Conversations concerning treating pregnant Lyme patients and neonatal Lyme disease, between a number of well known and highly respected Lyme treating/research doctors. March 7- 12, 2015. Names have been removed and contents were slightly edited for grammar and privacy.
March 2015- At least two antibiotics are required, and if the mother is treated APPROPRIATELY, the odds of congenital Lyme are dramatically reduced.
The doctor adds that Mepron is safe during pregnancy; babies born with Babesiosis can be quite ill, but have been successfully treated (with transfusion, among other things), if it is recognized and caught early.
Bartonella is a problem, as the antibiotics needed to treat it aren't safe during pregnancy. The doctor advises women infected with Bartonella to try to treat to efficacy prior to becoming pregnant.
March 2015-
I have enormous respect for Dr X as an expert in therapy on clinical diagnosis.
I must disagree based on the Weber report which is a classic from the last century.
And on the 500 yrs of accumulated experience with congenital syphilis and on the world experience with pregnancy relapsing fever infection.
All of these data refute the notion that even the most proper and complete antibiotic coverage of maternal Lyme Borreliosis anywhere in the world today can actually guarantee that the infant will grow in Utero in a borrelia negative " bubble " and will forever be Not at Risk For fetal DIVERSE COMPLICATIONS DUE TO BORRELIA INFECTION ACQUIRED IN UTERO AND STILL PRESENT SOMEWHERE IN THE FETUS AT THE TIME OF birth.
These complications may be immediately evident, or may appear in the young infant later in infancy or even in onset in adolescence (TARDIVE BORRELIOSIS MANIFESTATIONS)- most often within the neurological domains, or behavioral domains, or autism like domains.
NEUROPSYCH experts have collected cases of post natal Borrelia induced behavioral disorders which can be traced back to fetal infection in utero. The case of Elise in the documentary UOS1. And UOS 2- Emergence is particularly instructive in this regard.
March 2015- Tardive
http://www.thefreedictionary.com/tardive
"Having symptoms that develop slowly or appear long after inception. Used of a disease."
A more common words is late diagnosed, late treated!
Plenty of literature
http://www.ncbi.nlm.nih.gov/m/pubmed/?term=Borreli*+late
March 2015- As soon as I'm able to publish my fascinating case study on gestational Lyme you will see a good example of the devastation of neonatal Lyme. Better safe than sorry, I always say!
March 2015- Dealing with over 500 misc impacts on the brain in children and adolescents with these things makes me terrified of tick infections in the womb, and I have NEVER had a mother not want to be treated. We have NEVER EVER seen a pure Lyme patient with only Lyme, perhaps due to my filtered failed patients, but I cannot and do not assume that.
I think if the genetically simple syphilis is a monster, and Lyme is markedly more complex, has a biofilm, in my opinion people have Bartonella, and usually Babesia also present, even if missed by our favorite labs, we simply always treat. Testing for one infection means a tick gut is sterile except for a few things. They are utter sewers.
I do feel the onset of signs and symptoms can be highly variable, and feel what I am seeing in 15, 25, 35 year old folks was always present. An infected person with infections may not be ill for 20 years or can be ill in months.
This crew have enough experience to treat and not harm either the baby at any age or the mother.
I would appeal that many are moving to some expression like TICK INFECTION COMPLEX and while it is not easy to use in a 30 second hook, it is what I would appeal is the norm.
I look at those vast routine viruses on my labs, and think most are tick bite markers, but each have many studies that show emerging other actions as many of you worry.
But I just think this is one area where we DO have centuries of simple syphilis data [thx XX], and the awareness that no one ever has just Lyme in 2015--ever. Even the most Lyme primary folks quote other viruses.
And do we want that tick gut sewer messing with delicate neurons?
March 2015- Gestational Lyme/Tick-borne disease
• Jones et al. performed a comprehensive case history review on the charts of 102 gestational Lyme/tick-borne disease cases.
• 9% had been diagnosed with autism and 56% with attention deficit disorder.
Psychiatric symptoms included irritability or mood swings (54%),
anger or rage (23%),
anxiety (21%),
depression (13%),
emotional (13%),
OCD (11%)
and suicidal thoughts (7%).
Neurological symptoms included headache (50%),
vertigo (30%),
developmental delays (18%),
tic disorders (14%),
seizure disorders (11%),
involuntary athetoid movements (9%)
and hypotonia (7%).
Sensory sensitivity symptoms included photophobia (43%),
hyperacuity (36%),
motion sickness (9%)
and other (tactile, taste or smell) (23%).
Cognitive symptoms included poor memory (39%),
cognitive impairments (27%),
speech delays (21%),
reading/writing (19%),
articulation (17%),
auditory/visual processing (13%),
word selectivity (12%),
and dyslexia (18%).
GI symptoms were common and included GERD (27%),
abdominal pain (29%),
diarrhea or constipation (32%),
and nausea (23%).
As a control, 66 mothers with Lyme disease who were treated with antibiotics prior to conception and during the entire pregnancy; all gave birth to normal healthy infants.
Jones CR, Smith H, Gibb E, Johnson L.
Gestational Lyme Disease Case studies of 102 Live Births. Lyme Times 2005:34–6. Summer.
March 2015- I have evaluated many children with
assumed gestational exposure and those who in retrospect, after the
development of problems, were thought to have been exposed in utero.
They often develop learning problems and exhibit behavior
difficulties. On neuropsychological evaluation I find impairments in
working memory, processing speed, visual processing, auditory
processing, memory, and language-based skills.
Just about all these children show evidence on neuropsychological
testing of intact intellectual ability often in the High Average to
Superior range.
March 2015- Thank you and thank Dr. X for his experience with Gestational LB. AND overall good outcomes
If Patients Receive effective ABX RX. I am not a doom and gloom
pathologist, and I have in my series Clinical cases where Gestational LB WAS NOT TREATED WITH ANTIBIOTICS-- and both mother and baby did well.
None the less. I have in Research the Largest Autopsy Gestational LB cohort
of any single pathologist in the world.
I take no pride in holding onto this world record, established in the 1980-90 decade. It is a mark of my Specialty of AnatomicPathology Intentionally TURNING ITS BACK On the question of Gestational LB, and its failure to take up the challenge to learn techniques of the Lyme Focused Autopsy.
Patients are not well served by this attitude. Perhaps in some way Pathologists decline to do autopsies in ALL cases- No reimbursement, no appreciation from their medical staff
colleagues - no academic advancement for expertise in Autopsy techniques -
no inclination to leave the comfort of their warm offices to descend into
poorly maintained autopsy suites with no personnel to assist in the autopsy-
unreasonable fears about contracting infectious diseases while performing the
autopsy - reluctance to forestall golf appointments because of time
constraints demanded by solo performance of the autopsy - belief that
miscarried fetuses can adequately be examined with a quick external
photograph, fetal weight- foot length - and a statement " no external
malformations are noted.
Autopsies in general are a soon to be extinct medical entity with the
exception of the Forensic Autopsy, Or the CAT SCAN REPLACEMENT FOR THE TRADITIONAL AUTOPSY.
I have a question for Dr. X concerning the outcomes of infants borne
alive following Gestational Lyme Borreliosis. Does Dr. X have a series
of pediatric Lyme patients who acquired their LYME disease in utero...
And only manifest symptoms of Lyme later in childhood.. Ie "TARDIVE Lyme
pediatric patients."
March 2015- So, what to do now? This child is born. She seems healthy thus far. Of course the parents don't want to live in constant fear that Lyme will someday rear it's ugly head in their child. Any advise is appreciated.
March 2015- Serial Lyme urine antigens- monthly x 6 at the minimum
March 2015- Here is the link to order a test kit:
http://www.dnalymetest.com/requestatest.html
March 2015- I always pull out all methods to detect Borreliae in ANY -AT RISK FETUS-
,,,,,ALIVE. OR MISCARRIED Or Stillborn
Cord blood exam- Darkfield, FISH for Borrelia Detection,
Placental FreSH- Darkfield micro exam-
Placenta in formalin fixed state with multisection micro exam using H9724 and H5332 MAB
Focus Floating Microscopy -Eisendle And Zelger method
FISH METHOD FOR DETECTION Of Borrelia in maternal and, in Fetal peripheral blood
March 2015- Congenital Transmission of Lyme/TBD
MEDLINE results for: borrelia pregnancy AND human. 88 journal articles in the PubMed
database BDH, July 2012, Latest Revision November 2012, http://www.Huismans.de.vu
Mothers with active Lyme Disease, Treated: 14.6% of the pregnancies with sequelae, Untreated: 66.7% of the pregnancies with sequelae, Unknown as to treatment: 30.3% with sequelae.
Specific adverse outcomes included: cardiac 22.7%, neurologic 15.2%, orthopedic 12.1%, opthalmic 4.5%, genitourinary 10.6%, miscellaneous anomalies 12.1%, 2nd trimester demise 12.1%.
Highest rate of adverse outcome (72.7%) in women with infection acquired prior to or during first trimester. [Gardner T]