Medical brain teaser from a colleague...

Okay. So I love to play Scrabble on my computer, early in the morning, with a cup of coffee. 

This morning I played the word "pint" and the computer added an "a" to the word on the next round.  

Pinta? As in Nina, Pinta and the Santa Maria???

I was lost for a definition. So I asked the program to define the word and it came back: skin disease.

Well you all know how I love Google. And guess what, pinta is a skin disease caused by a spirochete -Treponema pallidum (as many of the docs here might well know).

From the Merck Manual:

Bejel, pinta, and yaws (endemic treponematoses) are chronic, tropical, nonvenereal spirochetal infections spread by body contact. Symptoms of bejel are mucous-membrane and cutaneous lesions, followed by bone and skin gummas. Yaws causes periostitis and dermal lesions. Pinta lesions are confined to the dermis. Diagnosis is clinical and epidemiologic. Treatment is with penicillin.

From the Encyclopedia of Children's Health.

Definition

Pinta is a bacterial infection of the skin that causes lesions, red to bluish-black colored spots and splotches, and discoloration of the skin.

Description

Pinta is a skin infection caused by the bacterium Treponema carateum , a relative of the bacterium that causes syphilis. The word "pinta" comes from Spanish and means "painted." Pinta is also known as "azula" (blue), and "mal de pinto" (pinto sickness). It is one of several infections caused by different Treponema bacteria, which are called "endemic" or "non-venereal" treponematoses.

Transmission

Pinta is spread from one person to another by direct skin-to-skin contact. The bacteria enter the skin through a small cut, scratch, or other skin damage. Once inside the body, warmth and moisture allow the bacteria to multiply. The bacterial infection causes red, scaly lesions on the skin.

The disease is also known as endemic syphilis. According to Medscape,

"Treponemes are highly sensitive to azithromycin and penicillin, which remain the drugs of choice. Yaws, pinta, and endemic syphilis are treated with azithromycin or penicillin G benzathine. Alternatives are appropriate only if penicillin cannot be used. Tetracyclines or chloramphenicol have been used. Treatment failures with penicillin have been reported, but reinfection could not be ruled out."

And look at this photo of rashes caused by the disease posted at a site run by BRIAN L. ALTONEN, MS MPH.  It resembles a bull's eye.

Here is Altonen's description of the disease:

Pintos Malady

Pinta is a skin condition that occurs in Mexico, Central America and South America.  It is caused by Treponema pallidum carateum, an organism quite similar in biology and genetics to the Treponema pallidum associated with syphilis.   The ability for a bacterium to evolve within a given region is obviously quite possible, and this version of Treponema is no exemption to this evolutionary concept.   The prevalence of  this version of Treponema is not unique to Mexico's epidemiological history.  As early as Chris Colon's arrival to the New World in 1492, it was possible for this form of sexually transmitted disease to make its way around the world in exchange for equally contagious forms of measles and small pox left behind by the same sailing crew.

The most noticeable feature of those infected by this bacterium is the mottled skin, with varying colors and sizes of the patches that are formed.  The resemblances of these patches to the mottled, marble-like patterns found on Pinto horses naturalizing to this region is the source of the name for this condition.  Pinta is transmitted through direct skin-to-skin contact rather than through mucosal membranes like the related Treponema pallidum when it is responsible for syphilis.  Two to three weeks following transmission the area in and around the point of contact erupts to form a papule, which ultimately becomes dry and scaley enabling the skin to flake off.  Three to nine months later, thick, flat patches are formed all over the body which can remain there permanently at times resulting in reductions and increases in the natural pigmentation process scattered about the body's surface irregularly.

What I haven't seen yet is how people come in contact with this bacteria in the first place.The disease common in childhood. Here's a 2014 article on the topic from Clinical Microbiology Reviews. 

I guess this rambling also speaks to six degrees of separation for bacteria too. And certainly provides food for thought about the rashes, sexual transmission and other issues we have discussed here.

PA woman says she was sickened by risky Lyme treatment

Mon Dec 14, 2015 12:24 pm (PST) . 

*Pa. woman says she was sickened by risky Lyme treatment*
Tom Avril, /The Philadelphia Inquirer/, Philadelphia, Pennsylvania

December 8, 2015
http://www.philly.com/philly/health/20151208_Pa__woman_says_she_was_sickened_by_risky_Lyme_treatment_.html
or http://tinyurl.com/jo9k45k

Ashley Pettis started to have trouble concentrating at the end of spring 
semester in 2013 at Lancaster Bible College, and soon began to feel 
sluggish and achy.

Exhausted by the end of the summer, she was found to have mononucleosis. 
But later, she still felt sick, and went that fall to Haverford Wellness 
Center in the Montgomery County town of Harleysville, seeking answers.

Clinicians there said she had late-stage Lyme disease, a chronic form of 
the tick-borne illness that is diagnosed in an estimated 300,000 
Americans a year.
...
The treatment they administered was controversial: five months of 
heavy-duty oral and intravenous antibiotics costing tens of thousands of 
dollars that her insurance would not cover.

Pettis did not have Lyme disease at all.

*Full story & comments*: http://tinyurl.com/jo9k45k

*Letters*: inquirer.letters@phillynews.com 
<mailto:inquirer.letters@phillynews.com>

What do you think? Leave comments!

-Bob

Ticks in Christmas trees

ALBANY, N.Y. (NEWS10) – An unseasonably warm winter could see ticks and mites in Christmas tree branches.

Every year, hundreds of thousands of trees are cut, sold, and stood up in houses all over the world. But this season has been abnormally warm, and experts say that can bring some unwanted insects hidden in the branches.

Christmas season is an industry all on its own. Troy's Landscaping in Albany New York sells over 1,500 trees each year. This winter is off to a mild start, and without snow to brush off the branches, some trees may have insects, such as ticks and mites, settled in for the winter.

"They can shake them out," tree salesman Justin Burbube said. "If they are nervous, they can go home, set it up in their garage for a day or two. If your garage is warm enough, if there are ticks, that may help them get out."

If you do find bugs in your tree, don't spray pesticides on the tree. It's toxic to breathe in and could cause the tree to catch on fire if it has Christmas lights.

Burbube said there's no way to know exactly what, if anything, is living in a Christmas tree, so it's important to remain observant.

"Just be vigilant," he said. "You check your kids and your dog that you aren't getting anything like that. A lot of places are like us. They do a good job of making sure that you don't get the ticks."

See the article:

http://wdtn.com/2015/12/09/warm-winter-could-mean-unwanted-insects-like-ticks-in-christmas-trees/

Isolation of live Borrelia burgdorferi sensu lato spirochetes....

Isolation of live Borrelia burgdorferi sensu lato spirochetes from patients with undefined disorders and symptoms not typical for Lyme borreliosis — ScienceDirectThis is groundbreaking, if confirmed!

http://www.sciencedirect.com/science/article/pii/S1198743X1500991X

Austrailian soldier claims antimarial drug mefloquine caused brain damage

This story is relevant to Lyme because of the references to doxycycline (the antibiotic most often used for treating Lyme disease) and anti-malarial drugs such as Lariam. That drug brings to mind other antimalarials such as Mepron and Malarone, both used for treating Babesia in the brain.

http://www.abc.net.au/news/2015-12-11/former-soldier-comes-forward-over-adf-drug-trial-brain-injury/7008620

A West Australian former soldier has spoken out over fears an anti-malaria drug he took as part of a pharmaceutical trial while serving has left him with a permanent and debilitating brain injury.

Former rifleman Mathew Emerson came forward after another high-ranking currently serving soldier gave evidence at a Senate inquiry last week,detailing concerns hundreds of soldiers may have suffered severe long-term side effects from the drug mefloquine, including depression, anxiety, vertigo, nightmares and suicidal thoughts.

Mr Emerson, 35, said his battalion was offered the choice of mefloquine, marketed as Lariam, or the older more established drug doxycycline, prior to a planned deployment to East Timor in 2001.

"They said 'it's got less side effects than doxycycline, and you only need to take it once a week', so most of the people I knew decided to take the mefloquine," he said.

"I felt perfectly safe and that the Army had my life as their best interest. They trained me, they're meant to look after me, but in this case, they didn't."

He said he was told to sign a consent form, and that if he did not sign it he could not deploy.

He stopped taking the drug after experiencing nausea, but then was placed back on it for another five weeks.

In 2003, Mr Emerson said he started to "go downhill" mentally.

"I started to feel depressed. I wanted to kill myself, had constant thoughts about it," he said.

"I went to see the Army psychiatrists, and it sounded stupid when I went to say the words so I didn't say anything, I just kept my mouth shut.

"I put on a rosy exterior, just tried to keep a smile on my face all the time."

He also started having nightmares and outbursts of anger, and in 2004 had a complete nervous breakdown where he woke up in hospital with no memory of the previous few days, despite being conscious and alert during that time.

Mefloquine use in Australia

• Mefloquine approved for use by Australian Therapeutic Goods Administration (TGA) in 1993
• Drug's factsheet from manufacturer Roche notes neuropsychiatric effects including anxiety, paranoia, depression and psychotic behaviour have been reported to occur long after the drug has ceased to be taken
• The ADF continues to prescribe mefloquine, but says it is a "third-line agent", and only used when one of two other TGA-approved medications are not appropriate
• ADF says prescriptions have averaged 25 per year for the past five years

Treatment for MS does well in phase 3 trials

(since this is one of the misdiagnoses of Lyme, maybe it will interest some)

Anti-CD20 antibody wows in multiple sclerosis

• Cormac Sheridan

Nature Biotechnology

33,

1215–1216

(2015)

doi:10.1038/nbt1215-1215

Published online

09 December 2015

Article tools

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Jessica Wilson / Science Source

MRI of normal brain (left) and one with multiple sclerosis (right).

Roche plans to seek approval early in the new year for its anti-CD20 antibody ocrelizumab as therapy in both forms of multiple sclerosis (MS)—primary progressive and relapsing remitting—following positive outcomes from recent phase 3 trials.

_______________________________________________

CFS = HHV6 IN VAGUS NERVE

Is chronic fatigue syndrome (CFS) actually an infection by a type of herpes virus?

CFS: a herpesvirus infection of the vagus nerve?

				CFS: a herpesvirus infection of the vagus nerve? CFS: a herpesvirus infection of the vagus nerve? Michael VanElzakker, a researcher affiliated with the Tufts University PTSD neuroimaging laboratory as well as the ...
				View on hhv-6foundation.org	Preview by Yahoo

Dolores Claesson, FL 

German sudy finds Lyme disease in mosquitoes

Ticks Tick Borne Dis. 2015 Nov 12. pii: S1877-959X(15)30032-7. doi: 10.1016/j.ttbdis.2015.10.018. [Epub ahead of print]

Occurrence of Borrelia burgdorferi s.l. in different genera of mosquitoes (Culicidae) in Central Europe.

Melaun C¹, Zotzmann S¹, Santaella VG¹, Werblow A¹, Zumkowski-Xylander H², Kraiczy P³, Klimpel S⁴.

 

Author information

http://www.sciencedirect.com/science/article/pii/S1877959X15300327

 

Abstract

 

Lyme disease or Lyme borreliosis is a vector-borne infectious disease caused by spirochetes of the Borrelia burgdorferi sensu lato complex. Some stages of the borrelial transmission cycle in ticks (transstadial, feeding and co-feeding) can potentially occur also in insects, particularly in mosquitoes. In the present study, adult as well as larval mosquitoes were collected at 42 different geographical locations throughout Germany. This is the first study, in which German mosquitoes were analyzed for the presence of Borrelia spp. Targeting two specific borrelial genes, flaB and ospA encoding for the subunit B of flagellin and the outer surface protein A, the results show that DNA of Borrelia afzelii, Borrelia bavariensis and Borrelia garinii could be detected in ten Culicidae species comprising four distinct genera (Aedes, Culiseta, Culex, and Ochlerotatus). Positive samples also include adult specimens raised in the laboratory from wild-caught larvae indicating that transstadial and/or transovarial transmission might occur within a given mosquito population.

Exploring The Link Between Infection And Mental Illness

The latest research into the link between germs and mental illness -- and what we all need to know. 

Internet Archive Book Images

In the early 20th century, if you displayed symptoms of mental illness a doctor might have searched you for signs of infection, and then removed the teeth, tonsils or other body part that was the suspected culprit. Treatment has evolved a great deal since then, but the idea that infection could play a significant role in some mental illness is making a comeback. A number of experts say ten to fifteen percent of conditions – from schizophrenia to bipolar disorder – could be caused by infection. But many others warn too much remains unknown to dramatically change our thinking about treatment. We explore the link between germs and our mental health.

Guests

• Dr. Robert Yolken director, Stanley Laboratory of Developmental Neurovirology; professor of pediatrics, Johns Hopkins School of Medicine
• Harriet Washington medical ethicist and writer; author of the new book "Infectious Madness: The Surprising Science of How We 'Catch' Mental Illness", and of 2007's "Medical Apartheid", winner of the National Book Critics Circle Award; Shearing fellow at the University of Nevada's Black Mountain Institute; former Research Fellow in Medical Ethics at Harvard Medical School
• Dr. James Giordano Professor of Neurology; Chief, Neuroethics Studies Program at Georgetown University Medical Center

Read full transcript and/or Listen to the show:

http://thedianerehmshow.org/shows/2015-11-24/exploring-the-link-between-infection-and-mental-illness

Lyme disease increase predicted by acorn boom

In New York's Hudson Valley, it's hard to go outside without stepping on an acorn. Oaks have 'boom and bust' acorn production cycles. In lean years, trees produce a handful of nuts. In boom years, acorns seem to rain down from the sky. We are currently experiencing an acorn bumper-crop, or what ecologists call a 'mast' year.

In some forests, there can be more than 100 acorns per square meter. This is welcome news to animals like mice, chipmunks, and squirrels. They can gorge on the bounty and stock their larders. Acorn caches help wildlife avoid predators and survive the lean months of winter. They even give well-fed rodents a jump-start on the breeding season.

For this reason, acorn "mast" years are also harbingers of future Lyme disease risk. In the summer following acorn booms, white-footed mouse numbers explode. In New York's Hudson Valley, these mice play a major role in infecting blacklegged ticks with the agents that cause Lyme disease, Babesiosis, and Anaplasmosis.

Cary Institute disease ecologist Rick Ostfeld explains.

"The ticks that are emerging as larvae in August – just as the mice and chipmunks are reaching their population peaks – they have tons of excellent hosts to feed from. They survive well and they get infected with tick-borne pathogens. And that means that two years following a good acorn crop we see high abundance of infected ticks, which represents a risk of human exposure to tick borne disease."

Predictions are based on 20 years of field studies that have confirmed the relationship among acorn mast years, mouse outbreaks, and the prevalence of infected ticks. Mark your calendars – 2017 will likely be a bad year for Lyme disease.

"Earth Wise" is heard on WAMC Northeast Public Radio and is supported by the Cary Institute.