The Lyme disease epidemic continues to rage world-wide in addition to the frightening explosion of confirmed cases in the US, and yet the CDC (Center for Disease Control) and the IDSA continue to publish the clearly untrue statement that Lyme disease is hard to contract and easy to treat.

What many people do not understand is that the western blot was never meant to be a diagnostic authority but a tool to support clinical diagnosis.  The test measures antibodies, not the actual bacteria so if you have any positive bands on the western blot it means you have been exposed to Lyme disease.  It is the controversial (although why there is controversy is confusing in the extreme) amongst any intelligent mind, perhaps even more so with trained medical minds, why a western blot with any positive bands be considered a “false positive” or worse yet “negative” when the patient exhibits all of the symptoms of Lyme.

Add to that puzzle the requirement of a bulls-eye rash when researchers know that some viral strains of borrelia do not cause bulls-eye rashes (and even when they do, the rash is easily hidden in hair where tiny ticks could easily hide as they take their meal) and we must wonder if the CDC is purposefully dropping the ball.

Now, as science around Lyme and other tick-related diseases become more precise, the question begs to be asked: “Why isn’t the western blot more accurate?”

Furthermore, the proteins evaluated within the test are purposefully limited – in fact originally the test evaluated more proteins, some of which were much more indicative of the presence and activity of Borreliosis burgdorferi.  The extra bands were later removed along while at the same time the criteria for positive results was raised to demand more positive bands (five), even though one positive band should be enough to confirm a clinical diagnosis keeping in mind the CDC’s own instructions to use the western blot as a confirmation tool NOT a diagnostic tool.

Currently, Lyme disease tests in the United States are geared to detect a strain or two of a single species: Borrelia burgdorferi sensu stricto (SOURCE:GALDA – Georgia Lyme Disease Association.)  Even though we know there are many more strains capable of causing illness. (Some strains do not cause illness in humans, and some do not cause a rash.)

Another reason for negative results with Lyme infected specimens is due to differing proteins found among numerous strains of various B. burgdorferi species which provide further explanation for the reason some suspected Lyme patients may only show a positive band or two instead of the CDC’s required five.

A Chinese study found that changing western blot criteria to detect the prevalent strain of Lyme bacteria in their region increased the accuracy of the tests. Another study in the United States proved that mixing two infectious Borrelia strains in a western blot assay increased the test’s sensitivity. If simply adding other strains of the same Lyme species increases the western blot’s sensitivity, the changes needed in order to detect various Lyme species may be incredible.

“Up to now, the only species in the complex Borrelia burgdorferi sensu lato known to cause Lyme borreliosis in the United States has been B. burgdorferi sensu stricto. However, some atypical strains closely related to the previously designated genomic group DN127 have been isolated in the United States, mostly in California. [...] we analyzed the nucleotide sequences of the rrf-rrl intergenic spacer regions from 19 atypical strains (18 from California and one from New York) and 13 North American B. burgdorferi sensu stricto  strains (6 from California). [...] A heterogeneous group comprising strains belonging to the previously designated group DN127 clustered separately from B. burgdorferi sensu stricto. Within this cluster, the deep branches expressing the distances between the rrf-rrl sequences reflect a high level of divergence. This unexpected diversity contrasts with the monomorphism exhibited by B. burgdorferi sensu stricto. [...] We conclude that the taxonomy and phylogeny of North American B. burgdorferi sensu lato should be reevaluated. For now, we propose that the genomic group DN127 should be referred to as a new species, B. bissettii sp. nov., and that other related but distinct strains, which require further characterization, be referred to as Borrelia spp. ” (SOURCE: Journal for Clinical Microbiology: “Expanded Diversity among Californian Borrelia Isolates and Description of Borrelia bissettii sp. nov. (Formerly Borrelia Group DN127)” December 1998

For excellent information to better understand the current process for diagnosing Lyme and specifically the western blot, please read http://www.lymenet.de/labtests/brenner.htm

Following are recently published medical abstracts courtesy of Journal of Clinical Microbiology:

“Genetic Heterogeneity of Borrelia burgdorferi Sensu Lato in the Southern United States Based on Restriction Fragment Length Polymorphism and Sequence Analysis”

T. Lin, J. H. Oliver Jr.,L. Gao,.T. M. Kollars Jr., and K. L. Clark

I am sorry to say that I missed it.  But thanks to Kettmann.com,  we are all able to watch it, and download it to share with friends and family.

Please watch it now or later  (the video is 40 minutes long.)  Just follow these simple steps – courtesy of Channel 5, Boston Massachusetts, ABC-TV WCVB.

For Windows click here to watch streaming download.

For Apple click here to watch streaming download.

Click on SAVE FILE, and then OPEN after the file has been completely downloaded.

The file is large and will take some time to download.  When it is finished, double-click on the GOM icon and the movie will open in a new window.

There is a button on the top right with 4 little boxes which will open the movie in full screen.

Enjoy!

People who are sick with Lyme disease and treating the disease for years with antibiotics and/or alternative treatments – sometimes with a single protocol and sometimes using several protocols at once – are beginning to wonder, “…maybe I don’t have Lyme, maybe it is something else.”

The  problem continues to rest with inadequate testing for a clear diagnosis. Researchers in Italy and subsequently in the UK have recently (October and November 2011) published findings that demonstrate Bartonella heslslae transferring DNA to human endothelial cells. Endothelial cells are the thin layer of cells that line the interior of blood vessels.  It doesn’t take a lot of imagination to consider the impact of this information with respect to the neurological aspect of our disease(s).

According to Dr. James Schaller (who actively researches and collaborates with doctors from around the world), Bartonella is far more common than Lyme and is spread not only by ticks but by just about every other biting insect you can think of.  He writes in his soon-to-be-published textbook on human infections spread by flea and ticks:

Bartonella is no footnote and is more common than Lyme.  Many years ago when I first got involved in the super specialtyof tick and flea infection medicine, no one took Bartonella seriously.  It was presented as an easy to kill infection, and of no real concern.  It was rarely discussed at infection medicine meetings, in guidelines or infection textbooks.  (I noticed the same thing after publishing four books on Babesia–the parasite books I purchased only had two pages on this serious infection).

When I published the most recent book on Bartonella, it showed that Bartonella did not have two or three skin patterns, but vast numbers.  This was a fully new and massively expanded diagnostic tool based on reading the world literature and examining heavily infected patients.  I was also surprised that no one was looking for the chemicals altered by the presence of Bartonella and the dynamic of these chemicals when both Babesia and Bartonella are present.  You can read this in the latter sections of my textbook, Babesia 2009 Update.

This year a new human Bartonella species was added to the over thirty five Bartonella species publically published in Genetic Data banks.  It was discovered and highlighted by the talented veterinarian researcher Edward Breitschwerdt.  He has said things more clearly than the ideas I was pondering in 2005, while doing most of my Bartonella book reading. 

Dr. Breitscwerdt has said simply, but with devastating and highly useful clarity that Bartonella testing is terrible, the treatments are poor, it is typically found on the outside of red blood cells, and the current research on Bartonella is pathetic (referencing one study at NIH.)

 If this was not enough, he said in 2011 “Bartonella is carried by more vectors than any infection on the earth.”  So it is hardly a backdoor “co-infection.”  Indeed, this month Bartonella was literally shown to alter human DNA.  The implications of this possibility are staggering, and may support what I reported six years ago—Bartonella is not killed simply or easily.  My appeal is simple: treating it like a footnote infection is outdated and harmful.

The symptoms of Bartonella are very similar to Lyme but may include other more specific symptoms such as swollen lymph glands, sore throat, painful soles of feet especially in the morning and hyperacusis (sharp pain from sound).  See more on Bartonella.

Watch ILADS Lyme disease conference lectures as leading professionals examine the cutting edge research and state-of-the-art clinical applications in the treatment and diagnosis of Lyme disease.

We will be restreaming select presentations on December 17, 2011 that were not seen due to technical difficulties on October 27th & 28th, 2011 free of charge.

http://www.ilads.org/emails/livestream_online12172011.html

See the December 17, 2011 video streaming schedule below:

1:00pm-1:30pm (EST) or (10:00am-10:30am PST) Understanding
Symptoms Related to Visual Dysfunction following a
Tick-Borne Event — William V. Padula, OD

1:30pm-2:15pm (EST) or (10:30am-11:15am PST) Borrelia
Infections- diagnosis and treatment — Joseph J. Burrascano,
Jr. MD

2:15pm-3:00pm (EST) or (11:15am-12:00pm PST) Lyme Disease &
Babesiosis: Updates on Diagnosis and Treatment 2011 —
Richard I. Horowitz, MD

3:00pm-3:45pm (EST) or (12:00pm-12:45pm PST) Pregnancy and
Tick-borne Diseases: Gestational Lyme — Charles Ray Jones, MD

3:45pm-4:30pm (EST) or (12:45pm-1:30pm PST) Overview of
Integrative Patient Care in Tick-Borne Diseases — Steven
Bock, MD

4:30pm-5:15pm (EST) 0r (1:30pm-2:15pm PST) Identifying
Environmental Illness and Mold Exposure in Patients with
Persistent Lyme Disease. — Lisa L. Nagy, MD

5:15pm-6:00pm (EST) or (2:15pm-3:00pm PST) Management of
Ixodes scapularis bites. — Elizabeth Maloney, MD

6:00pm-7:15pm (EST) or (3:00pm-4:15pm PST) Coinfections And
The Opportunistic Groupies — Christine Green, MD

For complete information about the ILADS Live Streaming
Conference Presentations, December 17, 2011:
http://www.ilads.org/emails/livestream_online12172011.html

In a vast section of the Maine Wilderness there were one hundred and forty-two (142) moose found dead according to a recent article in the Bangor Daily News (December 2, 2011). These apparently healthy moose are found dead covered with ticks which points to the astronomical increase in tick population, and fuels the raging epidemic of Lyme disease and other potentially fatal tick born diseases. (Article link at end of post)

The moose were unmarked and dead for no apparent reason other than the fact that they were completely covered in ticks.  Their natural predators will not eat the moose in this condition,but the ticks will.  The ticks fill their bellies and hop off to breed more – up to three thousand youngsters each.

Do the math.

It isn’t just the moose in trouble.

This alarming news travels fast in a state that depends greatly on tourists and hunters who bring revenue into the state when they venture north to view the beautiful Maine wilderness and hunt in the vast forests.  And with Lyme and other tick borne diseases spreading like wildfire, people are hesitating to risk the exposure.

Is an enjoyable week-end worth the very real possibility of ending up as a tragic statistic – out of work and painful suffering for who knows how many years?  In New England the epidemic is common knowledge, even in Maine there are very few people who don’t know someone stricken with the disease.

I won’t be surprised to see legislation asking for pesticide drops to push back the dangerous infestation (as hinted in the article.)

When it was just humans suffering with tick born diseases we were told that we were crazy.  Now that the moose are endangered something must be done.

To read the article click here.

Medical researchers and Lyme-literate doctors have known for some time that co-infections complicate the recovery from Lyme borreliosis and in some cases prevent it but the reason for such difficult complications was unclear.

After the discovery of the role of biofilms in Lyme disease by Dr. MacDonald, subsequent research has uncovered evidence of communication within the biofilm between different pathogens that may illuminate the key factors of the problem and hopefully lead to reliable solutions. See 2008 slide show re Borrelia in Biofilm.

Biofilm Overview

The National Institutes of Health estimates that 60% of all human infections and 80% of refractory infections (def. unresponsive to medical treatment) are attributable to biofilm colonies.

• The protection conferred upon microorganisms by biofilm allows them to achieve a high level of antibiotic resistance, stealth and invisibility.

• Biofilm not only provide a physical barrier to antimicrobial agents (pharmaceutical antibiotics) and host antibodies, but facilitate the exchange of antibiotic-resistant genetic material between organisms and may contain antibiotic-degrading enzymes.

• In fact, biofilm communities can be 1000 times more resistant to antibiotics than free-floating bacteria.

• The decreased growth rate of sessile microorganisms (def. Permanently attached to a substrate; not free to move about; “an attached oyster”) also reduces their antibiotic susceptibility as most antimicrobial agents require rapid cell growth in order to effectively kill or inhibit the microbes.  Biofilm thus render pathogenic microorganisms enormously difficult to eradicate, and can almost single-handedly contribute to localized or systemic inflammatory reactions and delayed wound healing.

• Depending on the type of biofilm, one or more species of pathogens may be found embedded in the extracellular polymeric substance (EPS).  Bacterial EPS maybe a carrier of, or may have heavy metals embedded in them which may require chelation.

Pathogenic bacterial known to reside in biofilms include, but are not limited to: Borrelia burgdorferi (Lyme bacteria), Escherichia coli, Candida albicans (yeast and fungal mutation), Clostridium difficile, Clostridium perfringens, Helicobacter pylori, Klebsiella pneumoniae, Legionella pneumophila, Listeria monocytogenes, Pseudomonas aeruginosa, Salmonella typhimurium, Staphylococcus aureus, Staphylococcus epidermidis, and Vibrio cholerae.

The number of human diseases shown to be associated with biofilms is ever expanding and includes: chronic bacterial prostatitis, chronic rhinosinusitis (chronic sinus infections), cystic fibrosis pneumonia, infective endocarditis, periodontitis, recurrent otitis media, and virtually all device and implant related infections.  Strong evidence is also beginning to emerge for an etiologic (causative) role of pathogenic mucosal biofilm in gastrointestinal diseases, such as Irritable Bowel Disorders (IBS): Crohn’s disease and ulcerative colitis.

Biofilms can be composed of multiple species of pathogens.

Lyme biofilms are composed of the covering of the biofilm which forms a matrix rich in sugars, called extracellular polymeric substance (EPS).  In addition to polymers, it is composed of extracellular DNA, proteins that are expressed by the pathogens, polysaccharides, metals, and minerals such as calcium, magnesium and iron. 

Lyme bacteria exhibit a double cell membrane envelope structure (with an outer and inner membrane ). However, the structure of the spirochete envelope is significantly different from the typical double membranes of gram-negative bacteria . At this time (2011) the outer membrane of Borrelia is determined to be fluid-like, and it is composed of 45-62% proteins (high in lipoproteins), 23-50% lipids (high in glycolipids), and 3-4% carbohydrates.

Lipoproteins (made of proteins and lipids) in Borrelia play a major role in the inflammatory response within the infection sites in the body. One of the functions of the lipoprotein is that it acts as an adhesion in order that the organism can stick to surfaces. Unfortunately the organism itself appears to have a pump system, whereby substances that are internally toxic to it may be removed – these substances include detergents, bile salts, antibiotics , dyes, and heavy metals.

Biofilm pathogens talk to each other

According to the massive textbook “Borrelia: Molecular Biology, Host Interaction and Pathogenesis” recently published by Caister Academic Press, biofilms act like an intelligent community of pathogens, and embedded pathogens appear to have a signaling communication system. Bacteria can produce chemical signals (“talk”) and other bacteria can respond to them (“listen”) in a process commonly known as cell-cell communication or cell-cell signaling. This communication can result in coordinated behavior of microbial populations.The pathogens aggregate together, then signal one another to secrete the sticky, protective covering and express proteins.  As biofilms stick to the tissue, inflammation and tissue damage occur.

Biofilm communication was first discovered in the 1970s, when scientists at Harvard University and Scripps Institute of Oceanography began to report on a unique and fascinating phenomenon.  The system they were investigating was the production of bioluminescence by the marine bacterium Vibrio fischeri (then called Photobacterium).  As a result of extensive studies, scientists Nealson, Platt and Hastings published their findings which indicated that the bacteria was “estimating” their population density, which of course implied that they were in communication with one another.  In 1970 the idea was absurd to mainstream science but today it is commonly accepted phenomena known as “quorum sensing”.

Montana State University (blog picture courtesy of Montana State University) has a National Science Foundation Engineering Research Center that focuses exclusively on biofilms.  They have found that each of the quorum sensing mechanisms they have examined is highly individualized to the specific bacterium possessing it.

Bonnie Bassler at Princeton University explains that this “census-taking” enables the group to express specific genes only at particular population densities. Quorum sensing is widespread; it occurs in numerous Gram-negative and Gram-positive bacteria. In general, processes controlled by quorum sensing are ones that are unproductive when undertaken by an individual bacterium but become effective when undertaken by the group.

She has also discovered that in addition to their “private languages”, many bacteria have developed generalized chemical messages that can be interpreted by members of other species. In lectures she postulates that in the future, we can hope to develop microbes that can “turn-on” good behavior and “turn-off” bad behavior.

For scientists in the biofilm community this information is like a lightning bolt that has sparked numerous implications in medicine.  For those of us with chronic Lyme, some believe that this may explain why and how co-infections stall or prevent recovery from our unique “Lyme soup.”

SOURCES: University of Montana, Borrelia: Molecular Biology, “Host Interaction and Pathogenesis” by Caister Academic Press, Princeton Department of Molecular Biology, Klaire Labs

The German  “Guidelines for the Diagnosis and Treatment of Lyme borreliosis” is a far cry from the US standard written by IDSA (Infectious Disease Society of America).  In fact it reads more like Dr. Burrascano’s Guide and therefore deserves a careful read.

Not only does the guide define chronic Lyme disease but it clearly validates it.  Also noteworthy is the statement, “A negative serological finding does not rule out Lyme borreliosis.”

It is exciting to see the progress that one year can make.

As each new discovery about Lyme and associated tick-borndiseases are made and published, creative theories are generated which stimulate further study and further discoveries are made which continues to snowball making science our best hope for a cure.

Thankfully, every year ILADS brings professionals together to examine the cutting edge research and state-of-the-art clinical applications that we are all hungry to hear. ILADS conference faculty will train the next generation of physician-scientists who will certainly be future leaders in the treatment of Lyme and associated tick-born diseases. This year’s Lyme Disease Professional Conference was held on October 28-30, 2011, Friday-Sunday at the Fairmont Royal York in Toronto, Canada.

Historically, the Annual ILADS Professional Conference is designed to foster collaboration and dialogue between Lyme disease researchers and those who care and advocate for Lyme disease patients in a variety of settings. The 2011 conference provided updates in clinical knowledge and treatment techniques. Innovations in care were also addressed in plenary sessions and workshops. Conference objectives for 2011 were:

• To teach medical professionals the cutting edge techniques of diagnosing and treating Lyme and Other Tick Borne Diseases
• To explore pathophysiological mechanisms of chronic diseases that may apply to Lyme and Other Tick Borne Diseases
• To enhance collaboration between community clinicians and university scientists
• To encourage initiation and publication of clinical studies of Lyme and Other Tick Borne Diseases by ILADS members

Those who were lucky enough to attend the conference were certainly overwhelmed by the mass amounts of information being presented.  Dr. Brian Fallon, the director of the Columbia University Chronic Lyme Research Facility and Scientific Director of the conference recently sent out a summary of the salient points of the conference.  You can access the entire summary on left panel below menu at this site.

 The International Lyme and Associated Diseases Society (ILADS) is firmly established as the only professional society dedicated exclusively to the diagnoses and treatment of these conditions.

As the controversy over Lyme disease dominates the news, professionals have learned and deployed new strategies to fundamentally improve patient care. As the numbers of Lyme disease grows, we anticipate a growing demand for expertise in Lyme disease for every specialty.  View ordering information for conference videos here.

According to “Private MD News” , a team of researchers recently reported that there may be a simpler way to treat early Lyme disease rather than six weeks of Doxycycline.

Researchers from Ludwig Maximilian University in Germany found that the application of a local antibacterial gel to the site of a bug bite that transmitted the infection may quickly kill the entire virus responsible for the disease. Of course it is important to recognize that some forms of Lyme disease create a rash but do not invade the blood stream to attack any other part of the body.  This makes it difficult for doctors to know just what kind of Lyme they are treating.

This new therapeutic approach would be easier for patients to complete, but oral antibiotics would still be necessary due to the possibility of a virulent form that enters the blood stream immediately and can enter the central nervous system within 24 hours of infection.

The therapy still needs to be tested in humans, as the currently trial involved testing on animals. However, the researchers said they believe that if it turns out to be as effective in people as it has proven to be animals it could represent a significant advancement in the treatment of Lyme disease.

The treatment is currently being tested in humans as part of a phase III clinical trial, which means that if it is proven effective, it could be approved relatively soon.

Lyme-TAP is a new patient assistance program helping patients with financial hardship pay for diagnostic Lyme testing who would otherwise be unable to afford testing.

The Lyme Test Access Program (Lyme-TAP) is a nationwide patient assistance program offered by Rotary Club of Ferndale Foundation (501c3) in coordination with Lyme Patients Assistance Group to provide assistance for initial Lyme-related lab tests to patients who demonstrate true financial need.

If approved, you may be reimbursed for up to 75% of your out-of-pocket costs of testing from a qualified CLIA/Medicare approved laboratory of your choice. Funds are limited & are available on a first-come, first-served basis. Children under 18 years of age are given priority. The intention of this program is to help as many patients in need as possible. It is not intended to cover insurance deductibles or to cover patients not truly in financial need.

This nationwide assistance program was made possible by a very generous donation from IGeneX Inc., a CLIA/Medicare licensed laboratory. Any CLIA/Medicare licensed laboratory may be selected for testing: you do not have to use IGeneX for this program.

To apply for assistance and for more information go to http://www.lymetap.com/.