< Back to Research Top Published Date 21/10/2010 Metamorphosis of Borrelia burgdorferi organisms-RNA, lipid and protein composition in context with the spirochete’s shape Journal Journal of Basic Microbiology Citation J Basic Microbiol. 2010 Dec;50 Suppl 1:S5-17 DOI doi: 10.1002/jobm.201000074 Authors Al-Robaiy S, Dihazi H, Kacza J, Seeger J, Schiller J, Huster D, Knauer J, Straubinger RK Abstract Borrelia burgdorferi, the agent of Lyme borreliosis, has the ability to undergo morphological transformation from a motile spirochetal to non-motile spherical shape when it encounters unfavorable conditions. However, little information is available on the mechanism that enables the bacterium to change its shape and whether major components of the cells--nucleic acids, proteins, lipids--are possibly modified during the process. Deducing from investigations utilizing electron microscopy, it seems that shape alteration begins with membrane budding followed by folding of the protoplasmatic cylinder inside the outer surface membrane. Scanning electron microscopy confirmed that a deficiency in producing functioning periplasmic flagella did not hinder sphere formation. Further, it was shown that the spirochetes' and spheres' lipid compositions were indistinguishable. Neither phosphatidylcholine nor phosphatidylglycerol were altered by the structural transformation. In addition, no changes in differential protein expression were detected during this process. However, minimal degradation of RNA and a reduced antigen-antibody binding activity were observed with advanced age of the spheres. The results of our comparisons and the failure to generate mutants lacking the ability to convert to spheres suggest that the metamorphosis of B. burgdorferi results in a conditional reconstruction of the outer membrane. The spheres, which appear to be more resistant to unfavorable conditions and exhibit reduced immune reactivity when compared to spirochetes, might allow the B. burgdorferi to escape complete clearance and possibly ensure long-term survival in the host. URL Previous https://www.ncbi.nlm.nih.gov/pubmed/20967786 No Review Needed? Next

< Back to Research Top Published Date 15/04/2013 Bartonella henselae bacteremia in a mother and son potentially associated with tick exposure Journal Parasites & Vectors Citation Parasit Vectors. 2013 Apr 15;6:101 DOI 10.1186/1756-3305-6-101 Authors Maggi RG, Ericson M, Mascarelli PE, Bradley JM, Breitschwerdt EB Abstract BACKGROUND: Bartonella henselae is a zoonotic, alpha Proteobacterium, historically associated with cat scratch disease (CSD), but more recently associated with persistent bacteremia, fever of unknown origin, arthritic and neurological disorders, and bacillary angiomatosis, and peliosis hepatis in immunocompromised patients. A family from the Netherlands contacted our laboratory requesting to be included in a research study (NCSU-IRB#1960), designed to characterize Bartonella spp. bacteremia in people with extensive arthropod or animal exposure. All four family members had been exposed to tick bites in Zeeland, southwestern Netherlands. The mother and son were exhibiting symptoms including fatigue, headaches, memory loss, disorientation, peripheral neuropathic pain, striae (son only), and loss of coordination, whereas the father and daughter were healthy. METHODS: Each family member was tested for serological evidence of Bartonella exposure using B. vinsonii subsp. berkhoffii genotypes I-III, B. henselae and B. koehlerae indirect fluorescent antibody assays and for bacteremia using the BAPGM enrichment blood culture platform. RESULTS: The mother was seroreactive to multiple Bartonella spp. antigens and bacteremia was confirmed by PCR amplification of B. henselae DNA from blood, and from a BAPGM blood agar plate subculture isolate. The son was not seroreactive to any Bartonella sp. antigen, but B. henselae DNA was amplified from several blood and serum samples, from BAPGM enrichment blood culture, and from a cutaneous striae biopsy. The father and daughter were seronegative to all Bartonella spp. antigens, and negative for Bartonella DNA amplification. CONCLUSIONS: Historically, persistent B. henselae bacteremia was not thought to occur in immunocompetent humans. To our knowledge, this study provides preliminary evidence supporting the possibility of persistent B. henselae bacteremia in immunocompetent persons from Europe. Cat or flea contact was considered an unlikely source of transmission and the mother, a physician, reported that clinical symptoms developed following tick exposure. To our knowledge, this is the first time that a B. henselae organism has been visualized in and amplified from a striae lesion. As the tick bites occurred three years prior to documentation of B. henselae bacteremia, the mode of transmission could not be determined. URL Previous https://parasitesandvectors.biomedcentral.com/articles/10.1186/1756-3305-6-101 No Review Needed? Next

< Back to Research Top Published Date 10/07/2016 Living in Limbo: Contested Narratives of Patients With Chronic Symptoms Following Lyme Disease Journal Qualitative Health Research Citation Qual Health Res. 2017 Mar;27(4):534-546 DOI 10.1177/1049732315619380 Authors Rebman AW, Aucott JN, Weinstein ER, Bechtold KT, Smith KC, Leonard L Abstract Persistent, subjective symptoms of unknown etiology following treatment for Lyme disease have been termed post- treatment Lyme disease syndrome or chronic Lyme disease (PTLDS/CLD). The objective of this study was to give primacy to the patient experience of this medically contested condition by eliciting patient illness narratives and identifying emergent issues through semistructured interviews conducted among 29 participants. We used thematic narrative analysis to identify three predominant themes: (a) Physical and social limitations lead to a "new normal" characterized by fundamental shifts of ways of being in the world, (b) disease-specific factors contribute to symptom and illness invisibility that affects social support in nuanced ways, and (c) pervasive medical uncertainty regarding PTLDS/CLD promotes an increased sense of personal responsibility for care. Similar to other contested or medically unexplained syndromes, our findings suggest that the social sequelae of PTLDS/CLD can be equally protracted as the physical effects of this illness. URL Previous https://journals.sagepub.com/doi/10.1177/1049732315619380 No Review Needed? Next

< Back to Research Top Published Date 07/06/2021 Lyme Neuroborreliosis in Children Journal Brain Sciences Citation 11(6):758 DOI 10.3390/brainsci11060758 Authors Kozak S, Kaminiow K, Kozak K, Paprocka J Abstract Lyme neuroborreliosis (LNB) is an infectious disease, developing after a tick bite and the dissemination of Borrelia burgdorferi sensu lato spirochetes reach the nervous system. The infection occurs in children and adults but with different clinical courses. Adults complain of radicular pain and paresis, while among the pediatric population, the most common manifestations of LNB are facial nerve palsy and/or subacute meningitis. Moreover, atypical symptoms, such as fatigue, loss of appetite, or mood changes, may also occur. The awareness of the various clinical features existence presented by children with LNB suspicion remains to be of the greatest importance to diagnose and manage the disease. Keywords: children; diagnosis; facial nerve palsy; lyme borreliosis; meningitis; neuroborreliosis; neurological manifestations; treatment. URL Previous https://www.mdpi.com/2076-3425/11/6/758 No Review Needed? Next

< Back to Research Top Published Date 01/01/2010 A clear and present danger: tick-borne diseases in Europe Journal Expert Review of Anti-infective Therapy Citation Expert Rev Anti Infect Ther. 2010 Jan;8(1):33-50 DOI 10.1586/eri.09.118 Authors Heyman P, Cochez C, Hofhuis A, van der Giessen J, Sprong H, Porter SR, Losson B, Saegerman C, Donoso-Mantke O, Niedrig M, Papa A Abstract Ticks can transmit a variety of viruses, bacteria or parasites that can cause serious infections or conditions in humans and animals. While tick-borne diseases are becoming an increasing and serious problem in Europe, tick-borne diseases are also responsible for major depressions in livestock production and mortality in sub-Saharan Africa, Latin America and Asia. This review will focus on the most important circulating tick-transmitted pathogens in Europe (Borrelia spp., Anaplasma phagocytophilum, Babesia spp., tick-borne encephalitis virus, Rickettsia spp. and Crimean-Congo hemorrhagic fever virus). URL Previous https://www.ncbi.nlm.nih.gov/pubmed/20014900 No Review Needed? Next

< Back to Research Top Published Date 24/10/2018 "Ticking Bomb": The Impact of Climate Change on the Incidence of Lyme Disease Journal The Canadian journal of infectious diseases & medical microbiology Citation Dumic, Igor & Severnini, Edson. (2018). "Ticking Bomb": The Impact of Climate Change on the Incidence of Lyme Disease. Canadian Journal of Infectious Diseases and Medical Microbiology. 2018. 1-10. DOI 10.1155/2018/5719081 Authors Dumic I, Severnini E Abstract Lyme disease (LD) is the most common tick-borne disease in North America. It is caused by Borrelia burgdorferi and transmitted to humans by blacklegged ticks, Ixodes scapularis. The life cycle of the LD vector, I. scapularis , usually takes two to three years to complete and goes through three stages, all of which are dependent on environmental factors. Increases in daily average temperatures, a manifestation of climate change, might have contributed to an increase in tick abundance via higher rates of tick survival. Additionally, these environmental changes might have contributed to better host availability, which is necessary for tick feeding and life cycle completion. In fact, it has been shown that both tick activity and survival depend on temperature and humidity. In this study, we have examined the relationship between those climatic variables and the reported incidence of LD in 15 states that contribute to more than 95% of reported cases within the Unites States. Using fixed effects analysis for a panel of 468 U.S. counties from those high-incidence states with annual data available for the period 2000–2016, we have found sizable impacts of temperature on the incidence of LD. Those impacts can be described approximately by an inverted U-shaped relationship, consistent with patterns of tick survival and host-seeking behavior. Assuming a 2°C increase in annual average temperature—in line with mid-century (2036–2065) projections from the latest U.S. National Climate Assessment (NCA4)—we have predicted that the number of LD cases in the United States will increase by over 20 percent in the coming decades. These findings may help improving preparedness and response by clinicians, public health professionals, and policy makers, as well as raising public awareness of the importance of being cautious when engaging in outdoor activities. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220411/ No Review Needed? Next

< Back to Research Top Published Date 17/05/2011 Burden and viability of Borrelia burgdorferi in skin and joints of patients with erythema migrans or Lyme arthritis Journal Arthritis and Rheumatism Citation Arthritis Rheum. 2011 Aug;63(8):2238-47 DOI 10.1002/art.30384 Authors Li X, McHugh GA, Damle N, Sikand VK, Glickstein L, Steere AC Abstract OBJECTIVE: To determine the burden and viability of Borrelia burgdorferi in the skin and joints of patients with Lyme disease. METHODS: Standard and quantitative polymerase chain reaction (PCR) techniques were used to detect B burgdorferi DNA in skin samples from 90 patients with erythema migrans (EM) and in synovial fluid (SF) from 63 patients with Lyme arthritis (LA) and in synovial tissue from 9 patients. Quantitative PCR determinations of B burgdorferi DNA, messenger RNA (mRNA), and ribosomal RNA (rRNA) were made in 10 skin samples from EM patients and 11 SF samples from LA patients. RESULTS: Skin lesions in most patients with EM had positive PCR results for B burgdorferi DNA. In the majority of patients with LA, a late disease manifestation, PCR results in pretreatment SF samples were positive. In patients with antibiotic-refractory arthritis, positive PCR results persisted for as long as 11 months, but positive results in samples taken during the postantibiotic period did not correlate with relapse or with the subsequent duration of arthritis, and at synovectomy, all results of PCR of synovial tissue were negative. B burgdorferi mRNA, a marker of spirochetal viability, was detected in 8 of 10 skin samples from EM patients, but in none of 11 SF samples from LA patients, even when obtained prior to antibiotic administration. Moreover, the median ratio of spirochetal rRNA to DNA, a measure of ribosomal activity, was 160 in the 10 EM skin samples, but only 0.15 in the 3 LA SF samples with positive results. CONCLUSION: B burgdorferi in the skin lesions of EM patients were active and viable, whereas those in the SF of LA patients were moribund or dead at any time point. Thus, detection of B burgdorferi DNA in SF is not a reliable test of active joint infection in Lyme disease URL Previous https://onlinelibrary.wiley.com/doi/full/10.1002/art.30384 No Review Needed? Next

< Back to Research Top Published Date 29/08/2017 First record of locally acquired human babesiosis in Canada caused by Babesia duncani: a case report Journal SAGE Open Medical Case Reports Citation SAGE Open Med Case Rep. 2017 Aug 29;5:2050313X17725645 DOI 10.1177/2050313X17725645 Authors Scott JD Abstract Objectives: The aim of this clinical assessment was to ascertain whether a 70-year-old Canadian patient, who had no history of out-of-country travel, had contracted a Babesia infection. Methods: The adult human male developed constitutional symptoms, which included sweats, chills, and immobilizing fatigue, and was screened for human babesiosis. Subsequent testing included a complete Babesia panel that consisted of B. microti immunoflourescent antibody IgM and IgG, B. duncaniimmunofluorescent antibody IgM and IgG, Babesia PCR, and Babesia fluorescent in situ hybridization (FISH) test. Results: Both the IgM serology and the molecular FISH RNA probe were positive for B. duncani; all tests for B. microti were negative. Based on clinical symptoms and laboratory tests, the patient was diagnosed with human babesiosis. Interestingly, the patient’s wife also was confirmed positive using serological and molecular testing. Conclusions: This is the first report of a locally acquired case of human babesiosis in Canada caused by Babesia duncani. The geographical distribution of B. duncani in North America is much greater than previously anticipated, especially north of the Canada-United States border. Since the patient was bitten by a blacklegged tick, Ixodes scapularis, a carrier of multiple zoonotic pathogens, the author suggests that this tick species is a vector of B. duncani. Health-care providers must be aware that B. duncani is present in Canada, and poses a public health risk. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5580841 No Review Needed? Next

< Back to Research Top Published Date 25/01/2020 High frequency of paediatric facial nerve palsy due to Lyme disease in a geographically endemic region Journal International Journal of Pediatric Otorhinolaryngology Citation 132:109905 DOI 10.1016/j.ijporl.2020.109905. Authors Munro APS, Dorey RB, Owens DR, Steed DJ, Petridou C, Herdman T, Jones CE, Patel SV, Pryde K, Faust SN Abstract Introduction: Idiopathic facial nerve palsy (FNP) is an uncommon but important presentation in children, with Lyme disease known to be a common cause. The UK county of Hampshire is a high incidence area of Lyme disease. We conducted a retrospective review of the investigation and management of paediatric FNP at a large University hospital, including serologic testing and treatment of Lyme disease. Methods: We conducted a retrospective chart review of children under 18 presenting between January 1st, 2010 and December 31st, 2017 with a diagnosis of FNP. Patients with clear non-Lyme aetiology at presentation were excluded. Data was collected on demographics, initial presentation, investigations including Lyme serology, and management. Results: A total of 93 children were identified, with an even proportion of male to female and median age 9.3 years (IQR 4.6-12 years). A history of rash was present in 5.4%, tick bite in 14% and recent travel to, or residence in the New Forest in 22.6%. Lyme serology was performed in 81.7% of patients, of which 29% were positive. Antibiotics were prescribed for 73.1% of patients, oral steroids for 44% and aciclovir for 17.2%. Conclusion: Lyme disease is a significant cause of FNP in this endemic area of the UK, and there was a large degree of variability in management prior to national guideline publication. Areas with endemic Lyme disease should consider introducing local guidelines supporting routine investigation and management for FNP, including empiric treatment for Lyme disease in accordance with NICE guidelines to improve care and reduce variability. Keywords: Bells palsy; Facial nerve palsy; Lyme disease. URL Previous https://pubmed.ncbi.nlm.nih.gov/32035348/ No Review Needed? Next

< Back to Research Top Published Date 04/08/2016 Brucellosis in a refugee who migrated from Syria to Germany and lessons learnt, 2016 Journal Eurosurveillance Citation Euro Surveill. 2016 Aug 4;21(31) DOI 10.2807/1560-7917.ES.2016.21.31.30311. Authors Grunow R, Jacob D, Klee S, Schlembach D, Jackowski-Dohrmann S, Loenning-Baucke V, Swidsinski S, Eberspacher B Abstract A teenage woman migrating from Syria arrived in May 2015 in Germany. She gave birth to a healthy child in early 2016, but became febrile shortly after delivery. Blood cultures revealed Brucella melitensis. In retrospect, she reported contact with sheep in Syria and recurrent pain in the hip joints over about five months before diagnosis of brucellosis. We discuss consequences for adequate treatment of mother and child as well as for clinical and laboratory management. URL Previous https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2016.21.31.30311 No Review Needed? Next

< Back to Research Top Published Date 29/10/2020 The Platelet Fraction Is a Novel Reservoir to Detect Lyme Borrelia in Blood Journal Biology (Basel) Citation 9(11):366 DOI 10.3390/biology9110366 Authors Sanderson VP, Mainprize IL, Verzijlenberg L, Khursigara CM, Wills MKB Abstract Serological diagnosis of Lyme disease suffers from considerable limitations. Yet, the technique cannot currently be replaced by direct detection methods, such as bacterial culture or molecular analysis, due to their inadequate sensitivity. The low bacterial burden in vasculature and lack of consensus around blood-based isolation of the causative pathogen, Borrelia burgdorferi, are central to this challenge. We therefore addressed methodological optimization of Borrelia recovery from blood, first by analyzing existing protocols, and then by using experimentally infected human blood to identify the processing conditions and fractions that increase Borrelia yield. In this proof-of-concept study, we now report two opportunities to improve recovery and detection of Borreliafrom clinical samples. To enhance pathogen viability and cultivability during whole blood collection, citrate anticoagulant is superior to more commonly used EDTA. Despite the widespread reliance on serum and plasma as analytes, we found that the platelet fraction of blood concentrates Borrelia, providing an enriched resource for direct pathogen detection by microscopy, laboratory culture, Western blot, and PCR. The potential for platelets to serve as a reservoir for Borrelia and its diagnostic targets may transform direct clinical detection of this pathogen. Keywords: Borrelia; EDTA; Lyme disease; OspA; blood processing; citrate; culture; diagnosis; molecular detection; platelets. URL Previous https://www.mdpi.com/2079-7737/9/11/366 No Review Needed? Next

< Back to Research Top Published Date 07/01/2011 Lyme disease: the next decade Journal Infection and Drug Resistance Citation Infect Drug Resist. 2011;4:1-9 DOI 10.2147/IDR.S15653 Authors Stricker RB , Johnson L Abstract Although Lyme disease remains a controversial illness, recent events have created an unprecedented opportunity to make progress against this serious tick-borne infection. Evidence presented during the legally mandated review of the restrictive Lyme guidelines of the Infectious Diseases Society of America (IDSA) has confirmed the potential for persistent infection with the Lyme spirochete, Borrelia burgdorferi, as well as the complicating role of tick-borne coinfections such as Babesia, Anaplasma, Ehrlichia, and Bartonella species associated with failure of short-course antibiotic therapy. Furthermore, renewed interest in the role of cell wall-deficient (CWD) forms in chronic bacterial infection and progress in understanding the molecular mechanisms of biofilms has focused attention on these processes in chronic Lyme disease. Recognition of the importance of CWD forms and biofilms in persistent B. burgdorferi infection should stimulate pharmaceutical research into new antimicrobial agents that target these mechanisms of chronic infection with the Lyme spirochete. Concurrent clinical implementation of proteomic screening offers a chance to correct significant deficiencies in Lyme testing. Advances in these areas have the potential to revolutionize the diagnosis and treatment of Lyme disease in the coming decade. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108755/ No Review Needed? Next