211 < Back to Research Top Published Date 30/07/2014 Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease Journal Expert Review of Anti-infective Therapy Citation Expert Rev Anti Infect Ther. 2014 Sep;12(9):1103-35 DOI 10.1586/14787210.2014.940900 Authors Cameron DJ, Johnson LB, Maloney EL Abstract Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions - the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1-13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols. URL Previous https://www.tandfonline.com/doi/full/10.1586/14787210.2014.940900 No Review Needed? Next

Retraction request cites harm to pregnant women and children New York, NY, USA – WEBWIRE – Tuesday, November 9, 2021 < Back Mothers Against Lyme Calls for Retraction of False Info on Congenital Lyme in IDSA, AAN, ACR LRC 10 Nov 2021 Retraction request cites harm to pregnant women and children New York, NY, USA – WEBWIRE – Tuesday, November 9, 2021 It is disheartening and alarming that the authors of medical guidelines that direct the care of pregnant women with Lyme disease are ignoring their own research to put forward guidelines based on “expert opinion” rather than their own discoveries. Their own work conclusively proves that perinatal transmission of B. burgdorferi during pregnancy does occur and may have dire consequences for the pregnant mother and her fetus. Mothers Against Lyme, a group of advocates concerned about the impact of Lyme disease and its co-infections on pregnant women, children and families, is calling for retraction of a statement in the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), American College of Rheumatology (ACR) 2020 Clinical Practice Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease that contributes to misdiagnosis and harm to pregnant women and children who are congenitally infected. On October 20, Mothers Against Lyme sent a retraction request letter to the editors of the journals that published the Guidelines and the leadership of the sponsoring organizations. Copies were sent to the clinical practice guidelines committees of the sponsoring organizations and the co-authors of the guidelines. The Guidelines were published in Clinical Infectious Diseases, Neurology, Arthritis Care & Research, and Arthritis & Rheumatology. Page e12 of the Guidelines “Treatment of Lyme Disease” section states: “To date, Lyme disease in pregnancy has not been found to result in congenital infection or a syndrome of congenital abnormalities, and no additional treatment or monitoring of the mother or infant is recommended beyond the standard of care.” According to the letter, the statement “To date, Lyme disease in pregnancy has not been found to result in congenital infection” is not true. The letter cites more than 40 peer reviewed articles, including a systematic review co-authored by a CDC epidemiologist, that provide evidence of congenital infection with Lyme disease. The letter also cites studies and review articles that show adverse birth outcomes are common for both treated and untreated pregnant women with Lyme disease. Adverse outcomes include fetal death, newborn death, and newborns with an abnormal outcome (e.g. birth defects, hyperbilirubinemia, respiratory distress). According to Mothers Against Lyme Chair Isabel Rose, “Correction of this error is vital and warrants an expedited review and notice of correction. The potential harm to mothers, children, and families from the inaccurate information in the IDSA, AAN, ACR Guidelines is significant. Providers who rely on the Guidelines will fail to diagnose and treat Lyme disease in pregnancy and fail to recognize the offspring of women with Lyme disease as infants and children at risk. Countless tragic births and fetal losses will result, with a lifetime of harm to the children and their families.” The letter also cites eight articles co-authored by IDSA, AAN, ACR Guidelines authors that “clearly contradict what they’ve written in the Guidelines, and which address the issue of intrauterine transmission and fetal abnormalities head-on.” Following are examples. Clinical pathologic correlations of Lyme disease by stage Duray PH, Steere AC, Annals of the New York Academy of Sciences, Vol 539:65-79, 1988 “It is clear that B. burgdorferi can be transmitted in the blood of infected pregnant women across the placenta into the fetus. This has now been documented with resultant congenital infections and fetal demise.” Treatment of Borrelia burgdorferi infection Gary P. Wormser. Laboratory Medicine, Volume 21, Issue 5, 1 May 1990, Pages 316-321 “The precise risk to the developing fetus of maternal Lyme disease during pregnancy is unknown, although it is well documented that fetal infection can occur and may have deleterious outcomes, including malformations and death.” A perspective on the treatment of Lyme borreliosis Luft BJ, Gorevic PD, Halperin JJ, Volkman DJ, Dattwyler RJ. Rev Infect Dis. 1989 Sep-Oct;11 “The aim of treatment of early Lyme disease during pregnancy is not only to treat the infection and prevent long-term sequelae but to eliminate the infection as quickly as possible so as to prevent congenital transmission to the fetus.” According to Rose, “It is disheartening and alarming that the authors of medical guidelines that direct the care of pregnant women with Lyme disease are ignoring their own research to put forward guidelines based on ‘expert opinion’ rather than their own discoveries. Their own work conclusively proves that perinatal transmission of B. burgdorferi during pregnancy does occur and may have dire consequences for the pregnant mother and her fetus.” The IDSA, AAN, ACR Guidelines say that “ no additional treatment or monitoring of the mother or infant is recommended beyond the standard of care .” Instead of denying the existence of congenital Lyme, the letter says “the Guidelines should acknowledge that Lyme bacteria can cross the placenta, both infecting and causing harm to unborn children, and describe the manifestations of Lyme in pregnancy that the research has uncovered and advise screening and treatment according to the knowledge we have to date.” Rose points out that researchers who depend on the IDSA, AAN, ACR Guidelines for information will be less likely to submit grant applications for much needed research if they rely on the statement that congenital Lyme disease does not exist. She notes that this is especially important since more than $29 million in new annual funding for NIH has been appropriated that could support this type of research. NIH has also issued several notices of special interest to encourage research on Lyme and other tick-borne diseases. A recent notice includes a section that calls for research on “gestational Lyme disease” and the impact on pregnancy on immune response. Rose says, “Correcting this error does not undo the harm. In addition to making this correction in a timely manner, the sponsoring organizations should encourage their members to conduct research on congenital Lyme that will improve health outcomes for pregnant women with Lyme disease and children who are congenitally infected.” About Mothers Against Lyme We’re a group of mothers, and mother-advocates, who are concerned about the impact of Lyme disease and its co-infections on pregnant women, children and families. Our focus includes awareness, education, advocacy and community building, as we promote research that advances diagnosis, treatment and prevention. For more information visit www.MothersAgainstLyme.org Publication Source Previous Next

48 < Back to Research Top Published Date 12/08/2020 A Survey of Ticks Infesting Dogs and Cats in Ireland Journal Animals (Basel) Citation 10(8):1404 DOI 10.3390/ani10081404 Authors de Waal T, Lawlor A, Zintl A, Cowley B, Bagha A Abstract Ticks are important ectoparasites of dogs and cats. Infestations can result in itching and localised dermatitis. In addition, ticks can act as vector of a range of viral, bacterial and protozoal pathogens. This paper reports the results of a nationwide survey of ticks infesting dogs and cats in Ireland. Seventy veterinary practices submitted a total of 120 ticks collected from 56 dogs and 16 cats. Ixodes ricinus was the most abundant species on dogs while Ixodes hexagonus was the most abundant species on cats. The remainder were identified as Ixodes canisuga and a single Rhipicephalus sanguineus specimen. The garden was most frequently associated with tick exposure in both dogs and cats. Sporting dog breeds (n = 17; 31%) were more likely to be infested with ticks than any other breed. Nearly all (n = 56; 95%) veterinarians indicated that ticks are a concern to their clients when they are found on their pets. Pet owners used a variety of products to control ectoparasites on their animals but a significant number (n = 18, 31%) indicated that they felt that the products are less effective highlighting the need for further investigations. Field sampling indicated that ticks are present at a low level in much of the greater Dublin area. Keywords: Ireland; companion animals; owner attitudes; ticks. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460173/ No Review Needed? Next

119 < Back to Research Top Published Date 01/03/2019 Tick-borne encephalitis in a pregnant patient Journal Klinick? mikrobiologie a infek?n? l?ka?stv? Citation Klin Mikrobiol Infekc Lek . 2019 Mar;25(1):16-19 DOI Authors Hockickova I, Sekul J, Hudackova D, Paralicova Z Abstract There is a lack of information in the literature about the course and risk of vertical transmission of tick-borne encephalitis (TBE) during pregnancy. Presented is a case report of a female patient in the 37th week of pregnancy infected by foodborne transmission. She developed meningitis with no neurological damage. Three weeks after the first symptoms, she gave birth to a healthy child who, at the age of 30 months, had a negative result of anti-TBE antibodies in both IgM and IgG classes. In the child, no signs of neurological injury or impaired psychomotor development were observed throughout the follow-up period. URL Previous https://pubmed.ncbi.nlm.nih.gov/31266089/ No Review Needed? Next

43 < Back to Research Top Published Date 02/09/2020 Targeted metagenomics for clinical detection and discovery of bacterial tickborne pathogens Journal Journal of Clinical Microbiology Citation J Clin Microbiol 2020 Sep 2; JCM.00147-20 DOI 10.1128/JCM.00147-20 Authors Kingry L 4, Sheldon S, Oatman S, Pritt B, Anacker M, Bjork J, Neitzel D, Strain A, Berry J, Sloan L, Respicio-Kingry L, Dietrich E, Bloch K, Moncayo A, Srinivasamoorthy G, Hu B, Hinckley A, Mead P, Kugeler K, Petersen J Abstract Tickborne diseases, due to a diversity of bacterial pathogens, represent a significant and increasing public health threat throughout the northern hemisphere. A high-throughput 16S V1-V2 rDNA-based metagenomics assay was developed and evaluated using >13,000 residual samples from patients suspected of tickborne illness and >1000 controls. Taxonomic predictions for tickborne bacteria were exceptionally accurate, as independently validated by secondary testing. Overall, 881 specimens were positive for bacterial tickborne agents. Twelve tickborne bacterial species were detected, including two novel pathogens, representing a 100% increase in the number of tickborne bacteria identified compared to what was possible by initial PCR testing. In three blood specimens, two tickborne bacteria were simultaneously detected. Seven bacteria, not known to be tick-transmitted, were also confirmed unique to samples from persons suspected of tickborne illness. These results indicate 16S V1-V2 metagenomics can greatly simplify diagnosis and accelerate discovery of bacterial tickborne pathogens. URL Previous https://jcm.asm.org/content/58/11/e00147-20.long No Review Needed? Next

279 < Back to Research Top Published Date 18/12/2010 'Rare' infections mimicking multiple sclerosis: consider Lyme disease Journal Clinical Neurology and Neurosurgery Citation Clin Neurol Neurosurg. 2011 Apr;113(3):259-60 DOI 10.1016/j.clineuro.2010.11.017 Authors Stricker RB , Johnson L Abstract URL Previous https://www.ncbi.nlm.nih.gov/pubmed/21168953 No Review Needed? Next

288 < Back to Research Top Published Date 12/05/2010 Morgellons disease: Analysis of a population with clinically confirmed microscopic subcutaneous fibers of unknown etiology Journal Clinical, Cosmetic and Investigational Dermatology Citation Clin Cosmet Investig Dermatol. 2010 May 13;3:67-78 DOI Authors Savely VR, Stricker RB Abstract BACKGROUND: Morgellons disease is a controversial illness in which patients complain of stinging, burning, and biting sensations under the skin. Unusual subcutaneous fibers are the unique objective finding. The etiology of Morgellons disease is unknown, and diagnostic criteria have yet to be established. Our goal was to identify prevalent symptoms in patients with clinically confirmed subcutaneous fibers in order to develop a case definition for Morgellons disease. METHODS: Patients with subcutaneous fibers observed on physical examination (designated as the fiber group) were evaluated using a data extraction tool that measured clinical and demographic characteristics. The prevalence of symptoms common to the fiber group was then compared with the prevalence of these symptoms in patients with Lyme disease and no complaints of skin fibers. RESULTS: The fiber group consisted of 122 patients. Significant findings in this group were an association with tick-borne diseases and hypothyroidism, high numbers from two states (Texas and California), high prevalence in middle-aged Caucasian women, and an increased prevalence of smoking and substance abuse. Although depression was noted in 29% of the fiber patients, pre-existing delusional disease was not reported. After adjusting for nonspecific symptoms, the most common symptoms reported in the fiber group were: crawling sensations under the skin; spontaneously appearing, slow-healing lesions; hyperpigmented scars when lesions heal; intense pruritus; seed-like objects, black specks, or "fuzz balls" in lesions or on intact skin; fine, thread-like fibers of varying colors in lesions and intact skin; lesions containing thick, tough, translucent fibers that are highly resistant to extraction; and a sensation of something trying to penetrate the skin from the inside out. CONCLUSIONS: This study of the largest clinical cohort reported to date provides the basis for an accurate and clinically useful case definition for Morgellons disease. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047951 No Review Needed? Next

76 < Back to Research Top Published Date 04/02/2020 Lymelight: forecasting Lyme disease risk using web search data Journal Nature Partner Journal Digital Medicine Citation 03:16 DOI 10.1038/s41746-020-0222-x Authors Sadilek A, Hswen Y, Bavadekar S, Shekel T, Brownstein JS, Gabrilovich E Abstract Lyme disease is the most common tick-borne disease in the Northern Hemisphere. Existing estimates of Lyme disease spread are delayed a year or more. We introduce Lymelight-a new method for monitoring the incidence of Lyme disease in real-time. We use a machine-learned classifier of web search sessions to estimate the number of individuals who search for possible Lyme disease symptoms in a given geographical area for two years, 2014 and 2015. We evaluate Lymelight using the official case count data from CDC and find a 92% correlation (p < 0.001) at county level. Importantly, using web search data allows us not only to assess the incidence of the disease, but also to examine the appropriateness of treatments subsequently searched for by the users. Public health implications of our work include monitoring the spread of vector-borne diseases in a timely and scalable manner, complementing existing approaches through real-time detection, which can enable more timely interventions. Our analysis of treatment searches may also help reduce misdiagnosis of the disease. URL Previous https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000681/ No Review Needed? Next

187 < Back to Research Top Published Date 24/07/2015 Biofilm formation by Borrelia burgdorferi sensu lato Journal FEMS Microbiology Letters Citation FEMS Microbiol Lett. 2015 Aug;362(15):fnv120 DOI 10.1093/femsle/fnv120 Authors Timmaraju VA, Theophilus PA, Balasubramanian K, Shakih S, Luecke DF, Sapi E Abstract Bacterial biofilms are microbial communities held together by an extracellular polymeric substance matrix predominantly composed of polysaccharides, proteins and nucleic acids. We had previously shown that Borrelia burgdorferi sensu stricto, the causative organism of Lyme disease in the United States is capable of forming biofilms in vitro. Here, we investigated biofilm formation by B. afzelii and B. garinii, which cause Lyme disease in Europe. Using various histochemistry and microscopy techniques, we show that B. afzelii and B. garinii form biofilms, which resemble biofilms formed by B. burgdorferi sensu stricto. High-resolution atomic force microscopy revealed similarities in the ultrastructural organization of the biofilms form by three Borrelia species. Histochemical experiments revealed a heterogeneous organization of exopolysaccharides among the three Borrelia species. These results suggest that biofilm formation might be a common trait of Borreliagenera physiology. URL Previous https://academic.oup.com/femsle/article/362/15/fnv120/550276 No Review Needed? Next

132 < Back to Research Top Published Date 25/07/2018 Far-Reaching Dispersal of Borrelia burgdorferi Sensu Lato-Infected Blacklegged Ticks by Migratory Songbirds in Canada Journal Healthcare (Basel, Switzerland) Citation Healthcare (Basel). 2018 6, 89. DOI 10.3390/healthcare6030089 Authors Scott JD, Clark KL, Foley JE, Bierman BC, Durden LA Abstract Lyme disease has been documented in northern areas of Canada, but the source of the etiological bacterium, Borrelia burgdorferi sensulato (Bbsl) has been in doubt. We collected 87 ticks from 44 songbirds during 2017, and 24 (39%) of 62 nymphs of the blacklegged tick, Ixodes scapularis, were positive for Bbsl. We provide the first report of Bbsl-infected, songbird-transported I. scapularis in Cape Breton, Nova Scotia; Newfoundland and Labrador; north-central Manitoba, and Alberta. Notably, we report the northernmost account of Bbsl-infected ticks parasitizing a bird in Canada. DNA extraction, PCR amplification, and DNA sequencing reveal that these Bbsl amplicons belong to Borrelia burgdorferi sensu stricto (Bbss), which is pathogenic to humans. Based on our findings, health-care providers should be aware that migratory songbirds widely disperse B. burgdorferi-infected I. scapularis in Canada's North, and local residents do not have to visit an endemic area to contract Lyme disease. URL Previous https://www.mdpi.com/2227-9032/6/3/89 No Review Needed? Next

257 < Back to Research Top Published Date 01/02/2012 Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here? Journal Quality of Life Research Citation Qual Life Res. 2013 Feb;22(1):75-84 DOI 10.1007/s11136-012-0126-6 Authors Aucott JN, Rebman AW, Crowder LA, Kortte KB Abstract PURPOSE: A subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatmentLyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time. METHODS: Sixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 (daily life functioning) and the Beck Depression Inventory, Second Edition (BDI-II) (depression), at each of five visits over a period of 6 months. RESULTS: Signs of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than "minimal" depression across the entire period. Those with PTLDS (36%) did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales (with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health) of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months. CONCLUSIONS: Unlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms. URL Previous https://link.springer.com/article/10.1007%2Fs11136-012-0126-6 No Review Needed? Next

101 < Back to Research Top Published Date 27/06/2019 Characteristics of transfusion-transmitted Babesia microti, American Red Cross 2010-2017 Journal Transfusion Citation Transfusion. 2019 Jun 27 DOI 10.1111/trf.15425 Authors L Tonnetti, RL Townsend, RY Dodd, SL Stramer Abstract BACKGROUND: Babesia microti, a red blood cell (RBC) parasite transmitted naturally to vertebrate hosts by ixodid ticks, is endemic to the northeastern and upper midwestern United States, with the geographic range of infected ticks expanding. B. microti is a blood safety issue with >200 transfusion-transmissions reported. METHODS: The American Red Cross's Hemovigilance program investigated hospital-reported transfusion-transmitted babesiosis (TTB) cases. Follow-up samples from involved donors were tested for B. microti antibodies and parasite DNA, the latter by real-time polymerase chain reaction (PCR). Test-positive donors were permanently deferred from future donations. RESULTS: B. microti-positive donors were implicated in 77 of 143 suspect TTB cases investigated from 2010 through 2017. In four cases, two positive donors were identified for a total of 81 positive donors. In three cases, a RBC unit was split and components transfused multiple times to the same pediatric recipient. RBCs were the transmitting product in all cases. At follow-up, all involved donors were antibody positive; 25 donors were also PCR positive. Positive donations were collected throughout the year, peaking in the summer. Most donors (78) were resident of, or traveled to (2), an endemic state. One donor resided in a non-endemic state without relevant travel history. One fatality listed babesia as a contributing factor. No implicated donation was screened by an investigational protocol. CONCLUSIONS: Babesiosis remains a blood safety issue. Prior to FDA-licensed screening test availability and final FDA Guidance, blood collectors in endemic states investigationally tested none, a portion, or all collections. Future expanded testing will reduce the frequency of TTB cases. URL Previous https://www.ncbi.nlm.nih.gov/pubmed/31250463 No Review Needed? Next