Econintersect: This news will be no surprise to thousands (tens of thousands? hundred of thousands?) of people who have been treated for Lyme disease and yet have had symptoms persist or reoccur after a period of absence. New research using mice as the test vehicle shows that Lyme Disease can persist in a host after antibiotic treatment. In such cases blood tests and tissue cultures for Lyme Disease have been negative.
The new research has shown that after mice have been treated with antibiotics and found (by blood test and tissue cultures) to be negative for Lyme Disease they can still reinfect ticks that attach. It turns out that the tick itself has a test capability for detection of Lyme organisms that escape the traditional testing used for decades.
Lyme disease is a tick-born affliction transmitted to humans by one of three varieties of black-legged tick (commonly called "deer tick") found in North America and Europe. The common hosts for the three species of lxodes ticks are deer and rodents, but the vectors for Lyme Disease (three spirochete bacteria known as Borrelia) are not found in deer, only in rodents, most commonly mice.
Some other diseases transmitted by other (not Borrelia) spirochetes include leptospirosis, relapsing fever, yaws and syphilis.
The official position of the CDC (U.S. Center for Disease Control) on Lyme Disease treatment has been to endorse the regimen prescribed by the 2006 Guidelines for treatment developed by the Infectious Diseases Society of America. These IDSA guidelines are based on the conclusions:
1. There is no well-accepted definition of post-Lyme disease syndrome.
2. To date, there is no convincing biologic evidence for the existence of symptomatic chronic B. burgdorferi infection among patients after receipt of recommended treatment regimens for Lyme disease.
A rival organization has grown over the years as doctors in Lyme Disease endemic areas have found the IDSA treatment prescription to be inadequate to deal with many cases that present to them. The International Lyme and Associated Diseases Society (ILADS) has hundreds of members in 11 countries. The doctors in this organization are involved with patients who repeatedly present for Lyme Disease symptoms, both with and without evidence of repeated infection exposures. Extensive clinical experience within this group is at odds with the the stated conclusions (above) upon which the UDSA guidelines are based.
There is a long, ongoing debate between IDSA and ILADS about continuing treatment beyond a preliminary course of antibiotics. IDSA guidelines say that extended treatment should be rare and ILADS says that repeated treatments beyond the preliminary course are indicated based on presentation of symptoms.
The significance of the new work on reinfection from "cured" hosts which had negative blood and tissue culture tests is emphasized by the following from IDSA review and guidelines which indicate the dependance of the IDSA on tissue culture examinations in establishing their treatment recommendations:
Do viable B. burgdorferi persist in tissues despite antibiotic treatment? There is no convincing evidence in North America for the persistence of B. burgdorferi in the skin of humans after treatment with antibiotic regimens known to be active against B. burgdorferi in vitro. In the 2 US studies in which this question has been investigated systematically, skin biopsy samples from sites of a prior, resolved erythema migrans lesion were cultured. In one study, none of 18 biopsy cultures for 13 patients with erythema migrans grew B. burgdorferi (5 patients had negative skin biopsy culture results on 2 separate occasions 3-5 months apart), although all of these patients were culture positive prior to treatment with an antibiotic . In the second study, 13 previously culture-positive patients were all culture negative when an additional biopsy specimen from the site of the resolved erythema migrans lesion was evaluated .
The conclusions of the ISDA assessment and treatment document depend on research using blood tests and tissue cultures as definitive determinants of the absence or presence of Lyme Disease. When published research is evaluated by IDSA they frequently dismiss research that contradicts their guidelines for treatment because of the possibility of sample contaminations.
The new research suggests that the entire analytical structure of IDSA may be flawed. If further research continues to show the presence of Lyme Disease spirochetes in the absence of traditional blood and tissue confirmation, and if such research can eliminate possibilities of sample contaminations, the treatment guidelines for Lyme Disease may be radically overhauled.
Overhaul of CDC endorsed guidelines would be a welcome event for members of ILADS.
Following are three videos discussing aspects of Lyme Disease that may not be familiar to many. The first discusses the possibility of Lyme Disease as a factor in some psychiatric disorders. The second is a short summary from CNN. The third is an extended trailer for the documentary "Under Our Skin". (Click on link for free access to full documentary.)
Disclosure: John Lounsbury has been successfully treated for management of Lyme Disease symptoms several times over the past 25 years by Dr. Daniel Cameron, current president of ILADS, who is in the three videos above. John's wife, Evelyn, died in 1997, either "with" or "of" an unidentified psychiatric/neurological disorder. She underwent spinal fluid and blood tests for Lyme disease (suspected as possibly involved) in the final stages of her illness, but all tests were negative. She had been diagnosed with and treated for Lyme disease on two occasions in the ten years preceding her death, the first time before the presentation of any psychological symptoms. The possibility of Lyme involvement has remained a nagging, unanswered question to this day.
- Lyme disease (Wikipedia) Other Wikipedia sources are linked in the article.
- Antibiotics don't always kill Lyme, studies say (John Ferro, Poughkeepsie Journal, 27 March 2014)
- Research Op-Ed and Commentary (Lyme and Tick-Borne Diseases Research Center, Columbia University Medial Center)
- 2006 Guidelines for treatment developed by the Infectious Diseases Society of America (Gary P. Wormser et al, Oxford Journals, Vol. 23, Issue 9, pp. 1089-1134, 2006)
- Lyme Disease articles at GEI News.