USA Studies- Other Countries Studies

2017 Comparison

Lucy Barnes

There is no questioning the fact the Lyme disease epidemic continues to grow by leaps and bounds each year and seriously affects individuals and their families both medically and financially. For example, recently it was discovered the Centers for Disease Control (CDC) case reports fell short of the actual incidence of Lyme disease with 30,000 cases reported each year in the USA, when it should have been over 300,000 cases. That is not a minor calculating error in anyone's mind, it is a major disaster and only one of many related to Lyme and tick borne diseases.

The CDC's prevention efforts have failed miserably to control the epidemic and not only are ticks showing up in places where they had not been reported previously, they have been discovered to harbor over a dozen additional infectious disease causing organisms that are disabling and killing our children and countless others.

To make matters worse, insurers are still shamefully clinging to their precious, outdated yet cost-effective Infectious Diseases Society of America's (IDSA) unsuccessful treatment guidelines whose authors were found to be riddled with conflicts of interest by the Connecticut Attorney General almost a decade ago. After a lengthy investigation Senator Richard Blumenthal stated in his report, dated May 1, 2008:

"The IDSA's 2006 Lyme disease guideline panel undercut its credibility by allowing individuals with financial interests -- in drug companies, Lyme disease diagnostic tests, patents and consulting arrangements with insurance companies -- to exclude divergent medical evidence and opinion."

In the meantime, millions of dollars in federal grants continue to be directed to the same tight-knit group of IDSA guideline friends and supporters who originally instigated and have maintained an all out brutal war in the medical arena by rushing to market and patenting Lyme disease related tests that fail to detect Lyme disease, and investing in vaccines that were promoted to the public that were pulled from the market within a few years after multiple reports of injury and death surfaced.

This egregious act of putting profits above patients' interests, pitting doctor against doctor and researchers against others in the field, while patients have been left to fend for themselves or die trying has allowed million of people to go undiagnosed, or be improperly diagnosed and/or be inadequately treated.

Studies indicate one-third of the people that get Lyme disease aren't "cured" using the current short term antibiotic protocols offered by the Infectious Diseases Society of America (IDSA) and as a result suffer for years with chronic, often painful and disabling symptoms. With effective treatments currently unavailable and none in sight, many have unfortunately decided to commit suicide.

In a recent publication by Dr. Robert Bransfield, 'Suicide and Lyme and associated diseases' he reviewed the literature and medical files of patients suffering from chronic Lyme disease and has for the first time been able to calculate that Lyme disease is responsible for at least:

"1,244 suicides, 14,928 self-harm events, 31,100 suicide attempts, and 414,540 patients with suicidal ideations in the US per year."

So what is being done with this broken system to help reduce the exploding number of new cases and address the medical needs of the chronically ill patients?

People with late-stage, chronic Lyme disease are still experiencing major problems with getting a diagnosis (average of eight years from tick bite to diagnosis) and by then mild to severe damage to tissues and organ systems occurs. Sick patients, often unable to work, are still being forced to pay for Lyme disease tests developed over 30 years ago that continue to miss 74.9% of those who have the infection. In Michael Cook's study, 'How Accurate Are The Tests For Lyme Disease', he states compared to the methods used to test for HIV, Lyme disease tests can produce up to 560 times more false negative results.

"This degree of inaccuracy is probably unknown to the majority of clinicians and patients."

A review of the science maintain the status quo by rehashing their old data and presenting them anew as a sign of "progress".

1. Ehrlichia canis and Rickettsia spp. in dogs from urban areas in Paraiba state, northeastern Brazil.

2. A study of ticks and tick-borne livestock pathogens in Pakistan.

3. The burden of tick-borne diseases in the Altai region of Russia.

4. Range Expansion and Increasing Borrelia burgdorferi Infection of the Tick Ixodes scapularis (Acari: Ixodidae) in Iowa, 1990-2013.

5. Rickettsia sibirica mongolitimonae Infection, Turkey, 2016.

6. First isolation of Rickettsia monacensis from a patient, South Korea.

7. Serological and molecular detection of spotted fever group Rickettsia in a group of pet dogs from Luanda, Angola.

8. Candidatus Neoehrlichia mikurensis and Borrelia burgdorferi sensu lato detected in the blood of Norwegian patients with erythema migrans.

9. Rickettsia rickettsii infecting Rhipicephalus sanguineus sensu lato (Latreille 1806), in high altitude atlantic forest fragments, Ceara State, Brazil.

10. Evidence of infection with Leptospira interrogans and spotted fever group rickettsiae among rodents in an urban area of Osaka City, Japan.

11. Seroprevalence of Scrub Typhus, Typhus, and Spotted Fever Among Rural and Urban Populations of Northern Vietnam.

12. The presence of Rhipicephalus muhsamae north of the Sahara.

13. Molecular analyses reveal an abundant diversity of ticks and rickettsial agents associated with wild birds in two regions of primary Brazilian Atlantic Rainforest.

14. First report of a Rickettsia asembonensis related infecting fleas in Brazil.

15. Spotted Fever: Epidemiology and Vector Rickettsia Host Relationship in Rio de Janeiro State.

16. Widespread subcutaneous necrosis in spotted fever group Rickettsioses from the coastal belt of Sri Lanka- a case report.

17. Israeli Spotted Fever in Sicily. Description of two cases and minireview.

18. Tick-borne infectious diseases in Australia.

19. Rickettsial seropositivity in the indigenous community and animal farm workers, and vector surveillance in Peninsular Malaysia.

20. High Prevalence of Rickettsia spp. in Dog Fleas (Siphonaptera: Pulicidae) in Rural Uganda.

21. Epidemiological evaluation of Mediterranean spotted fever in children of the Karak province in south Jordan.

22. Rickettsia parkeri in Amblyomma dubitatum ticks in a spotted fever focus from the Brazilian Pampa.

23. Mediterranean spotted fever in Spain, 1997-2014: Epidemiological situation based on hospitalization records.

24. Molecular evidence of Rickettsia spp. in ixodid ticks and rodents in suburban, natural and rural habitats in Slovakia.

25. Genetic characterization of spotted fever group rickettsiae in questing ixodid ticks collected in Israel and environmental risk factors for their infection.

Vaccination of horses with Lyme vaccines for dogs induces short-lasting antibody responses.

Pet ownership increases human risk of encountering ticks.

Serious Bacterial Infections Acquired During Treatment of Patients Given a Diagnosis of Chronic Lyme Disease - United States

The Clinical Relevance of Studies on Borrelia burgdorferi Persisters (Baker, Wormser)

Geographic Expansion of Lyme Disease in Michigan, 2000-2014 (Lantos, Auwaerter)

Borrelia burgdorferi-specific IgA in Lyme Disease. (Dattwyler- Early LD)

Isolation of the Lyme Disease Spirochete Borrelia mayonii From Naturally Infected Rodents in Minnesota. (CDC- mice & squirrels may be potential hosts for spirochete)

Lyme disease ecology in a changing world: consensus, uncertainty and critical gaps for improving control (Fish, Diuk-Wasser, CDC- list of things to study later on prevention)

Detection of Anaplasma phagocytophilum, Babesia microti, Borrelia burgdorferi, Borrelia miyamotoi, and Powassan Virus in Ticks by a Multiplex Real-Time Reverse Transcription-PCR Assay (NY DOH- sales pitch for a test for ticks)

Tick bite and Lyme disease-related emergency department encounters in New Hampshire, 2010-2014 (NH DOH- educational materials needed)

Standardized Symptom Measurement of Individuals with Early Lyme Disease Over Time (Hopkins)

Early Disseminated Lyme Disease (Mayo Clinic- no abstract- pay per view)

Early Disseminated Lyme Disease Causing False Positive Serology for Primary Epstein-Barr Virus Infection - Report of 2 Cases (NIH NIAID)

Evaluation of the SELECT Tick Control System (TCS), a Host-Targeted Bait Box, to Reduce Exposure to Ixodes scapularis (Acari: Ixodidae) in a Lyme Disease Endemic Area of New Jersey (CDC- "future needs research" on bait boxes)

Evaluation of Modified 2-Tiered Serodiagnostic Testing Algorithms for Early LymeDisease (Steere, Lantos- Don't need to do a Western Blot)

Metabolomics of the tick-Borrelia interaction during the nymphal tick blood meal (CDC- need to understand mechanisms of tick feeding)

Vancomycin Reduces Cell Wall Stiffness and Slows Swim Speed of the Lyme Disease Bacterium (Bockenstead, Yale- slow win speed of spirochetes so they can be caught by phagocytes)

A critical appraisal of the mild axonal peripheral neuropathy of late neurologic Lyme disease (Halperin- addressing Wormser, polyneuropathy with Lyme.)

Response letter to Drs. Halperin and Greenberg (Wormser, Strle, Shapiro, Dattwyler, Auwaerter- arguing with Haperin- and a phone call wouldn't suffice?)

False and Misleading Information About Lyme Disease (Shapiro, Baker, Wormser)

Division of the genus Borrelia into two genera (corresponding to Lyme disease and relapsing fever groups) reflects their genetic and phenotypic distinctiveness and will lead to a better understanding of these two groups of microbes (Margos et al. (2016) There is inadequate evidence to support the division of the genus Borrelia. Int. J. Syst. Evol. Microbiol. doi: 10.1099/ijsem.0.001717) (Barbour- Wants to change how Borrelia is classified)

Host-Seeking Phenology of Ixodes pacificus (Acari: Ixodidae) Nymphs in Northwestern California in Relation to Calendar Week, Woodland Type, and Weather Conditions (Ben Beard- how ticks live in CA weather)

T-Helper 17 Cell Cytokine Responses in Lyme Disease Correlate With Borrelia burgdorferi Antibodies During Early Infection and With Autoantibodies Late in the Illness in Patients With Antibiotic-Refractory Lyme Arthritis (Strle, Steere- antibiotic refractory?)

MicroRNA Expression Shows Inflammatory Dysregulation and Tumor-Like Proliferative Responses in Joints of Patients With Postinfectious Lyme Arthritis (Strle, Steere, Yale- post infectious Lyme)

Pathogenetic implications of the age at time of diagnosis and skin location for acrodermatitis chronica atrophicans (Strle, Wormser- ACA in older people with old skin)

Evaluation of Doxycycline-Laden Oral Bait and Topical Fipronil Delivered in a Single Bait Box to Control Ixodes scapularis (Acari: Ixodidae) and Reduce Borrelia burgdorferi and Anaplasma phagocytophilum Infection in Small Mammal Reservoirs and Host-Seeking Ticks (CDC bait boxes)

Prophylaxis with topical azithromycin against Lyme borreliosis (Shapiro, Wormser- One dose Doxy works well- need azithromax for pregnant women.)

The domestic pig as a potential model for Borrelia skin infection (Stanek- pig skin)

Antibiotics for the neurological complications of Lyme disease (Auwaerter- No treatment for Lyme neurological symptoms necessary)

A critical appraisal of the mild axonal peripheral neuropathy of late neurologic Lyme disease (Wormser, Strle, Shapiro, Dattwyler, Auwaerter)

Neuroborreliosis (Halperin- neuro symptoms that remain after 6 months after treatment is not real and not Lyme related)

Structural and molecular analysis of a protective epitope of Lyme disease antigen OspA and antibody interactions (Klempner- vaccine related)

Lyme Disease. (Hu, L. xeno-diagnosis guys - putting live ticks on humans- this is an argument about about transmission times and one dose doxy.)

Infection with the Lyme disease pathogen suppresses innate immunity in mice with diet-induced obesity (Wormser- fat mice with Lyme have suppressed immune systems)

Immunogenic HLA-DR-Presented Self-Peptides Identified Directly from Clinical Samples of Synovial Tissue, Synovial Fluid, or Peripheral Blood in Patients with Rheumatoid Arthritis or Lyme Arthritis. (Steere- HLA-DR rehashing.)

Host-Seeking Phenology of Ixodes pacificus (Acari: Ixodidae) Nymphs in Northwestern California in Relation to Calendar Week, Woodland Type, and Weather Conditions (Ben Beard- how ticks live in CA weather- AGAIN?)

Longer-Term Therapy for Symptoms Attributed to Lyme Disease (Wormser- letter arguing Lyme)

Need for a New Lyme Disease Vaccine (Plotkin- vaccine pro)

Expression of C-Reactive Protein and Serum Amyloid A in Early to Late Manifestations of Lyme Disease (Wormser- inflammatory, not active Lyme)

Fatigue in patients with erythema migrans (Wormser, Shapiro- fatigue is no more than "acute sickness response")

Live-vaccinia virus encapsulation in pH-sensitive polymer increases safety of a reservoir-targeted Lyme disease vaccine by targeting gastrointestinal release. (Hu, LT. Vaccine)

Characterizing Lyme Disease Surveillance in an Endemic State (Feldman MD DHMH- wants to change reporting to estimating cases- too much work)

Long-term antibiotics after ceftriaxone did not improve quality of life in persistent Lyme disease. (Meyerhoff- Maryland Task Force supporting IDSA)

Diagnostic Lumbar Puncture Among Children With Facial Palsy in a Lyme Disease Endemic Area (Lantos- children with Lyme can have facial palsy)

Did Garin and Bujadoux Actually Report a Case of Lyme Radiculoneuritis? (Wormser- slamming original paper and the credit given to authors)

Insights into Borrelia miyamotoi infection from an untreated case demonstrating relapsing fever, monocytosis and a positive C6 Lyme serology. (Krause, Wormser- more studies needed)

Infection resistance and tolerance in Peromyscus spp., natural reservoirs of microbes that are virulent for humans (Barbour- mice have some infection tolerance)

Human Granulocytic Anaplasmosis and Lyme Disease (Wormser- telling authors in China they misdiagnosed patients he never saw or had records for)

CCL19 as a Chemokine Risk Factor for Posttreatment Lyme Disease Syndrome: a Prospective Clinical Cohort Study (Aucott/Hopkins- PTLDS)

Pre-exposure Prophylaxis With OspA-Specific Human Monoclonal Antibodies Protects Mice Against Tick Transmission of Lyme Disease Spirochetes (Klempner- vaccine)

Borrelial Lymphocytoma in Adult Patients (Strle- 14 days cures BL, just like RX for EM rash)

Invasion of two tick-borne diseases across New England: harnessing human surveillance data to capture underlying ecological invasion processes (Krause- Babesia and Lyme go together)

Comparison of males versus females with culture-confirmed early Lyme disease at presentation and at 11-20 years after diagnosis (Wormser- males and females- no differences in Lyme presentation or cure rates, etc.)

Editorial Commentary: Neuroborreliosis: What Is It, What Isn't It? (Halperin)

Course and Outcome of Early European Lyme Neuroborreliosis (Bannwarth Syndrome): Clinical and Laboratory Findings. (Strle- negative outcomes were rare)

False Positive Lyme Disease IgM Immunoblots in Children (Lantos- over diagnosis of Lyme)

The heat is on: Killing blacklegged ticks in residential washers and dryers to prevent tick borne diseases (Mead, CDC- repeat of older study- same results)

Lyme Disease (Hu, LT- clinical overview of Lyme.)

Lyme Disease Serology (Lantos, Auwaerter, CDC- rash faded after a couple of weeks, and tests on child- one border line and one negative, so stop the 14 days doxy she was RX)

Diagnosis, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: A Review- (Wormser, Hu, LT- 10 days max of Doxy for anyone with lyme rash.)

Nat Rev Dis Primers. 2016 Dec 15;2:16090. doi: 10.1038/nrdp.2016.90.

Lyme borreliosis.

Steere AC1,2, Strle F3, Wormser GP4, Hu LT5, Branda JA6, Hovius JW7, Li X8, Mead PS9.

Author information

1

Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114, USA.

2

Harvard Medical School, Harvard University, Boston, Massachusetts, USA.

3

Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia.

4

Division of Infectious Diseases, New York Medical College, Valhalla, New York, USA.

5

Department of Molecular Biology and Microbiology, Tufts Medical Center, Boston, Massachusetts, USA.

6

Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.

7

Center for Experimental and Molecular Medicine, University of Amsterdam, Amsterdam, The Netherlands.

8

Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA.

9

Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA.

Abstract

Lyme borreliosis is a tick-borne disease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the bacterium Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. During infection, the bacteria migrate through the host tissues, adhere to certain cells and can evade immune clearance. Yet, these organisms are eventually killed by both innate and adaptive immune responses and most inflammatory manifestations of the infection resolve. Except for patients with erythema migrans, Lymeborreliosis is diagnosed based on a characteristic clinical constellation of signs and symptoms with serological confirmation of infection. All manifestations of the infection can usually be treated with appropriate antibiotic regimens, but the disease can be followed by post-infectious sequelae in some patients. Prevention of Lyme borreliosis primarily involves the avoidance of tick bites by personal protective measures.

PMID:

27976670

DOI:

10.1038/nrdp.2016.90

https://www.ncbi.nlm.nih.gov/pubmed/27976670

MUST see responses to this "Primer".

Small RNAs of Borrelia burgdorferi: Characterizing Functional Regulators in a Sea of sRNAs .

Segregation Lag in Polyploid Cells of the Pathogen Genus Borrelia: Implications for Antigenic Variation

Reciprocal cooperation of phytochemicals and micronutrients against typical and atypical forms of Borrelia spp.

Range Expansion and Increasing Borrelia burgdorferi Infection of the Tick Ixodes scapularis (Acari: Ixodidae) in Iowa, 1990-2013.

Detection and Differentiation of Lyme Spirochetes and Other Tick-Borne Pathogens from Blood Using Real-Time PCR with Molecular Beacons.

The Geographic Distribution of Ixodes scapularis (Acari: Ixodidae) Revisited: The Importance of Assumptions About Error Balance.

Lyme carditis with complete heart block: management with an external pacemaker.

BosR Is A Novel Fur Family Member Responsive to Copper and Regulating Copper Homeostasis in Borrelia burgdorferi.

Insights into PG-binding, conformational change, and dimerization of the OmpA C-terminal domains from Salmonella enterica serovar Typhimurium and Borrelia burgdorferi

T2 Magnetic Resonance-based Direct Detection of Three Lyme Disease-Related Borrelia Species in Whole Blood Samples

Bibrachial plegia due to Lyme radiculopoliomyelitis-myelitis

Receptor tyrosine kinases play a significant role in human oligodendrocyte inflammation and cell death associated with the Lyme disease bacterium Borrelia burgdorferi.

Early-onset Lyme carditis with concurrent disseminated erythema migrans

Clinical Presentation and Outcomes of Children With Human Granulocytic Anaplasmosis

Rearing Ixodes scapularis, the Black-legged Tick: Feeding Immature Stages on Mice

A Case of Early Disseminated Neurological Lyme Disease Followed by Atypical Cutaneous Manifestations

Western Blot Techniques

Junctional ectopic tachycardia secondary to myocarditis associated with sudden cardiac arrest

Powassan/Deer Tick Virus and Borrelia Burgdorferi Infection in Wisconsin Tick Populations

Identification of a defined linear epitope in the OspA protein of the Lyme disease spirochetes that elicits bactericidal antibody responses: Implications for vaccine development

Application of Bayesian decision-making to laboratory testing for Lyme disease and comparison with testing for HIV

Acquisition of Borrelia burgdorferi Infection by Larval Ixodes scapularis (Acari: Ixodidae) Associated With Engorgement Measures

Commentary Re: a critical appraisal of the mild axonal peripheral neuropathy of late neurologic Lyme disease, by Wormser et al. DMID 2016

Activity of Sulfa Drugs and Their Combinations against Stationary Phase B. burgdorferi In Vitro

Commercial test kits for detection of Lyme borreliosis: a meta-analysis of test accuracy

Lucy Barnes

AfterTheBite@gmail.com