https://madisonarealymesupportgroup.com/wp-content/uploads/2019/01/at_a_glance_wln_newsletter_1_29_19.pdf

Learn about Lyme Workshop

Lyme and other tick-borne diseases continue to rise in our area. Hear from experts in this field, who will share evidenced-based information and education on this rapidly growing health concern. Whether you are looking for prevention tips or are suffering the effects of a tick-borne disease, this day is for you. Please join us as we discuss the number one vector-borne disease in the United States.

Date: Saturday, March 23, 2019 Time: 9am to 4pm

Location: Black River Beach Neighborhood Center 1433 Rose Street, La Crosse, WI

Cost per Participant: $10
*Gluten Free/Dairy Free lunch is included.

To register for this workshop, please visit our City of La Crosse Parks & Recreation website at or, call 608-789-8640. https://www.cityoflacrosse.org/Parks
**Registration Deadline: Monday, March 18, 2019

Guest Experts Include:

Dr. Elizabeth L. Maloney
Rebecca Keith, Family Nurse Practitioner
Phillip Pratt, Coppe Laboratories
Erika Schlick, IIN Certified Health Coach Cookbook Author & Blogger

This event is supported by the Wisconsin Lyme Network and the Minnesota Lyme Association. Workshop Presenters:

Dr. Elizabeth L. Maloney is the President of Partnership for Tick-Borne Diseases Education, a non-profit organization providing online and live evidence-based continuing medical education programming and materials on tick-borne diseases for physicians and other healthcare professionals. She is a graduate of the University of Minnesota Medical School and its affiliated Family Medicine residency.

Dr. Maloney also acts as a consultant to government agencies and private organizations. She recently served on the Pathogenesis, Transmission and Treatment subcommittee of the federally mandated Tick-borne Diseases Working group. She frequently speaks to the general public on tick-borne diseases, emphasizing the need for primary and secondary prevention.

Rebecca Keith, Family Nurse Practitioner

Keith obtained both her undergrad and graduate degrees from the College of St Scholastica in Duluth, MN. Having spent most of her life in Wisconsin and actively enjoying the outdoors, ticks and insects are no strangers to her. Rebecca began paying more attention to Lyme and co- infections by 2008. After experiencing success in treating patients she opened her practice in 2010. Rebecca primarily sees patients in Minong, WI. Rebecca is a member of ILADS, Lymedisease.org, and the American Academy of Nurse Practitioners. She utilizes integrative medical approaches in treating Lyme and the multi system dysfunction which accompanies it.

Erika Schlick, IIN Certified Health Coach | Cookbook Author and Blogger

Erika Schlick is a Certified Health Coach and Author of the Wandering Palate which features 28 days of travel inspired paleo meals to make it easy to stay on track and eat healthy. She herself was affected by Lyme in 2012 and was diagnosed in 2014. After 3 years of treatment, she has been in remission for over 2 years and has made it her life mission to help others affected by Lyme.

She is also the voice behind The Trail To Health ( ) which is a health and wellness blog documenting her journey with Lyme disease and everything she learned about health along the way. http://www.thetrailtohealth.com

Phillip Pratt, Coppe Laboratories

Coppe Laboratories is dedicated to discovering and providing diagnostic and treatment solutions for illnesses caused by infectious agents. We offer quality diagnostic testing that exceeds regulatory expectations and provides clear answers with actionable results. We strive to eliminate barriers experienced by physicians and patients in the diagnosis and management of disease through scientific research and innovative diagnostic assays. Coppe Laboratories uses their scientific expertise to transform novel procedures routinely used in the research setting into high-complexity, CLIA-certified diagnostic tests. This work, in conjunction with groundbreaking research and development, makes Coppe Laboratories a leading provider of diagnostic tests for arthropod-borne disease, women’s health and transplant.

 

 

https://www.change.org/p/the-us-senate-calling-for-a-congressional-investigation-of-the-cdc-idsa-and-aldf/u/24170834?

The CDC is a “Captured Agency”

FEB 14, 2019 — 

The letter below is a follow-up to earlier correspondence regarding wasteful government spending by the CDC. Previously posted here: https://www.change.org/p/the-us-senate-calling-for-a-congressional-investigation-of-the-cdc-idsa-and-aldf/u/24149441

———- Original Message ———-
From: CARL TUTTLE <runagain@comcast.net>
To: tickbornedisease@hhs.gov, brett.giroir@hhs.gov
Cc: (79 undisclosed recipients)
Date: February 14, 2019 at 1:49 PM
Subject: The CDC is a “Captured Agency”

On Feb 9, 2019 Carl Tuttle Wrote: “Wormser’s study was funded directly from the US Centers for Disease Control……Funding: RO1 CK 000152 which appears to be an open checkbook…..”

Efficacy of a 14-day course of amoxicillin for patients with erythema migrans.
https://www.sciencedirect.com/science/article/pii/S0732889318303304
Feb 14, 2019

U.S. Department of Health & Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Attn: ADM Brett P. Giroir, M.D., Assistant Secretary for Health

Dr. Giroir,

The US Centers for Disease Control continues to waste taxpayer dollars on Dr. Gary Wormser’s frivolous junk science which over the years has negatively influenced the response to this runaway plague.

You have received numerous emails with scientific reference after reference, testimony after testimony of how Lyme disease is destroying lives nationwide yet you remain silent to every one of my inquiries.  

There is absolutely no question whatsoever that the CDC is a captured agency controlled by the con artists exploiting the system under government protection.

Regulatory Capture
https://en.wikipedia.org/wiki/Regulatory_capture

According to Wikipedia:

Regulatory capture is a form of government failure which occurs when a regulatory agency, created to act in the public interest, instead advances the commercial or political concerns of special interest groups that dominate the industry or sector it is charged with regulating.[1] When regulatory capture occurs, the interests of firms or political groups are prioritized over the interests of the public, leading to a net loss for society. Government agencies suffering regulatory capture are called “captured agencies”.

Your silence Dr. Giroir is a vote of no confidence.

Carl Tuttle
Lyme Endemic Hudson, NH

_______________

For more:  https://madisonarealymesupportgroup.com/2017/01/13/lyme-science-owned-by-good-ol-boys/

https://madisonarealymesupportgroup.com/2017/09/25/speaking-of-fake-science-fifty-seven-million-anti-trust-lawsuit-against-cdc-lyme-tests/

https://madisonarealymesupportgroup.com/2017/12/13/suppression-of-microscopy-for-lyme-diagnostics-professor-laane/

https://madisonarealymesupportgroup.com/2018/01/31/when-als-is-lyme-letter-to-tbi-working-group/ The racketeering scheme to downplay the severity of Lyme disease as identified in the RICO lawsuit should be addressed and documented by the TBD Working Group and not ignored as if this crime does not exist otherwise it will be business as usual at the Centers for Disease Control and we’ll have another thirty years of failure to properly diagnose, treat and control this life-altering infection.

https://madisonarealymesupportgroup.com/2017/09/07/20268/  (complete convoluted history about Lymerix found in this link)  In 2012, when the CDC revised the official case number of new Lyme disease infections per year from 30,000 to over 300,000 new Lyme––overnight, those of us in the know understood that they were getting the public ready to accept this upcoming vaccine with open arms and a sense of relief. In other words, scare the public just enough to make them open to wanting this product without causing mass panic nationwide or worldwide. And without having to explain their denial to date.

https://madisonarealymesupportgroup.com/2017/07/01/pbs-lyme-vaccine/  Did you know that the LYMERIX vaccine caused 640 emergency room visits, 34 life threatening reactions, 77 hospitalizations, 198 disabilities, and 6 deaths? In a vile cesspool of conflicts of interest are university patent holders, drug companies, and the FDA itself as another patent holder. It generated 40 million dollars before it was yanked. (2008, Drymon)

https://madisonarealymesupportgroup.com/2019/02/10/wormsers-worthless-study-waste-of-taxpayer-money/

https://madisonarealymesupportgroup.com/2018/12/10/tuttles-letter-to-the-assistant-secretary-for-health-is-the-mishandling-of-lyme-a-result-of-incompetence-or-collusion/

https://madisonarealymesupportgroup.com/2018/04/06/cdcs-troubling-lack-of-research-ethics/

https://madisonarealymesupportgroup.com/2018/07/18/hhs-not-to-be-trusted-with-lyme/

https://madisonarealymesupportgroup.com/2016/11/29/spider-attacks-cdc/

 

 

(Wisconsin residents, please see my comment at end of article)

STATUS OF VACCINE RELATED LEGISLATION IN THE UNITED STATES

FEBRUARY 14, 2019

CONTACT YOUR LEGISLATORS

As of Thursday, February 14, 2019, NVIC is tracking on the NVIC Advocacy Portal 113 vaccine related bills across 27 States.  Currently, the following states have bills you need to know about: Arizona, Connecticut, Florida, Hawaii, Iowa, Idaho, Illinois, Indiana, Kentucky, Massachusetts, Maryland, Maine, Mississippi, Montana, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Utah, Vermont, Nevada, Washington, West Virginia and Wyoming.

Breaking these 113 bills down by our NVIC position registered on the NVIC Advocacy Portal, we support on 48, oppose 60, and we are watching to see what happens with 5.

We are just a little over a month into most legislative sessions, so we are expecting more bills affecting even more states to still be filed.

This snapshot does not include all bills we track on the NVIC Advocacy Portal. 

Login to the NVIC Advocacy Portal OFTEN to check for more detailed information and updates.  We review bills and make updates daily. Bills can change many times over the legislative process and your timely visits, calls, and emails directed at the correct legislators are critical to this process.

Please check your state page on the NVIC Advocacy portal for bill descriptions including our position on the bill, links to the bill information in your state legislature, where the bill is in the legislative process, and most importantly, what the recommended action you can take to help pass the good bills and defeat the bad ones.

BILLS AFFECTING VACCINE EXEMPTIONS

There are currently 11 bills filed in 8 states which are adding or expanding vaccine exemptions that deserve your support.

Arizona HB 2470 and SB 1114 add a religious exemption for kindergarten through 12th grade students.

Hawaii HB 1182 adds a conscientious belief exemption for children.

Iowa SF 239 adds a conscientious belief exemption.

Mississippi SB 2255 adds philosophical and religious belief exemptions for school, and SB 2398 adds religious belief exemption.  HB 479 allows adults to deny vaccines including for employment and adds a philosophical exemption for first responders.

Montana SB 99 expands the existing exemptions by allowing for a personally written exemption where someone wouldn’t need to use the state form.

New York S 477 strengthens and expands the medical exemption.

Rhode Island H 5165 adds personal and philosophical exemptions for all school and college students.

West Virginia SB 454 adds religious and conscientious exemptions for students and employees.

There are currently 18 bills filed in 10 states which are removing or restricting vaccine exemptions that need your opposition. There are 3 states under a verified threat of a bill to remove exemptions.

Arizona HB 2162 eliminates the personal and philosophical exemption for children and HB 2505 also removes the personal and philosophical exemption but replaces them with a religious exemption.

Colorado has not yet filed a bill to remove exemptions, but there has been verified discussion of one being considered.  For details, see the Colorado State Page Announcements on http://NVICAdvocacy.org.

Connecticut HB 7005 removes school nurses from list of people who can acknowledge religious exemption making it harder for a parent to submit their exemption, and HB 5277makes changes to the qualifications for a temporary waiver and is vulnerable to more restrictive or eliminating amendments. Both bills filed restrict exemptions and could lead to amendments of further restrictions or removal of the religious exemption.

Iowa HF 206 eliminates the religious belief exemption.

Maine LD 798 removes both religious and philosophical exemptions for students and staff working in nursery schools, and consequently for health care workers since the bill also calls for the elimination of exemptions for anyone granted them by rule.

New Jersey A 3818 was amended on the floor of the Assembly to remove the religious exemption, and S 2173 severely restricts the religious exemption.

New York A 2371 and S 2994 eliminate the religious exemption, and A 1135 and S 2289restrict the religious exemption by requiring a health care provider signature. S 3424A creates a uniform religious exemption form but subjects it to an arbitrary superintendent approval process.

Oregon HB 2783 requires health care provider signatures on all exemptions, and there has been verified discussion of a bill to remove the philosophical exemption being ordered.   For details, see the Oregon State Page Announcements on http://NVICAdvocacy.org.

Nevada AB 123 forces parents to consent to sharing of medical and religious exemptions to public health.

Vermont H 238 eliminates religious exemption for required vaccines.

Washington SB 5841 eliminates the personal and philosophical exemption and HB 1638eliminates personal and philosophical exemptions for the MMR vaccine.

Wisconsin has not yet filed a bill to remove exemptions, but there has been verified discussion of one being considered.  For details, see the Wisconsin State Page Announcements on http://NVICAdvocacy.org.

UPCOMING VERIFIED SCHEDULED HEARINGS (CONTACT COMMITTEE MEMBERS)

Arizona SB 1114, SUPPORT, Adds a religious belief exemption to vaccination for pupils through 12th grade. Scheduled for a hearing in the Senate Education Committee on 2/19/19.

Connecticut HB 7101, OPPOSE, Requires hospitals to offer flu vaccines to patients 65 and older before discharge. Scheduled for a hearing on 2/19/19 in the Joint Committee on Aging.

Florida SB 354, OPPOSE, Mandatory reporting and tracking of vaccines by health care practitioners in registry. SB 354 is scheduled for a hearing in Senate Health Policy Committee on 2/19/19.

Maryland SB 783, SUPPORT, Requires informed consent be given before administration of HPV Vaccine.  Scheduled for a hearing on 2/26/2019.

Oregon SB 649, SUPPORT, Requires information packets be given by health care providers before vaccination. Scheduled for a public hearing on 2/18/2019.

Washington SB 5841, OPPOSE, Eliminates personal and philosophical exemptions to all mandated vaccines. Scheduled for a hearing in the Senate Health and Long Term Care Committee on 2/20/2019.

OTHER BILLS NEEDING YOUR SUPPORT IN THE FOLLOWING STATES

Improving Vaccine Informed Consent: Arizona, Connecticut, Idaho, Iowa, Illinois, Mississippi, Montana, Oregon, Pennsylvania, and Rhode Island.

Removing The Ability to Mandate by Health Department Rule: Hawaii, Oklahoma

Prohibit Vaccine Mandates for Certain Employees: Minnesota, Oregon

Add Positive Serological Testing in Lieu of Vaccination Requirements: Arizona, Oklahoma, and Washington

OTHER BILLS NEEDING OPPOSITION IN THE FOLLOWING STATES

Expanding Vaccine Tracking Registries: Florida, Indiana, Massachusetts, Maryland and Texas.

Vaccine Mandates:

HPV: Florida, Massachusetts, New Jersey and New York
Meningitis: New Jersey
Flu: New York for school and day care
ACIP Recommendations to Mandates: Kentucky for college
Occupational Mandates: New Jersey
Workers in Children’s Camps: New York

School Disclosure of Exemption Rates (leads to shaming and discrimination): Arizona, Oklahoma and Texas.

Minor Children Consenting to Vaccines: New York for Hepatitis B and HPV.

Pharmacists and/or Optometrists Giving Vaccines: Montana, Oregon, and Wyoming.

COMMINICATING WITH LEGISLATORS

It is important that you make your position to bills that affect your rights known to your legislators.

Everyone should be visiting or calling their own State Representative and State Senator and asking them to OPPOSE any restriction or removal of personal, religious or medical exemptions to vaccine mandates. 

Personal visits and phone calls are the most effective. You should follow up with an email note for legislators looking to read your information, but in no way should the only communication with your legislators be an email as these can be easily ignored or deleted.

If you do not know who your State Representative or State Senator are, or their contact information, you can login to the NVIC Advocacy Portal, click on the “State Teams” tab and then “My State,” and your elected officials are automatically posted on the right hand side of the page http://NVICAdvocacy.org.  This is why we ask for your address when you register so we can connect you to your legislators.

When communicating with your legislators, be polite but be direct. It is important to voice your position on a bill and BRIEFLY share your vaccine reaction, harassment, or vaccine failure story in addition to the pros or cons on all bills you are highlighting.

Those seeking to restrict or remove exemptions have tried to create an environment dismissive of the experiences people have with real vaccine reactions. The VAXXED Website, http://vaxxed.comhas thousands of video clips of people sharing their vaccine reactions.  They also have a state map where you can click on your state and view testimonials in your state! These testimonials can be shared on social media and to legislators and staff directly.

Please refer to NVIC’s “Reforming Vaccine Policy and Law” guide for answers to questions your legislators may have.  The fully referenced version can be found at: http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/Reforming-Vaccine-Policy—Law-Guide.aspx.

Sincerely,

NVIC Advocacy Team
National Vaccine Information Center
http://NVIC.org and http://NVICAdvocacy.org
https://nvicadvocacy.org/members/Members/ContactUs.aspx

The National Vaccine Information Center (NVIC) works diligently to prepare and disseminate our legislative advocacy action alerts and supporting materials.  We request that organizations and members of the public forward our alerts in their original form to assure consistent and accurate messaging and effective action. Please acknowledge NVIC as originators of this work when forwarding to members of the public and like-minded organizations. To receive alerts immediately, register  at http://NVICAdvocacy.org, a website dedicated to this sole purpose and provided as a free public service by NVIC. 

__________________

**Comment**

In brief, Wisconsin still allows all 3 exemptions from vaccines:  Religious, Conscientious Objection, and Medical; however, the above communication states that there is verified discussion of a bill to remove exemptions.  

For details, see the Wisconsin State Page Announcements on http://NVICAdvocacy.org.

https://nvicadvocacy.org/members/Home/tabid/39/ctl/ViewItem/mid/1420/itemid/1339/Default.aspx  Details:

Description: Dear Wisconsin NVIC Advocacy Members,

We want to make you aware that some legislators have been quoted in the media as saying they support eliminating personal belief exemptions or intend on introducing legislation to do so.

If and when a bill is filed in WI, NVIC Advocacy will post and track it on the NVIC Advocacy portal.

There are a few things you can do now.  Contact Representatives Kolste and Hintz.  Tell them not to introduce or support legislation to eliminate exemptions to vaccines.  Explain why this is an important issue for your family.  If someone in your family has suffered a vaccine injury, share your story with them.  Also contact your own personal Wisconsin State Senator and Assembly Rep.

Rep. Hintz https://docs.legis.wisconsin.gov/2019/legislators/assembly/1848

Madison Office:
Room 201 West
State Capitol
PO Box 8952
Madison, WI 53708

Telephone: (608) 266-2254 (888) 534-0054

Fax: (608) 282-3654

District Phone: (920) 232-0805

Email:
Rep.Hintz@legis.wisconsin.gov

Voting Address:
502 East Irving Avenue
Oshkosh, WI 54901

Rep. Kolste – https://docs.legis.wisconsin.gov/2019/legislators/assembly/1838

Madison Office:
Room 107 North
State Capitol
PO Box 8952
Madison, WI 53708 Telephone: (608) 266-7503 (888) 947-0044

Fax: (608) 282-3644

Email:
Rep.Kolste@legis.wisconsin.gov

Voting Address:
4105 Parkview Dr.
Janesville, WI 53546

See the end of this article – https://www.postcrescent.com/story/news/education/2019/02/04/personal-conviction-waivers-up-wisconsin-measles-mumps-rubella-polio-vaccines-down-anti-vax-parents/2452523002/

Rep. Debra Kolste, D-Janesville, said she supports removing the personal conviction waiver. Kolste is on the Assembly Committee for Health and is a former medical technologist.

Hintz acknowledged that the goal is to keep herd immunity strong across the state, in whatever way necessary. He said conversations about the importance of vaccination, compelling personal stories, or restrictions on personal conviction waivers could be the first steps toward change.

But he’s pushing for the personal conviction waiver removal because, he said, it’s “the best way” to reach that goal.

“I think as leaders, we don’t do enough on public health in a number of areas that deserve more attention,” Hintz said.

“This is one where, for decades, we did and we were successful at reducing human suffering. So, in addition to being more proactive, I think we really need to worry about reversing the trend that we’re seeing is heading in the wrong direction.”

He plans to re-introduce the bill this legislative session.

*****************************************************

FB Post by Rep. Hintz – https://www.facebook.com/GordonHintz/posts/2105714296130912

Gordon Hintz

February 6 at 6:35 PM ·

The issue goes beyond ideology, Hintz said. Vaccination is a question of the social compact.

“What people need to understand is, we’re not telling anybody that they have to get vaccinated,” Hintz said. “We’re saying if you want to enter public schools and interact with other children, you’re not going to risk their livelihood and health.”

When contacting these folks, please mention that Wisconsin is 4th in the nation for Lyme.  Vaccines have reactivated latent Lyme/MSIDS infections:  

https://madisonarealymesupportgroup.com/2017/12/02/scottish-doctor-gives-insight-on-lyme-msids/

Vaccine activated a Bartonella infection which was proved with testing:  https://madisonarealymesupportgroup.com/2016/04/24/gardasil-and-bartonella/

Retroviruses were spread by vaccines:  https://madisonarealymesupportgroup.com/2017/10/15/vaccines-and-retroviruses-a-whistleblower-reveals-what-the-government-is-hiding/

Retroviruses are STILL plaguing us years later & play a role in Lyme/MSIDS.  https://madisonarealymesupportgroup.com/2018/06/23/the-role-of-retroviruses-in-chronic-illness-a-clinicians-perspective/

As for this supposed herd immunity, entire vaccinated populations are not immune from contracting disease:  https://www.sciencemag.org/news/2014/04/measles-outbreak-traced-fully-vaccinated-patient-first-time

https://realfarmacy.com/?s=vaccinated+spreading+disease  This article also gives studies showing the fact that many vaccines are ineffective. Merck has recently been slapped with two separate class action lawsuits contending they lied about the effectiveness of the mumps vaccine in their combination MMR shot, and fabricated efficacy studies to maintain the illusion for the past two decades that the vaccine is highly protective.

This informative website shows studies comparing the health of vaccinated children vs unvaccinated.  The results speak for themselves:  http://www.vaxchoicevt.com/science/studies-comparing-vaccinated-to-unvaccinated-populations/

https://madisonarealymesupportgroup.com/2017/05/18/first-peer-reviewed-study-of-vaccinated-vs-unvaccinated-children/   The study suggests that fully vaccinated children may be trading the prevention of certain acute illnesses (chicken pox, pertussis) for more chronic illnesses and neurodevelopmental disorders like ADHD and Autism. The scientists also found that children born prematurely, who were vaccinated, were 6.6 times more likely to have a neurodevelopmental disorder.

More and more is coming out on the fraud, collusion, and conflicts of interest surrounding the vaccine debate:  https://madisonarealymesupportgroup.com/2016/11/29/spider-attacks-cdc/

https://madisonarealymesupportgroup.com/2018/08/24/financial-kickbacks-for-vaccinations-abusive-illegal-fraudulent/

https://madisonarealymesupportgroup.com/2019/02/02/the-cdc-is-the-fox-guarding-the-henhouse-regarding-vaccines/

https://madisonarealymesupportgroup.com/2018/04/06/cdcs-troubling-lack-of-research-ethics/

https://madisonarealymesupportgroup.com/2018/11/08/vaccination-cabal-revealed/

https://madisonarealymesupportgroup.com/2018/10/05/drug-companies-pay-fda-nih-to-fast-track-market-vaccines/

https://madisonarealymesupportgroup.com/2018/10/19/fda-official-uses-revolving-door-to-join-biotech-company-developing-mrna-vaccines/

https://madisonarealymesupportgroup.com/2018/10/08/vaccine-safety-efficacy-studies-that-are-the-bases-for-marketing-authorizations-are-a-complete-methodological-mess/

The ACIP votes “yes” for a new vaccine despite the lack of safety studies on the cumulative effects:  https://madisonarealymesupportgroup.com/2018/09/08/acip-vote-yes-for-new-vaccine-despite-no-safety-studies-on-cumulative-effect-with-other-vaccines/

https://madisonarealymesupportgroup.com/2019/01/07/the-vaccine-debate-top-government-expert-states-vaccines-can-cause-autism-in-some-children/

 

I’ll stop here.  But, you get the point.  Vaccines are not only unsafe, they can reactivate latent infections and suppress the immune system, worsening chronically ill patients.

https://www.lymedisease.org/hipaa-privacy-rules/

12 FEB  2019

 

https://www.ncbi.nlm.nih.gov/pubmed/30680557

2019 Jan 24. doi: 10.1007/s10096-018-03451-5. [Epub ahead of print]

Impact of pre-operative antimicrobial treatment on microbiological findings from endocardial specimens in infective endocarditis.

Abstract

Treatment of infective endocarditis (IE) should be initiated promptly. This might hamper the chances to identify the causative organism in blood cultures. Microbiological sampling of infected valve in patients undergoing surgery might identify the causative organism. The impact of pre-operative antimicrobial treatment on the yield of valve samples is not known. This study evaluated the impact of the duration of the pre-operative antibiotic treatment on valve culture and 16S rRNA PCR findings from resected endocardial samples. Patients meeting the modified Duke criteria of definite or possible IE and undergoing valve surgery due to IE during 2011-2016 were included from Southern Finland. Eighty-seven patients were included.

In patients with shorter than 2 weeks of pre-operative antimicrobial treatment, PCR was positive in 91% (n = 42/46) and valve culture in 41% (n = 19/46) of cases. However, in patients who had 2 weeks or longer therapy before operation, PCR was positive in 53% (n = 18/34) and all valve cultures were negative. In 14% of patients, PCR had a diagnostic impact. In blood-culture negative cases (n = 13), PCR could detect the causative organism in ten patients (77%). These included five cases of Bartonella quintana, one Tropheryma whipplei, and one Coxiella burnetii. Long pre-operative antimicrobial treatment was shown to have a negative impact on microbiological tests done on resected endocardial material. After 2 weeks of therapy, all valve cultures were negative, but PCR was positive in half of the cases. PCR aided in diagnostic work-up, especially in blood culture negative cases.

____________________________

**Comment**

The dilemma “to treat or not to treat” because of hampered ability to subsequently test for organisms is real; however, the risk for not treating is potentially death.

The big point for Lyme/MSIDS patients; however, is the fact they found Bartonella and Coxiella burnettii, also known as Q-fever in patients with infective carditis.

https://www.columbia-lyme.org/q-fever  Those working with farm animals are at greater risk through inhalation or ingestion of soil or animal waste particles; however, ticks do transmit it.

Signs and Symptoms

Symptoms include high fever, headache, sore throat, malaise, nausea, diarrhea, chest pain, nonproductive cough, pneumonia, and hepatitis. Neurological manifestations occur in about one percent of patients and could develop into meningitis, encephalitis, myelitis and/or peripheral neuropathy. Endocarditis, infection of the heart valves, is the most serious manifestation. However, it is usually found in patients with preexisting valvular disease. Unfortunately, the mortality rate is increasingly high, currently at 65 percent.

Go here for a nifty table with the various coinfections, vectors, causative agent, endemic area, and symptoms: https://www.lymedisease.org/lyme-basics/co-infections/other-co-infections/

You will note that the brown dog tick, Rocky Mountain Wood tick, and the Lone Star Tick are all vectors and Q-fever is endemic throughout the U.S.  Treatment is doxycycline.

https://www.wrair.army.mil/Documents/TropMed/(18)%20Lyme%20and%20Rickettsial%20Disease_LTC%20Waterman.pdf  This document states endocarditis caused by Q fever may be chronic.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC88923/  Interestingly, even as far back as the 30’s, Q fever was noted to have properties of both viruses and rickettsiae. This document states Q fever may occur in patients without any animal contact due to it’s ability to be spread by wind.  The same document states human Q fever cases have occurred in the following:

  • An OB after an abortion on an infected woman
  • transplacental transmission
  • autopsies
  • intradermal inoculation
  • blood transfusion
  • tick bite
  • sexually in infected mice
  • possibly from infected dogs
  • infected cats

The real kicker on that last one was the 1984 report of 13 people who developed febrile respiratory disease by playing poker in a room where a cat had delivered kittens.  Abstract here:

Kosatsky T. Household outbreak of Q-fever pneumonia related to a parturient cat. Lancet. 1984;ii:1447–1449. [PubMed]

Symptoms were:

  • bradycardia (slow heart rate)
  • fever
  • palatal petechiae (red or purple spots on mouth palate)
  • rapidly enlarging bilateral pulmonary infiltrates (fluid in both lungs)