Work with us Below are some of the ways that you could help to support the Lyme Resource Centre in our mission is to educate the public and healthcare professionals about Lyme disease and related tick-borne infections: May Lyme Awareness Month -help to raise awareness by encouraging organisations to ‘light up for Lyme’ Contact your local councillors to put up LRC signage locally about ticks Contact your MSPs to raise the issue in Parliament. Volunteer with us Sign up to our newsletter and share it with others Share LRC social media posts with your networks Share your own personal story about ticks and Lyme disease Are you a health professional who would like to work with us or enquire about education and training? Contact us . Do you have ideas on how we can increase the number of people we reach to help them safely enjoy the outdoors? Please send your ideas here . Or are you simply keen to help LRC but unsure how? Please contact us and we can help identify how best you can help!

The Lyme Resource Centre is a registered Scottish Charitable Incorporated Organisation (SCIO), established in 2019, with registration number SC049151. Who We Are The Lyme Resource Centre (or LRC as commonly known) is a Scottish Registered charity. This unique Lyme disease charity is run by a team of trustees, volunteers and clinical advisers who give their time freely and voluntarily to help the charity meet its aims. It benefits from a highly skilled team of medical advisers, pharmacists, educationalists, engineers and other business professionals who guide and advise on policy, projects and collaborative partnerships. Our registered office is in Kinghorn, Fife, but we operate virtually so no donations or funds raised are spent on buildings or workspaces. At present, only a small proportion of staff are employed to undertake part time roles; but we look forward to growing the organisation. The charity was founded in 2019 by Prof Jack Lambert, alongside founding trustees Janey Cringean, Arlene Brailey and James Davies. Norman Lannigan OBE then joined as a trustee in 2021. OUR TEAM Prof. John (Jack) Lambert Founder of LRC and lead trustee As founder of LRC and lead trustee, Prof. John (Jack) Lambert, is a Professor in Medicine and Infectious Diseases at Mater Misericordiae University Hospital and UCD School of Medicine, Dublin, with both extensive clinical and research expertise. He has been director of the National Isolation Unit for Highly Infectious Diseases at the Mater Misericordiae University Hospital and a member of the National Viral Hemorrhagic Fever Committee of the HSE. He has also been involved in the Sexual Health Strategy group in Ireland and teaching GPs in Ireland on the subject of STDs. He has been Fellow of the Royal College of Paediatrics and Child Health since 2000 and Fellow of the Royal College of Physicians since 2005. Prof Lambert has presented widely in the field of Lyme and co-infections since 2016 through EU and USA conferences supported by the International Lyme and Associated Diseases Society (ILADS). He has undertaken specialist training through ILADS and has significant experience of treating Lyme Disease and co-infections. He organises and runs Global Crypto-Infections Conferences, looking at the science behind Lyme Disease and co-infections. Three conferences have now been held in 2019, 2020 and 2023. Recorded presentations can be found under ’Resources for Health Professionals’ . Arlene Brailey Trustee Arlene is a registered pharmacist who worked as Assistant Director of NHS Education for Scotland (Pharmacy) for over 20 years. In 2020 she was designated as a Fellow of the Royal Pharmaceutical Society. Arlene also developed and led an award-winning patient support programme from 2019-2023 for a national antibiotic research charity. She now provides educational consultancy work to the NHS. She uses her educational experience and expertise to guide the charity’s education programme for health professionals. Arlene also provides oversight of a variety of activities, programmes, and development campaigns for LRC as a trustee. She works with many of the volunteers to help deliver the plans and wide-ranging projects which raise awareness of Lyme disease and other tick-borne infections. Arlene was a carer for her son for over ten years, after he was bitten by a tick while hillwalking in the Scottish Highlands as a teenager. He subsequently suffered with undiagnosed Lyme disease and other tick-borne infections. You can read more about Arlene's experience here: https://pharmaceutical-journal.com/article/opinion/would-my-son-have-his-lyme-disease-diagnosis-without-my-mothers-instinct-its-time-we-trusted-our-patients You can read more about Arlene's experience here: Norman Lannigan Trustee Norman is a retired pharmacist who has served the NHS in Scotland for forty years. He is a Fellow of the Royal Pharmaceutical Society and was awarded an OBE for services to pharmacy and pharmaceutical care in October 2018. His last position was as Head of Pharmacy and Prescribing Support for Scotland’s largest NHS Health Board, NHS Greater Glasgow and Clyde. Norman had responsibility for all aspects of pharmacy service delivery in hospitals, in community pharmacy and within GP surgeries and for safe and effective use of medicines within the Health Board. He led the redesign of pharmacy services which involved the establishment of the world’s largest robotic pharmacy. Norman held Visiting Professor positions within the Strathclyde Institute of Pharmacy and Biomedical Sciences and within the School of Pharmacy at Robert Gordon University in Aberdeen. Norman has taken on responsibility for coordinating and developing LRC outdoor initiatives and partnerships. He is using his experience, leadership skills and knowledge of healthcare and management to help LRC to grow and achieve its aims of raising awareness of tick-borne infection amongst the public and healthcare professionals. He lives in West Calder and is now enjoying global travel once again! . Liz Murray Trustee Liz has a Masters in Business Administration and recent experience in marketing, customer experience and digital communications. She worked in the NHS for 15 years as a Physiotherapist and Senior Manager before moving across to the commercial health sector, where she worked for a further 25 years until recently retiring. Liz now helps the charity with strategy, planning and communications strategy as well as some medium-longer term projects. She also has a deep understanding of the challenges of Lyme disease, having been diagnosed and treated with the condition after almost 6 years of symptoms. . The Right Reverend Dr Christopher Herbert Patron Dr Herbert was ordained as a priest in Hereford in 1967. He was appointed Bishop of St Albans (1995-2009) and is a former member of the House of Lords (1999-2009). He presently holds the post of Visiting Professor of Christian Ethics at School of Medical Sciences, University of Surrey. He brings a wealth of experience in the fields of Education, Health and Social Care Ethics and has a genuine commitment to making a positive impact both for individuals and through our work as a charity. Dr Herbert’s passion for raising awareness of Lyme disease has been primarily driven by his granddaughter’s ill health following a tick bite and a subsequently delayed diagnosis of Lyme disease. . Trevor Brailey Treasurer Trevor retired in 2016 as a Senior Engineering Associate within the petrochemical industry. He was appointed as treasurer for LRC, having recently completed seven years as treasurer for a medium-sized non-profit charitable company. Trevor brings his knowledge and experience of policies, practices, and good governance to ensure our finances are well managed. . Anne Cruikshank GP Advisor Anne is a general practitioner, based in Oxfordshire, England. She has had a long standing interest in Lyme disease - ever since a close family member was hospitalised with Lyme carditis in 2007. She has experience of managing patients with Lyme disease within both primary care and a consultant-led Lyme disease Clinic In 2018, the Royal College of General Practitioners (RCGP) appointed Anne as the Clinical Champion for Lyme disease, tasked with leading the CG Lyme disease Spotlight Project to raise awareness of Lyme disease within primary care. She is a co-author of the RCGP Lyme Disease Toolkit - a user-friendly, open access, guide for health care professionals. patients and the general public. Whilst acknowledging the complexities of diagnosis and treatment of Lyme disease, Anne recognises that well informed healthcare professionals hold the key to early diagnosis and the prevention of long term complications. . Angus (Gus) Walker Team Member Angus has a background in engineering and presently works as an engineer in the oil and gas industry, with extensive experience in mechanical engineering and project management disciplines. Angus runs our Social Media programme and campaigns. He also helps deliver our outdoor awareness projects. This includes the production of the LRC outdoor signs and liaison with councils and outdoor volunteers such as The Conservationist Volunteers (TCV). He is a keen cyclist and was first involved with the charity in 2021, taking inspiration from a family member affected by tick borne illness, undertaking a huge cycling challenge to mark his 40th birthday – cycling more than 4040km and raising over £4000 for Lyme Resource Centre. . Pauline Bowie Ambassador and team member A schoolteacher for 33 years, Pauline is a curricular leader of technologies with a focus on engineering subjects in the West of Scotland. She has personal experience of Lyme disease undiagnosed for 29 years. As a Patient Ambassador, Pauline is actively involved in promoting and coordinating many outreach activities within LRC. She works with media and with Scottish MSPs to highlight the issues and is currently developing a Lyme disease education programme for schools across Scotland. She actively engages her Young Enterprise Group of senior school students in Lyme disease community outreach. Pauline also participates in our outdoor awareness programme, educating the public at events across the country, and raising awareness of ticks and Lyme disease with those leading scout groups, Duke of Edinburgh expeditions and outdoor events. Each year, she coordinates the global ‘Light up for Lyme’ campaign across Scotland, asking public and private organisations to light up their buildings with green light throughout May. This helps focus and raise public awareness during May Lyme Awareness Month. . Anne Lee MPhil FRPharmS Team Member Anne Lee graduated in pharmacy from Heriot Watt University in Edinburgh in 1984, then worked in hospital pharmacy, in Edinburgh, Newcastle, and Glasgow. She completed an MPhil on the causality of adverse drug reactions and led research on aspects of adverse drug reaction reporting through the Medicines and Healthcare products Regulatory Agency’s yellow card scheme. Anne has published widely on medicines safety, editing textbooks on Adverse Drug Reactions and Prescribing in Pregnancy and Breastfeeding. The third edition of Adverse Drug Reactions was published by Pharmaceutical Press in 2023. Anne took up a post with the Scottish Medicines Consortium (SMC) at Healthcare Improvement Scotland in 2005, and was the Chief Pharmacist there from 2012 until August 2022. Anne led an extensive change programme at SMC, aimed at increasing transparency, enhancing patient and public involvement and improving health technology assessment of new medicines. She was awarded a Fellowship of the Royal Pharmaceutical Society in 2022 and is now working as a freelance medical writer and editor. . Monica Wilde Team Member Monica Wilde is a Research Herbalist (M.Sc. Herbal Medicine, University of Central Lancashire) with a special interest in concomitant prescribing of drugs, herbs and nutrients. Recognising the financial hardship that many Lyme patients find themselves in, she has run a low income Lyme clinic since 2015. Monica is helping the charity by documenting the use of herbs alongside prescription and OTC medicines to increase knowledge, assure safety, and develop understanding of best practice. She is also organising CPD training in Lyme protocols and support for herbal medicine practitioners Research has shown that some herbal products are effective against Lyme on a par with antibiotics. As many Lyme patients find that an integrated medicine approach gives them the best support and results, she is committed to working with clinical practitioners across disciplines. . Margaret Miller Team Member Prior to retirement, Margaret worked with NHS Education for Scotland as the Pharmacy Team Manager, alongside Arlene Brailey. She brings wide and varied administrative experience having worked in several Office Manager and Executive Assistant roles including Scottish Government and Ernst & Young. Margaret provides administrative support to LRC in several areas – including building the research publications facility on the website. . Joanne Durnan Team Member Joanne studies Marine Engineering at the University of Strathclyde as well as being a keen watersports instructor. She started volunteering for the Lyme Resource Centre after taking part in the ‘Young Enterprise Company' programme. Joanne's company decided to have an outdoor focus to promote the benefits of being outdoors but with a social enterprise part which would include outdoor safety. ‘In-seed-out’ became a business and social enterprise with a mission of “promoting the outdoors safely". The company had great success coming second place in the local area as well as being invited to a parliamentary debate about Lyme Disease. Joanne helped to co-ordinate the LRC 2024 Light up for Lyme Campaign . Founder Trustees The Lyme Resource Centre is grateful for the work and support of those who helped to establish this unique charity in 2019. Dr Janey Cringean Trustee of LRC from 2019 - July 2021 James Davies Trustee of LRC from 2019 - May 2023 C. Geoghegan Web Developer from Sept 2021 - July 2023 Gordana Avramovic Team Member from 2019 - August 2024

DISCLAIMER Lyme Resource Centre (LRC) aims to provide helpful signposting towards further information and support. Any medical information referred to in any communication from Lyme Resource Centre is given for information purposes only and is not intended to: constitute professional advice for medical diagnosis or treatment; replace consultation with a qualified medical practitioner; advocate or recommend the purchase of any product; endorse or guarantee the credentials or appropriateness of any health care provider. Please consult with an appropriate professional for advice specific to your situation. LRC is not responsible for any omissions, errors or for any loss or damage resulting from information it provides.

Resources for schools & youth organisations Schools, colleges and other educational facilities can play a vital role in protecting staff and pupils by raising awareness of the steps needed to protect against ticks bites and Lyme disease. Ticks are tiny, their bites are painless and can easily go unnoticed. Young children are potentially more vulnerable to tick-borne diseases because they are physically low to the ground, where the ticks are. They play in leaves, roll on grass, hug their pets, which all increase their exposure to ticks. Older children are potentially at risk of tick bites during outward bound activities such as camping and hiking. The tell tale ‘bullseye’ rash of Lyme disease may be unusual, misdiagnosed or absent. Other symptoms of Lyme disease can be non-specific, vague and changeable. Children can’t always explain what feels wrong, and parents may assume that their child is tired or stressed rather than ill. Tick Awareness is the key to enjoying the outdoors safely. Resources for Camping, Hiking & Outdoor Expeditions Click the link above (For leaders, participants and parents/guardians too!) Free Educational Awareness Material For pre-school and primary age children: For Secondary Schools and Youth Groups For teachers and youth organisation leaders: Key information on tick bite avoidance Risk assessment check list for teaching staff Parental letter templates Pre trip Following a tick bite For secondary ages and young adults: NHS Inform video - Top Tips for Fighting Ticks LRC - Wordsearch Worksheet Tick Removal Advice on tick removal: Ticks should be removed promptly and carefully - ideally using a tick removal tool LRC - Correct use of a tick removal card Tick removal cards are available for purchase from the LRC website Printable Education Worksheets Colouring Worksheet Wordsearch Poem Kahoot! Quiz LRC awareness materials LRC information leaflets - download or contact LRC LRC Tick awareness poster Make May our annual Tick Awareness month for schools, colleges, guides, scouts, Duke of Edinburgh, outward bounds etc. Aligning with May being global ‘Light up for Lyme’ month where buildings and landmarks across the world light up green to raise awareness. West Dunbartonshire Lyme awareness pilot project With the support of local councillor Sophie Traynor and Laura Mason, director of education, West Dunbartonshire Council introduced ‘tick safety’ into all West Dunbartonshire schools in May2024. LRC plan to support a full education scheme of work across all stages in schools and youth organisations. Other ways to raise awareness in schools: Charity Events: Football competition to raise awareness for Lyme disease Please get in touch with us at admin@lymeresourcecentre.com if we can help in developing tick awareness projects in your school.

Presentations related to Lyme and other co-infections. Presentations Long COVID from a Clinical Perspective A presentation provided by: Professor John (Jack) S. Lambert, Consultant in Infectious Diseases, Mater and Rotunda Hospitals, and Full Professor, UCD School of Medicine, Dublin, Ireland CHRONIC LYME/CO-INFECTIONS & LONG COVID - WHAT DO THEY HAVE IN COMMON? A presentation provided by: Professor John (Jack) S. Lambert, Consultant in Infectious Diseases, Mater and Rotunda Hospitals, and Full Professor, UCD School of Medicine, Dublin, Ireland

289 < Back to Research Top Published Date 01/05/2010 The utility of "Google Trends" for epidemiological research: Lyme disease as an example Journal Geospatial Health Citation Geospat Health. 2010 May;4(2):135-7 DOI 10.4081/gh.2010.195 Authors Seifter A, Schwarzwalder A, Geis K, Aucott J Abstract Internet search engines have become an increasingly popular resource for accessing health-related information. The key words used as well as the number and geographic location of searches can provide trend data, as have recently been made available by Google Trends. We report briefly on exploring this resource using Lyme disease as an example because it has well-described seasonal and geographic patterns. We found that search traffic for the string "Lyme disease" reflected increased likelihood of exposure during spring and summer months; conversely, the string "cough" had higher relative traffic during winter months. The cities and states with the highest amount of search traffic for "Lyme disease" overlapped considerably with those where Lyme is known to be endemic. Despite limitations to over-interpretation, we found Google Trends to approximate certain trends previously identified in the epidemiology of Lyme disease. The generation of this type of data may have valuable future implications in aiding surveillance of a broad range of diseases. URL Previous https://www.ncbi.nlm.nih.gov/pubmed/20503183 No Review Needed? Next

36 < Back to Research Top Published Date 29/09/2020 A Distinct Microbiome Signature in Posttreatment Lyme Disease Patients Journal American Society for Microbiology Citation 11(5):e02310-20 DOI 10.1128/mBio.02310-20 Authors Morrissette M, Pitt N, Gonzalez A, Strandwitz P, Caboni M, Rebman AW, Knight R, D'Onofrio A, Aucott JN, Soloski MJ, Lewis K Abstract Lyme disease is the most common vector-borne disease in the United States, with an estimated incidence of 300,000 infections annually. Antibiotic intervention cures Lyme disease in the majority of cases; however, 10 to 20% of patients develop posttreatment Lyme disease syndrome (PTLDS), a debilitating condition characterized by chronic fatigue, pain, and cognitive difficulties. The underlying mechanism responsible for PTLDS symptoms, as well as a reliable diagnostic tool, has remained elusive. We reasoned that the gut microbiome may play an important role in PTLDS given that the symptoms overlap considerably with conditions in which a dysbiotic microbiome has been observed, including mood, cognition, and autoimmune disorders. Analysis of sequencing data from a rigorously curated cohort of patients with PTLDS revealed a gut microbiome signature distinct from that of healthy control subjects, as well as from that of intensive care unit (ICU) patients. Notably, microbiome sequencing data alone were indicative of PTLDS, which presents a potential, novel diagnostic tool for PTLDS.IMPORTANCE Most patients with acute Lyme disease are cured with antibiotic intervention, but 10 to 20% endure debilitating symptoms such as fatigue, neurological complications, and myalgias after treatment, a condition known as posttreatment Lyme disease syndrome (PTLDS). The etiology of PTLDS is not understood, and objective diagnostic tools are lacking. PTLDS symptoms overlap several diseases in which patients exhibit alterations in their microbiome. We found that patients with PTLDS have a distinct microbiome signature, allowing for an accurate classification of over 80% of analyzed cases. The signature is characterized by an increase in Blautia, a decrease in Bacteroides, and other changes. Importantly, this signature supports the validity of PTLDS and is the first potential biological diagnostic tool for the disease. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527730/ No Review Needed? Next

230 < Back to Research Top Published Date 01/06/2013 Development of a foundation for a case definition of post-treatment Lyme disease syndrome Journal International Journal of Infectious Diseases Citation Int J Infect Dis. 2013 Jun;17(6):e443-9 DOI 10.1016/j.ijid.2013.01.008 Authors Aucott JN, Crowder LA, Kortte KB Abstract OBJECTIVES: The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lymedisease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America. METHODS: Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment. RESULTS: Eight (11%) patients met our operationalized definition of PTLDS, which included self-reported symptoms of fatigue, widespread musculoskeletal pain or cognitive complaints, and functional impact as measured by a T score of <45 on the composite SF-36. No controls met the functional impact criteria. Forty-three (60% patients returned to their previous health status when measured at 6 months post-treatment. Twenty (28%) patients had either residual symptoms or functional impact, but not both, and did not meet criteria for PTLDS. CONCLUSIONS: This operationalized definition of PTLDS allows for identification of those patients who are treated for early Lyme diseaseand have significant post-treatment illness, as they have both residual symptoms and impact on daily life functioning. With further refinement and improvement of this operationalized definition, the true incidence of PTLDS can be determined and future studies can be designed to examine its pathophysiology and treatment. URL Previous https://www.ijidonline.com/article/S1201-9712(13)00046-5/fulltext No Review Needed? Next

Educational Events for Health Professionals Upcoming Events The Lyme Resource Centre has been invited to attend a range of medical educational events in the coming months, as we continue to raise awareness of the risks of ticks and Lyme disease. BPNA 2026 Annual Conference 28-30 Jan 2026 Glasgow International keynote speakers, platform and poster presentations covering various aspects of paediatric neurology. Find out more Past Events 1st Annual Conference on Chronic Infection Pathologies Jyväskylä , Finland Understanding, prevention, and treatment of infectious chronic illnesses. Clinical Pharmacy Congress Excel London Europe's largest event for clinical pharmacy professionals RCPCH Conference Glasgow Royal College of Paediatrics and Child Health Conference Royal Pharmaceutical Society Webinar RPS/LRC - ‘Recognising the symptoms of Lyme disease’ Best Practice Birmingham NEC GP presentation ‘Identifying Lyme disease - the 'New Great Imitator' RCGP Annual Conference and Exhibition 2025 ICC Wales, Newport GP presentation : Lyme disease - The New Great Imitator Primary Care Show Birmingham NEC Event for NHS and private clinicians working in primary and community care. Guidelines Live Excel London GP Presentation ‘Diagnosing Lyme disease - unmasking the ‘New Great Imitator’ The Pharmacy Show Birmingham NEC LRC presentation ‘Recognising the signs and symptoms of Lyme Disease’ FAIB/FOFATO Conference Stockport ‘Understanding Lyme disease’ Video: GP presentation : Lyme disease - The New Great Imitator Webinars for health professionals During 2021, 2022 and 2023, The Lyme Resource Centre, led by Professor Lambert and our GP advisors presented a number of free interactive webinars for health professionals. Recordings of these events, along with several other recordings by Professor Lambert are freely accessible. A series of educational resources for health professionals can be found here

82 < Back to Research Top Published Date 14/01/2020 Lyme Aortitis Journal BMJ Case Reports Citation 13(1):e231957 DOI 10.1136/bcr-2019-231957. Authors Correia RR, Cruz F, Martin S, Andre ME Abstract A 72-year-old man was admitted with complaints of sudden-onset oppressive precordial pain radiating to the back for 1 hour. He had hypotension, peripheral cyanosis and cold extremities. An initial assessment was done and acute coronary syndrome was excluded. After the patient was admitted, he developed fever and increased levels of inflammatory markers. Data obtained from CT angiography and transoesophageal echocardiogram revealed diffuse parietal thickening of the arch and the descending thoracic aorta, as well as dilatation of the aortic root and the proximal ascending aorta. In addition, the test for Borrelia burgdorferi was positive, and the patient was diagnosed with Lyme vasculitis of the thoracic aorta. He was treated with doxycycline for 3 weeks. Two months later, the patient exhibited a Stanford type A aortic dissection (clinically stable), which was treated by prosthesis replacement. The patient has remained asymptomatic for 1 year after the episode, performing his routine daily activities. Keywords: cardiovascular system; infections. URL Previous https://casereports.bmj.com/content/13/1/e231957.long No Review Needed? Next

191 < Back to Research Top Published Date 30/04/2015 Repellent efficacy of DEET, Icaridin, and EBAAP against Ixodes ricinus and Ixodes scapularis nymphs (Acari, Ixodidae) Journal Ticks and Tick-borne Diseases Citation Ticks Tick Borne Dis. 2015 Jun;6(4):494-8 DOI 10.1016/j.ttbdis.2015.03.019 Authors Bendin J, Gharbi A , Rahlenbeck S, Dautel H, Buchel K Abstract Repellent efficacy of 10% EBAAP (3-[N-butyl-N-acetyl]-aminopropionic acid, ethyl ester) and 10% Icaridin ((2-(2-hydroxyethyl)-1-piperidinecarboxylic acid 1-methylpropyl ester)) were evaluated against 20% DEET (N,N-diethyl-3-methylbenzamide) in human subject trials against ticks. Responses of host-seeking nymphs of the European castor bean tick (Ixodes ricinus L.; Acari: Ixodidae) and the North American blacklegged tick (I. scapularis Say; Acari: Ixodidae) were compared. Tests were carried out according to the US-EPA standard protocol with ethanolic solutions of the active ingredients of repellents being applied to the forearm of 10 volunteers. The upward movement of ticks was monitored until repellent failure taking up to 12.5 h. Application of 20% DEET resulted in median complete protection times (CPT; Kaplan-Meier median) between 4 and 4.5 h, while 10% EBAAP yielded CPTs of 3.5-4h. No significant differences were found between the efficacies of two repellents nor between the two species tested. The median of the CPT of a 10% Icaridin solution was 5h in nymphs of I. scapularis, but 8h in those of I. ricinus (P<0.01). Based on these studies, EBAAP and Icaridin are efficacious alternatives to DEET in their repellent activity against nymphs of the two Ixodes ticks with Icaridin demonstrating particularly promising results against I. ricinus. Future research should investigate whether similar results occur when adult Ixodes ticks or other tick species are tested. URL Previous https://www.ncbi.nlm.nih.gov/m/pubmed/25936273 No Review Needed? Next

126 < Back to Research Top Published Date 12/11/2018 A systematic review on the impact of gestational Lyme disease in humans on the fetus and newborn Journal PLoS One Citation PLoS One. 2018 Nov 12;13(11):e0207067. doi: 10.1371/journal.pone.0207067. eCollection 2018 DOI 10.1371/journal.pone.0207067 Authors Waddell LA, Greig J, Lindsay LR, Hinckley AF, Ogden NH Abstract Lyme disease (LD), caused by bacteria of the Borrelia burgdorferi sensu lato species complex, is the most common vector-borne disease in North America and Europe. A systematic review (SR) was conducted to summarize the global literature on adverse birth outcomes associated with gestational LD in humans. The SR followed an a priori protocol of pretested screening, risk of bias, and data extraction forms. Data were summarized descriptively and random effects meta-analysis (MA) was used where appropriate. The SR identified 45 relevant studies, 29 describing 59 cases reported as gestational LD in the United States, Europe, and Asia (1969-2017). Adverse birth outcomes included spontaneous miscarriage or fetal death (n = 12), newborn death (n = 8), and newborns with an abnormal outcome (e.g. hyperbilirubinemia, respiratory distress and syndactyly) at birth (n = 16). Only one report provided a full case description (clinical manifestations in the mother, negative outcome for the child, and laboratory detection of B. burgdorferi in the child) that provides some evidence for vertical transmission of B. burgdorferi that has negative consequences for the fetus. The results of 17 epidemiological studies are included in this SR. Prevalence of adverse birth outcomes in an exposed population (defined by the authors as: gestational LD, history of LD, tick bites or residence in an endemic area) was compared to that in an unexposed population in eight studies and no difference was reported. A meta-analysis of nine studies showed significantly fewer adverse birth outcomes in women reported to have been treated for gestational LD (11%, 95%CI 7-16) compared to those who were not treated during pregnancy (50%, 95%CI 30-70) providing indirect evidence of an association between gestational LD and adverse birth outcomes. Other risk factors investigated; trimester of exposure, length of LD during pregnancy, acute vs. disseminated LD at diagnosis, and symptomatic LD vs. seropositive women with no LD symptoms during pregnancy were not significantly associated with adverse birth outcomes. This SR summarizes evidence from case studies that provide some limited evidence for transplacental transmission of B. burgdorferi. There was inconsistent evidence for adverse birth outcomes of gestational LD in the epidemiological research, and uncommon adverse outcomes for the fetus may occur as a consequence of gestational LD. The global evidence does not fully characterize the potential impact of gestational LD, and future research that addresses the knowledge gaps may change the findings in this SR. Given the current evidence; prompt diagnosis and treatment of LD during pregnancy is recommended. URL Previous https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207067 No Review Needed? Next