Madeleine A. Pfaff, and Michael J. Yabsley DOI: 10.3201/eid2505.180438
The southeastern United States has multiple tick species that can transmit pathogens to humans. The most common tick species, Amblyomma americanum, is the vector for the causative agents of human ehrlichioses and southern tick-associated rash illness, among others (1). Dermacentor variabilis ticks can transmit the causative agent of Rocky Mountain spotted fever, and Ixodes scapularis ticks can transmit the causative agents of Lyme disease, babesiosis, and human granulocytic anaplasmosis (1). Although less common in the region, A. maculatum ticks are dominant in specific habitats and can transmit the causative agent of Rickettsia parkeri rickettsiosis (1).
Persons who have occupations that require them to be outside on a regular basis might have a greater risk for acquiring a tickborne disease (2). Although numerous studies have been conducted regarding risks for tickborne diseases among forestry workers in Europe, few studies have been performed in the United States (2,3). The studies that have been conducted in the United States have focused on forestry workers in the northeastern region (2). However, because of variable phenology and densities of ticks, it is useful to evaluate tick activity and pathogen prevalence in various regions and ecosystems.
Burn-tolerant and burn-dependent ecosystems, such as pine (Pinus spp.) and mixed pine forests commonly found in the southeastern United States, have unique tick dynamics compared with those of other habitats (4). The objective of this study was to determine the tick bite risk and tickborne pathogen prevalence in ticks removed from forestry workers working in pine and mixed pine forests in southwest Georgia and northwest Florida, USA.
During June 2009–December 2011, forestry workers in southwestern Georgia (7 counties) and northwestern Florida (1 county) submitted ticks crawling on or attached to them. We identified ticks and tested them for selected pathogens (Appendix). Immature forms of the same species from the same day and person were pooled (<5 nymphs and <20 larvae) for testing.
A total of 53 persons submitted 362 ticks (Table). Excluding larvae, the most common tick species submitted was A. maculatum, followed by A. americanum, I. scapularis, and D. variabilis. On 4 occasions, 1 person submitted A. tuberculatumticks (3 batches of larvae and 1 batch of nymphs) from a longleaf pine site in Baker County, Georgia. Average submissions per persons were 2.6 ticks (median 1 tick), but 1 person submitted 100 ticks. A total of 24 persons submitted ticks more than once, and they submitted an average of 0.08–6.5 ticks/month (overall average submission rate of 1.1 ticks/month). Three ticks were engorged (1 D. variabilis adult, 1 A. americanum nymph, and 1 Amblyomma sp. nymph); only the Amblyomma sp. nymph was positive for a pathogen (R. amblyommatis).
Rickettsia spp. prevalence was 36.4% in adult, 27.9% in nymphal, and 20% in larval A. americanum ticks; R. amblyommatis was the only species identified (Table).
Rickettsia spp. were detected in 23% of A. maculatum adults;R. amblyommatis was most common (6.0%), followed by R. parkeri (4.8%).
A previously detected novel Rickettsia sp. was identified in 10 of 11 A. tuberculatum larval pools and was reported by Zemtsova et al. (6). An additional pool of A. tuberculatum nymphs was tested in this study and also was positive for the novel Rickettsia sp.
E. chaffeensis was detected in 1 A. maculatum adult (prevalence 1.2%), and Panola mountain Ehrlichia sp. was detected in 2 A. maculatum adults (prevalence 2.4%) and 1 D. variabilis adult (prevalence 10%).
No ticks were positive for Borrelia spp., E. ewingii, or Anaplasma phagocytophilum.
Thus, forestry workers were found to encounter ticks on a regular basis, and peak encounter rates reflected previously reported tick seasonality in this region (4). Only 3 (0.8%) of the ticks submitted were engorged, indicating prompt removal of most ticks and thus low risk for pathogen transmission. A. maculatum, a fairly uncommon tick in the southeastern United States, was the most commonly submitted tick. However, A. maculatum ticks dominate in regularly burned pine ecosystems (4), which is where most of these workers spent their time.
We observed several unique findings related to pathogens during this study. Larvae and nymphs of A. tuberculatum ticks were submitted on multiple occasions, a tick rarely reported on humans (7). These findings in conjunction with the identification of a novel Rickettsia sp. (6), suggest that additional research is warranted. This study also identified E. chaffeensis and Panola Mountain Ehrlichia in A. maculatum ticks. Although A. americanum ticks are considered the primary vector of Ehrlichia spp., these pathogens have been occasionally reported in questing A. maculatum ticks, suggesting that this tick might be involved in their transmission cycles (5,8). We also detected Panola Mountain Ehrlichia in 1 D. variabilis tick. Thus, further research regarding these alternative tick species as potential vectors of these pathogens is warranted, particularly in the case of A. maculatum ticks, which were a common species on forestry workers and are widespread in this region (4).
At the time of this study, Dr. Gleim was a research scientist at the University of Georgia, Athens, GA. She is currently a disease ecologist at Hollins University, Roanoke, VA. Her research interests include wildlife and zoonotic diseases with a particular emphasis on tickborne diseases.
Acknowledgments
We thank the persons whom submitted ticks for this study and members of the Yabsley and Levin laboratories for providing laboratory assistance.
This study was supported by the Centers for Disease Control and Prevention/University of Georgia (UGA) collaborative grant (#8212, Ecosystem Health and Human Health: Understanding the Ecological Effects of Prescribed Fire Regimes on the Distribution and Population Dynamics of Tick-Borne Zoonoses); the Oxford Research Scholars Program at Oxford College of Emory University; the Joseph W. Jones Ecological Research Center, the Warnell School of Forestry and Natural Resources (UGA); the Southeastern Cooperative Wildlife Disease Study (UGA) through the Federal Aid to Wildlife Restoration Act (50 Statute 917); and Southeastern Cooperative Wildlife Disease Study sponsorship from fish and wildlife agencies of member states.
References
Stromdahl EY, Hickling GJ. Beyond Lyme: aetiology of tick-borne human diseases with emphasis on the south-eastern United States.Zoonoses Public Health. 2012;59(Suppl 2):48–64. DOIPubMed
Covert DJ, Langley RL. Infectious disease occurrence in forestry workers: a systematic review.J Agromed. 2002;8:95–111. DOIPubMed
Lee S, Kakumanu ML, Ponnusamy L, Vaughn M, Funkhouser S, Thornton H, et al.Prevalence of Rickettsiales in ticks removed from the skin of outdoor workers in North Carolina.Parasit Vectors. 2014;7:607. DOIPubMed
Gleim ER, Conner LM, Berghaus RD, Levin ML, Zemtsova GE, Yabsley MJ. The phenology of ticks and the effects of long-term prescribed burning on tick population dynamics in southwestern Georgia and northwestern Florida.PLoS One. 2014;9:e112174. DOIPubMed
Loftis AD, Kelly PJ, Paddock CD, Blount K, Johnson JW, Gleim ER, et al.Panola Mountain Ehrlichia in Amblyomma maculatum From the United States and Amblyomma variegatum (Acari: Ixodidae) From the Caribbean and Africa.J Med Entomol. 2016;53:696–8. DOIPubMed
Zemtsova GE, Gleim E, Yabsley MJ, Conner LM, Mann T, Brown MD, et al.Detection of a novel spotted fever group Rickettsia in the gophertortoise tick.J Med Entomol. 2012;49:783–6. DOIPubMed
Goddard J. A ten-year study of tick biting in Mississippi: implications for human disease transmission.J Agromed. 2002;8:25–32. DOIPubMed
Again, folks down South should be taken seriously when they present with symptoms. BTW: Southern advocates tell me that STARI looks, smells, and feels just like Lyme disease.
The take home: Clark found live Bbsl (bissettii-like strain) in people from the Southeast who had undefined disorders not typical of LD, and were treated for LD even though they were seronegative, proving that B. bissetti is responsible for worldwide human infection.
He also showed DNA of Bbsl in Lone Star ticks which might be a bridge vector of transmission to humans.
Dr. Clark was the first to report finding LD spirochetes in animals and ticks in South Carolina, as well as in wild lizards in South Carolina and Florida. He has documented the presence of LD Borrelia species, Babesia microti,Anaplasma phagocytophilum, Rickettsia species, and other tick-borne pathogens in wild animals, ticks, dogs, and humans in Florida and other southern states.
Clark is infected. Surprised? This is why he’s finding answers – it’s much more than a job to him.
Your body has a barrier to keep foreign chemicals from accessing your brain and spinal cord. Researchers have discovered by coating nanocapsules with CBD oil, they could carry particles into the brain of mice
CBD is the nonpsychoactive component of cannabis, which has strong anti-anxiety effects. Its ability to cross the blood-brain barrier suggests your brain has cannabinoid receptors used to maintain health
Although it’s normal to be concerned, too much stress and anxiety steals your time, energy and health; according to the World Health Organization, by 2030 global costs of anxiety treatment are expected to reach $147 billion annually
Low levels of endocannabinoids impact your risk of migraines, fibroids, irritable bowel syndrome and neurological conditions, but using CBD alone is not the answer to support your endocannabinoid system (ECS)
Natural ways to boost your ECS include avoiding pesticides, optimizing omega-3 intake, fasting, exercise and reducing stress
The cannabis plant has over 400 chemicals and at least 60 different cannabinoids1 — chemical compounds the human body is uniquely equipped to respond to. Of the two primary chemicals, cannabidiol (CBD) and tetrahydrocannabinol (THC), only THC has psychoactive properties.
THC is the compound in cannabis triggering a “high,” whereas CBD has no psychoactive effects. Both compounds, and other phytochemicals found in medical marijuana plants, have a long list of beneficial effects on health.
Medical marijuana is a term used for the use of the whole, unprocessed plant or its chemicals to treat a medical condition.2,3 With the exception of four cannabis-containing or cannabis-related products for specific conditions with a prescription, the U.S. Food and Drug Administration has not approved any “marketing application for cannabis for the treatment of any disease or condition.”4 On the other hand, some states have gone ahead and approved it themselves for certain medical conditions.5
The number of states that have decriminalized, legalized or allowed medical marijuana sales continues to grow. In some states, cannabis is fully legal or illegal, but in others the laws are mixed, allowing medicinal use but not recreational.6
According to the National Institute on Drug Abuse,7 notable scientific study results led to the creation of two FDA-approved medications containing cannabinoid chemicals in pill form, but not the use of the whole plant. Recently scientists proved CBD can carry other chemicals across the blood brain barrier, opening up its medicinal potential even further.
The Blood-Brain Barrier Is Designed to Protect Your Brain
More than 100 years ago, scientists discovered not everything injected into the bloodstream would reach the brain or spinal cord.8 Through research, scientists discovered the blood-brain barrier is semi permeable; in other words, it allows some materials to cross into your neurological system, but prevents others.
The importance of the blood-brain barrier to the health of your neurological system cannot be overstated. One portion of the system is formed by endothelial cells lining the microvasculature, which feeds your brain. This protects it from circulating agents and substances capable of disturbing your neurological functioning.9
The endothelial tissue in other capillaries in your body have small spaces allowing substances to move between the inside and outside of the vessel. In the brain, these cells fit together so tightly that many substances cannot leave the bloodstream and enter the brain.10
Additionally, glial cells — astrocytes — form another layer around the blood vessels and are involved in a two-way communication affecting physiology and pathology.11 This barrier mechanism is vital for normal functioning and providing a stable internal environment. One compound known to normally pass the blood-brain barrier is CBD.
Pharmaceutical Industry Finds Way to Use CBD as a Trojan Horse
In Greek mythology, the Trojan War was fought between the Greeks and the city of Troy.12 To gain access, the Greeks used a massive wooden horse constructed to hide a select force of men. It was presented as a gift, thereby allowing the Greek warriors to enter and destroy the city. Researchers believe CBD can act as a Trojan horse, helping move restricted chemicals across the blood-brain barrier.13
Researchers were interested in using CBD as a means to an end. They attached CBD, resembling endocannabinoids made by both mice and humans, to the outside of nanocapsules loaded with fluorescent molecules.
The fluorescence enabled the researchers to track the particles with the hope the experiment would mimic what occurs in the blood-brain barrier of humans. They demonstrated the CBD nanocarriers could transport fluorescent molecules across the blood-brain barrier in mice.14
When added in vitro to human cells mimicking the blood-brain barrier, the nanocarriers with CBD were more successful in passing through the cells than those without the CBD. Researchers also found when CBD nanocapsules were injected into healthy mice, 2.5 times more of them entered the animals’ brains than nanocarriers of equal size lacking the CBD coating.
Cannabidiol — Nonpsychoactive Component Has Anti-Anxiety Effects
The ability of CBD to naturally move across the blood-brain barrier indicates there are endocannabinoid receptors in the brain, which your neurological system uses to maintain optimal health. One of the benefits of CBD on your neurological system is reducing anxiety.
A meta-analysis15 evaluated the potential for CBD as a treatment for anxiety-related disorders. They found preclinical evidence strongly supported it for the treatment for panic disorder, social anxiety disorder, obsessive-compulsive disorder and post-traumatic stress disorder (PTSD).
A second large retrospective study16 looked at cases in psychiatric clinics involving the application of CBD for anxiety and sleep complaints. It too found the data supported the use of CBD for anxiety-related disorders.
In a small study17 involving 24 patients with generalized social anxiety disorder who, while diagnosed, had never been treated, half received CBD while the other half received a placebo. Another 12 healthy control subjects performed the test without receiving either medication or a placebo.
Each volunteer participated in a double-blind procedure. The researchers compared the effects of a simulation of public speaking on the 36 individuals, finding CBD pretreatment significantly affected cognitive impairment, anxiety and discomfort in speech performance.
The participants in the placebo group experienced higher anxiety, cognitive impairment and alert levels than the control group. No significant differences were observed between those taking CBD and the healthy control subjects who took nothing.18
These results piqued the interest of Dr. Esther Blessing, psychiatrist and researcher at New York University. She obtained funding from the National Institutes of Health, and along with collaborators are beginning a clinical trial to test if CBD helps those with PTSD and moderate or severe alcohol use disorder.19
The researchers plan to use pharmaceutical grade CBD or a placebo daily on 50 participants with the goal of evaluating alcohol intake in those who take CBD.
A second study20 now in Phase II is exploring whether CBD may help prevent relapse in opioid addicts. As explained by Blessing, CBD is different from cannabis. Although it’s extracted from cannabis, it does not lead to altered perception or cognition.21 She commented:22
“Drugs can be non-psychoactive and still have an effect on the brain. CBD does have an effect on the brain, but it seems to affect the brain in possibly medicinal ways.”
Anxiety Steals Time, Energy and Lives
Although it’s normal to be concerned about aspects of your life, too much stress and worry may devastate your health. A rise in stress levels and anxiety may trigger physical, mental or emotion changes, an indicator of anxiety disorders.23 Anxiety disorders are among the most common mental illnesses in the U.S., affecting an estimated 40 million adults.
Those suffering are three to five times more likely to see their physician and six times more likely to be hospitalized. It’s not uncommon for someone with anxiety to also suffer depression.24 Anxiety disorders carry a significant financial burden to individuals, families and communities.
According to the World Health Organization (WHO), by 2030, the global annual cost of anxiety will reach $147 billion.25 Researchers in one study concluded:26
“The cost burden of depression, anxiety, and emotional disorders is among the greatest of any disease conditions in the workforce. It is worth considering methods for quantifying direct and indirect costs that use administrative data sources given their utility.”
The cost of anxiety is measured in more than finances, as it takes an enormous emotional and physical toll. Long-term negative health effects may include digestive issues, insomnia, substance abuse disorders and depression,27 each of which come with a laundry list of physical symptoms, emotional disruption and financial burden.
Differences Between Recreational and Medicinal Use
The healing properties of medical cannabis come primarily from high levels of CBD and critical levels of other medicinal terpenes and flavonoids. However, THC, responsible for the psychoactive effects of cannabis, also has medicinal benefits.28,29 Growers are able to use selective breeding techniques to increase CBD and lower levels of THC for medicinal use.
While CBD has gained the most attention, CBD alone cannot fully support your body’s endocannabinoid system (ECS). Cannabinoid receptors in the human body were discovered in the 1990s,30 which in turn led to the realization our body makes endogenous cannabinoids that influence these receptors.
It was also discovered the ECS orchestrates communication between other bodily systems, such as your respiratory, digestive, immune and cardiovascular systems. The ECS does this via receptors found in every organ, including your skin. The use of medicinal CBD is aimed at the health benefits derived from providing your ECS with sufficient support.
However, if you choose to use exogenous CBD, it’s important to choose the right product as some do not meet the claims made on the label.31 Since CBD oil became a focus of popular holistic medicine almost overnight, the rapid innovations in the market have been impressive. However, while products quickly enter the market, effective control has not caught up yet.
Despite CBD being sold as a food supplement, it is often used for significant health problems. The WHO analyzed available scientific data and concluded CBD does not require drug scheduling. Nevertheless, CBD manufacturing may benefit from a preparation analysis to reduce contaminants and ensure the product in the bottle is what’s on the label.32
Researchers believe the methodology to achieve this goal already exists and the approach would hold the producer accountable for quality and safety. Until a system is in place, if you live in a state that has legalized CBD, it is important you purchase any products from a trusted source.
Single Magic Bullet Is Not the Answer to Support Your Endocannabinoid System
In this video clip from an interview with Carl Germano, board-certified nutritionist and phytocannabiniods expert, he discusses the need to move away from the single magic bullet idea of separating one nutritional compound from a plant and expecting miraculous results.
It’s important in many cases to consume the whole plant. The cannabis plant contains at least 60 other cannabinoids and 400 other chemicals, and many of these other phytocannabinoids and terpenes are needed to fully support your ECS.
However, the vilification of cannabis continues to negatively impact the ability to use the compounds medicinally.33CBD oil has demonstrated use in the treatment of pain,34 which represents a significant threat to the sale of opioids responsible for a large piece of the financial growth of Big Pharma in the past decade.35
Purdue Pharma went even further, trying to position the company as an “end-to-end provider” of opioids and the treatment for addiction.36 The cannabis plant also poses economic threats37 to the lumber, energy, food and other industries as the fiber may be used to make paper, biofuel, building materials, food products and oil, clothing, shoes and even jewelry.
Cannabinoids Necessary for Optimal Health
Low levels of endocannabinoids in your system result in ill health. As you age, your body becomes less efficient in creating endocannabinoids needed for optimal health. According to Germano, cannabinoids may be used as biological markers for specific conditions and illnesses.
Endocannabinoid deficiency has been identified in those with migraines, fibromyalgia, irritable bowel syndrome and neurological conditions, for example. Research has also discovered an intimate relationship between ECS and your omega-3 status, as omega-3 fat improves your cannabinoid receptors.
Other conditions associated with low levels include stress, anxiety, insomnia and eye health. For a long list of health benefits you’ll receive from supporting your ECS system, see my previous article, “The Many Medicinal Benefits of Cannabis and Cannabidiol (CBD).”
Avoid pesticides and phthalates — Start by avoiding chemicals blocking the receptivity of your endogenous system by reducing your exposure to neonicotinoid pesticides and phthalates. Find more information about phthalates in my previous article, “Phthalate Exposure Threatens Human Survival.”
Optimize your omega-3 intake — There’s an intimate relationship between your ECS and your omega-3 status. Omega-3 fats make your cannabinoid receptors more active, and are used as backbone structures to produce cannabinoids in your body.
Expose yourself to cold temperatures — In past articles I’ve written about some of the surprising benefits of extreme temperatures. One of those benefits is the regulation of endocannabinoid in white and brown adipose tissue.
Fasting —Intermittent fasting may improve your health using yet another mechanism in your body — by increasing your endocannabinoid levels, and regulating your ECS.
Caffeine — Regular caffeine consumption regulates and enhances the activation of cannabinoid receptors. Remember the added caffeine may also disrupt quality sleep, so it’s important to forgo any caffeinated substances after 2 p.m.
Exercise — Although exercise is an excellent stress reducer, research also finds the much talked about “runner’s high” may be a function of the release of endocannabinoids in your brain and not just endorphins. If you are new to exercise, you’ll find suggestions and links in my previous article, “Exercise to Improve Your Body and Your Brain.”
An estimated 329,000 Americans are diagnosed with Lyme disease each year and the prevalence is rising across the world
Lyme disease is becoming more widely recognized as a real disease, and one that can have chronic consequences, but sufferers still meet plenty of resistance from the medical community and insurers
The film reveals medical collusion and conflicts of interest that keep Lyme patients suffering, but ends on a hopeful note, showing how patients in the prequel have managed to improve their health and reclaim their lives
According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 329,000 Americans are diagnosed with Lyme disease each year, although some data suggest it may actually be over 444,000.1 While exact numbers are difficult to ascertain, what is known is that the prevalence is rising.
Since Lyme disease became a nationally notifiable condition in 1991,2 the number of U.S. counties considered at high risk for Lyme disease has increased by more than 300%.3 The disease is also expanding rapidly all over the world,4 as new research presented in April 2019 shows that the outbreaks are creeping steadily into northern countries with less temperate climates.
Likewise, by the end of 2018 eight northern U.S. states had more Lyme disease cases than southern states like Florida or those with moderate climates like West Virginia and North Carolina.5 In fact, Pennsylvania was leading the pack with 119,000 cases, according to the CDC.
Today, Lyme disease is becoming more widely recognized as an actual disease, but sufferers still meet plenty of resistance from the medical community and insurers. In years past, Lyme sufferers were often told their problem was psychiatric; in essence, the symptoms were “all in their head.”
Under Our Skin
“Under Our Skin 2: Emergence” is a sequel to the award-winning and Academy Award semifinalist documentary “Under Our Skin,”6 which exposed the hidden story of “medical and scientific malfeasance and neglect,” as thousands of people with Lyme disease go undiagnosed, or get misdiagnosed each year.
“Under Our Skin” had a tremendous impact raising awareness among patients, doctors and health authorities alike. Since the film’s release in 2014, the CDC has raised its estimated prevalence of Lyme more than 10 times, making it more prevalent than HIV and breast cancer combined in the U.S.
Even more importantly, scientific hypotheses presented in the film — such as the theory that Lyme organisms may thrive in biofilms, which helps explain why treatment is so difficult and recurrence so common — have now become widely accepted.
However, despite progress, Lyme patients still face an uphill battle. “Emergence” examines the deepening crisis, as prevalence is rising far faster than the evolution of diagnosis and treatment.
This article was originally published in 2016, and it’s been updated in 2019 in preparation for Lyme Disease Awareness Month in May in the United States. I believe this is the perfect time to share this important film once again, in case you haven’t seen it.
Around the world, controversy around Lyme disease continues to brew, and the film reveals medical collusion and conflicts of interest that keep Lyme patients suffering. The film ends on a hopeful note, however, by showing how patients in the original film have managed to improve their health and reclaim their lives.
The History of Lyme Disease
Lyme disease was named after the East Coast town of Lyme, Connecticut, where the disease was first identified in 1975.7 By 1977, the black-legged tick (Ixodes scapularis, also known as the deer tick) was linked to transmission of the disease.
In November 1981, Willy Burgdorfer, Ph.D., discovered the bacterium responsible for the infection: Borrelia burgdorferi (B. burgdorferi),8 a relative to the spirochete bacterium that causes syphilis.9 The bacteria are released into your blood from the infected tick.
We now know there are about two dozen species of B. burgdorferi with hundreds of strains worldwide,10 many of which show resistance to antibiotics, with the disease recurring when antibiotics are stopped. New research11 shows that one reason for this may be that B. burgdorferi form protective biofilms around themselves, enhancing antibiotic resistance.
While not all the species are human pathogens, part of what makes B. burgdorferi such a formidable foe is its ability to take different forms in your body, depending on the conditions. This clever maneuvering helps it to hide and survive and ultimately to form these biofilms.
Its corkscrew-shaped form also allows it to burrow into and hide in a variety of your body’s tissues, which is why it causes such wide-ranging multisystem involvement.
Increasing the complexity further, some symptoms may also be due to coinfections triggered by other disease-causing organisms that like to travel with the B. burgdorferi bacterium. Many Lyme patients have one or more of these coinfections, which may or may not respond to any given treatment for B. burgdorferi.
To learn more about the symptoms and prevention of Lyme disease, make sure to check out the award-winning films “Under Our Skin” and “Under Our Skin 2: Emergence.”
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**Comment**
I can’t recommend viewing this documentary enough. I hope all of you that attended the Lyme Awareness event yesterday take the time to view this sequel as it does offer much hope to patients. They follow the same patients in “Under Our Skin,” and reveal how they are all substantially better, with some completely off treatment.
There is a huge difference between ‘untreatable’ and incurable. While some may remain with symptoms for life, treatment is imperative and will allow patients to retrieve their health back, or improve their condition vastly. Don’t let anyone tell you this is ‘untreatable.”
Ambien and other prescription drugs for insomnia have been linked to behaviors that can cause serious injuries.
Ambien and other prescription sleep medications are getting a new “black box” warning label from the U.S. Food and Drug Association (FDA). This type of label is the strongest that the agency issues, calling attention to side effects that can lead to serious injury or death.
The change follows the FDA’s evaluation of reports describing “rare but serious” incidents that occurred when users of these medications experienced complex sleep behaviors: sleepwalking, sleep driving “and engaging in other activities while not fully awake,” FDA representatives wrote yesterday (April 30) in a drug safety announcement.
A prominent boxed warning will now appear on patient medication guides and prescription information for insomnia drugs such as Ambien (generic name zolpidem), Sonata (generic name zaleplon), Lunesta (generic name eszopiclone) and others, according to the announcement. [7 Bizarre Drug Side Effects]
Another of the FDA’s most stringent warnings — a contraindication, which recommends avoiding a drug under certain conditions — will also be included, advising people who have already experienced complex sleep behaviors while using these drugs to stop use.
The FDA investigated data spanning 26 years, and found 66 examples of complex sleep behaviors associated with these medications. Patients performed actions that led to hypothermia or lost limbs after exposure to extreme cold; there were instances of carbon-monoxide poisoning, drowning, apparent suicide attempts, self-inflicted gunshot wounds and car crashes — with the patient at the wheel.
In most cases, the patients did not even remember the incidents that led to their injuries, according to the FDA.
As these findings were based just on case reports in medical literature and accounts that were sent directly to the FDA, it’s possible that there are even more examples of injury from complex sleep behaviors that have not been documented, FDA officials said.
Millions of Americans experience insomnia and rely on medication to help them sleep, but “it’s important that patients and health care professionals are aware of the risk,” FDA Acting Commissioner Dr. Ned Sharpless said in a statement.
“These incidents can occur after the first dose of these sleep medicines or after a longer period of treatment, and can occur in patients without any history of these behaviors and even at the lowest recommended doses,” Sharpless said.
It is not well understood how these medications trigger complex sleep behaviors that can lead to injury, FDA officials said. The agency will continue to monitor insomnia medications and evaluate the risks that are linked to them, to determine if further actions will be required, Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research, said in the statement.
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