Chronic Lyme Dos And Don’ts
Chronic Lyme disease is an ongoing Borrelia burgdorferi infection that can involve any body system or tissue. The infection produces a wide range of symptoms and signs, which can be debilitating for some patients. Common symptoms include severe fatigue, migratory musculoskeletal pain, headaches, and impaired memory. Unfortunately, chronic Lyme disease is complex and often misunderstood, which means that many patients will struggle to obtain the care they need to regain their health. Every patient concerned about Lyme disease and tick-borne illness should know the following.
Transmission Of Bb Via Ixodes Spp Vectors
The black-legged ticks, Ixodes scapularis and Ixodes pacificus on the West Coast, are the primary vectors of Bb in the USA. In endemic areas, the proportion of Ixodes spp. ticks infected with Bb can be remarkably high. One recent survey of the pathogen burden of 197 Ixodes scapularis ticks collected from New York and Connecticut where LD is endemic, revealed 111 ticks were infected with Bb and 37 were co-infected with more than one human pathogen . The high pathogen burden is consistent with previous tick surveys in the same region . In contrast, the percent of infected ticks in other regions of the USA is much lower. In recently published surveys across California, for example, fewer than 5% of Ixodes spp. ticks were infected . Ixodes ticks sometimes carry multiple strains of Bb that may impact the course of disease in people that are co-infected. One tick survey showed that 39% of Ixodes ticks in North America are infected with multiple genotypes of Bb .
Clinical Approach To Patients With A Chronic Lyme Disease Diagnosis
Even if CLD lacks biological legitimacy, its importance as a phenomenon can be monumental to the individual patient. This is because many if not most patients who believe they have this condition are suffering, in many cases for years. Many have undergone frustrating, expensive, and ultimately fruitless medical evaluations, and many have become quite disaffected with a medical system that has failed to provide answers, let alone relief.
Beyond this generalization, patients referred for CLD have heterogeneous medical, social, and educational backgrounds. Furthermore, there is great variation in their commitment to a CLD diagnosis. Some patients are entirely convinced they have CLD, they request specific types of therapy, and they are not interested in adjudicating the CLD diagnosis. By contrast, others are not particularly interested in CLD per se, and are content to move on to a broader evaluation. In the authors experience most patients fall somewhere in betweena certain amount of time must be spent reviewing past experiences and past laboratory tests, then explaining why Lyme disease may not account for their illnesses.
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Eradication Of Lyme Disease
“I hope that it will continue moving forward in development and will become the first therapeutic to treat Lyme disease,” Lewis says. “It will be very important to see whether treating with hygromycin A will diminish the probability of developing chronic Lyme.”
But the plans go even further: Lewis’ team has also shown that feeding hygromycin-laced bait to mice can eliminate Borrelia burgdorferi infections. Theoretically at least, putting out such bait could eradicate Lyme disease from entire areas or even entire countries.
This idea is not entirely new: A field trial with doxycycline baits was successful. But widespread use of this drug for that purpose is undesirable because it could lead to many microbes developing antibiotic resistance. In the case of hygromycin, however, Lewis’ studies indicate that it is extremely difficult for Borrelia burgdorferi to develop a resistance.
The first field trial against Borrelia burgdorferi is scheduled to start next summer. And Lewis’ team is also investigating whether hygromycin A can treat other diseases caused by spirochetes, such as syphilis, which is caused by the bacterium Treponema pallidum.
This article was translated from German.
Ticks – a plague for humans and animals alike
Plotting The End Of Lyme Disease
As people weary of being cooped up during a pandemic winter look forward to a summer outside, residents across the northeastern United States are once again confronted with a familiar virulent pathogen lurking in the woods and fields. Unlike coronavirus, however, this dangerous microorganism doesnt float through the airit enters the body through the bite of a tick.
Lyme disease has been a constant scourge since it was identified five decades ago on the Connecticut coastline, before spreading across the New England and Mid-Atlantic states. Caused by the bacterium Borrelia burgdorferi , the disease has long baffled scientists with its strangely stealthy manifestations.
While Lyme can sometimes be diagnosed early from its telltale bullseye-shaped rash, it often goes unnoticed for weeks in a person before it starts leading to complications including arthritis andin severe casesattacks on heart and brain tissue. While it can often be resolved with antibiotics, some 10 to 20 percent of patients see infections persist, with fatigue, joint pain, and mental impairment lasting months and even years. Sometimes doctors who treat such long-suffering patients arent even able to definitively pinpoint Lyme as the cause. All of those complications make the mission of the new Tufts Lyme Disease Initiative even bolder: Eliminate Lyme Disease by 2030.
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Biological Explanations For Chronic Lyme Disease
Several arguments have been made to support the biological plausibility of CLD and to justify its treatment with lengthy courses of antibiotics. One is that B burgdorferilocalizes intracellularly in the infected host, and that the antibiotics typically chosen to treat it do not penetrate cells effectively. Aside from the fact that B burgdorferi predominantly occupies the extracellular matrix, the antibiotics currently recommended to treat Lyme disease are well-established to treat a variety of intracellular infections. For example, doxycycline and azithromycin are first-line drugs for the treatment of Mycoplasma, Chlamydia, and Legionella, and doxycycline is the drug of choice for Rickettsia and related species. Ceftriaxone is effective against Salmonella and Neisseria, both of which are predominantly intracellular amoxicillin is effective against Listeria.
Another commonly voiced argument is that B burgdorferi assumes a round morphology, variously described as cyst forms,spheroplasts,L-forms, and round bodies. These variants are said to be resistant to antibiotic treatment and require alternative antibiotics and dosing strategies. On close review of the literature there is little evidence that these variants arise in vivo in humans, let alone that they are associated with CLD-like symptom complexes or that they require treatment.
Don’t Let Ticks Get To You
It is not yet possible to prevent Lyme disease. Tick bites should be avoided from the outset also in view of the fact that the insects can transmit other diseases as well, such as tick-borne encephalitis , for example.
This means that anyone who is out and about in meadows or forests should wear clothing that is as long as possible, especially on the legs. Putting on long socks also makes life a little more difficult for the little parasitic arachnids, especially if they are pulled up over the bottom of the pant legs.
Ticks are more visible on light-colored clothing. Anti-tick sprays keep ticks away, at least for a limited time, but not all products are equally reliable.
After returning home from an outing in the wild, you should thoroughly check for ticks. If you find one, you should remove it immediately . The sooner, the better!
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Idsa Publishes New Lyme Disease Treatment Guidelines
The following is a press release from the Infectious Disease Society of America. Analysis from LymeDisease.org will be forthcoming.
New evidence-based clinical practice guidelines for the prevention, diagnosis, and treatment of Lyme diseasehave been developed by a multidisciplinary panel led by the Infectious Diseases Society of America, the American Academy of Neurology, and the American College of Rheumatology. Representatives from an additional 12 medical specialties and patients also served on the panel.
The guidelines provide practical recommendations for clinicians treating patients with Lyme disease, including, but not limited to, primary care physicians, infectious diseases specialists, emergency physicians, internists, pediatricians, family physicians, neurologists, rheumatologists, cardiologists, and dermatologists.
These recommendations aim to serve as a meaningful resource for the safe, effective, evidence-based care of people with Lyme disease. They address clinical questions related to the prevention, diagnosis, and treatment of Lyme disease complications from neurologic, cardiac, and rheumatic symptoms disease expression commonly seen in Eurasia and complications from coinfection with other tick-borne pathogens.
The guidelines include 43 recommendations related to diagnostic testing, including testing scenarios detailed recommendations about Lyme carditis and a discussion of chronic Lyme disease.
Can Stem Cells Treat Lyme Disease
Innovative stem cell treatments may potentially be excellent alternative therapies for the treatment of Lyme and Post-treatment Lyme Disease Syndrome symptoms. Mesenchymal Stem Cells have potent anti-inflammatory and immunomodulatory effects. This ability to positively alter the immune system as well as reduce inflammation may be able to reduce the severity of symptoms in patients with Lyme Disease. When applied systemically through IV deployment, Mesenchymal Stem Cells can travel the body, seeking out inflammation and damaged tissue for repair.
Patients can expect a reduction in inflammation-related symptoms, reduction in pain, regulation of the immune system, and assistance in eliminating the Borrelia bacteria. Additionally, the effects of treatment may last for lengthy periods, potentially even halting the progression of symptoms.
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Treatment For Other Forms Of Lyme Disease
People with other forms of disseminated Lyme disease may require longer courses of antibiotics or intravenous treatment with antibiotics such as ceftriaxone. For more information about treating other forms of Lyme disease, see:
The National Institutes of Health has funded several studies on the treatment of Lyme disease that show most people recover within a few weeks of completing a course of oral antibiotics when treated soon after symptom onset. In a small percentage of cases, symptoms such as fatigue and myalgia can last for more than 6 months. This condition is known as post-treatment Lyme disease syndrome , although it is also sometimes called chronic Lyme disease. For details on research into chronic Lyme disease and long-term treatment trials sponsored by NIH, visit the visit the National Institutes of Health Lyme Disease web siteexternal icon.
Tick Saliva With Healing Powers
Many ticks transfer bacteria or viruses that can lead to serious illnesses. If you get bitten by a tick in Germany, you could contract Lyme disease or Encephalitis. But the small animals can also do good. Oxford researchers have recently found out that a protein from the tick’s saliva can block infections, which makes it a potential cure for a certain type of heart disease.
Ticks – a plague for humans and animals alike
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The Confusing Terminology Of Chronic Lyme Disease
The mere name chronic Lyme disease is in itself a source of confusion. Lyme disease, in conventional use, specifically describes infection with the tick-borne spirochete B burgdorferi sensu lato. The diagnosis chronic Lyme disease, by incorporating that terminology, connotes a similar degree of microbiologic specificity the addition of the word chronic further implies that there is some distinction between chronic Lyme disease and other manifestations of the infection. This distinction in itself is problematic because several manifestations of Lyme disease may indeed present subacutely or chronically, including Lyme arthritis, acrodermatitis chronicum atrophicans, borrelial lymphocytoma, and late Lyme encephalopathy.
Chronic Lyme disease, however, has no clinical definition and is not characterized by any objective clinical findings. The only published attempt to define CLD provisionally produced a description too broad to distinguish CLD from myriad other medical conditions, and the case definition did not mention evidence of B burgdorferi infection . The absence of a definition makes it impossible to investigate whether a patient population with putative CLD has evidence of infection with B burgdorferi this would seem to be a basic requirement to include a syndrome within the term Lyme disease. It stands to reason that it is impossible to even posit a well-designed antibiotic trial when the study population is undefined.
The Misdiagnosis Of Chronic Lyme Disease
Many patients referred for Lyme disease are ultimately found to have a rheumatologic or neurologic diagnosis. Rheumatologic diagnoses commonly misdiagnosed as Lyme disease include osteoarthritis, rheumatoid arthritis, degenerative diseases of the spine, and spondyloarthropathies.,, Some patients are found to have neurologic diseases, including multiple sclerosis, demyelinating diseases, amyotrophic lateral sclerosis, neuropathies, and dementia. Some CLD advocates have argued that these various conditions are simply manifestations of Lyme disease,, but these hypotheses are untenable. Lyme disease is transmitted quite focally, and there is no epidemiologic evidence that these alternative diagnoses cluster in regions with high Lyme disease transmission. There has been no association between diagnoses such as multiple sclerosis, amyotrophic lateral sclerosis, or rheumatoid arthritis and antecedent Lyme disease, these diagnoses do not arise concurrently with other recognized manifestations of disseminated Lyme disease , and there is no quality evidence associating any of these diagnoses with seroconversion to B burgdorferi. Although there can certainly be clinical overlap between Lyme disease and other conditions, objective findings and studies will generally allow them to be differentiated.
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Researchers Investigate Four Promising New Treatments For Lyme Disease
The ticks that transmit Lyme disease have multiplied aggressively over the past 20 years, and now thrive in half of all counties in the U.S., according to a recent study in the Journal of Medical Entomology.
So its no surprise that when Northeastern researchers reported last May how the bacterium that causes the disease evades antibiotics, suggesting new treatments, the media and the general public took notice.
University Distinguished Professor Kim Lewis, who leads the Lyme disease research team, is now expanding that therapeutic reach with the help of a $1.5 million grant from the Steven and Alexandra Cohen Foundation.
The team is pursuing four arms of treatment-related research at Northeasterns Antimicrobial Discovery Center, which Lewis directs.
Northeastern researcher Kim Lewis.
They are: a mouse study of a regimen that eradicated the bacterium in the test tube, setting the stage for human trials antibiotic cocktails using existing drugs strategies to discover new drugs that selectively target the Lyme bacterium and ways to alter the composition of the microbiomethe community of microorganisms inhabiting the human bodyto stop the autoimmune reactions that characterize the disease.
All four show exciting promise. The grant, Lewis says, will give us the flexibility to test our approaches in parallel, which will save us an enormous amount of time.
Preventing chronic disease
Tobacco To Turn Off Ticks
Birds get ticks, too. The house finch has developed a strategy to fight ticks. A study in the Avian Biology journal has shown that breeding house finches use cigarette stubs to “proof” their nests. The nicotine wards off parasites, but sadly the neurotoxin can also have negative effects on the chicks.
Ticks – a plague for humans and animals alike
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Two Standards Of Care For Lyme Disease Treatment
There is significant controversy in science, medicine, and public policy regarding Lyme disease. Two medical societies hold widely divergent views on the best approach to diagnosing and treating Lyme disease. The conflict makes it difficult for patients to be properly diagnosed and receive treatment.
One medical society, the Infectious Diseases Society of America , regards Lyme disease as hard to catch and easy to cure with a short course of antibiotics. IDSA claims that spirochetal infection cannot persist in the body after a short course of antibiotics. The group also denies the existence of chronic Lyme disease.
In contrast, the International Lyme and Associated Diseases Society , regards Lyme disease as often difficult to diagnose and treat, resulting in persistent infection in many patients. ILADS recommends individualized treatment based on the severity of symptoms, the presence of tick-borne coinfections and patient response to treatment.
LDo believes that patients and their doctors should make Lyme disease treatment decisions together. This requires that patients be given sufficient information about the risks and benefits of different treatment options. Then, patient and health care provider can collaborate to reach an informed decision, based on the patients circumstances, beliefs and preferences.
Possible Alternative Treatment For Lyme Disease
- University of Oklahoma
- Researchers have described a new antibiotic that appears to have the potential to cure Lyme disease.
As if COVID and RSV weren’t bad enough, incidents of Lyme disease — a potentially serious disease caused by the bacteria Borrelia burgdorferi and transmitted following a bite of an infected deer tick — also are on the rise in the United States.
Lyme disease affects an estimated 300,000 people in the United States alone. Humans and animals can be infected with B. burgdorferi following the bite of an infected deer tick, also known as the black-legged tick. About 80% of those who contract the disease will develop a bulls-eye rash around or near the site of the bite anywhere from three to 30 days following the bite.
Although early antibiotic treatment is effective for most patients, some 10-20% of patients continue to suffer from symptoms that may include fatigue, muscle pain and cognitive impairment for over six months after therapy. The significance of this debilitating disease has been recently brought into focus by a set of very similar symptoms in patients with “Long COVID.”
The antibiotics currently used to treat Lyme disease are broad-spectrum with significant effects on the human gut microbiome and the potential for increasing resistance in non-target bacteria, Zgurskaya explained, adding that the team sought to identify a compound acting with a narrower spectrum of activity against B. burgdorferi.
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