Here's a video about Lyme disease in Vermont. It was published in the Poughkeepsie Journal. Two Vermont farmers with Lyme diagnoses are interviewed.
http://www.poughkeepsiejournal.com/videonetwork/2487602337001?odyssey=mod%7Ctvideo2%7Carticle
Sunday, June 30, 2013
Friday, June 28, 2013
How Quickly Can a Tick Infect You?
Clinical evidence for rapid transmission of Lyme disease following a tickbite
Eleanor D. Hynote, Phyllis C. Mervine, Raphael B. Stricker
Diagnostic Microbiology and Infectious Disease, online
before print, November 20, 2011.
http://dx.doi.org/10.1016/j.diagmicrobio.2011.10.003
Abstract
Lyme disease transmission to humans by Ixodes ticks is
thought to require at least 36–48 h of tick attachment. We
describe 3 cases in which transmission of Borrelia
burgdorferi, the spirochetal agent of Lyme disease, appears
to have occurred in less than 24 h based on the degree of
tick engorgement, clinical signs of acute infection, and
immunologic evidence of acute Lyme disease.
Health care providers and individuals exposed to ticks
should be aware that transmission of Lyme disease may occur
more rapidly than animal models suggest. A diagnosis of Lyme
disease should not be ruled out based on a short tick
attachment time in a subject with clinical evidence of B.
burgdorferi infection.
The rest of the study can be found here: http://dx.doi.org/10.1016/j.diagmicrobio.2011.10.00
Petition: Calling for a Congressional investigation of the CDC, IDSA and ALDF
Letter to the Editor, The Lancet Infectious Diseases Published May 2012
Eleanor D. Hynote, Phyllis C. Mervine, Raphael B. Stricker
Diagnostic Microbiology and Infectious Disease, online
before print, November 20, 2011.
http://dx.doi.org/10.1016/j.diagmicrobio.2011.10.003
Abstract
Lyme disease transmission to humans by Ixodes ticks is
thought to require at least 36–48 h of tick attachment. We
describe 3 cases in which transmission of Borrelia
burgdorferi, the spirochetal agent of Lyme disease, appears
to have occurred in less than 24 h based on the degree of
tick engorgement, clinical signs of acute infection, and
immunologic evidence of acute Lyme disease.
Health care providers and individuals exposed to ticks
should be aware that transmission of Lyme disease may occur
more rapidly than animal models suggest. A diagnosis of Lyme
disease should not be ruled out based on a short tick
attachment time in a subject with clinical evidence of B.
burgdorferi infection.
The rest of the study can be found here: http://dx.doi.org/10.1016/j.diagmicrobio.2011.10.00
Petition: Calling for a Congressional investigation of the CDC, IDSA and ALDF
Letter to the Editor, The Lancet Infectious Diseases Published May 2012
Thursday, June 27, 2013
Who says Lyme disease persists after antibiotic therapy?
This amazing library of information about Lyme disease was just brought to my attention this evening. Check it out. This is just one example of what is on the site:- Persistence File:
- 77 peer-reviewed studies showing that Lyme disease can persist or relapse despite antibiotic therapy. 18 pages. Last modified: May 2012
Blumenthal Chairs Senate Hearing In State On Lyme Disease Prevention
Blumenthal Chairs Senate Hearing In State On Lyme Disease Prevention, Hears From Senate Colleague, Patients And Experts
Read the testimony from our panel of patients and experts here.
(Hartford, Conn.) – Today, Senator Richard Blumenthal (D-Conn.) chaired a U.S. Senate field hearing on the federal response to Lyme disease in his capacity as a member of the U.S. Senate Committee on Health, Education, Labor, and Pensions. This hearing, which was widely attended by patients, researchers, and health care providers from the northeast, explored next steps the federal government must take to combat Lyme disease, and how the patient perspective can assist in this effort.
“Today’s field hearing emphasized the importance of putting politics aside and bringing all stakeholders together in the fight against Lyme,” said Blumenthal who has been a leader in the fight against Lyme disease throughout his career and a strong advocate for patients with the disease. He introduced the bipartisan Lyme and Tick-Borne Disease Prevention, Education, and Research Act (S. 1381) during his first year as a U.S. Senator, legislation that would raise awareness about Lyme disease, support diagnostic research, and provide more resources to fight the illness
Blumenthal added, “Lyme disease is a pervasive and pernicious public health disaster that is aggressively spreading to other regions of the country. This hearing further underscored the urgent need for a strong national initiative to combat Lyme disease. Today there was strong consensus that the nation must improve reporting of Lyme cases and develop better diagnostic tools. Inadequate diagnosis and reporting cause devastating damage to countless individuals every day. The disease has reached epidemic proportions, and a national advisory body that gives patients a voice and a seat at the table with policymakers, scientists, researchers and others is imperative to better prevent and treat this disease. I will continue to fight for a bill that will establish such a body, along with other reforms.”
The hearing included three panels. Senator Kirsten Gillibrand (D-N.Y.) – a powerful voice in the fight against Lyme disease –testified on the first panel. Senator Gillibrand provided her perspective on the actions that are needed to fight Lyme disease as a legislator representing the state of New York – a state that has one of the highest incidences of Lyme disease in the country.
“Summer is in full swing, and there is nothing better than enjoying the weather outside with friends and family. But the joy of a summer day can too easily turn deadly from Lyme disease that's taken too many of our loved ones,” said Gillibrand. “It's time once and for all to take the right steps to prevent this horrible disease. We need to do more than check our kids for ticks when they come in from playing. We must invest in better research, educate families on the risks and emphasize prevention, and improve treatment strategies. This bill would develop better tools for diagnosing and reporting Lyme disease, and ensure doctors are better equipped to diagnose and treat those who become infected.”
Three patients testified on the second panel – Mark Hopwood of Trumbull, Dwight Harris of Burlington, and Katy Reid of Ridgefield. They discussed their experience as Lyme disease patients and the need for a patient voice in the prevention, research, and treatment discussion.
Three Lyme disease experts testified on the third panel – Dr. Kirby Stafford, a medical-veterinary entomologist with the Connecticut Agricultural Experiment Station who is an expert on controlling the blacklegged tick that transmit the agents of Lyme disease, Dr. Amiram Katz, an assistant clinical professor of neurology at the Yale University School of Medicine who specializes in the treatment of Lyme disease, and Dr. Joann Petrini, the Director of Clinical Outcomes and Health Services Research in the Department of Medical Education and Research at Western Connecticut Health Network and an integral member of the Lyme Disease Registry Team.
Dr. Stafford spoke about the prevalence of tick-borne illness and the need for better prevention efforts. Dr. Katz spoke about different clinical manifestations of Lyme, the challenges posed by long-term Lyme symptoms, and the need to remain open-minded in considering how to treat the disease. And finally, Dr. Petrini spoke about ongoing research efforts and the need for patient-centered, comprehensive investigations into Lyme disease.
See the source, other links, and contact information:
Dynamics of connective-tissue localization during chronic Borrelia burgdorferi infection
Laboratory Investigation , (24 June 2013) | doi:10.1038/labinvest.2013.81
Dynamics of connective-tissue localization during chronic Borrelia burgdorferi infection
Denise M Imai, Sunlian Feng, Emir Hodzic and Stephen W Barthold
Abstract
The etiologic agent of Lyme disease, Borrelia burgdorferi, localizes preferentially in the extracellular matrix during persistence. In chronically infected laboratory mice, there is a direct association between B. burgdorferi and the proteoglycan decorin, which suggests that decorin has a role in defining protective niches for persistent spirochetes. In this study, the tissue colocalization of B. burgdorferi with decorin and the dynamics of borrelial decorin tropism were evaluated during chronic infection. Spirochetes were found to colocalize absolutely with decorin, but not collagen I in chronically infected immunocompetent C3H mice. Passive immunization of infected C3H-scid mice with B. burgdorferi-specific immune serum resulted in the localization of spirochetes in decorin-rich microenvironments, with clearance of spirochetes from decorin-poor microenvironments. In passively immunized C3H-scid mice, tissue spirochete burdens were initially reduced, but increased over time as the B. burgdorferi-specific antibody levels waned. Concurrent repopulation of the previously cleared decorin-poor microenvironments was observed with the rising tissue spirochete burden and declining antibody titer. These findings indicate that the specificity of B. burgdorferi tissue localization during chronic infection is determined by decorin, driven by the borrelia-specific antibody response, and fluctuates with the antibody response.
Wednesday, June 26, 2013
Viruses in gut confer antibiotic resistance to bacteria
http://www.vetscite.org/publish/items/008045/index.html
25 June 2013
Potential new target to thwart antibiotic resistance: Viruses in gut confer antibiotic resistance to bacteria
Bacteria in the gut that are under attack by antibiotics have allies no one had anticipated, a team of Wyss Institute scientists has found. Gut viruses that usually commandeer the bacteria, it turns out, enable them to survive the antibiotic onslaught, most likely by handing them genes that help them withstand the drug. What's more, the gut viruses, called bacteriophage or simply phage, deliver genes that help the bacteria to survive not just the antibiotic they've been exposed to, but other types of antibiotics as well, the scientists reported online June 9 in Nature. That suggests that phages in the gut may be partly responsible for the emergence of dangerous superbugs that withstand multiple antibiotics, and that drug targeting of phages could offer a potential new path to mitigate development of antibiotic resistance. "The results mean that the antibiotic-resistance situation is even more troubling than we thought," said senior author Jim Collins, Ph.D., a pioneer of synthetic biology and Core Faculty member at the Wyss Institute for Biologically Inspired Engineering, who is also the William F. Warren Distinguished Professor at Boston University, where he leads the Center of Synthetic Biology.
Today disease-causing bacteria have adapted to antibiotics faster than scientists can generate new drugs to kill them, creating a serious global public-health threat. Patients who are hospitalized with serious bacterial infections tend to have longer, more expensive hospital stays, and they are twice as likely to die as those infected with antibiotic-susceptible bacteria, according to the World Health Organization. In addition, because first-line drugs fail more often than before, more expensive therapies must be used, raising health-care costs. In the past, Collins and other scientists have probed the ways gut bacteria adapt to antibiotics, but they've focused on the bacteria themselves. But Collins and Sheetal Modi, Ph.D., the lead author of the study and a postdoctoral fellow in Collins' laboratory and at the Wyss Institute, knew that phage were also abundant in the gut, and that they were adept at ferrying genes from one bacterium to another. The researchers wondered whether treating mice with antibiotics led phage in the gut to pick up more drug-resistance genes, and if so, whether that made gut bacteria stronger. They gave mice either ciprofloxacin or ampicillin -- two commonly prescribed antibiotics. After eight weeks, they harvested all the viruses in the mice's feces, and identified the viral genes present by comparing them with a large database of known genes. They found that the phages from antibiotic-treated mice carried significantly higher numbers of bacterial drug-resistance genes than they would have carried by chance. What's more, phage from ampicillin-treated mice carried more genes that help bacteria fight off ampicillin and related penicillin-like drugs, while phage from ciprofloxacin-treated mice carried more genes that help them fight off ciprofloxacin and related drugs. "When we treat mice with certain classes of drugs, we see enrichment of resistance genes to those drug classes," Modi said. The phage did more than harbor drug-resistance genes. They could also transfer them back to gut bacteria -- a necessary step in conferring drug resistance. The researchers demonstrated this by isolating phage from either antibiotic-treated mice or untreated mice, then adding those phage to gut bacteria from untreated mice.
Phage from ampicillin-treated mice tripled the amount of ampicillin resistance, while phage from ciprofloxacin-treated mice doubled the amount of ciprofloxacin resistance. That was bad enough, but the scientists also found signs that the phage could do yet more to foster antibiotic resistance. That's because gut phage from mice treated with one drug carried high levels of genes that confer resistance to different drugs, which means that the phage could serve as backup when bacteria must find ways to withstand a variety of antibiotics. "With antibiotic treatment, the microbiome has a means to protect itself by expanding the antibiotic resistance reservoir, enabling bugs to come back to be potentially stronger and more resistant than before," Collins said. "Antibiotic resistance is as pressing a global health problem as they come, and to fight it, it's critical to understand it," said Don Ingber, M.D., Ph.D., Wyss Institute Founding Director. "Jim's novel findings offer a previously unknown way to approach this problem -- by targeting the phage that live in our intestine, rather than the pathogens themselves."
Science Daily
June 25, 2013
Original web page at Science Daily
25 June 2013
Potential new target to thwart antibiotic resistance: Viruses in gut confer antibiotic resistance to bacteria
Bacteria in the gut that are under attack by antibiotics have allies no one had anticipated, a team of Wyss Institute scientists has found. Gut viruses that usually commandeer the bacteria, it turns out, enable them to survive the antibiotic onslaught, most likely by handing them genes that help them withstand the drug. What's more, the gut viruses, called bacteriophage or simply phage, deliver genes that help the bacteria to survive not just the antibiotic they've been exposed to, but other types of antibiotics as well, the scientists reported online June 9 in Nature. That suggests that phages in the gut may be partly responsible for the emergence of dangerous superbugs that withstand multiple antibiotics, and that drug targeting of phages could offer a potential new path to mitigate development of antibiotic resistance. "The results mean that the antibiotic-resistance situation is even more troubling than we thought," said senior author Jim Collins, Ph.D., a pioneer of synthetic biology and Core Faculty member at the Wyss Institute for Biologically Inspired Engineering, who is also the William F. Warren Distinguished Professor at Boston University, where he leads the Center of Synthetic Biology.
Today disease-causing bacteria have adapted to antibiotics faster than scientists can generate new drugs to kill them, creating a serious global public-health threat. Patients who are hospitalized with serious bacterial infections tend to have longer, more expensive hospital stays, and they are twice as likely to die as those infected with antibiotic-susceptible bacteria, according to the World Health Organization. In addition, because first-line drugs fail more often than before, more expensive therapies must be used, raising health-care costs. In the past, Collins and other scientists have probed the ways gut bacteria adapt to antibiotics, but they've focused on the bacteria themselves. But Collins and Sheetal Modi, Ph.D., the lead author of the study and a postdoctoral fellow in Collins' laboratory and at the Wyss Institute, knew that phage were also abundant in the gut, and that they were adept at ferrying genes from one bacterium to another. The researchers wondered whether treating mice with antibiotics led phage in the gut to pick up more drug-resistance genes, and if so, whether that made gut bacteria stronger. They gave mice either ciprofloxacin or ampicillin -- two commonly prescribed antibiotics. After eight weeks, they harvested all the viruses in the mice's feces, and identified the viral genes present by comparing them with a large database of known genes. They found that the phages from antibiotic-treated mice carried significantly higher numbers of bacterial drug-resistance genes than they would have carried by chance. What's more, phage from ampicillin-treated mice carried more genes that help bacteria fight off ampicillin and related penicillin-like drugs, while phage from ciprofloxacin-treated mice carried more genes that help them fight off ciprofloxacin and related drugs. "When we treat mice with certain classes of drugs, we see enrichment of resistance genes to those drug classes," Modi said. The phage did more than harbor drug-resistance genes. They could also transfer them back to gut bacteria -- a necessary step in conferring drug resistance. The researchers demonstrated this by isolating phage from either antibiotic-treated mice or untreated mice, then adding those phage to gut bacteria from untreated mice.
Phage from ampicillin-treated mice tripled the amount of ampicillin resistance, while phage from ciprofloxacin-treated mice doubled the amount of ciprofloxacin resistance. That was bad enough, but the scientists also found signs that the phage could do yet more to foster antibiotic resistance. That's because gut phage from mice treated with one drug carried high levels of genes that confer resistance to different drugs, which means that the phage could serve as backup when bacteria must find ways to withstand a variety of antibiotics. "With antibiotic treatment, the microbiome has a means to protect itself by expanding the antibiotic resistance reservoir, enabling bugs to come back to be potentially stronger and more resistant than before," Collins said. "Antibiotic resistance is as pressing a global health problem as they come, and to fight it, it's critical to understand it," said Don Ingber, M.D., Ph.D., Wyss Institute Founding Director. "Jim's novel findings offer a previously unknown way to approach this problem -- by targeting the phage that live in our intestine, rather than the pathogens themselves."
Science Daily
June 25, 2013
Original web page at Science Daily
Tuesday, June 25, 2013
Accelerating Lyme Disease Diagnostics
Accelerating Lyme Disease Diagnostics
New measurement technologies bring hope for early-stage detection
Department: Government & Policy
Keywords: Lyme disease, diagnostics, NIH
DISEASE AGENT
B. burgdorferi, spirochetal bacteria that cause Lyme disease, are difficult to detect directly because only a small number are present in a patient’s blood. The average length of the bacterium is 20–30 µm.
Credit: Janice Haney Carr/CDC
When Tracy Lambeth woke up one day with extreme back pain, she brushed it off as a pulled muscle. But after several weeks, the pain did not go away. She was tested for Lyme disease, even though she did not have a bull’s-eye rash—a common sign of the illness—or any recollection of a tick biting her. The results were negative. Tracy, then 26 and living in Pennsylvania, was told she had fibromyalgia and was sent home without any treatment.
One-and-a-half years later, Tracy was bitten by a tick and developed a bull’s-eye rash on the back of her knee. She was hospitalized for four days. “We think I had the bacteria in my system, and this next tick bite just made everything worse,” she says.
Read rest of story: http://cen.acs.org/articles/91/i25/Accelerating-Lyme-Disease-Diagnostics.html
Friday, June 21, 2013
Congressional investigation of the CDC, IDSA and ALDF?
The U.S. Senate: Calling for a Congressional investigation of the CDC, IDSA and ALDF
Sign the petition:
Petitioning The U.S. Senate
This petition will be delivered to:
- The U.S. Senate
- The U.S. House of Representatives
- The Governor of NH
- The NH State Senate
- The NH State House
- The U.S. Senate
- United States Senator for Connecticut
- Senator Richard Blumenthal
- Comptroller General of the United States
- Gene L. Dodaro
- Congressional Relations GAO
- Katherine Siggerud
We
are experiencing a health crisis here in New Hampshire and across the
country with the growing epidemic of Lyme disease. A number of
legislators have personally been affected and have introduced
legislation to address this problem. Here are just a few recent
examples.
We
are experiencing a health crisis here in New Hampshire and across the
country with the growing epidemic of Lyme disease. A number of
legislators have personally been affected and have introduced
legislation to address this problem. Here are just a few recent
examples.
Massachusetts
Representative David Linsky: “The
occurrence of Lyme disease has reached near epidemic proportions in
Massachusetts. Virtually every family in Massachusetts has been affected
by Lyme disease in some way. Lyme disease is a public health crisis in
the Commonwealth.” Read more…
Connecticut, Rhode Island, New York
Senator Richard Blumenthal: "Today
for me culminates more than a decade of work and probably a decade more,
because I've seen firsthand the devastating, absolutely unacceptable
damage done by Lyme disease to individual human beings, Connecticut
children and residents whose lives have been changed forever as a result
of Lyme disease” Read more….
New Jersey, Pennsylvania
Congressman Chris Smith: "It seems
everywhere I go, someone comes up to me to talk about how Lyme disease
has severely impacted their lives or someone they know," Read more…
Virginia
Virginia Governor’s Task Force Chair
Michael P Farris, Esq: "Doctors here in Virginia are committing
malpractice by saying the ELISA test is sufficient." Read more…
Sign the petition:
Taking back the Lyme research agenda, one project at a time
13th June 2013
How the Lyme community stepped up--with donations big and small--to buy a sophisticated microscope and support the groundbreaking research of Dr. Eva Sapi. (Pssst: still time to donate!)
More than 20 years of government-funded Lyme disease research hasn’t brought us any closer to a cure. Basically, the same folks who created the IDSA Lyme guidelines–which systematically deny care to thousands of Lyme patients every year–also have a lock on government-funded Lyme research money. This results in dead-end projects that waste time and money and do nothing to help suffering Lyme patients.
That’s why we support the trailblazing Lyme research of Dr. Eva Sapi, of the University of New Haven. She has made great strides towards solving the puzzle of Lyme disease—developing new culture techniques, investigating how antibiotics affect all forms of the Lyme bacteria, and examining the role of biofilms in Lyme. She is committed to finding out why the Lyme bacteria can persist in the face of antibiotic treatment, which is critical to finding a cure.
A few months ago, we found out she needed a new piece of equipment–an atomic force microscope–to take her research to the next level. This sophisticated instrument can magnify the Lyme spirochete 1000 times more than standard microscopes, allowing her to observe many live forms of Borrelia under many different conditions.
One of these babies costs about $110,000. We contacted some of our donors privately, asking if they wanted to help out. Some generous people answered that call, and by April, we needed only $20,000 more to complete the purchase.
On May 1, in honor of Lyme Awareness Month, we launched a fundraising page, asking members of the Lyme community to help us close the gap and buy the microscope. Via donations big and small, the needed $20,000 was raised in three days!
Since people still wanted to donate, we pledged that all additional funds raised via that page will go towards Dr. Sapi’s first research project with the new microscope, aimed at unlocking the secrets of Lyme biofilms. More people donated, bringing the current amount raised on the page to more than $30,000.
You guys are great!
The fundraising page will be active until the end of June. I repeat, after the purchase of the microscope, all additional money raised via this channel will go to support Dr. Sapi’s research.
Think we can hit $40,000?
Click here to go to the fundraising page.
TOUCHED BY LYME is written by Dorothy Kupcha Leland, LymeDisease.org’s VP for Education and Outreach. Contact her at dleland@lymedisease.org.
Monday, June 17, 2013
IVIG for Peripheral Neuropathy
I saw this note on the California Lyme listserv today:
A listserv member brought this to the attention of the group today.
Intravenous immunoglobulin therapy helped all of the lyme patients with neuropathy
after 6 months of one treatment per month. You may be put off by the
starting premise of the study -- that their symptoms were part of post-lyme
treatment syndrome -- but the conclusion seemed to be that they still had Lyme or
would not have benefited from the IVIG therapy.
Source: DGNews
Immunoglobulin Therapy Effective for Neuropathy in Patients With
Post-Treatment Lyme Syndrome
Presented at AAN
By Andrew Wilner, MD
SEATTLE, Wash -- May 2, 2009 -- Intravenous immunoglobulin (IVIG) therapy
may improve neuropathic symptoms in patients with post-treatment Lyme
syndrome, researchers stated here on April 28 at the American Academy of
Neurology (AAN) 61st Annual Meeting.
A significant number of patients who had Lyme disease will continue to
have lingering symptoms referred to as post-treatment Lyme syndrome,
according to presenter Amiram Katz, MD, Lambert Professional Center, Orange,
Connecticut. Similar symptoms are seen in patients who have received the Lymerix
vaccine.
The study included 30 patients seen by Dr. Katz (13 females, 17 males;
mean age 48.2 years) who complained of neuropathic pain.
Of the patients, 22 had a history of Lyme disease and 8 patients had
received the Lymerix vaccine. All patients had antibodies to outer surface
protein A (anti-OspA) and persistent symptoms despite at least 1 course of
antibiotics.
Twenty-four patients had electrodiagnostic studies, but there was a poor
correlation between electrodiagnostic and nerve biopsy results.
Four patients with abnormal electrodiagnostic studies had normal epidermal
nerve fibre density on nerve biopsy, while 10 patients with normal
electrodiagnostic studies had abnormal epidermal nerve fibre density on nerve
biopsy. Three patients had inflammatory changes around the nerve endings on
skin biopsy.
All patients were treated with IVIG 2 g/kg per month for at least 6 months.
After IVIG treatment, all patients had improvement of their neurological
examination with respect to their sensation, Achilles reflex, and Romberg
test. Several patients also showed improvement in the number of nerve fibres
on repeat nerve biopsy after treatment. There was no placebo group.
"The diagnosis of chronic Lyme disease is not widely accepted, yet these
patients have symptoms and nerve biopsies that respond to IVIG treatment,
legitimising their complaints," concluded Dr. Katz.
[Presentation title: Diminished Epidermal Nerve Fiber Density in Patients
With Antibodies to Outer Surface Protein A (OspA) of B. burgdorferi
Improves with Intravenous Immunoglobulin Therapy. Abstract P02.021]
after 6 months of one treatment per month. You may be put off by the
starting premise of the study -- that their symptoms were part of post-lyme
treatment syndrome -- but the conclusion seemed to be that they still had Lyme or
would not have benefited from the IVIG therapy.
Source: DGNews
Immunoglobulin Therapy Effective for Neuropathy in Patients With
Post-Treatment Lyme Syndrome
Presented at AAN
By Andrew Wilner, MD
SEATTLE, Wash -- May 2, 2009 -- Intravenous immunoglobulin (IVIG) therapy
may improve neuropathic symptoms in patients with post-treatment Lyme
syndrome, researchers stated here on April 28 at the American Academy of
Neurology (AAN) 61st Annual Meeting.
A significant number of patients who had Lyme disease will continue to
have lingering symptoms referred to as post-treatment Lyme syndrome,
according to presenter Amiram Katz, MD, Lambert Professional Center, Orange,
Connecticut. Similar symptoms are seen in patients who have received the Lymerix
vaccine.
The study included 30 patients seen by Dr. Katz (13 females, 17 males;
mean age 48.2 years) who complained of neuropathic pain.
Of the patients, 22 had a history of Lyme disease and 8 patients had
received the Lymerix vaccine. All patients had antibodies to outer surface
protein A (anti-OspA) and persistent symptoms despite at least 1 course of
antibiotics.
Twenty-four patients had electrodiagnostic studies, but there was a poor
correlation between electrodiagnostic and nerve biopsy results.
Four patients with abnormal electrodiagnostic studies had normal epidermal
nerve fibre density on nerve biopsy, while 10 patients with normal
electrodiagnostic studies had abnormal epidermal nerve fibre density on nerve
biopsy. Three patients had inflammatory changes around the nerve endings on
skin biopsy.
All patients were treated with IVIG 2 g/kg per month for at least 6 months.
After IVIG treatment, all patients had improvement of their neurological
examination with respect to their sensation, Achilles reflex, and Romberg
test. Several patients also showed improvement in the number of nerve fibres
on repeat nerve biopsy after treatment. There was no placebo group.
"The diagnosis of chronic Lyme disease is not widely accepted, yet these
patients have symptoms and nerve biopsies that respond to IVIG treatment,
legitimising their complaints," concluded Dr. Katz.
[Presentation title: Diminished Epidermal Nerve Fiber Density in Patients
With Antibodies to Outer Surface Protein A (OspA) of B. burgdorferi
Improves with Intravenous Immunoglobulin Therapy. Abstract P02.021]
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