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Volume: 6
Issue: 03
Date: 16-Mar-98


Table of Contents:

I.    LDF: LDF To Sponsor Satellite Conference on LD
II.   LDF: 11th Annual International Scientific Conference On LD
III.  LDRC: Yale Ignores True Consequences of Treatment Denial
IV.   J CLIN MICROBIOL: First isolation and cultivation of
      Borrelia burgdorferi sensu lato from Missouri.
V.    J CLIN MICROBIOL: Heterogeneity of BmpA (P39) among European
      isolates of Borrelia burgdorferi sensu lato and influence of
      interspecies variability on serodiagnosis.
VI.   ABOUT THE LYMENET NEWSLETTER


Newsletter:

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*                  The National Lyme Disease Network                  *
*                       http://www.lymenet.org/                       *
*                         LymeNet Newsletter                          *
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                   Volume 6 / Number 03 / 16-MAR-98
                                INDEX


I.    LDF: LDF To Sponsor Satellite Conference on LD
II.   LDF: 11th Annual International Scientific Conference On LD
III.  LDRC: Yale Ignores True Consequences of Treatment Denial
IV.   J CLIN MICROBIOL: First isolation and cultivation of
     Borrelia burgdorferi sensu lato from Missouri.
V.    J CLIN MICROBIOL: Heterogeneity of BmpA (P39) among European
     isolates of Borrelia burgdorferi sensu lato and influence of
     interspecies variability on serodiagnosis.
VI.   ABOUT THE LYMENET NEWSLETTER



=====*=====


I.    LDF: LDF To Sponsor Satellite Conference on LD
----------------------------------------------------
Sender: The Lyme Disease Foundation <lymefnd@aol.com>


The Lyme Disease Foundation and the Illinois Academy of Family
Practice Physicians and the Illinois Dept of Health will be
broadcasting a FREE conference on Lyme disease on March 23rd from
9 am to noon. For more information on the conference and satellite
coordinates, visit the LymeNet home page at:


                      http://www.lymenet.org/


=====*=====


II.   LDF: 11th Annual International Scientific Conference On LD
----------------------------------------------------------------
Sender: The Lyme Disease Foundation <lymefnd@aol.com>


11th INTERNATIONAL SCIENTIFIC CONFERENCE ON LYME DISEASE AND OTHER
               TICK-BORNE & SPIROCHETAL DISORDERS
               with emphasis on Clinical Management
  April 25th (Sat) & 26th (Sun), 1998   Reception Sat night 6-8pm
           7:30am  sign-in   8am - 5 pm program each day


PROGRAM COMMITTEE

James N. Miller, PhD
Professor-on-Recall, UCLA School of Medicine


Sam T. Donta, MD
Infectious Diseases, Boston University


Edward Bosler, PhD
Research Scientist, Stonybrook School of Medicine


Charles S. Pavia, PhD
New York Medical College


KEYNOTE
Willy Burgdorfer, PhD, MD(Hon)
Scientist Emeritus, National Institutes of Health


The registration form is accessible from the LymeNet web site at:

                      http://www.lymenet.org/


=====*=====


III.  LDRC: Yale Ignores True Consequences of Treatment Denial
--------------------------------------------------------------
Sender: Phyllis Mervine, President, Lyme Disease Resource Center
       and Editor, the Lyme Times, <pcm@pacific.net>
       Jean Hubbard, Associate Editor, the Lyme Times


The following review represents the opinions of the authors and not
necessarily the perspectives of the editors.


-

A recent AP press release reported on a study from Yale University
Lyme Disease Clinic which alleged: "Fear of Lyme disease causes
many people bitten by deer ticks to become depressed and pursue
aggressive medical treatment they may not need."


It is always galling to those of us who are or work with Lyme
disease patients when AP or Reuters picks up a story from Yale or
one of the other big research centers and spreads their propaganda
all over the country.  Galling because their reports not only fly
in the face of patients' experience, but also contradict other,
less well publicized reports which point up the very serious
consequences of untreated and undertreated Lyme disease.


Some doctors are definitely loath to diagnose or treat Lyme disease.
This practice has serious consequences.  We have no argument that
some patients are treated unnecessarily, and that antibiotic
resistance is of global concern.  What we do contest is the
assumption that the risk to the patient of unnecessary treatment is
greater than the risk of failure to treat true Lyme disease.
We contend that it would be preferable for physicians to stop
treating viral illnesses with antibiotics - as they commonly do -
than to deny treatment to a single person with possible Lyme disease.
Treating viruses with antibiotics is no use at all. Treating a
potential case of Lyme disease can save that person immeasurable
life-long pain and suffering.


Do the authors of the Yale paper really think that worrying about
having Lyme disease is as bad or worse than actually having Lyme
disease?  The notion is ludicrous.  There is well-documented evidence
of serious, persistent problems in more than 50% of treated
patients -- the vast majority being those patients whose treatment
was delayed.  Many people with chronic Lyme disease do suffer from
depression, but not, as the authors imply, from worry.  It is because
of real, measurable effects on the brain by this bacterium, which is
neurotropic - that is, it seeks out nervous system cells.  These
objective effects are often quite obvious if the patient undergoes a
SPECT scan of the brain.  SPECT scans in late Lyme patients with
depression or other central nervous system symptoms often show a
changed pattern in the cerebral white matter areas of the brain, a
"hypoperfusion" that is due either to restriction of the blood supply
to those areas or dysfunction at the cellular level.  These changes
are associated not only with depression, but also with a number of

other neurologic deficits, including attention problems (including
ADD itself), mood disorders, marked phobias, measurably slower mental
processing, and even dementia.  In fact, although Lyme disease was
originally described as a musculoskeletal disease, the list of
neurologic symptoms now is considerably longer - and more frightening.
Depression strikes from 20% to 70% of Lyme disease patients, more than
any other chronic illness.  Some of the most prominent Lyme
neurologists and physicians consider encephalopathy -- a degenerative
disease of the brain -- to be the most common late manifestation of
Lyme disease.  Suicide is the most common kind of fatality.


Does this sound like "worry"?

Of course the Yale authors were claiming that 60% of the study
patients did not have Lyme disease after all.  We have heard that
story before and it is patently false.  They use insensitive tests
and case standards so restrictive that they have all but defined the
disease out of existence.  So much so that a patient who has once
been treated with an arbitrary 2 or 3 weeks of antibiotics, who
relapses after completing those antibiotics, and continues to have
symptoms, is often reclassified with fibromyalgia (for which there
is no cure), given aspirin, and sent home.  It is not uncommon for
such patients to be closely questioned about their sex lives and
referred to a psychiatrist.  This in spite of the fact that the Lyme
disease bacterium is known to disguise itself and hide deep in
tissues.  This in spite of the fact that there are many published
accounts, in the peer-reviewed medical journals doctors like to
quote, of treatment failures and persistence of infection despite
aggressive antibiotic treatment.  In no other disease are patients

treated with such callous disregard, or such denial of facts which
seem to stare one in the face.


Why is Lyme disease treated differently?

-

The Lyme Disease Resource Center is an educational nonprofit
corporation dedicated to sharing knowledge to fight Lyme and other
tick-borne diseases.  The authors may be contacted at LDRC, PO Box
1423, Ukiah CA 95482.



=====*=====


IV.   J CLIN MICROBIOL: First isolation and cultivation of
     Borrelia burgdorferi sensu lato from Missouri.
----------------------------------------------------------
AUTHORS: Oliver JH Jr, Kollars TM Jr, Chandler FW Jr, James AM
        Masters EJ, Lane RS, Huey LO
ORGANIZATION: Institute of Arthropodology and Parasitology,
             Georgia Southern University, Statesboro 30460-8056, USA.
             JOliver@gasou.edu
REFERENCE: J Clin Microbiol 1998 Jan;36(1):1-5
ABSTRACT:


Five Borrelia burgdorferi sensu lato isolates from Missouri are
described.  This represents the first report and characterization
of such isolates from that state.  The isolates were obtained from
either Ixodes dentatus or Amblyomma americanum ticks that had been
feeding on cottontail rabbits (Sylvilagus floridanus) from a farm in
Bollinger County, Mo., where a human case of Lyme disease had been
reported.  All isolates were screened immunologically by indirect
immunofluorescence by using monoclonal antibodies to B. burgdorferi-
specific outer surface protein A (OspA) (antibodies H3TS and H5332),
B. burgdorferi-specific OspB (antibody H6831), Borrelia (genus)-
specific antiflagellin (antibody H9724), and Borrelia hermsii-specific
antibody (antibody H9826).  Analysis of the isolates also involved a
comparison of their protein profiles by sodium dodecyl sulfate-
polyacrylamide gel electrophoresis.  Finally, the isolates were
analyzed by PCR with six pairs of primers known to amplify selected
DNA target sequences specifically found in the reference strain B.

burgdorferi B-31.  Although some genetic variability was detected
among the five isolates as well as between them and the B-31 strain,
enough  similarities were found to classify them as B. burgdorferi
sensu lato.



=====*=====


V.    J CLIN MICROBIOL: Heterogeneity of BmpA (P39) among European
     isolates of Borrelia burgdorferi sensu lato and influence of
     interspecies variability on serodiagnosis.
------------------------------------------------------------------
AUTHORS: Roessler D, Hauser U, Wilske B,
ORGANIZATION: Max von Pettenkofer-Institut fur Hygiene und
             Medizinische Mikrobiologie der Ludwig-Maximilians
             Universitat Munchen, Lehrstuhl fur Bakteriologie,
             Munich, Germany. Roessler@mvp.med.uni-muenchen.de
REFERENCE: J Clin Microbiol 1997 Nov;35(11):2752-8
ABSTRACT:


The molecular and antigenic variabilities of BmpA (P39) among European
isolates of Borrelia burgdorferi were analyzed.  The bmpA sequences of
12 isolates representing all three species of B. burgdorferi sensu
lato pathogenic for humans were amplified by PCR, cloned, and
sequenced.  The BmpA protein of Borrelia garinii is heterogeneous,
with an amino acid sequence identity ranging from 91 to 97%, whereas
the BmpA proteins of Borrelia afzelii and B. burgdorferi sensu
stricto strains appear to be highly conserved (>98.5% intraspecies
identity).  The interspecies identities ranged from 86 to 92%.
Cluster analysis of BmpA reflected the subdivision of B. burgdorferi
sensu lato isolates into the three species as well as a considerable
heterogeneity among B. garinii strains.  The BmpA protein of each
species of B. burgdorferi sensu lato was recombinantly expressed in
Escherichia coli, purified, and used to generate monoclonal
antibodies.  Seven BmpA-specific antibodies were identified; six of
them recognized conserved epitopes of all three species, whereas one

was specific for BmpA of B. afzelii and B. garinii.  A monoclonal
antibody (H1141) recommended by the Centers for Disease Control and
Prevention for use in the standardization of immunoblots showed strong
reactivity with BmpA of B. burgdorferi sensu stricto but no or only
weak reactivity with BmpA of B. garinii and B. afzelii, respectively.
Sera from 86 European patients with Lyme borreliosis in different
stages and 73 controls were tested in immunoglobulin G (IgG) and IgM
immunoblots with the recombinant BmpA proteins of the three species,
revealing specificities of 98.6 to 100%.  IgM antibodies against
recombinant BmpA were only rarely detected (1.1 to 8.1%).  With the
BmpA proteins of B. afzelii and B. garinii, sensitivities for the IgG
test (sera from stages I to III) were 36.0 and 34.9%, respectively, in
contrast to 13.9% with BmpA of B. burgdorferi sensu stricto.
Therefore, we  recommend that recombinant BmpA of B. afzelii or B.
garinii should be used solely, or in addition to B. burgdorferi sensu

stricto BmpA, in serodiagnostic tests for Lyme borreliosis in Europe.


=====*=====


VI.   ABOUT THE LYMENET NEWSLETTER
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         The Lyme Disease Network of New Jersey
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