LymeNet Newsletter Volume 4 Issue 05

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:

*********************************************************************** * 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 <[email protected]>

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: [email protected]

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II. MLDA: Human Serosurvey in Oakland County, MI -------------------------------------------------- Sender: Kim Weber <[email protected]>

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.

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III. LYMENET: Questions about LD and Pregnancy (Q) --------------------------------------------------- Sender: Brian Reynolds <[email protected]>

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 [email protected], and to this list.

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IV. LYMENET: Patient Diagnosed with "Lyme-Like" disorder (A) -------------------------------------------------------------- Sender: Doris Aaronson <[email protected]>

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.

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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.

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