Texas Lyme disease
Lyme disease is a bacterial infection caused by members of the Borrelia burgdorferi sensu lato complex. Although the disease was initially identified in Europe, it was named after the town where the first group of US cases was described. While historically most cases clustered into certain geographic regions, the infection is increasingly widespread across the globe. Lyme disease is the most common vector-borne disease in the United States, with the Centers for Disease Control (CDC) estimating that more than 477,000 cases of Lyme disease are diagnosed each year.1 Lyme disease is also the most common vector-borne illness in Europe. Lyme/tick-borne illnesses IDSA recommendations are inappropriately outdated and were just published in 2020 but was no update for Lyme. It still promotes guidelines that ensure "treatment failure" in a large population. This is also known as Post Treatment Lyme Disease/PTLDS which has no scientific merit to earn a diagnosis. Patients' push for change has succeeded nationally where in 2020, we increased funding to $91 MILLION in government appropriations!
Lyme disease can be very serious. The infection is often multisystem – involving joints, heart, and the nervous system. Although early recognition and treatment lead to resolution of illness for many patients, there are many who live with persistent, debilitating symptoms, and persistent infection – which ILADS terms chronic Lyme disease. The IDSA still does not admit persistence or that congenital Lyme exists.
This document attempts to explain the many challenges faced by patients with tick-borne illnesses, including controversies over terminology and treatment. It seeks to describe ILADS’ position in these controversies and challenges. ILADS Treatment Guidelines, a comprehensive review of the best science on effective treatment for particular aspects of Lyme disease, touch on many of these controversial issues within the context of our evidence-based treatment recommendations.
During the insect bite, additional “coinfections” can be transmitted, such as babesia, Bartonella, Rocky Mountain spotted fever, ehrlichia, anaplasma and 20+ others. The insect transmits an average of three infections with each bite, so symptoms can be many and complex to diagnose and treat. Lyme Complex is the full set of infections transmitted during the tick bite.
AMA approved CME's in Lyme- Physician Training Program
ILADEF and ILADS are committed to supporting medical professionals as they take on the challenges in evaluating and treating patients with tick-borne diseases. Lyme disease and other tick-borne infections are complex illnesses which can be difficult to diagnose and challenging to treat effectively. This is especially true for patients with chronic Lyme disease or multiple infections.
ILADEF’s training program provides a foundation in the evidence-based treatment of Lyme and associated diseases, and directly addresses commonly encountered diagnostic and therapeutic challenges. This intensive, one-to-two week program places trainee-physicians in the clinical offices of experts, where they learn how to evaluate and treat patients for Lyme and other tick-borne diseases in a real world setting that allows physicians to appreciate diverse and often subtle presentations of tick-borne disease.
Participants will return to practice with enhanced clinical skills and an integrated, nuanced approach to directing treatment. The program is appropriate for, and tailored to meet, the educational needs of its participants, no matter their general experience level or familiarity with tick-borne disease.
AMA approved CME's in Lyme- Physician Training Program https://www.lymecme.info/
This document attempts to explain the many challenges faced by patients with tick-borne illnesses, including controversies over terminology and treatment. It seeks to describe ILADS’ position in these controversies and challenges. ILADS Treatment Guidelines, a comprehensive review of the best science on effective treatment for particular aspects of Lyme disease, touch on many of these controversial issues within the context of our evidence-based treatment recommendations
Congenital Transmission
Untreated Lyme disease during pregnancy can lead to infection of the placenta, states the CDC. Spread from mother to fetus is possible but rare. https://www.cdc.gov/lyme/transmission/index.html Note that not all fetus's infected gestationally with borrelia parish. A lot survive to live challenging lives sick left to be cared for debilitated and sick parents.
It has been shown that an infected mother can transmit the infections to the fetus which can cause many difficulties during childhood that often persist throughout the child’s life. Symptoms in children can be devastating to the health and well-being of the children and their families. Often mothers experience seemingly unrelated physical and psychiatric symptoms that are diagnosed as Lyme when their child is diagnosed.
Chronic Lyme Disease: An Evidence-Based Definition by the ILADS Working Group †.
Lyme disease, resulting from an active infection with any of several pathogenic members of the Borrelia burgdorferi sensu lato complex (Bbsl), often affects multiple systems. It is the most common vector-borne illness in the United States [1] and Europe [2]. The Centers for Disease Control and Antibiotics 2019, 8, 269; doi:10.3390/antibiotics8040269
www.mdpi.com/journal/antibiotics Antibiotics 2019, 8, 269 2 of 20 Prevention (CDC) estimates that the annual incidence of Lyme disease in the United States exceeds 329,000 [3]. It is well-documented that many patients present with manifestations of late disease prior to receiving antibiotic therapy and investigators in the field have long known that the illness can be chronic [1,4–6]. While a history of a known blacklegged tick bite or erythema migrans (EM) rash allows for a timely diagnosis, few patients were aware of a tick bite prior to infection [7,8] and the incidence of EM rashes varies by geographic location and Borrelial species such that some patients never develop an EM [1,8,9]. Thus, chronic manifestations of Lyme disease may result from diagnostic delays.
Chronic manifestations of Lyme disease may also result from failed antibiotic therapy as commonly prescribed regimens can be non-curative [4,10–15]. Researchers have documented that patients with acute and/or long-standing Lyme disease frequently remain ill for prolonged periods of time following treatment and that some experience disease progression despite treatment [4,15–18]. Chronic manifestations of Lyme disease are associated with significant and long-standing quality-of-life (QoL) impairments in some patients [16–20]. QoL scores of participants in the four National Institutes of Health (NIH)-sponsored Lyme disease retreatment trials were consistently worse than those of healthy populations [16–18].
-Read the full version here:
ilads_evidence-based_definition_cld_w_appendix_final_final_antibiotics-08-00269-v2.pdf
Publications from 2017 on Lyme Borreliosis Infection during Pregnancy:
1) https://www.jscimedcentral.com/ClinicalCytology/clinicalcytology-3-1085.pdf
Infection with Borrelia: Implications for Pregnancy – (e-chapter)
2) http://www.smgebooks.com/lyme-disease/chapters/LD-17-05.pdf
Key points from second publication:
1: Gardner and other authors have conclusively shown that certain individuals infected with Borrelia acquired their disease gestationally. This is further supported by the finding of Borrelia in semen and by the similarity to which Treponema transmission has been abundantly documented in the literature.
2: Transplacental transmission has been clearly documented from case reports of infected fetuses
3: Complicating diagnosis even more, as previously displayed via case reports, serologic testing of mothers in post-partum period and their neonates is often negative.
4: It has been demonstrated that over 70% of neonates that have tissue verified borreliosis at the time of delivery, will NOT produce antibodies in sufficient quantity to be diagnosed as sero-positive.
5: Negative serology in the infant does not necessarily rule out the risk of congenital infection, since the majority of infants will indeed screen negative.
6: Transmission of Borrelia infection occurs via both zoonotic vectors AND other humans.
7: Congenital transfer is an established fact, and animal data in conjugation with other data support that sexual transfer can also occur.
8: Maternal to fetal transfer of Borrelia can furthermore be clinically silent or unrecognized, and if not successfully treated, infection can be life long, and latency, late activation and reactivation can occur.
Author lists several points which are evident from the review of current literature:
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-lack of tissue inflammation seen in tissues with evidence of spirochetes
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-significant discrepancy in maternal serology testing (serology often negative in mothers)
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-positive cultures of spirochetes from fetal organs
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-effects of infection during the first trimester with cardiac organogenesis
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-fetal growth restriction
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-mothers infected in 'non-endemic areas’
Video presentation on congenital Lyme https://youtu.be/SLFRYVcGeR4
PP slides and references can be found here: http://www.lymehope.ca/advocacy-updates/sharing-our-research-findings-on-lyme-and-pregnancycongenital-transmission-with-minister-of-health-and-public-health-agency-of-canada
Lessons From Lyme Disease: Six Reasons The CDC’s COVID-19 Failure Was predictable:
Lyme evades treatment and persists:
“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. https://www.lymedisease.org/lyme-study-embers/
An excellent review of the literature on Bb persisters, that led to disulfiram being studied to kill persisters:
This presentation was created using references from the CDC and ILADS medical information to inform pediatric medical offices and families about Lyme and coinfections. It was done in 2018 and some information may not current. You may want to pause it to read as it will move pretty fast through the information. Not medical advice.
