Lyme Disease Symptoms and Diagnosis

•November 4, 2018 • Leave a Comment

Excerpted from Psychology Today: (11/02/2018)

Lyme disease is the result of infection with one or more species of the spirochete Borrelia Burgdorferi. It is generally thought that the infection is the result of a tick bite, which about 50% of the time results in a rash, often described as a ‘Bulls Eye’ rash, but which can vary in appearance.

Symptoms of untreated Lyme disease typically start with:

  • nondescript flu-like symptoms (fever, chills, body aches, headache)
  • but eventually include joint aches (which may migrate from one joint to another over days),
  • neuropsychiatric problems (e.g., Bell’s palsy-paralysis of one side of the face)
  • fatigue, numbness, weakness
  • mood disorders, OCD, psychosis
  • cognitive impairment, seizures
  • Some people report abnormal heartbeats (conduction abnormalities), or gastrointestinal problems.

There is an extreme polarization of opinion around the twin questions of diagnosis and treatment for those with Lyme disease. The highly charged and politicized conflict between the Infectious Disease Society of America (IDSA) and International Lyme and Associated Diseases Society (ILADS) is well described in Pamela Weintraub’s excellent book, Cure Unknown.

On the one side, is the position of the Infectious Diseases Society of America (IDSA), which has a strict requirement for diagnosis and treatment (, and has concluded that long-term antibiotic therapy (greater than one month) is not indicated in those who continue to have symptoms despite the normal treatment regimen (2-4 weeks of oral or IV antibiotics, depending on the symptoms and laboratory data).

On the other side, is The International Lyme and Associated Diseases Society (ILADS), which is a conglomeration of “Lyme Literate” physicians, non-physician health care practitioners, patients, and their families. They believe that scientific data has proven that residual symptoms are the result of either co-infections or chronic infections.   The tick often contains numerous bacterial and parasitic organisms, such as Bartonella species, Babesia, Ehrlichia, etc. Borrelia Burgdorferi infections may develop, as part of the bacterial life cycle and protective mechanisms, intracellular forms. Because of this, and other defense and host mechanisms, it may not be detectable using routine testing. Furthermore, standard Lyme disease testing (a Western Blot) is believed to highly insensitive, by ILADS, giving rise to many false negatives.

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6 Sneaky Signs of Lyme Disease

•October 28, 2018 • Leave a Comment

Excerpted from The US News & World Report: (06/18/2018)

“Ticks are the epitome of the accidental hitchhiker.”

I recently came across this quote and thought it was a brilliant analogy. You’re enjoying an outdoor hike or family outing, and without your knowledge, you’ve become the host to an unwanted guest. Smaller than the size of an eraser, this pest, better known as a deer tick, not only attaches to your skin and feeds on your blood, but is also the carrier of Lyme disease, a bacterial infection.


Lyme Disease: Symptoms, Prevention and…

Lyme disease is caused by the bite of a deer tick, and most recipients will have no idea they were bitten. And contrary to its name, a deer tick can also be carried by dogs who can infect their canine owners without contracting this bacterial disease themselves.

Typically, the incidence of this disease peaks in the summer months when the deer tick thrives and multiplies. Long known as a disease tiendemic to the northeast, Lyme disease has now been found across America. According to a recent report by the Center for Disease Control and Prevention, “The number of people getting diseases transmitted by mosquito, tick and flea bites has more than tripled in the United States in recent years.”

Though the telltale symptom of the bull’s-eye rash is well known, there are some sneaky and potentially difficult to diagnose symptoms that can mimic other diseases.

Case in point: I recently had a patient who came to the emergency room complaining of shortness of breath and palpitations. Initially, the on-call team thought it was an acute heart problem. But congestive heart failure or a heart attack were eventually ruled out. The patient was found to have a large collection of fluid compressing the heart muscle and was subsequently admitted and diagnosed with pancarditis, or inflammation of the heart muscle and the pericardium, the sac that encases the heart.

We had pinpointed the symptoms but needed a cause. Once CHF and heart attack were ruled out, I had to wonder whether these symptoms were a result of an autoimmune disease, where the body attacks itself. Or could this be a sign of an infection that had been brewing for years?

After running an exhaustive battery of tests, I found the patient had a rip-roaring Lyme infection that had remained indolent for decades.

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New, aggressive tick is now in New Jersey and New York

•August 5, 2018 • Leave a Comment

Longhorned tick clones itself and bleeds livestock dry: It’s already known to spread several human diseases

Excerpted from The Chronicle : (08/04/2018)

The longhorned tick, an invasive species that clones itself and is known to suck livestock dry, is spreading fast. It’s now been confirmed in New Jersey and New York.

The Lyme Disease Association says the longhorned tick is already known to transmit several human diseases, including spotted fever rickettsiosis, in its native East Asian countries of China, Japan, and Australia. It may be only a matter of time before they become carriers of tick-borne diseases that affect humans, it says.

According to the National Veterinary Services Laboratory in Ames, Iowa, this exotic new tick was first found in the United States in Virginia, appearing on an orphaned calf on a beef farm It was also confirmed in West Virginia in May and in Arkansas in June. It’s also in North Carolina.

The tick reached New Jersey in November, when it was found on a sheep farm in Hunterdon County, N.J. Mystery still surrounds its appearance. The species survived the winter. There is no known direct link from the Virginia farm to the New Jersey farm. The longhorned tick has spread to other parts of New Jersey, including Middlesex, Union, Mercer, and Bergen counties.

The longhorned tick reproduces by parthenogenesis, that is, without fertilization. Males are very rare.

The species is dark brown and grows to the size of a pea when fully engorged. Both larval and nymphal stages are very small and difficult to observe with the naked eye. Adult ticks are seen mainly during early summer.

This tick is a serious pest to livestock, says New Jersey Secretary of Agriculture Douglas Fisher. It strikes cattle, horses, farmed deer, sheep, and goats, particularly in New Zealand, as well as wildlife, pets, and humans. The New Jersey Division of Fish and Wildlife is watching to see if the tick has spread to wildlife.

Fisher said farmers should monitor their livestock for the presence of this tick. They should look for decreased growth rates, or signs of anemia.

He said it’s still too early to tell how the new tick will affect local residents.

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Lyme disease study looks at factors that may increase threat

•July 15, 2018 • 1 Comment

Excerpted from The Poughkeepsie Journal; (07/12/2018)

A new study examining nearly 20 years of data on forests and climate in Dutchess County may shed light on how ecology directly impacts the spread of Lyme disease.

Researchers at the Cary Institute of Ecosystem Studies, a not-for-profit environmental research and education organization based in Millbrook, analyzed the data and found a higher risk of contracting Lyme disease in forests with a larger rodent population and lower numbers of foxes, possums and raccoons.

They also found that tick-borne diseases, including Lyme disease, are closely tied with fluctuating acorn supply and predator communities in forests with many oak trees.

A research team spent 19 years collecting data and monitoring small mammals including mice and chipmunks, as well as black-legged ticks, climate and forests in Dutchess County. Richard Ostfeld, a disease ecologist at the Cary Institute, led the team.

Ostfeld said he hopes the information will help communities and residents determine how to exercise caution when they are outside, whether in their backyards or out in nature.

“Using nearly two decades of data on the forest food web, we were interested in untangling the ecological conditions that regulate the number of infected ticks in the landscape,” said Ostfeld.

The findings were recently published in an issue of Ecology, a journal of the Ecological Society of America.

Key findings included:

  • Tick-borne diseases are linked with fluctuating acorn supply and the structure of the predator community.
  • Forests with coyotes that lack a mix of bobcats, foxes and possums saw the highest risk of tick-borne diseases.
  • Sites with high diversity in predators had lower infection in nymphal ticks – black legged ticks that are the size of a poppy seed – compared to sites dominated by coyotes. Coyotes sometimes displace other predators such as foxes and bobcats that are more effective at controlling rodent populations versus coyotes.
  • The number of infected nymphal ticks was lowest at sites with denser forests and a greater diversity of predators.
  • Climate impacts Lyme disease since humidity and moisture cause a greater number of infected ticks. Warm, dry spring or winter weather causes a  decrease in infected ticks.

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The Mistreatment of People With Lyme Disease Needs to End

•May 19, 2018 • Leave a Comment

*Excerpted from Yahoo! : (05/08/2018)

Since it’s Lyme Disease Awareness Month, I’d like to shed light on the real difficulties and darkness that comes only with chronic Lyme disease. It’s its own specific nightmare of an invisible illness – those who have it only truly understand how hard each day really is, and why.

Let’s start with the origin, ticks. We don’t know much about these insects. They often aren’t seen as real threats. These bugs can carry up to 16 co-infections, some fatal. Ticks can be as tiny as a poppyseed, so how do we stand any chance against finding a tiny dot on our body? Or on our pets? Knowing this tiny creature has ruined my body and lives just outside my doorstep fills me with fear. How can I walk across grass comfortably again? Or lay on a blanket in the sun?

Once bitten, the bullseye rash may or may not develop. At your primary doctor’s office, they generally run standard CDC-approved testing for Lyme. This does not cover different levels of Lyme disease, or any co-infections. So even if you do the right thing and go to the doctor, get tested, your results are not always reliable. And you may continue living with a disease continuing to destroy your body.

There can be years, actual years and years of people’s lives that are falling apart due to misunderstood symptoms. Jobs are hard to keep up with, relationships are just a struggle. So much is blamed on stress, or our “crazy” mind. It may feel random but after a while, you know when something is wrong, but what?

There’s no cure for chronic Lyme. If you are able to afford or have your insurance cover an appointment with a Lyme-literate medical doctor (LLMD), all your hopes may ride on this one doctor and practice to save you. That doctor can become powerful since we often no longer have resources. And these doctors may be at risk themselves, for losing their licenses or more. Finding the right LLMD can be the make it or break it moment of our lives.

Most Lyme patients don’t just get handed medical professionals who actually understand what’s happening. Often we are ignored, turned away from services, unable to afford help or just don’t know where to go. Many can be very hurtful with their choice of words, and treat us like we don’t have Lyme, actually causing more damage. Any medical professional can lead us down the wrong path. So while fighting for our lives, we have to have the wherewithal to see if this professional first believes in my disease, and actually cares about me as a human.


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Tick and Mosquito Infections Spreading Rapidly, C.D.C. Finds

•May 4, 2018 • Leave a Comment

Excerpted from The NY Times : (05/01/2018)

Farewell, carefree days of summer.

The number of people getting diseases transmitted by mosquito, tick and flea bites has more than tripled in the United States in recent years, federal health officials reported on Tuesday. Since 2004, at least nine such diseases have been discovered or newly introduced here.

The Centers for Disease Control and Prevention did not suggest that Americans drop plans for softball games or hammock snoozes. But officials emphasized that it’s increasingly important for everyone — especially children — to be protected from outdoor pests with bug repellent.

New tickborne diseases like Heartland virus are showing up in the continental United States, even as cases of Lyme disease and other established infections are growing. On island territories like Puerto Rico, the threat is mosquitoes carrying viruses like dengue and Zika.

Warmer weather is an important cause of the surge, according to the lead author of a study published in the C.D.C.’s Morbidity and Mortality Weekly Report.

But the author, Dr. Lyle R. Petersen, the agency’s director of vector-borne diseases, declined to link the increase to the politically fraught issue of climate change, and the report does not mention climate change or global warming. Many other factors are at work, he emphasized, including increased jet travel and a lack of vaccines.

C.D.C. officials called for more support for state and local health departments. Local agencies “are our first line of defense,” said Dr. Robert Redfield, the new director at the agency, which is facing its own deep budget cuts. “We must enhance our investment in their ability to fight these diseases.”

Although state and local health departments get brief infusions of cash during health scares like the Zika epidemic in 2016, they are chronically underfunded. A recent survey of mosquito control agencies found that 84 percent needed help with such basics as surveillance and testing for resistance to pesticides, Dr. Petersen said.

[READ: Tips for Protecting Yourself Against Mosquitoes and Ticks]

Between 2004 and 2016, about 643,000 cases of 16 insect-borne illnesses were reported to the C.D.C. — 27,000 a year in 2004, rising to 96,000 by 2016. (The year 2004 was chosen as a baseline because the agency began requiring more detailed reporting then.)

The real case numbers were undoubtedly far larger, Dr. Petersen said. For example, the C.D.C. estimates that about 300,000 Americans get Lyme disease each year, but only about 35,000 diagnoses are reported.

The study did not delve into the reasons for the increase, but Dr. Petersen said it was probably caused by many factors, including two related to weather: ticks thriving in regions previously too cold for them, and hot spells triggering outbreaks of mosquito-borne diseases.

Other factors, he said, include expanded human travel, suburban reforestation and a dearth of new vaccines to stop outbreaks.

More jet travel from the tropics means that previously obscure viruses like dengue and Zika are moving long distances rapidly in human blood. (By contrast, malaria and yellow fever are thought to have reached the Americas on slave ships three centuries ago.)

A good example, Dr. Petersen said, was chikungunya, which causes joint pain so severe that it is called “bending-up disease.”

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These invasive ticks can appear in such numbers that they drain cattle of their blood — and they’ve now been found in the US for the first time

•March 10, 2018 • Leave a Comment

Excerpted from MSN : (03/08/2018)

New Jersey residents know they need to look out for ticks. The state has one of the highest concentrations of Lyme disease in the country.

But one recent finding could lead Garden State residents to keep an even closer eye out for the bloodsuckers than normal.

Somehow, an east Asian tick that has the ability to essentially clone itself and is a noted invasive species in other parts of the world made its way to Hunterdon County.

And it wasn’t just an isolated tick. There were more than 1,000 found in the western area of New Jersey.

The story began in August 2017, when a resident showed up at the Hunterdon County Health Department with samples of the ticks that had started crawling on her arm while she’d been shearing a sheep.

Health department officials noticed that the resident’s clothes were covered with the creatures, all tiny larval specimens.

“I get this call from my assistant and he said, ‘We’ve got a resident here who showed up covered in ticks; she’s panicking; now we’re panicking and her pants are in our freezer,'” Tadhgh Rainey, the head of the health department and lead author on a report documenting the incident, told NPR.

The researchers were able to tell that the ticks belonged to the Haemaphysalis genus, but the specimens didn’t match any known Western Hemisphere species. After further analysis, they identified the culprit: Haemaphysalis longicornis, a tick native to East Asia. The species can be parthenogenetic, meaning the ticks can reproduce asexually, essentially cloning themselves (this study provides more details on the unique reproductive processes of these particular ticks).

Other regions of the world have had serious problems with this tick, which is capable of “intense infestations,” according to the study. Sometimes the insects have even killed animals by draining them of blood, a phenomenon known as exsanguination.

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Severe, lingering symptoms seen in some patients after Lyme disease treatment

•February 14, 2018 • Leave a Comment

Excerpted from John Hopkins Univ. : (02/02/2018)

In a study of 61 people treated for the bacteria that causes Lyme disease, Johns Hopkins researchers conclude that fatigue, pain, insomnia, and depression do indeed persist over long periods of time for some people, despite largely normal physical exams and clinical laboratory testing.

“Post-treatment Lyme disease syndrome (PTLDS) is a real disorder that causes severe symptoms in the absence of clinically detectable infection,” says John N. Aucott, associate professor of medicine at the Johns Hopkins University School of Medicine and director of the Johns Hopkins Lyme Disease Clinical Research Center.

The findings, published in the December issue of Frontiers in Medicine, could spur further investigation into the cause of persistent symptoms, a source of medical controversy.

An estimated 300,000 people in the U.S. are diagnosed with the disease each year, and as Lyme disease rates have steadily climbed, so have reports of a collection of symptoms that patients commonly refer to as chronic Lyme disease. Experts in the field have questioned the validity of this term because of the lack of direct evidence in this group of patients of ongoing infection with Borrelia burgdorferi, the bacterium that causes Lyme disease.

Efforts to better understand patients with these symptoms have largely failed, says Aucott, because patients grouped under the umbrella term “chronic Lyme disease” could belong to one of various subgroups.

“People have been comparing apples to oranges by grouping all of those with chronic Lyme disease together,” he says. “Our study was designed to compare apples to apples.”

To do that, Aucott and his colleagues first agreed to study individuals with PTLDS, a disorder defined by the Infectious Diseases Society of America as the development of significant fatigue, widespread musculoskeletal pain, and/or cognitive difficulties that arise within six months after completion of antibiotic therapy for physician-documented Lyme disease and that last for at least six months. They meticulously gathered prior medical records for evidence of Lyme disease and excluded patients with conditions that may mimic those of PTLDS.

Aucott cautions that because so little is known about the origins of PTLDS, its underlying cause has remained unclear, and a range of hypotheses exist. This study, and the term “PTLDS,” do not define the cause of the condition, but do provide a starting place for future studies.

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Lyme patients file lawsuit against IDSA and insurers over treatment denials

•November 16, 2017 • Leave a Comment

Excerpted from :  (11/14/2017)

TEXARKANA, Texas (CN) – Twenty people claim in a federal antitrust lawsuit that Lyme disease victims are being forced to pay hundreds of thousands of dollars for treatment because health insurers are denying coverage with bogus guidelines established by their paid consultants, who falsely say the disease can always be cured with a month of antibiotics.

Suffering from migraine headaches, an irregular heartbeat, hearing problems and nerve pain, lead plaintiff Lisa Torrey says in the lawsuit filed Friday in Texarkana, Texas federal court that she visited 36 doctors, some of whom misdiagnosed her with multiple sclerosis and fibromyalgia and said her symptoms “were all in her head,” before she was properly diagnosed with Lyme disease.

People get the disease from the bites of infected ticks and many break out with a large red rash around the bite that looks like a bullseye.

There were more than 28,000 confirmed cases of Lyme disease in the United States in 2015, 95 percent of which came from  14 states in the Northeast and Midwest, according to the Centers for Disease Control and Prevention. The agency estimates that 300,000 people are infected with the disease each year.

Torrey – represented by lead attorney Eugene Egdorf with Shrader & Associates in Houston – lays part of the blame for her lack of health insurance coverage on the Infectious Diseases Society of America, or IDSA, a medical association whose 11,000 members research diseases and lead panel discussions about them. IDSA also develops clinical practice guidelines.

Torrey claims in her lawsuit that several major health insurers decided in the 1990s that treating Lyme disease was too expensive and bad for their bottom lines, so they paid IDSA-affiliated doctors – who were researching, not treating, Lyme disease – to establish arbitrary guidelines in 2000 that said the disease could be treated with 28 days of antibiotics.

“These doctors knew that short term antibiotics of twenty-eight days failed to treat up to 40 percent of patients with Lyme disease.  This means more than 100,000 Lyme disease patients every year would be untreated if the IDSA guidelines were followed,” the lawsuit states.

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Do Microbes Trigger Alzheimer’s Disease?

•September 9, 2017 • Leave a Comment

Excerpted from The Scentist :  (09/01/2017)

In late 2011, Drexel University dermatology professor Herbert Allen was astounded to read a new research paper documenting the presence of long, corkscrew-shape bacteria called spirochetes in postmortem brains of patients with Alzheimer’s disease.1 Combing data from published reports, the International Alzheimer Research Center’s Judith Miklossy and colleagues had found evidence of spirochetes in 451 of 495 Alzheimer’s brains. In 25 percent of cases, researchers had identified the spirochete as Borrelia burgdorferi, a causative agent of Lyme disease. Control brains did not contain the spirochetes.

The study made Allen think back to 40 years earlier, when he was an intern at Johns Hopkins University and had treated a patient diagnosed with neurosyphilis, a neurological syndrome that included dementia and resulted from the invasion of the syphilis spirochete into the brain. “The parallel between Lyme disease and syphilis had me intrigued,” he says.

Allen had recently proposed a novel role for biofilms—colonies of bacteria that adhere to surfaces and are largely resistant to immune attack or antibiotics—in eczema. He suggested that because biofilms block skin ducts and trigger innate immune responses, they may cause the stubborn skin condition. Allen knew of recent work showing that Lyme spirochetes form biofilms,2which led him to wonder if biofilms might also play a role in Alzheimer’s disease. When Allen stained for biofilms in brains from deceased Alzheimer’s patients, he found them in the same hippocampal locations as amyloid plaques.3 Toll-like receptor 2 (TLR2), a key player in innate immunity, was also present in the same region of the Alzheimer’s brains but not in the controls. He hypothesizes that TLR2 is activated by the presence of bacteria, but is locked out by the biofilm and damages the surrounding tissue instead.

Spirochetes, common members of the oral microbiome, belong to a small set of microbes that cross the blood-brain barrier when they’re circulating in the blood, as they are during active Lyme infections or after oral surgery. However, the bacteria are so slow to divide that it can take decades to grow a biofilm. This time line is consistent with Alzheimer’s being a disease of old age, Allen reasons, and is corroborated by syphilis cases in which the neuroinvasive effects of spirochetes might appear as long as 50 years after primary infection.

Allen’s work contributes to the revival of a long-standing hypothesis concerning the development of Alzheimer’s. For 30 years, a handful of researchers have been pursuing the idea that pathogenic microbes may serve as triggers for the disease’s neuropathology. Most came across the connection serendipitously, as Allen did, and some have made it their life’s work, in spite of scathing criticism and related challenges in attracting funding and publishing results.

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