LymeNet Newsletter Volume 1 Issue 24

Volume: 1
Issue: 24
Date: 25-Oct-93

Table of Contents:

Prehistoric Lyme (The History of Lyme Disease)

Newsletter:

***************************************************************************** * Lyme Disease Electronic Mail Network * * LymeNet Newsletter * ***************************************************************************** Volume 1 - Number 24 - 10/25/93

SPECIAL REFERENCE ISSUE PREHISTORIC LYME

I. Special Section II. Jargon Index III. How to Subscribe, Contribute and Get Back Issues

I. ***** SPECIAL SECTION *****

From: Frank Demarest <[email protected]> Subject: Prehistoric Lyme

We recently found an interesting publication which included the early history of Lyme Disease.

Acta Pediatrica Vol 82, Feb 1993, Supplement 386 (75 pages, 356 references). "Epidemiology and Clinical Manifestations of Lyme Borreliosis in Childhood - A Prospective Multicentre Study with Special Regard to Neuroborreliosis"

The following information is from Table 1 and the text. The reference numbers correspond to the original, and are in the bibliography which follows.

[[ Editorial comments in brackets ]] -----------------------------------------------------------------------------

Year Ref 1883 42 Acrodermatitis chronica atrophicans (ACA) 1902 120 ACA 1910 7 Erythema Chronicum Migrans (ECM) after tick bite (Afzelius) 1913 178 ECM after tick bite 1922 88 Deltoid paralysis after tick bite and ECM 1930 119 Erythema Migrans and Lymphocytic Meningitis 1941 22 Lymphocytic meningoradiculitis (Bannwarth) 1942 230 Allergic meningitis 1943 19 Lymphadenosis benigna cutis (LABC) 1946 355 Chronic allergic meningitis 1949 266 Chronic aseptic meningitis 1946 316 ACA - Penicillin therapy 1949 319 ACA - Penicillin therapy 1951 127 Erythema migrans / meningitis - Penicillin therapy 1954 94 ACA - transmission in humans 1955 95 ACA - transmission in humans 1955 38 ECM - transmission in humans 1957 225 LABC - Transmission in humans 1955 116 ACA after tick bites 1966 129 ACA and peripheral neuropathy 1966 265 Lymphocytic meningitis after tick bite and ECM 1973 212 International symposium on arboviruses "Nearly the entire clinical spectrum of the disease
known today as Lyme borreliosis was presented" 1973 130 International symposium on arboviruses 1976 304 Lyme arthritis after tick bite and ECM (Steere)

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The following information is from abstracts of Dr. Steere's papers:

Year Ref 1977 305 EM rash, arthritis, suspected arthropod vector. 1977 S1 EM rash, arthritis, malaise, fatigue, chills and fever, headache, stiff neck, backache, myalgias, nausea, vomiting, and sore throat, neurologic abnormalities, myocardial conduction abnormalities. 1978 S2 Has since been found elsewhere and may be caused by a virus transmitted by ticks. Symptomatic treatment only is advised, except in the rare instances of severe neurologic complications or myocardial conduction abnormality. 1978 S3 Findings support the hypothesis that erythema chronicum migrans and Lyme arthritis are tick-transmitted, specifically by I. scapularis. 1979 S4 Defined by erythema chronicum migrans and sometimes followed by neurologic, cardiac, or joint involvement. Distribution correlates closely with that of Ixodes dammini and Ixodes pacificus. 1980 S5 Erythema chronicum migrans and its associated symptoms resolved
faster in patients given penicillin or tetracycline. 1983 S6 Recovered spirochetes from the blood, skin lesions or cerebrospinal fluid of 3 of 56 patients with Lyme disease and from 21 of 110 ticks. 1983 S7 Reported studies done in 1980-81. For early Lyme disease, tetracycline appears to be the most effective drug, then penicillin, and finally erythromycin. Nearly half had later symptoms. 1983 S8 High-dose intravenous penicillin for neurologic abnormalities of Lyme disease. 1984 S9 Confirmed spirchetal cause of LD with experiments on rabbits. 1984 S10 Lyme disease long recognized in Europe but only recently recognized in the United States. Compared DNA of 10 strains. 1985 S11 A double-blind placebo-controlled trial carried out from 1980 to 1982, patients with established Lyme arthritis, 20 treated with penicillin weekly for three weeks and 20 received saline. Seven of the 20 penicillin-treated patients (35%) had complete
resolution of arthritis soon after the injections and have remained well during a mean follow-up period of 33 months. All 20 patients given placebo continued to have attacks of arthritis. In 1983, of 20 patients treated with daily intravenous penicillin G for 10 days, 11 (55 per cent) had complete resolution of arthritis and have remained well since. 1987 S12 To determine the clinical evolution of Lyme arthritis, 55 patients who did not receive antibiotic therapy for erythema chronicum migrans were followed longitudinally for a mean duration of 6 years.

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[[ Note that Dr. Steere studied the problem for about 3 years before reporting on trying antibiotics, then waited 3 more years, until Dr. Burgdorfer discovered the spirochete, before agressively using antibiotic treatment. Then the next year he mentions that the disease has long been recognized in Europe. It would be interesting to know if the study reported in 1987 continued after 1983, when the spirochete was discovered. It is apparent that Dr. Steere has done a lot of research, and his main talent is as an academic researcher, not as a clinician. ]]

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7 Afzelius A. Verhandlungen der dermatologischen Gesellschaft zu Stockholm. Arch Dermatol Syph 1910;101:404 19 Bafverstedt B. Uber Lymphadenosis benigna cutis. Eine klinische und pathologisch-anatomische Studie. Acta Derm Venereol (Stockh) 1943;23 (Supl 11):1-202 22 Bannwarth A. Chronische lymphocytare Meningitis, enzundliche Polyneuritis und "Rheumatismus". Arch Psychiatr Neurvenkr 1941;113:284-376 38 Binder E, Doepfmer R, Hornstein O. Experimentelle Ubertragung des erythema chronicum migrans von Mensch zu Mensch. Hautarzt 1955;6:494-6 42 Buchwald A. Ein Fall von diffuser idiopathischer Haut-Atrophie. Arch Derm Syph 1883;15:553-6 88 Garin CH, Bujadoux CH. Paralysie par les tiques J Med Lyon 1922;71:765-7 94 Gotz H. Die Acrodermatitis chronica atrophicans Herxheimer als Infektionskrankheit. Hautarzt 1954;5:491-504 95 Gotz H. Die Acrodermatitis chronica atrophicans Herxheimer als Infektionskrankheit (Erganzung zur l. Mitteilung).
Hautarzt 1955;6:249-52 116 Hauser W. Zur Kenntnis der Acrodermatitis chronica atrophicans. Arch Derm Syph 1955;199:350-93 119 Hellerstrom S. Erythema chronicum migrans Afzeli. Acta Derm Venereol (Stockh) 1930;11:315-21 120 Herxheimer K. Hartmann K. Uber Acrodermatitis chronica atrophicans. Arch Derm Syph 1902;61:57-76,255-300 127 Hollstrom E. Successful treatment of erythema migrans Afzelius. Acta Derm Venereol (Stockh) 1951;31:235-43 129 Hopf HC. Acrodermatitis chronica atrophicans (Herxheimer) und Nervensystem. Monographien aus dem Gesamtgebiet der Neurollogie und Psychiatrie. Heft 114. Berlin Heidelburg New York: Springer; 1966 130 Hopf HC. Epidemiologie der Radikulomyelomeningitis mit Erythem nach ZeckenbiB in der Umbebung von Gottingen. In: Muller WK, Schaltenbrand G eds Arboviruserkrankungen des Nervensystems in Europa. Stuttgart: Thieme; 1975;253-4 178 Lipschutz B. Uber eine seltene Erythemform (Erythema chronicum migrans).
Arch Derm Syph 1913;118:349-56 212 Muller WK, Schaltenbrand G eds Arboviruserkrankungen des Nervensystems in Europa. Stuttgart: Thieme; 1975 225 Paschoud JM. Die Lymphadenosis benigna cutis als ubertragbare Infektionskrankheit. Hautarzt 1957;8:197-211 230 Pette H. Die akut entzundlichen Erkrankungen des Nervensystems. Leipzig: Thieme; 1942;302-5 265 Schaltenbrand G. Durch Arthropoden ubertragene Erkrankungen der Haut und des Nervensystems. MMW 1966;108:1557-62 266 Schaltenbrand G. Chronische aseptische Meningitis. Nervenarzt 1949;20:433-42 304 Steere AC, Malawista SE, Snydman DR, Andiman WA. A cluster of arthritis in children and adults in Lyme, Connecticut. Arthritis Rheum 1976;19:824 305 Steere AC, Malawista SE, Snydman DR, Shope RE, Andiman WA, Ross MR, Steele FM. Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three Connecticut communities. Arthritis Rheum 1977;20:7-17.
316 Svartz N. Penicillinbehandling vid dermatitis atrophicans Herxheimer. Nord Med 1946;32:2783 319 Thyresson N. The penicillin treatment of acrodermatitis atrophicans chronica (Herxheimer). Acta Derm Venereol (Stockh) 1949;29:572-621 355 Zellweger H. Uber die chronische allergische Meningitis. Helv Paediatr Acta 1946;1:417-26

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S1 Steere AC Malawista SE Hardin JA Ruddy S Askenase W Andiman WA Erythema chronicum migrans and Lyme arthritis. The enlarging clinical spectrum. Ann Intern Med 1977 Jun;86(6):685-98 S2 Steere AC Hardin JA Malawista SE Lyme arthritis: a new clinical entity. Hosp Pract 1978 Apr;13(4):143-58 S3 Steere AC Broderick TF Malawista SE Erythema chronicum migrans and Lyme arthritis: epidemiologic evidence for a tick vector. Am J Epidemiol 1978 Oct;108(4):312-21 S4 Steere AC Malawista SE Cases of Lyme disease in the United States: locations correlated with distribution of Ixodes dammini. Ann Intern Med 1979 Nov;91(5):730-3 S5 Steere AC Malawista SE Newman JH Spieler PN Bartenhagen NH Antibiotic therapy in Lyme disease. Ann Intern Med 1980 Jul;93(1):1-8 S6 Steere AC Grodzicki RL Kornblatt AN Craft JE Barbour AG Burgdorfer W Schmid GP Johnson E Malawista SE The spirochetal etiology of Lyme disease.
N Engl J Med 1983 Mar 31;308(13):733-40 S7 Steere AC Hutchinson GJ Rahn DW Sigal LH Craft JE DeSanna ET Malawista SE Treatment of the early manifestations of Lyme disease. Ann Intern Med 1983 Jul;99(1):22-6 S8 Steere AC Pachner AR Malawista SE Neurologic abnormalities of Lyme disease: successful treatment with high-dose intravenous penicillin. Ann Intern Med 1983 Dec;99(6):767-72 S9 Kornblatt AN Steere AC Brownstein DG Experimental Lyme disease in rabbits: spirochetes found in erythema migrans and blood. Infect Immun 1984 Oct;46(1):220-3 S10 Schmid GP Steigerwalt AG Johnson SE Barbour AG Steere AC Robinson IM Brenner DJ DNA characterization of the spirochete that causes Lyme disease. J Clin Microbiol 1984 Aug;20(2):155-8 S11 Steere AC Green J Schoen RT Taylor E Hutchinson GJ Rahn DW Malawista SE Successful parenteral penicillin therapy of established Lyme arthritis. N Engl J Med 1985 Apr 4;312(14):869-74
S12 Steere AC Schoen RT Taylor E The clinical evolution of Lyme arthritis. Ann Intern Med 1987 Nov;107(5):725-31 -----------------------------------------------------------------------------

II. ***** JARGON INDEX *****

Bb - Borrelia burgdorferi - The scientific name for the LD bacterium. CDC - Centers for Disease Control - Federal agency in charge of tracking diseases and programs to prevent them. CNS - Central Nervous System. ELISA - Enzyme-linked Immunosorbent Assays - Common antibody test EM - Erythema Migrans - The name of the "bull's eye" rash that appears in ~60% of the patients early in the infection. IFA - Indirect Fluorescent Antibody - Common antibody test. LD - Common abbreviation for Lyme Disease. NIH - National Institutes of Health - Federal agency that conducts medical research and issues grants to research interests. PCR - Polymerase Chain Reaction - A new test that detects the DNA sequence of the microbe in question. Currently being tested for use in detecting LD, TB, and AIDS. Spirochete - The LD bacterium. It's given this name due to it's spiral shape. Western Blot - A more precise antibody test.

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