Tuesday, January 28, 2014

Plasma thermogram for Lyme

Studies show the blood tests could potentially offer a non-invasive method of showing whether a woman has cervical cancer

Here's an interesting announcement about a blood test that uses heating of the blood to reveal the existence of various diseases the patient might have. One of the diseases that a heat profile has been determined for is Lyme disease. Check out the article.


Sunday, January 26, 2014

Lyme Disease May Be Sexually Transmitted, Study Suggests

International team of scientists finds evidence for sexual transmission.

Carmel, CA (PRWEB) January 25, 2014 

A new study suggests that Lyme disease may be sexually transmitted. The study was presented at the annual Western Regional Meeting of the American Federation for Medical Research, and an abstract of the research was published in the January issue of the Journal of Investigative Medicine.

Lyme Disease -Induced Polyradiculopathy Mimicking ALS--Amyotrophic Lateral Sclerosis.

Lyme Disease -Induced Polyradiculopathy Mimicking ALS -- Amyotrophic Lateral Sclerosis.

Author information:

Burakgazi, A.Z.
Assistant Professor, Neuroscience Section, Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.

Int J Neurosci. 2014 Jan 7. [Epub ahead of print]

Saturday, January 25, 2014

Possible relationship between Lyme disease, inflammation and depression

The inflammation hypothesis of depression, or more broadly, common mental disorders, proposes that chronic inflammation plays an important role in the pathophysiology of these conditions.1, 2 The hypothesis is supported by experiments of inflammatory stimuli, antidepressant trials and studies on depression-related genes and pathogen host defense,2, 3, 4, 5 but direct population-based evidence from long-term inflammation is scarce. Because of a lack of studies on the effects of chronically elevated inflammation, assessed over several years using repeat measurements, it has remained unclear whether the association between inflammation and common mental disorder is the consequence of acute or chronic inflammation.

Friday, January 24, 2014

Resurgence of Persisting Non-Cultivable Borrelia burgdorferi following Antibiotic Treatment

Below you will find two studies about the persistence of Borrelia burgdorferi, post antibiotic treatment. Study results on this topic are becoming more and more significant as the battle heats up between the IDSA and ILADS doctors over the issue of whether or not Lyme disease is easily treated and eliminated from the human body. I would think the best collection of this literature would be found in Richard Horowitz's new book, "Why Can't I Get Better?" I believe I heard him say on national television a couple of months ago that he had over 100 references to post-treatment Bb persistence in his book. However, as newer studies come out I will continue to reprint them here. Be sure to click through to the actual studies. There is much more information on the source sites, of course.  -Bob

Thursday, January 23, 2014

Evidence for strain-specific immunity in patients treated for early Lyme disease

Evidence for strain-specific immunity in patients treated for early Lyme disease
Camilo E. Khatchikian, Ph.D., Robert B. Nadelman, M.D., John Nowakowski, M.D., Ira Schwartz, Ph.D., Gary P. Wormser, M.D. and Dustin Brisson, Ph.D.
Infection and Immunity, online before print, January 13, 2014.



Lyme disease, caused by Borrelia burgdorferi, is the most commonly reported vector-borne disease in the United States. Many patients treated for early Lyme disease incur another infection in subsequent years, suggesting previous exposure to B. burgdorferi may not elicit a protective immune response.

However, identical strains are almost never detected from patients who are infected multiple times, suggesting that B. burgdorferi exposure may elicit strain specific immunity. Probabilistic and simulation models assuming biologically-realistic data derived from patients in the Northeastern US suggest that patients treated for early Lyme disease develop protective immunity that is strain specific and lasts for at least six years.

Wednesday, January 22, 2014

New precedent for insurance coverage of Lyme treatments

UPDATE: I've been reading on the web that this is possibly erroneous in its conclusion. This case may not affect anything regarding the insurance coverage for Lyme patients. I'm looking into it.

This just in:

Please post, blog, like, circulate this article.


History was made, and has set a precedent, for all Lyme disease patients in a lawsuit, in which attorney, William L'Esperance, a longtime part of the Lyme Disease United Coalition (LDUC), has won a case where the Office of Professional Management (OPM), on the side of the insurance company, has been overruled.

The Lyme disease patient, in the lawsuit, submitted bills for hundreds of medical services, treatments, and tests.  The court ruled that the Lyme disease patient wins the case without regard to the medical necessity of the patient; or whether the medical treatments or tests were medically necessary or experimental or investigative.


The case is sealed.  However, attorney William L'Esperance has filed the case and outcome with the United States Federal Courts to set precedence to aid all Lyme disease patients in lawsuits against their insurance companies, and OPM, for not covering the ILADS guidelines or Dr. Burrascano's guidelines in treatment of Lyme disease.

What does this mean to each of us?
  1. The door has opened for Lyme-treating doctors to accept insurance -- once all is established in U.S. Federal Court.  (I will keep you posted about the advance of this outcome.)
  2. You may now sue your insurance company for past bills not covered or reimbursed by insurance.  The OPM cannot hold you back -- in other words, the IDSA'S guidelines are no longer accepted.
To contact our hero, attorney Bill L'Esperance:


snail mail:
William L'Esperance, Counselor at Law
P.O. Box 90668
Albuquerque, NM 87199

William L'Esperance does not want to take on new clients.  He is willing to be a resource for out-or-state attorneys handling similar cases.

Please send notes of thanks to our hero, Bill L'Esperance.We are winning the battle --
One step at a time --

Judith Weeg, President LDUC
Office: 800-311-7518
Fax: 888-746-3810
E-mail: Lymeinfo@LDUC.org  
Website: www.LDUC.org
P.O. Box 86
Story City, IA 50248

Our Motto: "Whoever destroys a soul, it is considered as if he destroyed an entire world.  And, whoever saves a life, it is considered as if he saved an entire world."  [Talmud]

Tuesday, January 21, 2014

Vitamin D levels and PD and Dementia

Higher vitamin D levels associated with better cognition and mood in PD patients

Findings published in the Journal of Parkinson's Disease

Amsterdam, NL, 16 January 2014 – A new study exploring vitamin D levels in patients with Parkinson's disease (PD) opens up the possibility of a new avenue of early intervention that may delay or prevent the onset of cognitive impairment and depression. The findings are published in the Journal of Parkinson's Disease.

Monday, January 20, 2014

Prof Holly Ahern’s Published Lyme Study Results

Comparison of Lyme Disease Prevalence and Disease Reporting in an Endemic Area

Journal of Microbiology Research
Holly Ahern Biology Department, State University of New York at Adirondack, Queensbury, NY, 12804, USA

Carl Tuttle's summary of this significant study:

The Lyme community has been reporting a completely different set of numbers in regards to the statistics of this disease which vary greatly from what the CDC has published and conveyed to the medical community. 
Professor Ahern's survey results were tabulated from a randomly selected population in a Lyme endemic region with no bias in this group to influence results.

2% of the surveyed population reported a diagnosis of Lyme disease. 50% of respondents diagnosed with Lyme disease did not recall a tick bite, 33% developed the bulls-eye rash and 50% remained ill after antibiotic treatment.

In contrast to those numbers the CDC claims that 80% of Lyme patients develop the bulls-eye rash and only a small subset of patients has persistent symptoms. 

It was concluded that Lyme disease reported at just 2% of the population for these three counties represents a possible 7,000 cases at the time of the survey but only 1,930 cases have been reported to the CDC over a nine year period (2002-2011). If you use the 2% conservative number there should have been 63,000 cases reported in just these three counties alone.

In addition, 16% of respondents experienced cardiac, rheumatologic, or neurological symptoms consistent with late-stage Lyme disease.

Comparing late-stage Lyme symptoms to the general population was a brilliant idea because we believe the vast majority of Lyme patients are already in the healthcare system being treated for everything else but Lyme.

Chronic disease is a valuable commodity and there is a high probability that undiagnosed Lyme disease represents a good portion of that that revenue stream.

Fungal Alcohol Disrupts Dopamine & Causes Neurodegeneration

This research study indicates that a common type of mold prevalent in houses that have been water damaged may be a significant contributor to the development of Parkinson's disease in humans. I am attaching a PDF file of the study. The report is highly technical, but the Introduction and Discussion sections are understandable to the lay reader (such as me). 

One of the more dramatic conclusions is that this type of mold is ten times more damaging to the dopamine system in humans than toluene is. I was exposed to toluene in my teenage years and know that it is nasty stuff. It's hard to believe that a naturally-occuring and ubiquitous substance such as mold could be so dangerous. 

Friday, January 17, 2014

Petition for Congressional inquiry on Lyme

The following petition provides evidence to suggest that Lyme disease has been intentionally mishandled. The petition has generated 16,311 signatures and 190 pages of heart wrenching stories from disabled Lyme patients across the globe. Please read and consider signing. 

Petition: Calling for a Congressional investigation of the CDC, IDSA and ALDF

Thursday, January 16, 2014

Discover - Mold VOC's possible link to Parkinson's ?

A Discover blog article summarizing research recently published in PNAS about how the VOC's made by mold (rather than the mycotoxins usually studied) caused Parkinson's like neurological problems in fruit flies and also caused damage to human cell lines.


The abstract for the article is here:


One MD who read this said s/he would suggest a different position to many of her statements. The author's positions show virtually nothing CLINICAL or advanced about mycotoxins and VOC's have not been ignored. Basic beliefs are false for vast reasons. The fact these ideas are published IS useful to share. 

www.personalconsult.com.... many free mold books

Lyme Disease Can Be Reliably Diagnosed by DNA Sequencing

This is potentially exciting, though apparently here is no change on validated tests for Bb on the CDC website.  They still want only the two-tier (ELISA and Western Blot) testing system. This press release seems to apply only to  B. miyamotoi strain of the Lyme spirochete, not Borrelia bergdorferi. -Bob

Press Release
Lyme Disease Bacteria and Borrelia Miyamotoi Can Be Reliably Diagnosed by DNA Sequencing, Milford Hospital Pathologist Announced 

Media Contact:
For Milford Medical Laboratory-affiliated with Milford Hospital
Kevin Moore

January 15, 2014
or http://tinyurl.com/q2oqooe

MILFORD, Conn.--(BUSINESS WIRE)--The nation's first reliable DNA test for Borrelia burgdorferi and Borrelia miyamotoi, the spirochetes causing Lyme disease and a Lyme disease-like infection in the U.S. is now also available nationwide, according to Sin Hang Lee, MD, a Milford Hospital pathologist and the director of Milford Medical Laboratory (MML)http://www.dnalymetest.com/

Wednesday, January 15, 2014

Recognizing Lyme Carditis

CDC Expert Commentary

Recognizing Lyme Carditis

Joseph D. Forrester, MD, MSc
DisclosuresJanuary 13, 2014
Hello. I am Dr. Joe Forrester, an Epidemic Intelligence Service Officer in the Bacterial Diseases Branch of CDC's Division of Vector-Borne Diseases. I'm pleased to speak with you as part of the CDC Expert Commentary Series on Medscape.
Today I will discuss Lyme carditis and describe 3 recent cases of sudden cardiac death among young adults with this condition. I will also provide guidance on evaluating patients with suspected Lyme carditis.

Saturday, January 11, 2014

Eating berries may lower risk of Parkinson's

Close to a decade ago, before I had developed Parkinson's symptoms, my integrative doctor told me I should start eating berries. He based this comment on blood test results he was looking at. At the time, I thought that was the strangest thing I had heard in quite a while. "Berries?", I thought. "Aren't very just full of sugar? And some of them such as blackberries have those little tiny grains of sand in them that I guess are seeds. And the blueberries stain my teeth blue." But I did always loved 

Human-Animal Infections: A Primer for Clinicians

This is from Medscape -- Infectious Disease section


Human-Animal Infections: A Primer for Clinicians

Tara C. Smith, PhD
December 16, 2013

MERS-CoV Leaves the Belfry

In September 2012, a 49-year-old man from Qatar was diagnosed with a case of acute respiratory syndrome with renal failure in a United Kingdom hospital. Initially seen in his home country after traveling to Saudi Arabia, he was transferred to the United Kingdom by air ambulance after 8 days in the hospital. Upon arrival in the United Kingdom, laboratory testing was done, and the presence of a novel coronavirus was confirmed.

Wednesday, January 8, 2014

Lyme Disease and Oncothermia

Conference Papers in Medicine
Volume 2013 (2013), Article ID 275013, 3 pages

Conference Paper
Lyme Disease and Oncothermia
Ortwin Zais

Hyperthermiezentrum Hochwald, Trierer Straße 44, 54411 Hermeskeil, Germany

Received 16 January 2013; Accepted 18 April 2013

Academic Editors: G. F. Baronzio, M. Jackson, and A. Szasz
This Conference Paper is based on a presentation given by Ortwin Zais at "Conference of the International Clinical Hyperthermia Society 2012" held from 12 October 2012 to 14 October 2012 in Budapest, Hungary.

Copyright © 2013 Ortwin Zais. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Lyme disease is a tick-borne disease with multiple organ failures, and systemic disorders. Dramatic change becomes apparent in the chronic phase of the disease. Chronic fatigue syndrome, lapse of concentration, depression, joint pain, and muscle pain are a few, but major clinical symptoms characterizing the disease. The human immune system is defenseless. Borrelia uses various mechanisms to escape from immunoattacks or antibiotic therapies. This "stealth phenomenon" needs new therapeutic principles to be interrupted. Our objective in this paper is to study the effect of oncothermia, which is a well-established oncological therapy, on Lyme disease. First, in our present work, we definitely concentrate on the quality of life of the patients.


Tuesday, January 7, 2014

List of all Lyme support groups in California

Here is the list of Lyme support support groups in CA, as of Dec 2013

LymeDisease.org (formally CALDA) 501c3 non-profit
Empowering patients through Advocacy, Education and Research 

Sign up for online newsletter: (http://www.lymedisease.org/

Santa Rosa 1 
cstoesser@sbcglobal.net_ (mailto:cstoesser@sbcglobal.net

Bob . 

Davis/ Sacramento 

Nevada City & Grass Valley 
poulton@acornknoll.com_ (mailto:poulton@acornknoll.com

Virginia Ward and Chris Ryland 
virward@sbcglobal.net_ (mailto:virward@sbcglobal.net

El Dorado Hills 
Carey Mencarini 

Shelly Mariposa 
Mariposa Marketing
PO Box 4620 
Chico, CA 95927 
(530) 891-8204 office
(530) 570-3659 cell 
We meet the third Monday of every month at 6pm inside Independent Living 
Services of Northern California. The address is 1161 East Avenue in Chico

Here is a map http://maps.google.com/maps?hl=en&tab=wl 
Truckee /Sierra Nevada 
hdnsdwn@hotmail.com_ (mailto:hdnsdwn@hotmail.com
Amanda Blaker 

San Francisco Grp 1 
Robin Krop 
sfrobink@aol.com_ (mailto:sfrobink@aol.com

San Francisco Grp 2
sf_lyme@yahoo.com_ (mailto:sf_lyme@yahoo.com

East Bay San Francisco 
Karen Fernandez. 
btrflynana@yahoo.com_ (mailto:btrflynana@yahoo.com


San Jose/Mid Penninsula 
El Camino Hospital/Room E
2500 Grant Road, Mt. View, CA
2nd Tuesday each month: 6:30-8:30 PM
ldsg_scott@hotmail.com_ (mailto:ldsg_scott@hotmail.com

Monterey/Santa Cruz 
judithain@mac.com_ (mailto:judithain@mac.com

Ventura Co.

Shannon,  senior coordinator



Orange County/Los Angeles group disbanded, refer to Lymedisease.orglymebarb@aol.com  Barb  310 456-9931 home 310 924-1406 cell

San Diego 

Hesperia/Apple Valley 
Misty Brown 
salonfam3@yahoo.com_ (mailto:salonfam3@yahoo.com

San Bernardino/Riversid
Anne RN 
mcfighter@adelphia.net_ (mailto:mcfighter@adelphia.net


Sunday, January 5, 2014

OCD, Tick-borne Illnesses + children

An Interesting thread on the Microbes and Mental Illness listserv today. As I have been instructed to do, I have removed names of people who submitted the articles. Research personnel names have been left in, though, as the papers have been published. One of the stories below was first published in 1991. It is still relevant today, so I have decided to repost it. 


Begin forwarded message:

From: Sandy 
Subject: Re: mmi OCD/Tick borne Illnesses
Date: January 4, 2014 12:01:00 PM PST

Anybody remember the article "Bicycle Boy", that told the story of a young child who couldn't stop bicycling on a stationary bike?  Lyme tx resolved the issue completely.


Sandy, LCSW, BCDF>

To: sue....
Subject: Re: mmi OCD/Tick borne Illnesses

I remember reading that OCD can be a symptom of Bartonella.  May want to consider assessing for this common infection.

Lyme Disease Assoc. of E. Shore of MD

On Friday, January 3, 2014 9:37 PM, Sue  wrote:
Any data on OCD in tick borne illnesses?

Common symptom as these diseases progress? 

Prescription drug induced side-effect?


Sue, PhD

Am J Psychiatry. 1994 Nov;151(11):1571-83.
Lyme disease: a neuropsychiatric illness.
Fallon BA, Nields JA.
Author information:
Department of Psychiatry, College of Physicians and Surgeons, Columbia
University, New York.
OBJECTIVE: Lyme disease is a multisystemic illness that can affect the central
nervous system (CNS), causing neurologic and psychiatric symptoms. The goal of
this article is to familiarize psychiatrists with this spirochetal illness.
METHOD: Relevant books, articles, and abstracts from academic conferences were
perused, and additional articles were located through computerized searches and
reference sections from published articles.

RESULTS: Up to 40% of patients with Lyme disease develop neurologic involvement
of either the peripheral or central nervous system. Dissemination to the CNS can
occur within the first few weeks after skin infection. Like syphilis, Lyme
disease may have a latency period of months to years before symptoms of late
infection emerge. Early signs include meningitis, encephalitis, cranial neuritis,
and radiculoneuropathies. Later, encephalomyelitis and encephalopathy may occur.
A broad range of psychiatric reactions have been associated with Lyme disease
including paranoia, dementia, schizophrenia, bipolar disorder, panic attacks,
major depression, anorexia nervosa, and obsessive-compulsive disorder. Depressive
states among patients with late Lyme disease are fairly common, ranging across
studies from 26% to 66%. The microbiology of Borrelia burgdorferi sheds light on
why Lyme disease can be relapsing and remitting and why it can be refractory to
normal immune surveillance and standard antibiotic regimens.

CONCLUSIONS: Psychiatrists who work in endemic areas need to include Lyme disease
in the differential diagnosis of any atypical psychiatric disorder. Further
research is needed to identify better laboratory tests and to determine the
appropriate manner (intravenous or oral) and length (weeks or months) of
treatment among patients with neuropsychiatric involvement.

Pol Merkur Lekarski. 2001 Nov;11(65):460-2.
[Mental disorders in Lyme disease].
[Article in Polish]
Rudnik-Szałaj I, Popławska R, Zajkowska J, Szulc A, Pancewicz SA, Gudel I.
Author information:
Klinika Psychiatrii AM w Białymstoku.
From the early 90-ties there is a growing number of patients suffering from Lyme
Disease all over the world, including Poland. Lyme Disease is the disorder
connecting physicians of various specialties. The authors reviewed literature on
mental disorders in Lyme Disease during different stages and in different types
of illness. Mental disorders are part of clinical picture of the acute stage of
Lyme Disease, and could also be its sequel. The most commonly found mental
disorders are: encephalopathy, other cognitive disorders, mood disorders
(depression), anxiety disorders and less often: psychotic disorders and eating
disorders (anorexia nervosa).

See the recently-released book:  Why I Can't Get Better
Richard Horowitz, MD
p. 305
(Available on Amazon)

"Neurological symptoms of Lyme disease include memory and concentration problems, difficulties wit processing new information, word finding problems, mood disorders (such as depression), anxiety, as well as a host of psychiatric manifestations, including the potential for mental health disorders such as obsessive compulsive disorder (OCD) and even schizophrenia."

He went on to talk about neuropsychiatric symptoms and autonomic neuropathy.

Lucia xxxxx, PhD, PHN, MSN, FNP-C
Fairhaven, MA

ARTICLE #2. About the kid who couldn't stop bicycling. OCD in a child;
source: The Washingtonian  (Jan. 1991)

Medicine by Neil Raven

title: Bicycle Boy

His Behavior Was Compulsive, Its Origins Unknown; Then a Good Doctor
Seemed to Make a Miracle Happen

He was 12 years old, and every day he pedaled furiously on his stationary
bicycle for as many hours as they would allow him. He was so absorbed in his
effort that it was all they could do to get him to stop for meals.
In fact, before he was hospitalized at a psychiatric institution he had
been unwilling to stop for meals, for school work, for the simple exchanges
of ordinary life. At age 12, he had lost almost 30 pounds. He looked, in the
language of the ward, cachetic, or in the language of his friends, as if he
had been an inmate in a concentration camp.

His parents, after all the agonizing, had coaxed him into a car and
driven him out to the facility, where they had carried his suitcase as they
walked him to the ward. And they had handed their son over to the care of
others, out of desperation, convinced that he was now beyond their help -
their son who wanted only to pedal, to exert himself and withdraw from the
world he had once embraced with such sunny exuberance.

The psychiatrists questioned the parents and the boy - the skeletal,
restless boy, who not so long before had been a good student, a healthy,
happy son. He had been a wonderful athlete, an exciting soccer player, but
he had had some knee problems. Over two years he had had four episodes in
which his right knee swelled enough to require treatment.

It was after the last episode that he had withdrawn. He spent most of
his time alone in his room, fiddling with a ham radio, not talking to his
friends or his parents. He stopped doing his homework. And then came the
exercising, the disinterest in food, the weight loss.

At a glance, the boy reminded the psychiatrists of the young women who
suffered from that dreaded and potentially lethal psychiatric condition,
anorexia nervosa. He had that bony look, that restless hyperactivity.
But he was male, which is unusual for anorexia nervosa patients. And he
was only 12 -- most patients with anorexia nervosa are older. It could be a
working diagnosis. But when things don't quite fit the pattern, you ask
questions. You call in more opinions. They called in Andrew Pachner.

Andrew Pachner looks over to the framed photograph on the wall of his
office at the Georgetown university Hospital's neurology department. The
photo is a blowup of a single Borrelia burgdorferi spirochete - a
microorganism that bears a striking resemblance to the organism that causes
syphilis. Pachner smiles.

The photo is one of the few clues that this the office of a physician.
It is a tiny office, crowded with a large ficus tree. More wall space is
devoted to photographs of his four children than to his diplomas from Yale
College, Yale School of Medicine, and Johns Hopkins. There are photos of
his wife, scenes of his family cavorting among the goats and cattle on the
Maryland farm where he lives and from which he commutes daily. There are
bookcases jammed with textbooks, but it could be the office of a professor of

He recalls the day he first laid eyes on the 12-year-old bicycle boy.
Pachner was then a junior faculty member in the Department of Neurology at
the Yale School of Medicine, living on a salary that didn't even approach
subsistence level. While the university looked the other way, all the junior
faculty members moonlighted to pay the rent. Among Pachner's stints was a
job evaluating patients at the psychiatric institute.

Not all patients were selected by the psychiatrists for Pachner's review.
But the bicycle boy was. For one thing, there were those swelling episodes
and the probable history of arthritis.

While he was still in training, Pachner had drifted down to the Yale
arthritis clinic. Diseases of the joints might seem an unlikely source of
fascination for a doctor specializing in diseases of the nervous system, but
there was a vital connection. Diseases of both are often caused by mistakes
that cause the immune system to turn against itself - autoimmune diseases.
The doctors studying arthritis were happy to have Pachner around. Many
of their arthritis patients were suffering from autoimmune diseases, such as
systemic lupus erythematosus, which have neurologic complications. Pachner's
neurology expertise was welcomed.

While Pachner was examining patients in the arthritis clinic, he became
an interested bystander to one of the most clebrated moments in medicine -
the identification of a new disease. An arthritis specialist, Allen Steere,
had become interested in a group of children in Old Lyme, Connecticut, not
far from Yale. The children had a curious form of arthritis that followed
the appearance of a peculiar and characteristic skin rash called erythema
chronicum migrans, or ECM.

Steere had described the condition in 1975. In 1982, Drs. Willy
Burgdorfer and Alan Barbour, working at the Rocky Mountain Laboratory in
Montana, pinpointed the cause of the disease.

It turned out that Steere's young patients had an arthritis caused by a
spirochete. Unlike bacteria, spirochetes are not easily grown in the
laboratory. The standard way to study a microorganism is to grow it on a
special broth, a culture plate. But spirochetes, like exotic zoo animals, do
not live long outside their native habitats. Once outside the body, they die.
The human body makes antibodies to the organism , which makes diagnosis
possible, but the antibody tests can be tricky, and occasionally misleading.
The world's best-known spirochete is Treponema pallidum, which causes
syphilis. The one that causes Lyme disease would prove to be an even bigger
problem than syphilis in some ways, because people could not avoid it by
abstemious behavior.

It was a spirochete that awaited children as they ran through the
Connecticut woods, doing what their parents thought was healthy and good.
The spirochete was carried by forest animals, and it waited for the
unsuspecting, anyone who cared to enjoy the great outdoors: hikers, pregnant
women toting little kids, fishermen, gardeners, and farm workers. It was the
tick-borne spirochete that causes Lyme disease.

The bicycle boy had had his first attack of Lyme arthritis in 1982, two
years before Pachner discovered him pedaling away on the psychiatric ward.
Pachner was aware that syndromes similar to Lyme arthritis, syndromes
suspected to be caused by an infectious agent, had been described in Europe,
and he knew these syndromes often included some neurological features,
usually a form of radicular pain, which radiates down an arm or a leg.
Radiculitis meant the trouble was in peripheral nerves, which flow to and
from the spinal cord out to the extremities.

But none of the these arthritis-related European syndromes involved the
central nervous system. None of these European syndromes caused complex
behavioral changes, and no connection had ever been drawn between an
infectious arthritis and any sort of neurological disease that might affect a
person's behavior.

In order to cause a behavioral change, a disease has to affect the brain
directly and in a widespread fashion. Various forms of vasculitis -
inflammation of the small blood vessels - can do this. Autoimmune diseases
can do this. But none of the infectious-arthritis group of diseases were
known to be capable of involving the whole brain. Focal lesions can "stroke
out" particular functions, causing paralysis, speech deficits, or sensory
loss, but the entire brain must be involved for memory deficits,
disorientation, or obsessive behavior to occur.

Clearly, what was going on in the bicycle boy was more than a simple
radiculitis: in which only a single nerve root would be affected.

By 1982, physicians in Connecticut had been alerted to the possibility
of Lyme arthritis, and the boy's first attack of knee pain had been treated
with a form of tetracycline. But two years later, when the boy started to
withdraw from life, started to become a behavior problem, his physicians
made no connection between his psychiatric symptoms and his earlier episodes
of arthritis. "Lyme arthritis" was a disease of the joints or, at most, of
the skin and the joints: nobody had any basis for suspecting a connection
between the knee and brain disease - except perhaps for Andrew Pachner.

Working in Steere's clinic, Pachner had begun to uncover neurological
symptoms and findings in his Lyme arthritis patients. Another neurologist,
Louis Reik, who had preceded Pachner in the arthritis clinic, had passed on
his suspicions that the Lyme patients might have more than simple radiculitis
complaints. But it was up to Pachner to push ahead with his observations.
Pachner connected the symptoms of the European patients to the new, more
diverse symptoms he was seeing in the Yale clinic. Reading through the chart
of that 12-year-old boy, Pachner began to get excited.

Could this boy have an infection that affected not just his knee but his
brain as well? The organism identified as causing Lyme arthritis was a
spirochete. Syphilis was a spirochete, and what syphilis could do to a brain
was well-known. It could cause dementia, bizarre pain syndromes, a whole
variety of symptoms so diverse that medical students are taught to think of
syphilis as the "great imitator".

Syphilis mimics many diseases because it can affect so many organs:
heart, brain, joints, nerve, eye. Wherever blood goes, syphilis can go.
Syphilis can cause a vasculitis of the small blood vessels in the brain, the
eye, almost anywhere. Could this new spirochete, this borrelia burgdorferi,
be as strange and protean in its manifestations as the "great imitator"

Could it be, thought Pachner, that this bicycle boy has Borrelia in his

If the spirochete that causes syphilis can enter the body through genital
tissues, multiply, migrate to small branches of the vascular tree, migrate
through the thin blood-vessel walls, and set up house in the brain and
nervous tissue, and in heart tissue and aorta, was it so farfetched to
believe that the Lyme spirochete might do something similar?

Might it enter the body through a break in the skin caused by an insect
bite, the way malaria does, enter the blood stream, and multiply first in a
knee joint causing arthritis, and then wreak havoc years later in the brain,
as syphilis has been known to do?

Not having an answer, not having solid evidence or similar cases, Pachner
could not voice his suspicions to the boy's parents. He spoke instead to the
psychiatrists and asked them to transfer the boy to Yale - New Haven
Hospital. The parents were told simply that there was a chance the therapy
at Yale could help their son. They were willing to try anything.

When the boy arrived at the hospital, he was taken to the neurological
ward. Pachner met his parents and explained that he believed there might be
a connection between their son's previous bouts of arthritis and the problems
that had landed him on the psychiatric ward. But Pachner could make no
promises--they were in unchartered waters.

The boy's parents did not know what to say. Their son's strange course
had been so baffling, their odyssey through the psychiatric wards so bizarre,
they could accept anything. They had no choice but to hope that Andrew
Pachner was correct.

On the neurology ward, Pachner did a lumbar puncture on the boy,
inserting a needle into the midline of his back, passing it between the
vertebral bones to the fluid-filled sac in which the spinal cord floats. Examining the fluid,
called cerebrospinal fluid, or CSF, Pachner noted a profusion of immune cells
called lymphocytes. Now he knew he had something. Patients in Europe who
had neurological symptoms following arthritic disease showed similar
findings in their cerebrospinal fluid. Those lymphocytes might be the marker
for the presence of the borrelia spirochete. Pachner ordered an intravenous
line started on the boy and 20 million units of penecillin to be infused
daily for fourteen days.

There was no reason to expect sudden response or improvement. If
Pachner was right, if the boy's current depression and compulsive behavior
were attributable to a brain infection with the spirochete Borrelia, then the
initial infection dated back two years, to his first episode of arthritis.
A long standing, deep-seated infection like that could not be expected to be
resolved overnight.


Within days of the initiation of therapy, Pachner recalls, "his
behavior changed."

The parents were speechless . Even now, Pachner finds it difficult to
describe the sensation of watching those first changes in the boy.
"It was like-" Pachner searches for a word, shakes his head, then finally
says, "a fairy tale. That's all you can say ."

The boy was discharged. Pachner watched him leave with his parents.
Two weeks later, the boy arrived with his parents at Pachner's clinic.
He had gained weight, but more important, he was talking again, was more
outgoing, and had gone back to school. Within months the boy was back
playing soccer and he was doing his homework. The transformation, or the
reclamation, was complete. He was back to normal.

In the process, the understanding of the disease that had been called
Lyme arthritis had expanded. The disease was no longer limited to the
joints. It would henceforth be called Lyme disease, a disease of many
organs, including the brain. IT WAS THE NEW GEAT IMITATOR.

Pachner has reported this new disease in many guises. A 21-year-old man
with a history of violent outbursts, confusion, and wild laughing was thought
to have a herpes-virus infection of his brain; treated for Lyme disease, he
returned to normal. A 55-year-old woman who had gone to her doctor with a
facial droop was cured after a diagnosis of Lyme disease led to early
tratment with intravenous penicillin. A 37-year-old man with fatigue, a sore
throat, joint and muscle pains, and facial-muscle paralysis who was thought
to have multiple sclerosis was found to have Lyme disease, and all symptoms
resolved . A 61-year-old man with double vision who was thought to have a
brain tumor was treated for Lyme disease with only partial improvement,
probably because his disease was too advanced to be cured. And a
6-year-old girl suffering from headaches, knee pain, and tingling in her toes
- and later from vertigo and staggering - was apparently cured after
treatment for Lyme disease followed positive studies of her blood and
cerebrospinal fluid.

Pachner thinks about the bicycle boy and says he was just one of many
cases. His eyes widen: "There are so many ways it can present. And there are
so many ways it presents that look like bad diseases, that when you identify
it and your reverse it - YOU FEEL LIKE GOD!"

Pachner finds all this humbling. He is quick to say that his insight was
built upon bricks laid by others: by Allen Steere, who identified the
disease in those children of Old Lyme; by Louis Reik, the Yale neurology
resident who preceded Pachner in the arthritis clinic and who convinced
Pachner that patients with Lyme arthritis actually had neurological problems:
by the whole structure of the Yale School of Medicine, which fostered clinical
investigation and which allowed neurologists to haunt the arthritis clinic.
He speaks of the subtle differences among the various strains of the
spirochete that may cause subtle differences in the damage, the signs, and
symptoms of the disease. In his laboratory, he is getting to know the
spirochete, or the "bug," as he calls it. He is fascinated by the mysteries:
Deer, for example, do not get sick, although they harbor large numbers of
Borrelia organisms. Why? "Host defenses," Pachner says. It comes back to
the immune system.

He seems driven by the will to know. He was working on his studies of
the Lyme disease patients while he was living the impoverished life of a
neurology resident, moonlighting like mad.

He never expected financial rewards from his work. Pachner's father, a
Czech diplomat before the Second World War, had fought Hitler, and after the
war he had come to America, but the best job he could get was in a factory.
The family was not wealthy. Yet they managed to send Andrew to Yale. His
widowed mother still doesn't understand what it is that Andrew does at
Georgetown. She wishes he would "be a real doctor," which is to say, she
wishes he would go into private practice. But that isn't what Pachner has in

There are still too many questions to answer.

Pachner left Yale for Georgetown in 1987, following Johnathan Pincus, the
Yale professor of neurology who had been appointed chairman of the neurology
department at Georgetown. Pinicus, author of the classic textbook Behavioral
Neurology, was able to attract Pachner offering lab space and freedom to
pursue his research interests. Pachner shows me around his laboratory, of
which he is proud. I remember how scarce lab space was at Yale, how people
doubled up and scraped by. The lab Pachner has at Georgetown would have been
considered a land of milk and honey at Yale. Several technicians work for
him, and they are busy with lab chores. He has set up an assay for the Lyme
antibodies, and a technician shows him some "runs."

The blood samples are sent in from local physicans, and some test

Although Lyme disease is known to occur in many countries, particularly in
Europe, and in 45 states in this country, the Mid-Atlantic and New England
states have an especially high infestation rate. The tick that carries the
disease, Ixodes dammini, [Ixodes scapularis] clings to deer, field mice, and
even dogs. Because the ticks are so small, their human victims are often
UNAWARE of having played host to this blood sucker, which may cling for four
to six days to an unsuspecting body.

In endemic areas such as certain parts of New England and Washington, any
patient who walks into the doctor's office with one side of his face drooping
in the classic manner of Bell's palsy should be suspected of Lyme disease.
And Bell's palsy is only one common neurologic complication.

Since Pachner's studies called attention to the many sites that may be
inhabited by the spirochete, attention has also been focused on heart
lesions, which vary from direct attack on the heart-muscle wall - myocarditis
- to an attack penetrating every layer of the heart from the inner lining
through the heart walls to its coverings -pancarditis.

Patients with Lyme disease can show up at the doctor's office with
anything from severe chronic fatigue to arm pain to a variety of palsies to
arthritis and skin rashes. Erroneous diagnoses of dementia, multiple
sclerosis, psychiatric disease, and arthritis are common, so closely can the
great imitator mimic the symptoms of other illnesses.

The diagnosis can be difficult even when the physician suspects Lyme
disease. In Pachner's laboratory at Georgetwown, blood, spinal fluid, or
joint fluid from patients with Lyme disease often fails to yield positive
cultures for the spirochete, which is difficult to keep alive outside the
body. While Pachner's laboratory has the highest-quality technicians and
antiserums, only about half the patients are positive for the antibody to the
B. burgdorferi spirochete early in the course of the disease. And, if the
patient happens to be treated with an antibioitc before the diagnosis is
made, the antibody test may turn negative while living spirochetes are still
reproducing inside the body.

Making matters worse, antibody tests for Lyme disease may be falsely
positive in patients who have no Lyme spirochetes but who have instead
syphilis or other disease. Special antibody tests have to be done to be sure
the doctor is not dealing with a "false positive," in which the test is
positive but the patient has no Lyme disease.

Questions have been raised about the wisdom of any pregnant woman in an
endemic area such as Washington venturing into wooded areas during tick
season. Late spring and early summer are the peak times for the bites that
leave the hallmark skin rash, but patients can BE INFECTED ON ANY WARM DAY OF
ANY MONTH. There is still no clear evidence about how much risk Lyme disease
poses to a developing fetus, but in the absence of hard data, may physicians
point to the concept that Andrew Pachner's studies implied: This spirochete
behaves in many ways like syphilis, infiltrating along blood vessels. With
syphilis as a model, few physicians feel comfortable about the risks for
mother and child infected with Lyme disease.

With its many parks running through the heart of the city, with the
C&O-Canal running into the heart of Georgetown, Washington is an area in
which the country laps up to the front door of suburban and urban dwellers.
Deer are common along the canals far into town as Glen Echo and Brookmont on
the Maryland-District line and, in Virginia, along the George Washington
Parkway almost to Rosslyn.

Over the coming years, as Washington physicians become more aware of its
many guises, more and more cases of Bell's palsy, dementia, fatigue, and
arthritis will prove to be Lyme disease.

And there may even be a few boys who have withdrawn from friends and
families-boys who are languishing on psychiatric wards-whose blood or spinal
fluid will wind up in Andrew Pachner's lab, registering positive.