Swedish MD suspended over Lyme disease care; patients bereft

•March 5, 2017 • Leave a Comment

sweden

Excerpted from the Huffington Post :  (03/03/2017)

The top doctor in Sweden for treatment of advanced Lyme disease has been suspended from practicing medicine, leaving hundreds of patients without care in a country with a large and growing problem of tick-borne disease.

The physician, Kenneth Sandström, said the action was taken because he treated patients with longer courses of antibiotics than recommended by prevailing treatment guidelines.

Sandström is a seasoned general practitioner who treated his first Lyme disease case about five years ago, when a registered nurse who had been diagnosed with multiple sclerosis asked him to treat her for possible Lyme disease. He studied the scientific literature for several months – he at first thought the idea was “rubbish” — then put her on four months of antibiotics.

“Twenty years of MS was gone,” he told me at a conference in Philadelphia last November when he was facing disciplinary charges. He acknowledged that other cases were not as “easy” but said he saw overall and sometimes-dramatic improvement from longer antibiotic treatment. “You have to accept this is something,” he said.

‘For patients, it’s a catastrophe.’ — Janna Strandli, president of the Swedish Lyme Disease Association

More than 6,000 people signed an online petition and 400 patients left messages of support when his disciplinary action was announced in 2014. People with Lyme disease and their advocates were devastated by the news of Sandström’s suspension.

“For the patients this means they have to turn to doctors abroad to get treatment, and for those who can’t afford this or are too ill to travel, it’s a catastrophe,” said Janna Strandli, president of the Swedish Lyme Disease Association. “Dr. Sandström has helped so many patients to regain their health and hope to get well again.”

In an email after the licensing board’s decision, Dr. Sandström said the suspension was based on charges related to prescribing the antibiotic Rifampicin to 13 patients, all of whom Sandström said got better. The suspension was not for a set amount of time; Sandström said he would appeal.

Southern Sweden has Western Europe’s highest rate of Lyme disease at 464 cases per 100,000 residents, according to published research, rivaling rates in the U.S. Northeast. In Sweden, a warming climate has helped push diseased ticks about 300 miles further north in recent years, part of a global trend that I will write about in an upcoming book.

Dr. Sandström’s case demonstrates the worldwide influence of Lyme treatment guidelines developed in the United States by the Infectious Diseases Society of America. Those guidelines, which generally limit antibiotic courses to 10 to 28 days, were removed last year from the National Guidelines Clearinghouse because they had not been updated since 2006. Currently, the NGC has approved posting the guidelines of the International Lyme and Associated Diseases Society, which recommend longer and, for potentially chronic cases of disease, repeated rounds of antibiotics, and which Sandström said he followed.

 

For more: httphttp://www.huffingtonpost.com/entry/swedish-md-suspended-over-lyme-disease-care-patients_us_58b9e03de4b02b8b584dfb74

Tick-borne Lyme disease exploding into Michigan; human cases up 5-fold

•March 1, 2017 • Leave a Comment

Excerpted from the Detroit free press: (02/23/2017)

They’re already back.

All it took was an unusual February warm spell this past week for the tiny insects causing an increasingly big problem in Michigan to become active once again, beginning their hunt for blood.

“A student in the medical entomology lab just brought in six adult blacklegged ticks — three male and three female — that were collected by his dog (Tuesday) in Lansing,” said Jean Tsao, an associate professor in Michigan State University’s departments of fisheries and wildlife and large animal clinical sciences.

The ticks are of interest because of what they often carry with them: the bacterium Borrelia burgdorferi. When the ticks bite an animal, seeking a blood meal, that bacteria can transfer. And that bacteria, in dogs, horses and humans, can cause Lyme disease, a serious affliction that can be permanently debilitating for people when it’s not treated early and well.

Tsao is a co-author of a recently published research paper documenting Lyme disease’s rapid spread into Michigan in recent years. There were fewer than 30 human cases of Lyme disease reported in Michigan in any year between 2000 and 2004. By 2009, the number had jumped to 90 reported cases. By 2013, it was 166 cases.

That number could be very low. The federal Centers for Disease Control and Prevention estimates the number of Lyme disease cases nationwide could be 10 times higher than what’s actually reported. Because of Lyme disease’s relative newness in Michigan, and because its early symptoms often mimic what feels like the flu,infected people — and even their doctors — often don’t test for it. Doctors also don’t always report finding Lyme disease to their local public health department, said Erik Foster, an entomologist with the Michigan Department of Health and Human Services and a co-author of the recent study.

The Lyme disease spike in Michigan correlates with the spread of blacklegged ticks here. In 1998, the ticks were established in only five counties — Berrien County in the southwestern-most Lower Peninsula, and four counties in the Upper Peninsula — and reported in 22 other counties. By 2016, however, the ticks were established in almost five times as many counties — established in 24 Michigan counties and reported in 18 others. The ticks have overtaken the entirety of the Lake Michigan shoreline in the Lower Peninsula, from Charlevoix to St. Joseph. But tick populations are not staying confined to coastal counties, becoming established increasingly to the east in the southern part of the state.

Tsao is always on the hunt for blacklegged ticks. In spring and summer, she can often be found dragging white corduroy cloth through Michigan forests, checking for the presence of the tiny bugs — usually only 3 to 5 millimeters in size, but that can grow more than twice that when engorged on a host’s blood. In the fall, Tsao and her students often check for the ticks on harvested deer at check stations during hunting season.

These days, the more Tsao looks, the more she finds.

“We know this is a real invasion,” Tsao said.

Why the increase?

Why the increase is happening now, scientists can’t say for sure. Lyme disease and the ticks that carry it have long been established on the East Coast. In the upper Midwest, states such as Wisconsin and Minnesota have more than 10 times as many human cases of Lyme disease as Michigan.

Tsao’s theory is that Lake Michigan served as a natural barrier holding the blacklegged ticks back. But the ticks are capable of being carried across the lake on birds, she said.

“Over time, as the Wisconsin, Minnesota and Upper Peninsula populations grew, that pressure of ticks coming down to places where birds like to stop over would have increased,” she said. “In the past, they could have come and died. But eventually, enough of them have arrived, survived the various life stages and began mating.

“Mom, if she gets a nice blood meal, she can lay 2,000 eggs. Nineteen-hundred and 99 can die; so long as one survives to meet another tick from another female, you have the next generation going.”

The ticks thrive in sandy areas with varied plant life, which is why they raced up Michigan’s Lake Michigan shoreline once established here, Tsao said. The ticks go through three life phases — larva, nymph and adult, and each stage needs a blood meal, she said. They perch on plants and branches, waiting for a host animal to brush by.

“It finds a host, takes its blood meal, falls off into the leaf litter, evolves and finds its next host,” she said.

The process can take two to three years for ticks in Michigan, the larvae feeding in year one; the nymph and adult in the second year, Tsao said. Each winter, the leaf cover and snow serve as an insulating blanket until spring.

While croplands farther east in Michigan’s Lower Peninsula aren’t as optimal for blacklegged ticks, all it takes are patches of woods and herds of deer to continue the in-state spread, Tsao said.

“If you’ve got nice woods around, and have nice habitat for deer, mice, birds and other species, you could have a little island for ticks,” she said.

Ticks have been found in East Tawas on the Lake Huron side of Michigan, as well as in the Thumb, Tsao said.

“I’m not trying to be fear-mongering,” she said. “But if you look at Michigan and look at other states where Lyme disease-causing ticks are found, what kind of vegetation is there? What kind of animals are there?

“There’s no reason we would not have ticks everywhere.”

For more: http://www.freep.com/story/news/local/michigan/2017/02/23/tick-borne-lyme-disease-exploding-into-michigan/98218954/

Lyme disease bill heads to President’s desk: Senator Gillibrand

•December 10, 2016 • 1 Comment

Excerpted from Outbreak News  Today: (12/08/2016)

U.S. Senator Kirsten Gillibrand today announced the passage of legislation that would take important steps to combat tick-borne diseases, which remain a significant public health threat in states across the country. The bill will now go to the President’s desk to be signed into law.

“This is an important advancement to help combat the growing epidemic of Lyme disease,” said Senator Gillibrand. “Our families should be able to enjoy nature without the fear of possibly contracting this disease. This bill would streamline and coordinate the federal resources needed to improve diagnosis, treatment, and reporting of Lyme disease, and ensure that a diversity of perspectives are represented within the newly established federal Tick-Borne Disease Working Group. I applaud my colleagues for joining me in support for this legislation, and look forward to seeing it signed into law by the President.”

“Lyme disease and tick-borne illnesses are devastating families across our region,” said Congressman Chris Gibson (NY-19). “This bipartisan, constituent-driven legislation will bring about effective ways to treat, detect, and prevent these conditions, including chronic Lyme. I want to thank the hundreds of patients, advocates, and physicians who have partnered with us to advance these reforms. To my House and Senate colleagues, thank you for supporting our efforts to bring relief to a long-suffering community.”

In February, Gillibrand along with Senators Richard Blumenthal (D-CT) and Kelly Ayotte (R-NH) wrote to the Senate Health, Education, Labor, and Pensions (HELP) Committee urging the consideration of their bipartisan bill to combat tick-borne diseases.

Between 2005 and 2014, there were 37,977 reported cases of Lyme disease in New York, one of the most heavily affected populations in the country, according to the Centers for Disease Control and Prevention (CDC). The CDC reports that Lyme disease is the most commonly reported vector-borne disease in the United States. However, reported cases do not accurately reflect every diagnosed case of Lyme disease. While approximately 30,000 cases of Lyme disease are reported to the CDC each year, the CDC estimates that roughly 300,000 people are diagnosed with the disease per year. 95% of confirmed Lyme disease cases in 2015 were reported from just fourteen states, including New York.

Senator Gillibrand introduced the Lyme and Tick-Borne Disease Prevention, Education, and Research Act, with Senators Richard Blumenthal (D-CT), Kelly Ayotte (R-NH), Jack Reed (D-RI), and Sheldon Whitehouse (D-RI). Representative Chris Gibson (R-NY) introduced a similar bill in the House of Representatives known as the Tick-Borne Disease Research Accountability and Transparency Act. Provisions from these bipartisan bills were included in the 21st Century Cures Act, which passed the House of Representatives last month.

For more: http://outbreaknewstoday.com/lyme-disease-bill-heads-presidents-desk-senator-gillibrand-18211/

Ticked off? New info on Lyme disease North Country people should know

•October 29, 2016 • Leave a Comment

Excerpted from North Country NOW: (10/29/2016)

Even though I was born and raised in New York State, I never cease to be awestruck by the beauty of our changing seasons, and cannot imagine living in a place where the years pass with scant visible change in the environment. Yet there is one season I cannot abide, and it has arrived with a vengeance: hunting season.

Mind you, I have no problem with safety-trained folks traipsing through the woods this time of year toting rifles or compound bows. What I object to are all the unlicensed, eight-legged hunters which have (literally) come out of the woodwork lately: ticks. A decade ago it was unusual to find a single tick after a northern New York wilderness weekend, but now in many places all you have to do is set foot in the brush and you’re ambushed by hordes of black-legged ticks, commonly known as deer ticks.

Smaller and more difficult to see than most other ticks, deer ticks can transmit a number of serious diseases, including Lyme, babesiosis, anaplasmosis, and Powassan virus. In fact it’s possible for two or more diseases to be transferred by a single tick bite. A high percentage of infections come from the immature or “nymph” stage deer tick, tinier than a poppy seed and nearly impossible to detect (at leasnat for those of us over fifty) without magnification. The adults are not exactly huge, being a bit smaller than a sesame seed, but they are the ones most active during hunting season, ahnd any time when winter temperatures get above freezing.

In light of new research published this summer, we need to update our understanding of the risks posed by deer ticks. Honestly, not even Captain Hook is more terrified of ticks than I am, but no one can afford to stick their head in the sand. We’d probably end up with grit in our ears, which is uncomfortable, and worse yet, we could contract a tick-borne disease.

In a July 2016 presentation to fellow physicians, Dr. Nevena Zubcevik of the Harvard Medical School, and co-director of the Dean Center for Tick-Borne Illnesses, warned that the medical community is not keeping up with current findings. For example, “The conception that the tick has to be attached for 48 hours is completely outdated,” she said, citing studies that show ticks can transmit disease in as little as 10 minutes.

For more: http://northcountrynow.com/news/ticked-new-info-lyme-disease-north-country-people-should-know-0183893a>

The secret Swiss Agent: Puzzling comments reveal new twist to the Lyme disease saga

•October 14, 2016 • Leave a Comment

Excerpted from the Stanford Medicine:  (10/13/2016)

While I was conducting a 2013 biographical interview with Willy Burgdorfer, PhD, the discoverer of the Lyme disease bacterium, he reluctantly confessed that he’d left something important out of his Lyme discovery articles. There was another bacterial perp at the scene of the mysterious outbreak of juvenile arthritis in Lyme, Connecticut, circa 1979. He nicknamed this new tick-borne organism (from the rickettsia genus) the “Swiss Agent,” after he found that many of the original Lyme patient blood samples reacted strongly to tests that identified a type of rickettsia found in Switzerland. Yet he never published these results, and he died before he could fully explain why.

For more: http://scopeblog.stanford.edu/2016/10/13/the-secret-swiss-agent-puzzling-comments-reveal-new-twist-to-the-lyme-disease-saga/a>

33 percent of area ticks carry Lyme disease, finds Pitt-Johnstown study

•September 27, 2016 • Leave a Comment

pitts

Excerpted from the Tribune’Democrat :  (09/26/2016)

But the results of the University of Pittsburgh at Johnstown associate professor’s multi-year study shocked her anyway.

DNA testing of 500 deer ticks caught across the region showed that one in three carried the Lyme bacteria, Henning and a team of six Pitt-Johnstown students found.

“Typically when you think about Lyme disease issues, people think of it as an East Coast thing. But the results show just how much it’s spreading west across the state,” she said. “It really shows that we’re dealing with a problem that continues to grow.”

Henning researched ticks and Lyme disease as an undergraduate and studied infectious diseases as a grad student at The University of Pittsburgh.

It wasn’t long after she joined Pitt-Johnstown’s faculty in 2010 that she realized it made good sense to continue her research, she said.

“This is an active area. A lot of people are into hiking and biking and other outdoor activities … and there isn’t a lot of research regarding ticks and their association with Lyme disease in this part of Pennsylvania,” she said.

The research also allowed her to biology students to gain engaging experience both in the field and in a lab setting, Henning said.

The team focused its research on “questing” deer ticks – those hunting for a new host – in Bedford, Cambria, Indiana and Westmoreland counties.

They acquired a state Game Commission permit to collect the tiny arachnids inside game land property, areas that are typically havens for mammals like mice, rabbits and deer that ticks feed on throughout their lifespan, she said.

Students dragged a white sheet through six different forested areas like the Prince Gallitzin area and central Bedford County to pick up the ticks.

“I made them pull up their hair and wear white so that any ticks that jumped on to them were easy to spot,” Henning said. Any openings between clothing where skin might be accessible were fastened with duct tape, she said.

Once students were back on campus, they crushed the ticks’ bodies with tweezers, she said. Their remains were placed into containers for DNA testing.

Approximately 500 deer ticks were tested – a four-hour process each time, Pitt-Johnstown senior Corey Coleman, 21, said.

The results stunned him, too.

“When you think of Lyme disease, you think it’s some kind of rare occurrence. But this shows that if you get bit by a tick, the odds aren’t rare that you can get it,” said Coleman. of Central City.

For more: http://http://www.tribdem.com/news/percent-of-area-ticks-carry-lyme-disease-finds-pitt-johnstown/article_5b814186-839f-11e6-bf90-073e988428e6.html

CDC Says Fewer Suffer After Lyme Disease. Doesn’t Say, If Treated Early.

•September 14, 2016 • Leave a Comment

Excerpted from the Huffington Post :  (09/08/2016)

For at least five years, the U.S. Centers for Disease Control and Prevention has officially stated that 10 to 20 percent of patients treated for Lyme disease — some 30,000 to 60,000 of 300,000 infected yearly — “will have lingering symptoms of fatigue, pain, or joint and muscle aches,” even after supposedly curative antibiotic treatment.

But quietly, without peer review or formal announcement, the agency has decided that the actual percentage is much smaller — half or a quarter as much. The decision was made, officials told me, based on a study that showed less than 5 percent of Lyme patients exhibit ongoing symptoms after treatment.

Consequently, the CDC’s web site now states that “a small percentage”
of patients will have lingering symptoms of what is called Post-treatment Lyme Disease Syndrome or PTLDS. Other studies have found higher shares of patients suffering after treatment, particularly when diagnosis is delayed. The study cited by the CDC was of patients treated early and who exhibited symptoms on average 15 years later.

The agency’s pronouncement involves the most contentious issue in the debate over Lyme disease: why — and how many — people have problems involving pain, mobility, and mental and physical functioning even after taking single-course antibiotics recommended by the Infectious Diseases Society of America, or IDSA.

For more: http://http://www.huffingtonpost.com/mary-beth-pfeiffer/cdc-citing-one-study-of-e_b_11877020.html