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Volume: 6
Issue: 10
Date: 16-Oct-98


Table of Contents:

I.    LDANJ: Great Imitator Family Masquerade Party Fundraiser Oct 25
II.   NIH: Chronic Lyme Borreliosis Clinical Trial RFP - NIH/ALI
III.  ARCH DEMATOL: Physician-diagnosed erythema migrans and erythema
      migrans-like rashes following Lone Star tick bites.
IV.   PEDIATR NEUROL: Pseudotumor cerebri in Lyme disease: a case
      report and literature review.
V.    AM J PHYS ANTHROPOL: Prehistoric juvenile rheumatoid arthritis
      in a precontact Louisiana native population reconsidered.
VI.   ABOUT THE LYMENET NEWSLETTER


Newsletter:

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                   Volume 6 / Number 10 / 16-OCT-98
                                INDEX



I.    LDANJ: Great Imitator Family Masquerade Party Fundraiser Oct 25
II.   NIH: Chronic Lyme Borreliosis Clinical Trial RFP - NIH/ALI
III.  ARCH DEMATOL: Physician-diagnosed erythema migrans and erythema
     migrans-like rashes following Lone Star tick bites.
IV.   PEDIATR NEUROL: Pseudotumor cerebri in Lyme disease: a case
     report and literature review.
V.    AM J PHYS ANTHROPOL: Prehistoric juvenile rheumatoid arthritis
     in a precontact Louisiana native population reconsidered.
VI.   ABOUT THE LYMENET NEWSLETTER



=====*=====


I.    LDANJ: Great Imitator Family Masquerade Party Fundraiser Oct 25
---------------------------------------------------------------------
Sender: Patricia Smith <LymeLiter@AOL.com>


The Lyme Disease Association of New Jersey, Inc., LDANJ, is
sponsoring its 8th annual Great Imitator Family Masquerade Party on
Sunday, October 25, 1998 from 2-7 PM at the Whiting Volunteer Fire
Co #1, Lacey Road, Whiting, NJ.  DJ Mr. Bill will lead the
festivities with dancing and costume contests with great prizes.
The Barnegat Bay Pipe band will also put in a guest appearance.


Tickets which include food, entertainment, and a chance for door
prizes are adults $15, children $7, 3 & under, free.  This is an
event for all ages to enjoy.  Come costumed or not.  Proceeds will
go to neuropsychiatric Lyme disease research being conducted by
Dr. Brian Fallon, Columbia University.  The all-volunteer LDANJ has
raised over $400,000 for Lyme research, education, and prevention.
For ticket and other information call Pam 732-886-5157,
Deb 732-370-3027, and Edina 609-463-8411, Margaret Grayson
Ph /609-296-7969/Fx. 609-296-9635.



=====*=====


II.   NIH: Chronic Lyme Borreliosis Clinical Trial RFP - NIH/ALI
----------------------------------------------------------------
Source: Carl Henn, Contracting Officer  <ch24v@nih.gov>
Release Date: 7 October, 1998
URL: http://web.fie.com/htdoc/fed/nih/gen/any/proc/any/10099808.htm


CHRONIC LYME BORRELIOSIS CLINICAL TRIAL SOL N01-AI-65296 DUE 110498
POC Mr. Carl Henn, Contracting Officer, 301-496-0993.


The National Institute of Allergy and Infectious Diseases, Division of
Microbiology and Infectious Diseases, is seeking sources capable of
conducting randomized, placebo-controlled, double-blind clinical
trials to demonstrate the efficacy of treatment with intravenous
ceftriaxone (2 grams per day for 30 consecutive days) followed by oral
doxycycline (200 mg per day for 60 consecutive days) for the treatment
of chronic Lyme borreliosis. The trials will involve defined cohorts of
patients, from regions of the United States in which Lyme disease is
endemic, that are either seropositive or seronegative for Lyme disease
(by the two-test CDC-Dearborn criteria) at the time of enrollment, and
who meet the inclusion and exclusion criteria established and approved
for this study. Primary analysis of the efficacy of the antibiotic
therapy used will be determined by improvement in the patient's
health-related quality of life, as measured by the SF-36 Health Survey;
it includes eight multi-item scales that measure physical functioning,

role-physical, bodily pain, general health, vitality, social
functioning, role-emotional, and mental health. Three additional
multi-item scales from the medical outcomes study (MOS) will be used to
measure cognitive functioning, pain, and role functioning; however,
they will not be used for primary analysis of efficacy. The SF-36
Health Survey (and additional MOS measures) will be administered to
study participants five times: at baseline (prior to therapy); at one
month (the end of intravenous therapy); at three months (the end of
intravenous and oral therapy); at six months; and at one year . Also,
at baseline and at defined intervals (as stipulated in the protocol
approved for use in these studies), specimens will be collected to test
for: (a) an immune response to Borrelia burgdorferi antigens in serum
and cerebrospinal fluid (CSF); (b) B. burgdorferi DNA in CSF; (c)
viable B. burgdorferi in CSF; (d) B. burgdorferi antigens in urine; and
(e) serum antibodies specific for possible co-infecting agents, e.g.,

Babesia microti and Ehrlichia species. Interested parties should
submit, no later than November 4, 1998, four (4) copies of a capability
statement addressing each of the areas outlined above. The statement
also should include information on numbers of eligible volunteers
likely to be enrolled per year (do not provide the names of prospective
volunteers or personal identifiers). A copy of the specific inclusion
and exclusion criteria approved for the study will be provided on
request. This Sources Sought Announcement is a request for information
to assist the NIAID in selecting additional sites for conducting the
studies described. It may or may not result in a solicitation.
Respondents are invited to discuss additional terms or conditions with
the NIAID by contacting: Carl Henn Contracting Officer Contract
Management Branch National Institute of Allergy & Infectious Diseases.



=====*=====


III.  ARCH DEMATOL: Physician-diagnosed erythema migrans and erythema
     migrans-like rashes following Lone Star tick bites.
---------------------------------------------------------------------
AUTHORS: Masters E, Granter S, Duray P, Cordes P
ORGANIZATION: Regional Primary Care, Cape Girardeau, Mo, USA.
REFERENCE: Arch Dermatol 1998 Aug;134(8):955-60
ABSTRACT:


OBJECTIVE: To differentiate cases of physician-diagnosed erythema
migrans and erythema migrans-like rashes associated with Lone Star
tick (Amblyomma americanum) bites.
DESIGN: Retrospective case series.
SETTING: Private primary care clinic in rural Missouri.
PATIENTS: Seventeen patients with physician-diagnosed erythema migrans
following a definite Lone Star tick bite at the rash site.
INTERVENTIONS: A biopsy was performed on all rash sites. All patients
were treated with oral antibiotics.
MAIN OUTCOME MEASURES: Rash appearance, size, body location, multiple
lesions, incubation times, associated symptoms, seasonal occurrence,
histopathological features, tick stage and sex, patient age and sex,
treatment response, growth in BSK II culture media, and serologic
evaluation.
RESULTS: Rashes associated with Lone Star ticks were similar to
erythema migrans vectored by other Ixodes ticks. Differences were
noted in Lyme disease serology results, especially flagellin-based
enzyme immunoassays, and failure to yield spirochetes in BSK II

cultures. Lyme serology results were often negative, but were also
frequently inconsistent with results of controls without Lyme disease.
CONCLUSIONS: Lone Star ticks are associated with rashes that are
similar, if not identical, to erythema migrans associated with
borrelial infection. The recent isolation and cultivation of Borrelia
burgdorferi from ticks (including 1 Lone Star tick) from the farm of
a patient included in this report has raised the possibility that Lone
Star ticks are "bridge vectors" for human borrelial infection.
Although further investigation is needed, these rashes may be
secondary to spirochetal infection.



=====*=====


IV.   PEDIATR NEUROL: Pseudotumor cerebri in Lyme disease: a case
     report and literature review.
------------------------------------------------------------------
AUTHORS: Kan L, Sood SK, Maytal J
ORGANIZATION: Division of Pediatric Neurology, Schneider Children's
             Hospital, Long Island Jewish Medical Center, Long Island
             Campus for the Albert Einstein College of Medicine, New
             Hyde Park, New York 11040, USA.
REFERENCE: Pediatr Neurol 1998 May;18(5):439-41
ABSTRACT:


Pseudotumor cerebri is an unusual presentation of Lyme disease. The
case of an 8-year-old girl with pseudotumor cerebri secondary to
acute neuroborreliosis is reported. She presented with acute onset of
headache, papilledema, sixth nerve palsy, increased intracranial
pressure, and cerebrospinal fluid pleocytosis. Serum and cerebrospinal
fluid Lyme antibodies were positive. Twelve reported cases that
mostly presented with systemic findings and signs of Lyme disease
before development of pseudotumor cerebri were reviewed. We conclude
that acute neuroborreliosis can present with pseudotumor cerebri as an
initial manifestation. It is important to include Lyme disease in the
differential diagnosis of pseudotumor cerebri in an area endemic for
Lyme disease.



=====*=====


V.    AM J PHYS ANTHROPOL: Prehistoric juvenile rheumatoid arthritis
     in a precontact Louisiana native population reconsidered.
--------------------------------------------------------------------
AUTHORS: Lewis BA
ORGANIZATION: Department of Geography and Anthropology, Louisiana
             State University, Baton Rouge, USA.
             galewi@unixl.sncc.lsu.edu
REFERENCE: Am J Phys Anthropol 1998 Jun;106(2):229-48
ABSTRACT:


Descriptions of skeletal pathological conditions evident in the
prehistoric Tchefuncte adolescent 16ST1-14883b are clarified. The
basis is reaffirmed for assigning to the described pathological
conditions a diagnostic perspective of juvenile rheumatoid arthritis
or juvenile Lyme disease--a disease that mimics juvenile rheumatoid
arthritis in its arthritic presentation--rather than of assigning them
as representative of juvenile onset ankylosing spondylitis or other
juvenile spondyloarthropathies. A hypothesis (Lewis [1994] Am. J.
Phys. Anthropol. 93:455-475) is restated that 1) the spirochete
Borrelia burgdorferi was the infectious agent responsible for
prevalence of adult rheumatoid arthritis in prehistoric southeastern
Native American populations, 2) that B. burgdorferi is a possible
cause of the arthritis evident in individual 16ST1-14883b, and 3) that
antibodies to B. burgdorferi provided partial immunity to the related
spirochete Treponema pallidum for the 16ST1 precontact Tchefuncte
population from Louisiana, protecting them from severe treponemal

response. Given the probable widespread existence of Ixodid tick
vectors for B. burgdorferi in prehistoric North America, coupled with
the existence of treponematosis, it follows that the transition of
Native American hunting-gathering economies to more sedentary
economies would predictably be linked to an increased incidence of
treponematosis due to the loss of benefits of the above-stated partial
immunity. In other words, as prehistoric Native American exposure to
tick vectors for B. burgdorferi decreased, susceptibility to
treponematosis increased. Inferences regarding biological controls
interacting with and influencing prehistoric Native American migration
patterns are suggested from the link of B. burgdorferi to an Ixodid
tick common to northeast Asia.



=====*=====


VI.   ABOUT THE LYMENET NEWSLETTER
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