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Volume: 4
Issue: 05
Date: 08-Apr-96


Table of Contents:

I.    LYMENET: VII LD Scientific Congress, June 16-21
II.   MLDA: Human Serosurvey in Oakland County, MI
III.  LYMENET: Questions about LD and Pregnancy (Q)
IV.   LYMENET: Patient Diagnosed with "Lyme-Like" disorder (A)
V.    INT J SYST BACTERIOL: Genetic and phenotypic analysis of
      Borrelia miyamotoi sp. nov., isolated from the ixodid tick
      Ixodes persulcatus, the vector for Lyme disease in Japan
VI.   About The LymeNet Newsletter


Newsletter:

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*                  The National Lyme Disease Network                  *
*                         LymeNet Newsletter                          *
***********************************************************************


IDX#                Volume 4 - Number 05 - 4/08/96
IDX#                            INDEX
IDX#
IDX#  I.    LYMENET: VII LD Scientific Congress, June 16-21
IDX#  II.   MLDA: Human Serosurvey in Oakland County, MI
IDX#  III.  LYMENET: Questions about LD and Pregnancy (Q)
IDX#  IV.   LYMENET: Patient Diagnosed with "Lyme-Like" disorder (A)
IDX#  V.    INT J SYST BACTERIOL: Genetic and phenotypic analysis of
IDX#        Borrelia miyamotoi sp. nov., isolated from the ixodid tick
IDX#        Ixodes persulcatus, the vector for Lyme disease in Japan
IDX#  VI.   About The LymeNet Newsletter
IDX#



I.    LYMENET: VII LD Scientific Congress, June 16-21
-----------------------------------------------------
Sender: James Herrington <JXH7@CIDVBI1.EM.CDC.GOV>


LYME DISEASE SCIENTIFIC CONGRESS ANNOUNCEMENT

The VII International Congress on Lyme Borreliosis promises to be
a valuable and informative venue for the exchange of scientific
information and progress in research on Lyme disease.  The Congress
will be held June 16-21, 1996 at The Fairmont Hotel, San Francisco,
California.


Eight scientific topics on Lyme disease will be presented at the
five-day conference during plenary, concurrent, and poster sessions:


* Ecology
* Prevention & Control
* Surveillance & Epidemiology
* Clinical Manifestations, Case Series & Treatment
* Laboratory Diagnosis
* Pathogenesis of Lyme disease
* Biology & Genetics
* Vaccines & Immunology


Registration fees (includes opening reception, coffee breaks, banquet,
and admittance to all scientific presentations)
Prior to April 15th          $450 US / person
After April 15th             $500
Student rate                 $250
Accompanying person          $150 (reception and banquet only)
Exhibitors                  $1000 (includes pipe and drape walls,
                                 ID sign, one table, and two chairs)


Special lodging rates are available at the historic Fairmont Hotel,
Atop Nob Hill, 950 Mason Street, San Francisco, California 94108;  
telephone:  (800) 527-4727;  (415) 772-5137.  


Reservations must be made directly with The Fairmont by May 14th to
obtain the following special rates.   Identify yourself as a VII
International Congress on Lyme Borreliosis participant.   Conference
rates will be valid for two days before and two days after the
Congress.  


Main building standard     $140 (single/double)
Main building deluxe       $160 (single/double)
Tower city  view           $180 (single/double)
Tower bay view             $200 (single/double)


For more information, please contact:

Mary Ellen Fernandez
Fort Collins, Colorado, USA
tel: (970) 221-6426
fax: (970) 221-6476
email: meg2@cidvbi1.em.cdc.gov



=====*=====


II.   MLDA: Human Serosurvey in Oakland County, MI
--------------------------------------------------
Sender: Kim Weber <Ticktalk2@aol.com>


A statement on the human serosurvey in Oakland County - by the
Michigan Lyme Disease Association


In cooperation with the University of Michigan School of Public
Health, the Michigan Dept. of Public Health has developed a study
utilizing serological testing to determine the prevalence of Lyme
disease in the lower peninsula, specifically Oakland County.  
Governor Engler has accepted this study in lieu of a blue ribbon
committee that was originally proposed by Oakland County Executive
L. Brooks Patterson and State Reps.  Penny Crissman (R-Rochester),
John Jamian (R-Blmfld. Twp.) and Sandra Hill (R-Flint).  This came
about as a result of public hearings in August, 1995 that were
initiated by Patterson, whose daughter, Mary has been battling Lyme
disease for two years.  Of the approximately 400 attendees, 114 from
Oakland County have been asked to participate in this two-stage
testing.


The serological tests that are being offered to these residents
consists of two-stage testing using ELISA (IFA) and Western Blot.  
If the patient tests positive on the ELISA, then the next step will
be testing with the Western Blot.  The criteria used in this testing
has been adopted by the CDC from a Dearborn, MI conference in 1994.  
The use of this type of testing, to determine the prevalence of Lyme
disease has stirred responses from both MLDA members and physicians.  
Members of the Lyme community have expressed uncertainty about
participating in such a study.  This should be a personal decision
based the patient's medical history and knowledge of the facts.


Physicians who treat a number of Lyme disease patients, have been
consulted by the MLDA.  They are in agreement that when looking at
this particular study, there are various factors that must be taken
into consideration.  Although serological tests (blood tests) may be
used primarily as a tool to help confirm the diagnosis of Lyme
disease, it does not rule out the presence of Lyme disease with
supportive clinical findings.  The physicians maintained that there
is a possibility that a patient may not seroconvert with early
antibiotic treatment; and if on prolonged antibiotic therapy or
steroids, the patient may not test positive.  Lyme disease patients
are often seen in the examining room while in the late-chronic stage
of Lyme disease, where the bacterial infection is well into the
tissues and organs.  And in light of more recent compelling research
on seronegative Lyme disease (with positive (+) tissue & spinal fluid
culture in late stage Lyme), it is reasonable to assume that blood
tests alone may not be a reliable indicator of presence of infection.  

These tests would then elicit a false-negative result, i.e.,
sero-negative Lyme disease.


Although this study is an effort to give us answers to the increasing
incidence of Lyme disease, it will not likely answer the prevalence of
Lyme disease in lower Michigan or elsewhere.  In conclusion,  only
those Lyme patients in the acute or first stage of Lyme disease may be
good candidates for this study.



=====*=====


III.  LYMENET: Questions about LD and Pregnancy (Q)
---------------------------------------------------
Sender: Brian Reynolds <0006827849@mcimail.com>


I'd like to pose a question to the list.  My wife and I lived in New
Jersey until the end of 1992.  The state's parting gift to my
wife (then 31), and my daughter (then 2) was Lyme disease.  My
daughter had the telltale rash, and was successfully treated with a
course or two of antibiotics.  She has been symptom free and doing
wonderfully since.  My wife, on the other hand, had no visible bite
marks or rash.  She did not begin treatments until about five months
after our daughter showed the rash.  We assume that they were
infected at about the same time.  Since that time, my wife has been
on just about every legal antibiotic on the market, including IV
Rocephin and IV Claforan, and many combinations thereof.  She
has been on Zithromax and Plaquinil since December '95 with no marked
improvements.  


My real question is this:  Is there any evidence of chronic Lyme
causing or increasing the chance of birth defects?  We were ready to
begin trying to have another child when Lyme entered our lives.  It
has scarred my wife emotionally permanently - and we don't want it to
ruin our chances of having more children.  ANY information on Lyme &
pregnancy would be greatly appreciated.


Please send any responses to me at 0006827849@mcimail.com, and to
this list.



=====*=====


IV.   LYMENET: Patient Diagnosed with "Lyme-Like" disorder (A)
--------------------------------------------------------------
Sender: Doris Aaronson <doris@psych.NYU.EDU>


RE: The letter from Sandy in the 3/6/96 newsletter.

It is unfortunate that her doctors gave her antibiotics for only
a month at a time (including Rocephin).  She may now have "chronic"
Lyme disease.  For some people in that situation, staying on
antibiotics for years (and perhaps for life) gradually reduces
the symptoms to a low frequency and intensity with which one can
live reasonably well, most of the time.  The antibiotics should
be combined with a low-stress life-style, and more sleep than the
typical person gets -- e.g., 9 or 10 hours per night.  The improvement
may be very gradual -- but something that is obvious from one year
to the next.  Many people with chronic Lyme are on a continuing
combination of Zithromax and Suprax.  A "symptom diary" should be
kept on a daily basis, perhaps rating symptoms from 1 to 5 for
intensity.  Then one can compare long stretches of time, e.g.,
from one month to the next, or one year to the next, to check
on improvement.  As we now know, many cases of Lyme disease are
"sero-negative" -- i.e., show up negative on the standard blood

tests.  

The onset of Sandy's disease, however, didn't sound quite
like the situations I've heard about from others or read about in
the literature.  So, it is possible that there is a disease
similar to Lyme, or that the Lyme bacteria which we see more often
on the northern parts of the country have DNA mutations that end up
to be somewhat different than the going varieties.  Physicians who
are Lyme specialists often recommend staying on antibiotics until
at least 3 months after all symptoms have gone.  That is not what
Sandy's doctors did.  Sandy, and others, who might be on long-term
antibiotics should take acidophilus pills 3 time/day, 1/2 hour
before meals, to keep the level of "good" gut bacteria at a
reasonable level, as antibiotics can cause serious intestinal
problems.



=====*=====



V.    INT J SYST BACTERIOL: Genetic and phenotypic analysis of
     Borrelia miyamotoi sp. nov., isolated from the ixodid tick
     Ixodes persulcatus, the vector for Lyme disease in Japan
----------------------------------------------------------------
AUTHORS: Fukunaga M, Takahashi Y, Tsuruta Y, Matsushita O
        Ralph D, McClelland M, Nakao M
ORGANIZATION: Faculty of Pharmacy and Pharmaceutical Sciences,
             Fukuyama University, Hiroshima, Japan.
REFERENCE: Int J Syst Bacteriol 1995 Oct;45(4):804-10
ABSTRACT:


The ixodid tick Ixodes persulcatus is the most important vector of
Lyme disease in Japan.  Most spirochete isolates obtained from I.
persulcatus ticks have been classified as Borrelia burgdorferi
sensu lato because of their genetic, biological, and immunological
characteristics.  However, we found that a small number of isolates
obtained from I. persulcatus contained a smaller 38-kDa endoflagellar
protein and single 23S-5S rRNA gene unit.  Representative isolate
HT31T (T = type strain) had the same 23S rRNA gene physical map as
Borrelia turicatae.  The DNA base composition of strain HT31T was
28.6 mol% G+C.  DNA-DNA hybridization experiments revealed that strain
HT31T exhibited moderate levels of DNA relatedness (24 to 51%) with
Borrelia hermsii, B. turicatae, Borrelia parkeri, and Borrelia
coriaceae.


However, the levels of DNA reassociation with the previously described
Lyme disease borreliae (B. burgdorferi, Borrelia garinii, and Borrelia
afzelii) were only 8 to 13%.  None of the previously described species
examined exhibited a high level of DNA relatedness with strain HT31T.
In addition, the 16S rRNA gene sequence (length, 1,368 nucleotides) of
strain HT31T was determined and aligned with the 16S rRNA sequences of
other Borrelia species.  Distance matrix analyses were performed, and
a phylogenetic tree was constructed.  The results showed that isolate
HT31T is only distantly related to both previously described Lyme
disease borreliae and relapsing fever borreliae.  Thus, the
spirochetes isolated from I. persulcatus and closely related isolates
should be classified as members of a new Borrelia species.  We propose
the name Borrelia miyamotoi sp. nov. for this spirochete; strain HT31
is the type strain.



======*======


VI.   ABOUT THE LYMENET NEWSLETTER
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