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New Study Finds Lyme Bacteria Survive a 28-day Course of Antibiotics When Treated Four Months After Infection by Tick Bite

Risk of Tick Bites in Tall Grass

Risk of Tick Bites in Tall Grass

All subjects treated with antibiotics were found to have some level of infection 7–12 months post treatment.

Despite testing negative by antibody tests for Lyme disease, two of 10 subjects were still infected with Lyme bacteria in heart and bladder.

Lyme bacteria which persist are still viable.

Portola Valley, California, Dec. 13, 2017 — Bay Area Lyme Foundation, a leading sponsor of Lyme disease research in the US, today announced results of two papers published in the peer-reviewed journals PLOS ONE (read full paper) and American Journal of Pathology (read full paper), that seem to support claims of lingering symptoms reported by many patients who have already received antibiotic treatment for the disease.

Based on a single, extensive study of Lyme disease designed by Tulane University researchers, the study employed multiple methods to evaluate the presence of Borrelia burgdorferi spirochetes, the bacteria that cause Lyme disease, before and after antibiotic treatment in primates. The study also measured the antibody immune response to the bacteria both pre- and post- treatment, as this is how current diagnostics typically evaluate Lyme disease in humans.

The data show that living B. burgdorferi spirochetes were found in ticks that fed upon the primates and in multiple organs after treatment with 28 days of oral doxycycline. The results also indicated that the immune response to the bacteria varied widely in both treated and untreated subjects.

“It is apparent from these data that B. burgdorferi bacteria, which have had time to adapt to their host, have the ability to escape immune recognition, tolerate the antibiotic doxycycline and invade vital organs such as the brain and heart,” said lead author Monica Embers, PhD, assistant professor of microbiology and immunology at Tulane University School of Medicine.

“In this study, we were able to observe the existence of microscopic disease and low numbers of bacteria, which would be difficult to see in humans but could possibly be the cause of the variable and nonspecific symptoms that are characteristic of post-treatment Lyme disease syndrome. Although current antibiotic regimens may cure most patients who are treated early, if the infection is allowed to progress, the 28-day treatment may be insufficient, based on these findings,” Embers said.

The findings also demonstrated:

  • All subjects treated with antibiotics were found to have some level of infection 7-12 months post treatment.
  • Despite testing negative by antibody tests for Lyme disease, two of 10 subjects were still infected with Lyme bacteria in heart and bladder.
  • Lyme bacteria which persist are still viable.

To better elucidate previous animal studies demonstrating that some B. burgdorferi bacteria survive antibiotics, the study explored Lyme disease infection in rhesus macaque primates treated with antibiotics and a control group who were also infected but not treated. This species has been shown to demonstrate a progression of Lyme disease most similar to humans, particularly related to erythema migrans, carditis, arthritis, and neuropathy of the peripheral and central nervous systems.

“Clearly, some medical practices governing diagnosis and treatment of Lyme disease should be reconsidered in light of this study. This study shows that we must reevaluate the current paradigm of antibody response tests for diagnosis and move away from the one size fits all approach to Lyme treatment,” said Wendy Adams, Research Grant Director, Bay Area Lyme Foundation. “Every day, patients with Lyme disease are told their symptoms cannot be caused by Lyme, because they test negative on antibody tests or because they have received a single course of antibiotics. More research and funding are imperative.”

In the study, ticks carrying B. burgdorferi spirochetes fed on ten primates. Four months post infection, half of the primates (five) received the antibiotic doxycycline orally for 28 days at a proportional dose to that used in human treatment. Five subjects were treated with placebo and all ten were evaluated by more than five different diagnostic methods to characterize any remaining infection. The researchers used several important techniques, including xenodiagnoses, to determine if the spirochete bacteria persisted.

The results show:

Few subjects displayed a rash. Although all subjects were infected, only one of the 10 displayed a rash with central clearing, the classical “bulls-eye” rash. The subject that developed this rash, interestingly, never mounted an immune response to five borrelia antigens throughout the study period, prior to and following treatment.

Organs may be infected even if antibody tests are negative. One subject which tested negative for B. burgdorferi by skin biopsy cultures, PCR and in vivo cultures, was found to have B. burgdorferi infecting the heart. Another untreated subject, who was ultimately shown to have residual Lyme bacteria in the bladder, showed a decrease in immune response over the course of infection, with a negative xenodiagnosis test in the late stage, which would signal that the animal self-cured.

Intact spirochetes were found in three of five treated and four of five untreated subjects based on xenodiagnosis results 12 months after the tick bite.

Immune responses to B. burgdorferi varied greatly post-treatment, with one subjects antibody levels dropping to pre-bite levels for three antigens while another subject experienced elevated antibodies for the same antigens throughout the study period. This is significant because it demonstrates that subjects infected with the same strain of B. burgdorferi may have different immune responses to the same antigen. And, because humans, like primates, are genetically diverse, it underscores that testing antibody responses may be inherently unreliable as a singular diagnostic modality for Lyme disease.

Widespread and variable microscopic disease was observed in all infected subjects, despite antibiotic treatment. Compared to uninfected subjects of the same age, infected subjects in this study (treated and untreated) demonstrated Inflammation in and around the heart, in skeletal muscles, joints, and the protective sheath that covers the brain, and near peripheral nerves.
Rare, but intact B. burgdorferi spirochetes were found in the tissues of both the treated and untreated subjects. In two subjects treated with doxycycline, multiple Lyme bacteria were observed in the brain tissue. Others organs in which the spirochetes were observed included the heart, joints, bladder, skeletal muscle and adjacent to peripheral nerves.

Variable manifestations, diverse seroreactivity and post-treatment persistence in non-human primates exposed to Borrelia burgdorferi by tick feeding

Late Disseminated Lyme Disease: Associated Pathology and Spirochete Persistence Posttreatment in Rhesus Macaques

About Lyme disease
One of the most common infectious diseases in the country, Lyme disease is a potentially disabling infection caused by bacteria transmitted through the bite of an infected tick to people and pets. If caught early, most cases of Lyme disease can be effectively treated, but it is commonly misdiagnosed due to lack of awareness and unreliable diagnostic tests. There are about 329,000 new cases of Lyme disease each year, according to statistics released in 2015 by the CDC. As a result of the difficulty in diagnosing and treating Lyme disease, as many as one million Americans may be suffering from the impact of its debilitating long-term symptoms and complications, according to Bay Area Lyme Foundation estimates.

About Bay Area Lyme Foundation
Bay Area Lyme Foundation, a national organization committed to making Lyme disease easy to diagnose and simple to cure, is the leading public foundation sponsor of innovative Lyme disease research in the US. A 501c3 non-profit organization based in Silicon Valley, Bay Area Lyme collaborates with world-class scientists and institutions to accelerate medical breakthroughs for Lyme disease. It is also dedicated to providing reliable, fact-based information so that prevention and the importance of early treatment are common knowledge. A pivotal donation from The Laure L STEM Fund covers all overhead costs and allows for 100% of all donor contributions to Bay Area Lyme Foundation to go directly to research and prevention programs. For more information about Lyme disease or to get involved, visit www.bayarealyme.org or call us at 650-530-2439.

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Environmental Working Group Guide to Bug Repellents

This is being reposted as a reminder of how important it is to chose the right insect repellent, both for effectiveness and for safety.

EWG Guide to Bug ReppelentMonday, June 17, 2013  Originally published at EWG
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 Download EWG’s tip sheet  |  Download EWG’s report
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Which is worse, bug bites or bug repellent?

Choosing the right bug repellent can make a hike, picnic or outdoor event a pleasure instead of a painful, itchy experience that may have serious consequences.

No repellent is right every time. Click to find your best bet.

ADULTS KIDS PREGNANT WOMEN

[Read more…]

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Environmental Working Group Guide to Bug Repellents

EWG Guide to Bug ReppelentMonday, June 17, 2013  Originally published at EWG
______________________________________________________________________________________
 Download EWG’s tip sheet  |  Download EWG’s report
______________________________________________________________________________________

Which is worse, bug bites or bug repellent?

Choosing the right bug repellent can make a hike, picnic or outdoor event a pleasure instead of a painful, itchy experience that may have serious consequences.

No repellent is right every time. Click to find your best bet.

ADULTS KIDS PREGNANT WOMEN

______________________________________________________________________________________

Executive Summary

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West Nile virus, carried by mosquitoes, infected more than 5,674 Americans last year and 286 of them died, according to the federal Centers for Disease Control and Prevention (CDC 2013C).

The incidence of Lyme disease, spread by ticks, has more than doubled over the last 15 years, with 24,364 confirmed cases recorded in 2011 (CDC 2013A, CDC 2013B).

Both these illnesses, and other pest-borne diseases, can have serious and occasionally life-altering consequences.   Many experts expect to see more cases in the future as the warming climate expands the habitat of species that spread pathogens.

Yet many people are understandably concerned about the possible drawbacks of common repellents such as DEET.  At EWG, we certainly were. So we spent 18 months digging into the question: what are the safest and most effective ways to prevent bug bites and the diseases they may transmit?  

The conclusions of our fact-finding investigation surprised and in some ways disappointed us.

The bad news:  there’s no sure, completely safe way to prevent bug bites.  All bug repellents have pros and cons.

The good news:  some repellents are effective and relatively low in toxicity — provided you take precautions when using them, particularly on children.

The surprising news:  among the four repellent chemicals EWG found to be top picks is DEET, which is widely used but much maligned.  DEET’s safety profile is better than many people assume. Its effectiveness at preventing bites is approached by only a few other repellent ingredients.

DEET isn’t a perfect choice nor the only choice.  But weighed against the consequences of Lyme disease and West Nile virus, we believe it is a reasonable one.

Continue reading on EWG: What to look for in a bug repellent.

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HSU professor lands grant for tick and Lyme disease research; study highlights problem, seeks ways to control tick population

Created:   09/01/2012 02:25:16 AM PDT

Once on a person, the nymph of the western black-legged tick (shown enlarged in inset) is readily overlooked because of its minute size.

A Humboldt State University professor recently received a $350,000 grant to fund research that may provide the foundation for reducing deer tick populations in Northern California — and, in turn, Lyme disease, the stealthy bacterial infection borne by the tiny insects.Professor Jianmin Zhong said the three-year grant from the National Institutes of Health will be used to research the possible existence of a symbiotic relationship between the deer tick and the bacteria that lives inside them. Zhong’s hypothesis is the bacteria produces vitamin B-9, which the tick relies on. In turn, the tick transmits the bacteria to future hosts.

If Zhong can prove that, researchers can focus on the more long-term goal of discovering ways to mutate the bacteria so it no longer produces vitamin B-9.

”Hopefully, we can manipulate the bacteria and eventually, control the population of ticks,” Zhong said.

According to the Centers for Disease Control, Lyme disease is the most reported insect-borne illness in the U.S.

”It’s a major concern for humans and animals,” Zhong said.

Nearly 200 people reported being infected with Lyme disease in California in 2010, according to the CDC. Those numbers don’t reach the heights that Northeastern states see, but it’s possible that cases go unreported and that some people live with symptoms that remain undiagnosed.

[Read more…]

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Coinfection Testing

Question: Does Igenex Labs Test for coinfections?

Answered by Susan Friedl – Gordon Medical Research Coordinator:

Igenex Labs does test for many of the tick borne coinfections, including a variety of tests for Borrelia burgdorferi (Lyme disease), Babesia microti and Babesia duncani, Human Monocytic Ehrlichia and Anaplasma Phagocytophila, Bartonella henselae, and Rickettsia species (Rocky Mountain spotted fever, Mediterranean spotted fever, Boutonneuse fever, Israeli spotted fever, Astrakhan fever, Indian tick typhus, Murine typhus, Cat flea rickettsiosis, flea-borne typhus.) [Read more…]