1

Study Provides Insights into Neuropathologies Associated with Lyme Disease

Neuropathologies Associated with Lyme DiseaseThe study, “A murine model of Lyme disease demonstrates that Borrelia burgdorferi colonizes the dura mater and induces inflammation in the central nervous system,” was published in the journal PLOS Pathogens. Prior to this, studies using inbred laboratory mice to observe B. burgdorferi infection and host immune responses in the central nervous system (CNS) were lacking, creating a major barrier to understanding the neuropathologies associated with Lyme disease.

The researchers developed a tractable animal model for investigating host-Borrelia interactions in the CNS and CNS pathogenesis. Using fluorescence-immunohistochemistry, intravital microscopy, bacterial culture, and quantitative PCR, they observed Bburgdorferi routinely colonized the dura mater of C3H mice, with peak spirochete burden at day 7 post-infection. Dura mater colonization was observed for BburgdorferiBgarinii, and Bmayonii.

RNA-sequencing and quantitative RT-PCR showed Bburgdorferi infection to be associated with increased expression of inflammatory cytokines and a robust interferon (IFN) response in the dura mater. The meninges showed histopathologic changes such as leukocytic infiltrates and vascular changes. The researchers did not find Bburgdorferi, infiltrating leukocytes, or large-scale changes in cytokine profiles in the cerebral cortex or hippocampus. However, both brain regions showed comparable changes in the expression of IFN-stimulated genes as was observed in peripheral tissues and meninges.

The paper reads, “Taken together, Bburgdorferi is capable of colonizing the meninges in laboratory mice, and induces localized inflammation similar to peripheral tissues. A sterile IFN response in the absence of Bburgdorferi or inflammatory cytokines is unique to the brain parenchyma, and provides insight into the potential mechanisms of CNS pathology associated with this important pathogen.”

The authors summarize, “Overall, these findings characterize the central nervous system responses to Borrelia burgdorferi infection in a cost-effective and genetically robust animal model, and provide insights into the mechanisms of neuropathologies associated with Lyme disease.”

Read “A murine model of Lyme disease demonstrates that Borrelia burgdorferi colonizes the dura mater and induces inflammation in the central nervous system” in PLOS Pathogens.




Pike County PA Tick Borne Diseases Task Force Releases Results Presentation

The Pike County (PA) Tick Borne Diseases Task Force has provided a 6 minute video slide show with results from the Pike County Tick Borne Diseases Base-Line Study, a county-wide assessment of the tick-borne diseases and infection rates of ticks funded in part by a 2018 grant awarded by the LDA.  

Graph from Pike County Tick Borne Diseases Base-Line Study
Graph from Pike County Tick Borne Diseases Base-Line Study

From Spring 2018 through Fall 2019 black-legged ticks in the nymph or adult stages were collected and tested for seven different disease-causing pathogens. Other types of ticks, including one Asian longhorned and one lone star tick, were collected but not tested.

There was nearly an even split between the number of male and female ticks collected. Results of this study show that over half of the male deer ticks tested positive for various tick-borne pathogens, * with a similar finding in the female population.  

The study also addressed co-infections with 123 of 988 black-legged ticks testing positive for two or more pathogens. The highest co-infection observed was Lyme disease and Anaplasmosis.

*It should be noted here that current research seems to indicate that male deer ticks do not transmit the Lyme bacteria, or rarely transmit, with varying reports of either they do not feed or briefly feed, and do not become engorged.

View the Pike County Tick Borne Diseases Base-Line Study slide show/video below.

For more information visit the Pike County Tick Borne Diseases Task Force webpage.

Read previous article, Pike County Ticks Exceed PA State Average for Carrying Tick-Borne Diseases on LDA’s website.

 




NIH Guideline Committee Changes Ivermectin Rec for COVID & FLCCC Responds

On January 14, 2021, The National Institute of Health (NIH) COVID-19 Treatment Guidelines Panel issued a change in position and are no longer recommending “against” the use of ivermectin for the treatment of COVID-19. This “permission” was issued 8 days after Drs. Paul Marik and Pierre Kory, founding members of the Front Line Covid-19 Critical Care Alliance (FLCCC), along with Dr. Andrew Hill, researcher/consultant to the World Health Organization, presented their data on ivermectin before the Panel, showing significant benefits of ivermectin in prophylaxis, early treatment and late-stage disease.

The NIH Panel stated that there is insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19, and that more clinical trials are needed. The FLCCC responded to the Panel in a public statement, dated January 18th, expressing gratitude for the Panel’s neutral stance on ivermectin. However, they questioned the Panel’s caution and criticism of the existing evidence, especially in the midst of escalating hospitalizations, and deaths from COVID-19.

In their response, FLCCC stated that both monoclonal antibodies and convalescent plasma therapies are also regarded as neutral, and are used widely in COVID-19 treatment in the U.S., but are inferior to ivermectin in 3 critical ways:

1) Ivermectin is the ONLY one of these 3 therapies that has multiple randomized controlled trials (RCT’s) and a meta-analysis of RCT’s that demonstrate statistically significant reductions in mortality rates; shorter durations of hospital stay; profound reductions in the infectivity rate in both pre-and post-exposure prophylaxis studies; faster times to clinical recovery; and faster times to viral clearance.

2) Ivermectin is the ONLY one of these 3 therapies that is globally available, low cost, given orally, requires no special shipping or handling, and is safe to use in nearly all clinical situations.

3) Ivermectin is the ONLY one of these three therapies that can be widely used in both early outpatient treatment as well as in prevention.

NIH Panel also stated that some clinical studies showed no benefits or worsening of disease after ivermectin use; however FLCCC objected, showing evidence of flawed studies. NIH Panel also listed “limitations” preventing them from making a stronger recommendation. FLCCC disagreed with these limitations. (See Public Statement)

FLCCC concludes: Ivermectin is one of the safest, low-cost, and widely available drugs in the history of medicine. The evidence in favor of ivermectin includes approximately 32 controlled trials, 20 of them RCT’s. Similar meta-analyses of these trials have been performed worldwide, concluding that ivermectin is a highly effective therapy for COVID-19 and/or should be widely adopted for use.

FLCCC:Why does the Panel’s opinion diverge from these other expert meta-analyses? Further, why does the Panel’s opinion diverge from the expert peer reviewers (two of whom we were told were FDA employees) that has now accepted our manuscript and its conclusions for publication? …Patients do not have time to wait, and we as healthcare providers in society do not have that time either. We plead with the Panel to rapidly re-review and re-consider the current strength of their recommendation.”

Read Public Statement (January 18th, 2021) –
FLCCC Alliance Response to the NIH Guideline Committee Recommendation on Ivermectin use in COVID-19 dated January 14th, 2021

 




Lyme Bacteria DNA Found in PA Haemaphysalis longicornis Tick

The study “Borrelia burgdorferi Sensu Stricto DNA in Field-Collected Haemaphysalis longicornis Ticks, Pennsylvania, United States” was recently published in the Centers for Disease Control & Prevention (CDC) Emerging Infectious Diseases. Pennsylvania has the highest number of reported Lyme disease cases in the US.

Longhorned Tick, Haemaphysalis longicornis
Haemaphysalis longicornis Ticks Photo courtesy of James Occi, (PhD cand.) LDA Scientific & Professional Advisory Board

Researchers performed weekly surveillance activities throughout 38 Pennsylvania counties from May 1–September 6, 2019, capturing nymphal I. scapularis ticks (deer tick) and adult and nymphal H. longicornis ticks (Asian longhorned ticks). Sampled sites were mostly high-use public areas located in deciduous forests, considered to be high-risk for recreational and occupational tick exposure, and are H. longicornis and I. scapularis tick habitats.

Using real-time PCR testing, the researchers analyzed a total of 263 questing Asian longhorned ticks from southeastern counties of Pennsylvania. One adult female tested positive for Borrelia burgdorferi sensu stricto, yielding a 0.4% infection rate. I. scapularis ticks collected during the same period and sites had infection rates for B. burgdorferi sensu lato ranging from 16.7% to 57.1%.

Previous Pennsylvania studies focused primarily on collecting and testing deer ticks – the primary vector of the Lyme disease-causing bacteria – and identified nearly 50% as carrying Borrelia burgdorferi sensu stricto. These initial surveillance efforts also recovered H. longicornis ticks.

H. longicornis was first discovered in New Jersey in 2017 and ever since the number of states that have reported confirmation of its presence has rapidly increased. The study’s authors note that, “Because ecologic characteristics and the pathogen diversity and prevalence of H. longicornis ticks in the United States are understudied, potential epidemiologic risks there remain unknown.” Continued monitoring of this invasive tick species is necessary to determine its impact on public health.

Read Borrelia burgdorferi Sensu Stricto DNA in Field-Collected Haemaphysalis longicornis Ticks, Pennsylvania, United States” in Emerging Infectious Diseases.

Read New Study Finds Haemaphysalis longicornis Fails as Experimental Vector of Lyme Disease on LDA’s website.

Read CDC Sounds Warning About Longicornis Tick on LDA’s website.




NY Supreme Court Judge Orders Hospital: Give Patient Ivermectin for COVID-19

According to “TrialSite News” on January 21, “Apparently, a judge just ordered the Millard Fillmore Suburban Hospital to allow an 80-year old woman to be treated with Ivermectin.  A New York Supreme Court judge ordered hospital to allow her to be treated with Ivermectin for COVID-19.  Ivermectin, which had been administered in the ICU with noticeable symptom improvement was discontinued when the patient was moved to another unit in the hospital. Family members took legal action after the doctor in the new unit disallowed the use of the drug, and the woman’s health condition again declined. Family members immediately involved lawyers and legal action to resume treatment. Judge, Henry J. Nowak aligned with the family.

Ivermectin is approved for fighting parasites and lice. NIH states that in general, the drug is well tolerated and is currently being evaluated as a potential treatment for COVID-19. However, is not yet approved for use by the US Food and Drug Administration (FDA).

The National Institute of Health (NIH) COVID-19 Treatment Guidelines Panel recently issued a change in position on Ivermectin

NIH COVID-19 Recommendation:

  • The COVID-19 Treatment Guidelines Panel (the Panel) has determined that currently there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin for the treatment of COVID-19.

Read full article here

 




County-Level Distribution of Ixodes and Lyme Disease Spirochetes in US

This new summary article by employees of the CDC, presents the first county-level map of the distribution of Lyme disease spirochetes in host seeking Ixodes ticks between 2004-2019 in the contiguous United States. Data compiled for this summary was from literature searches; publicly available tick-borne pathogen surveillance databases (ArboNet Tick module); and internal CDC pathogen testing databases to map the county-level distribution of Lyme disease spirochetes reported in host-seeking Ixodes pacificus and Ixodes scapularis across the contiguous US. 

Investigators narrowed their search to include only host-seeking ticks, because ticks in this state are most likely to bite humans, and because host-seeking ticks provide enhanced spatial precision compared to ticks collected from mobile hosts. Data used was restricted to studies that collected ticks by flagging, dragging or CO2 Traps. Ticks that were collected from mobile hosts such as wildlife, pets, and livestock were excluded because county of exposure could not be confirmed. County level pathogen infection data was included from these sources when provided. 

Authors report B. burgdorferi s.s. infected I. scapularis from 384 counties in 26 eastern states of the Northeastern, North Central and Mid-Atlantic regions. B. burgdorferi s.s. infected I. pacificus were reported from 20 counties 2 western states, primarily from northern and north-coastal California. Borrelia mayonii was reported in I. scapularis in 10 counties in Minnesota and Wisconsin, where records of B. burgdorferi s.s. were also reported. 

Important caveats that the authors state in regard to this mapping effort:

  • The reported distribution of  B. burgdorferi s.s and B. mayonii in host seeking ticks is almost certainly an underestimate of the actual distribution of these disease agents.”
  •  “Though support for and participation in tick and tick-borne pathogen surveillance has increased in the US in recent years, collection and pathogen testing efforts have been limited with most efforts focused on US regions where Lyme disease cases are most commonly reported.” 
  • “In some instances, lack of records could represent lack of sampling effort or low prevalence of pathogens within sampled tick populations.” 

The authors were confident in the distribution of tick presence records, but for counties where Lyme disease spirochete has not been documented in ticks, they were unable to determine whether this represented a true absence of pathogen or a merely a failure to detect the pathogen. Lack of data is especially evident in the Rocky Mountain region, Western plains and Southwestern region in regard to both tick presence and pathogen detection; and in the Southeastern region and Western states for pathogen detection. Continued surveillance and reporting will likely result in additional counties to be added to the map, and reporting densities of infected host-seeking ticks for many jurisdictions may be possible in the future.

In comparison to a broad distribution of vector ticks, the resulting map shows a more limited distribution of Lyme disease spirochetes.

Reported distribution of Lyme disease spirochetes, B. burgdorferi s.s. and B. mayonii in host-seeking I. scapularis (eastern United States) or I. pacificus (western United States), relative to the previously reported distribution of these vector species. Ticks were considered present in a county if at least one tick was recorded (Eisen et al. [2016] or CDC [2020]). Counties where ticks have been reported without records of infection may be reported as such either if ticks were not tested or if the pathogen was not detected in tested samples.
LDA NOTE: Contained in the journal article: This work is written by (a) US Government employee(s) and is in the public domain in the US.

 

Read full article here
Amy C Fleshman, Christine B Graham, Sarah E Maes, Erik Foster, Rebecca J Eisen, Reported County-Level Distribution of Lyme Disease Spirochetes, Borrelia burgdorferi sensu stricto and Borrelia mayonii (Spirochaetales: Spirochaetaceae), in Host-Seeking Ixodes scapularis and Ixodes pacificus Ticks (Acari:Ixodidae) in the Contiguous United States, Journal of Medical Entomology, 2021;tjaa283, https://doi.org/10.1093/jme/tjaa283

Read Entomology Today Press Release here

 

 




Does Bartonella Contribute to the Occurrence of Cutaneous Lesions and Neuropsychiatric Symptoms in Patients?

Breitschwerdta
Edward Breitschwerdt, DVM

Results of the study, “Bartonella Associated Cutaneous Lesions (BACL) in People with Neuropsychiatric Symptoms” was recently published in the journal, Pathogens, as part of the special issue, “The Evolving Biomedical Importance of Bartonella Species Infections.” The study’s authors describe Bartonella spp. test results for participants who reported neuropsychiatric symptoms, with a majority reporting the concurrent incidence of cutaneous lesions.

Participants completed a medical history and risk factor questionnaire, as well as provided photographs of their cutaneous lesions. As well, Bartonella spp. serology and Bartonella alpha proteobacteria enrichment blood culture/PCR were reviewed. The study took place over a 14-month period, during which 33 total participants enrolled. Twenty-nine of the 33 participants had serological and/or PCR evidence supporting Bartonella spp. infection. Of these, 24 reported concurrent cutaneous lesions since the onset of neuropsychiatric symptoms.

The researchers conclude that cutaneous lesions were common among people reporting neuropsychiatric symptoms and Bartonella spp. infection or exposure to infection. Furthered studies, using sensitive microbiological and imaging techniques, are necessary to determine if, or to what extent, Bartonella spp. contributes to the occurrence of cutaneous lesions and neuropsychiatric symptoms in patients.

Read the peer-reviewed study, “Bartonella Associated Cutaneous Lesions (BACL) in People with Neuropsychiatric Symptoms” in the journal Pathogens.

The Lyme Disease Association, Inc. (LDA) awarded lead author Edward B. Breitschwerdt, DVM, DACVIM (SAIM), a grant in 2020 for Bartonella research and awarded a grant in 2019 for Bartonella research, still ongoing, to a team of researchers including Dr. Breitschwerdt. 

See LDA website article: LDA Has Awarded 121 Research Grants Since 1992

 




New Estimates of People Diagnosed/Treated for Lyme: 476,000 Annually

Fig. 1: Prepared by LDA, Jan. 2021

476,000 People Diagnosed & Treated for Lyme Annually: The Centers for Disease Control and Prevention (CDC) published in the February edition of its Emerging Infectious Diseases two new papers pertaining to Lyme disease.

CDC states on its How Many People Get Lyme Disease? webpage (reviewed Jan 13, 2021), “A recently released estimate based on insurance records suggests that each year ~ 476,000 Americans are diagnosed & treated for Lyme disease.1,2  This number is likely an over-estimate of actual infections because patients are sometimes treated presumptively in medical practice. Regardless, this number indicates a large burden on the health care system and the need for more effective prevention measures.”

The researchers found ~ 476,000 people are diagnosed with and treated for Lyme disease each year in the U.S.  The prior Lyme estimates by CDC from 2005 to 2010 indicated “~300,000 people get Lyme disease  each year.”  Both estimates are based in part on insurance claim data.  Based on CDC’s estimates the LDA calculated a 59% increase in the estimated number of people diagnosed & treated for Lyme disease annually. (See Fig. 1)  

The CDC clearly states on its website, “It’s important to emphasize that 476,000 is the estimated number of people treated for Lyme disease and likely includes some patients who were not actually infected.”  Read the two papers below for their discussion on this new estimated number. 

The two 2021 research papers on which the new 476,000 estimate is based are:

  1. Schwartz AM, Kugeler KJ, Nelson CA, et al. Use of Commercial Claims Data for Evaluating Trends in Lyme Disease Diagnoses, United States, 2010-2018. Emerg Infect Dis. 2021;27(2).
  2. Kugeler KJ, Schwartz AM, Delorey M, et al. Estimating the frequency of Lyme disease diagnoses —United States, 2010-2018. Emerg Infect Dis. 2021;27(2).

The two research papers on which the prior 300,000 estimate was based are:


 

Fig. 2: New CDC Data Dashboard

CDC Creates New Tick-Bite Data Dashboard:  The CDC posted a new page, syndromic surveillance of emergency department visits for tick bites, to its website, last reviewed on January 4, 2021, showing tick bites by time, age/sex and region. (See Fig. 2)  

According to a CDC official, “Unlike some tickborne disease surveillance data, the data shown in the charts [on the above webpage] are updated weekly, rather than annually. These data can indicate when people in different parts of the country might be at highest risk for tick bites. We think this is the closest we have come to providing real-time risk data for tickborne diseases ….”  CDC also indicated they are working with data providers to make this type of data state-specific verse region-specific.

Syndromic surveillance is a term unfamiliar to the general public. In its September 2004 MMWR CDC describes syndromic surveillance, “Although syndromic surveillance was developed for early detection of a large-scale release of a biologic agent, current surveillance goals reach beyond terrorism preparedness. Medical-provider reporting remains critical for identifying unusual disease clusters or sentinel cases. Nevertheless, syndromic surveillance might help determine the size, spread, and tempo of an outbreak after it is detected (5), or provide reassurance that a large-scale outbreak is not occurring, particularly in times of enhanced surveillance (e.g., during a high-profile event). Finally, syndromic surveillance is beginning to be used to monitor disease trends, which is increasingly possible as longitudinal data are obtained and syndrome definitions refined. The fundamental objective of syndromic surveillance is to identify illness clusters early, before diagnoses are confirmed and reported to public health agencies, and to mobilize a rapid response, thereby reducing morbidity and mortality. Epidemic curves for persons with earliest symptom onset and those with severe illness can be depicted graphically …

Stakeholders need to understand the advantages and limitations of syndromic surveillance systems. Syndromic surveillance systems might enhance collaboration among public health agencies, health-care providers, information-system professionals, academic investigators, and industry. However, syndromic surveillance does not replace traditional public health surveillance, nor does it substitute for direct physician reporting of unusual or suspect cases of public health importance.”


 

Lyme Disease Association, Inc. (LDA) Response:  It is important that data surrounding Lyme and other tick-borne diseases be continuously collected and distributed to safeguard the health of the public.  Since the above material has just been released by the CDC, the LDA will review the material and comment further if necessary in the near future.


 

Click on Image to Watch CDC Video Tweet: The burden of Lyme disease in the U.S.

 

 

 

 

 

 

 


Other Links:

2016 Final Lyme Case Numbers: Wondering If Surveillance Can Get More Confusing?

LDA Maps for Lyme Cases

CDC Surveillance for Lyme Disease – US




Success in 2020: Help LDA Work for You in the New Year!

This year has been a challenge for all of us, and in particular, for those with chronic conditions such as Lyme disease, which is still unrecognized by the federal government. The Lyme Disease Association, Inc. (LDA) has been working for Lyme and tick-borne diseases (TBD) for 30 years, with individuals who are patients and family members of patients driving the programs. We care about you, your family, your friends, your pets, who have or might acquire Lyme disease and other TBD. That is why ~97% of our funds generally go directly to programs. We continue to have no employees to keep administrative costs down and we utilize consultants to provide expertise as needed.  Guidestar.org has designated LDA as a charity at its highest level committed to transparency, Platinum. LDA’s financial reports are on Guidestar. For 15 years, LDA has been designated as a national charity included in the Combined Federal Campaign (CFC) lists. Annually, federal employees are provided with approved charity lists for their workplace giving through CFC. Please help us continue our programs to help Lyme patients. DONATE TODAY

RESEARCH GRANTS: Over time, LDA has awarded 121 research grants resulting in 54 peer-reviewed journal articles− one published in 2020 by Columbia University’s Brian Fallon, MD. The LDA partnered to help to establish the endowed Columbia University Lyme & Tick-Borne Diseases Research Center 13 years ago. The Brain, Behavior & Immunity article conclusion states: “The finding of elevated anti-neuronal autoantibodies in our small sample of those with a prior history of Lyme disease but not in those without prior Lyme disease, if replicated in a larger sample, suggests an immune priming effect of repeated infection.” Published research moves the scientific field forward & brings us closer to a cure.

A 2020 published report resulting from a 2018 LDA grant awarded to Pennsylvania researchers to study infection rates of ticks (PA ranks #1 in Lyme cases in the US) indicates that in Pike County, PA, Borrelia burgdorferi prevalence in I. scapularis ticks overall was 39%, Bartonella next with 18.5%.  Further publications are expected in peer review soon. The 4 researchers awarded grants in 2019 by LDA have been granted a time extension for completion due to the pandemic. Research grants for 2020 will be awarded by LDA by year’s end.

MEDICAL SUPPORT GRANTS: To date, LDA’s LymeAid 4 Kids program has awarded $400,400 in grants ($17,000 in 2020) to families across the US who have financial difficulty, to help with their children’s medical expenses.

EDUCATION: The LDA has awarded 154 education grants over time (2020 grants to be awarded by year’s end), to other Lyme organizations/institutions who are providing programs materials, and help to patients. We have partnered with Columbia University annually to provide 20 Continuing Medical Education Conference designed for doctors, researchers, and the public. Unfortunately, due to the pandemic, we made the decision to cancel our conference plans for 2020. LDA has distributed millions of pieces of literature on Lyme & TBD and in 2020, we had our LymeR Primer brochure translated into Spanish and published online.  LDA brochures can be downloaded for free from the website and ordered for shipping costs. LDA provides a free online nationwide doctor referral system −(a state-of-the-art searchable system to be available in 2021). LDA created a webpage in 2020, COVID-19 & Lyme, to provide information for patients who have Lyme/TBD and then became infected with COVID-19. It includes protocols for COVID-19 as well as information for patients with both TBD & COVID-19.

We participated in educational radio and print media interviews and Zoom meetings throughout the year including LDA President Pat Smith speaking along with Robert Bransfield, MD, LDA Professional & Scientific Advisory Board Member, on the webinar hosted by Project Lyme on December 17. The webinar discussed newly released IDSA Lyme guidelines and their impact on patients and physicians. 

PUBLIC OFFICIAL EDUCATION: We continue to educate public officials. In 2020, we provided language included in the Congressional Lyme Caucus letter to the Subcommittee on Labor HHS, Education & Related Agencies House Committee on Appropriations. The language was for specific area increases for the agencies for Lyme/TBD. Increases for Lyme/TBD have just been passed by Congress and LDA will provide updated information soon. Additionally, we provided input into language the Caucus sent to Subcommittee on Defense House Appropriations for funding for the Congressionally Directed Medical Research Program (CDMRP), awarding research grants for Lyme/TBD, and language to ensure the burden of disease falls on Lyme disease. Past work by LDA through Congress led to the original inclusion of Lyme/TBD into the Department of Defense (DoD) CDMRP program and also led to an increase in funding in 2019. Additionally, working with Congressman Chris Smith, LDA helped to achieve in 2020 the passage by the House amendment #587 to the National Defense Authorization Act, which “Requires the GAO [Government Accountability Office] to conduct a study of possible experimentation of ticks, insects, or vector-borne agents by the DOD between 1950 and 1977 for use as a bioweapon.”

FEDERAL GOVERNMENT: In addition to my LDA work, I have just completed two terms over four years, as a public member of the HHS Working Group (TBDWG), helping to drive recommendations to Congress on Lyme & TBD. The 2020 report that was produced by the TBDWG contained recommendations that often dovetail with LDA efforts. I was Co-Chair of the Physician Education & Access to Care Subcommittee Chapter on which the patient section of the 2020 report to Congress is based. The 2020 report is now on the HHS Secretary’s desk for review and submission to Congress.

This year, a contentious situation developed pitting me in my TBDWG role as advocate/family member of patient against those members who are continuing to suppress anything supporting chronic/persistent Lyme disease. Despite intense efforts to remove/water down all patient information, I was able to keep much of the material in the patient chapter of the report included in 2020, but it was an epic battle. You can read some of the comments I made to win the battle in an 8-6 vote and other battles in the LDA TBDWG Section.

I also served on the DoD’s CDMRP Programmatic panel from its inception through early 2020 (4 years). I helped to make decisions for grant monies awarded by the DoD on Lyme and TBD. My grant work on LDA provides me with a better understanding of the entire research process necessary for this panel.

Please donate today. Help us provide a healthier New Year for people everywhere. Donations are tax-deductible to the fullest extent allowed by law.

Thank you & Happy, Healthy 2021.

Pat Smith
President
Lyme Disease Association, Inc.




Lyme Disease Pathogenesis- A Review

2012 Barthold BbInMouseCropSm
Borrelia burgdorferi in mouse, Photo by Stephen W. Barthold, DVM, PhD

Virulence of Borrelia involves multiple channels for transmission and establishment in multiple tissues, as well as evasion of the host immune responses. The bacteria undergo significant changes in gene expression and multiply and spread once transmitted to the host. These changes induce inflammatory responses that, in humans, result in clinical signs and symptoms of disease. In this review, the authors provide an overview on the ability of Borrelia burgdorferi to infect a host and the factors which decisively affect the nature or outcome of this infection that have been demonstrated in vivo, primarily in mouse models. 

Read the full review article: Lyme Disease Pathogenesis

Jenifer Coburn, Brandon Garcia, Linden T. Hu, Mollie W. Jewett, Peter Kraiczy, Steven J. Norris and Jon Skare Curr. Issues Mol. Biol. (2022) 42: 473-518. https://doi.org/10.21775/cimb.042.473