LymeNet Home Page LymeNet Flash Discussion LymeNet Support Group Database LymeNet Literature Library LymeNet Legal Resources LymeNet Medical & Scientific Abstract Database LymeNet Newsletter Home Page LymeNet Recommended Books LymeNet Tick Pictures Search The LymeNet Site LymeNet Links LymeNet Frequently Asked Questions About The Lyme Disease Network LymeNet Newsletter Volume 4 Issue 15 LymeNet Home Page LymeNet Flash Discussion LymeNet Support Group Database LymeNet Literature Library LymeNet Legal Resources LymeNet Medical & Scientific Abstract Database LymeNet Newsletter Home Page LymeNet Recommended Books LymeNet Pictures Search The LymeNet Site LymeNet Links LymeNet Frequently Asked Questions About The Lyme Disease Network LymeNet Home LymeNet Newsletter Library

Volume: 4
Issue: 15
Date: 04-Nov-96


Table of Contents:

I.    LYMENET: New LD Patient Documentary Available
II.   N ENGL J MED: Lyme Disease in Children in Southeastern CT
III.  LDF: Response to Recent NEJM Paper on LD in CT Children
IV.   INT J FOOD MICROBIOL: Borrelia burgdorferi: Another Cause
      of Foodborne Illness?
V.    About The LymeNet Newsletter


Newsletter:

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


IDX#                Volume 4 - Number 15 - 11/04/96
IDX#                            INDEX
IDX#
IDX#  I.    LYMENET: New LD Patient Documentary Available
IDX#  II.   N ENGL J MED: Lyme Disease in Children in Southeastern CT
IDX#  III.  LDF: Response to Recent NEJM Paper on LD in CT Children
IDX#  IV.   INT J FOOD MICROBIOL: Borrelia burgdorferi: Another Cause
IDX#        of Foodborne Illness?
IDX#  V.    About The LymeNet Newsletter
IDX#



I.    LYMENET: New LD Patient Documentary Available
---------------------------------------------------
Sender: <BlueSox111@aol.com>


We are pleased to offer a new one hour video entitled Lyme Disease,
Time For Truth.


This documentary reflects the struggles and hardships that Lyme
Disease victims face while searching for a diagnosis, physicians and
adequate treatment.  There are no actors.  The people tell the story.  
It features Denise Lang, author of Coping With Lyme Disease, several
courageous physicians, patient advocates, and Lyme patients talking
about the true issues that exist today from misdiagnosis to insurance
problems.


Now available for order.  The cost of the video is $19 with $4
shipping and handling.


Please make checks payable to Lyme Disease Awareness Fund (or LDAF)
mail to:


Lyme Disease Awareness Fund
PO BOX 3
Chester, NJ 07930


Delivery of premier orders will be sent via Priority Mail within 4-6
weeks.


This is a not for profit project.  Money derived from the sale of
this video will go to research on Lyme disease after payment is
completed for the production of it.



=====*=====


II.   N ENGL J MED: Lyme Disease in Children in Southeastern CT
---------------------------------------------------------------
AUTHORS: Michael A. Gerber, Eugene D. Shapiro, Georgine S. Burke,
        Valerie J. Parcells, Gillian L. Bell,
ORGANIZATION: Department of Pediatrics, University of Connecticut
             School of Medicine, Connecticut Children's Medical
             Center, Hartford (M.A.G.,G.S.B.); the Departments of
             Pediatrics (E.D.S., V.J.P.) and Epidemiology (E.D.S.)
             and the Children's Clinical Research Center (E.D.S.),
             Yale University School of Medicine, New Haven; and the
             Department of Pediatrics, University of Connecticut
             School of Medicine, Farmington (G.L.B.) --
            all in Connecticut.
REFERENCE: N Engl J Med 1996;335:1270-4
ABSTRACT:


BACKGROUND: Although the incidence of Lyme disease is highest in
children, there are few prospective data on the clinical manifestations
and outcomes in children.
METHODS: We conducted a prospective, longitudinal, community-based
cohort study of children with newly diagnosed Lyme disease in an area
of Connecticut in which the disease is highly endemic.  We obtained
clinical and demographic information and performed serial antibody
tests and follow-up evaluations.
RESULTS: Over a period of 20 months, 201 consecutive patients were
enrolled; their median age was 7 years (range, 1 to 21).  The initial
clinical manifestations of Lyme disease were a single erythema
migrans lesion in 66 percent, multiple erythema migrans lesions in 23
percent, arthritis in 6 percent, facial-nerve palsy in 3 percent,
aseptic meningitis in 2 percent, and carditis in 0.5 percent. At
presentation, 37 percent of the patients with a single erythema
migrans lesion and 89 percent of those with multiple erythema migrans
lesions had antibodies against Borrelia burgdorferi.  All but 3 of

the 201 patients were treated for two to four weeks with conventional
antimicrobial therapy, which was administered orally in 96 percent.
All had prompt clinical responses.  After four weeks, 94 percent were
completely asymptomatic (including the two patients whose parents had
refused to allow antimicrobial treatment).  At follow-up a mean of
25.4 months later, none of the patients had evidence of either chronic
or recurrent Lyme disease.  Six patients subsequently had a new
episode of erythema migrans.
CONCLUSIONS: About 90 percent of children with Lyme disease present
with erythema migrans, which is an early stage of the disease.  The
prognosis is excellent for those with early Lyme disease who are
treated promptly with conventional courses of antimicrobial agents.



=====*=====    


III.  LDF: Response to Recent NEJM Paper on LD in CT Children
-------------------------------------------------------------
Sender: Tom Forschner, The Lyme Disease Foundation <ldftf@aol.com>


EDITORS'S NOTE: The following letter was recently sent to Drs.
Gerber and Shapiro.  It is being reprinted below for your information.


Dr. Michael A. Gerber
Department of Pediatrics
University of Connecticut School of Medicine
282 Washington St.
Hartford, CT 06106


Dr. Eugene D. Shapiro
Department of Pediatrics
Yale University School of Medicine
New Haven, CT 06520


October 25, 1996

Dear Drs. Gerber & Shapiro:

I read your recent article in the New England Journal of Medicine,
and congratulate you on a what must be a significant career
accomplishment.  Your survey confirms what the Lyme Disease Foundation
and numerous published articles in peer reviewed journals have been
saying; that those with easily recognizable symptoms of Lyme disease,
who are diagnosed and treated early respond very well.


The press accounts of your article however, appear to be significantly
different than what was actually described in your paper. I hope that
in the interest of promoting safety and public health, you will
correct the misconception that has been created.


The Lyme Disease Foundation is particularly concerned by the
following quotes used by the Associated Press and New York Times:


"The study shows that Lyme disease in children is easy to diagnose and
easy to treat, " said Dr. Michael Gerber, a professor at the
University of Connecticut who conducted the study.


"It's amazing how many people in Connecticut think Lyme disease is not
curable," Gerber said.


"Over time, the disease tends to burn itself out, even without
treatment, in many people," Shapiro said.


Similar sound bites were used on television.  This is significantly
different than the conclusion in your paper:


"The prognosis is excellent for those with early Lyme disease who are
treated promptly with conventional courses of antimicrobial agents."


I am sure that these quotes must have been taken out of context since
your article focused only on early Lyme disease and the entry
criteria (CDC surveillance criteria ) was prejudiced toward patients
who had the most obvious signs and symptoms (primarily EM and swollen
joints) of Lyme disease.  It has been well documented that the
population selected in your study only represents a small portion of
all cases of Lyme disease.  Applying your conclusion to all Lyme
disease cases simply cannot be supported.  In addition, your
definition of a cure was based on a phone survey with the parents of
the children, not objective scientific evidence.


The unfortunate effect of this misinformation is confusion, and
dismissal of the fine educational efforts of many organizations
(NIH, CDC, Health Depts., LDF, etc.) who are trying to increase
awareness and protect the public.  A careless or frivolous attitude
toward this disease could be tragic.


I urge you to issue a press release immediately correcting the
misconception that all Lyme disease is easy to diagnose and easy to
treat, or may not require treatment, and restate the actual conclusion
of your paper.


Sincerely,

Thomas E. Forschner,
Executive Director


cc:

Editor <Comments@massmed.org>
New England Journal of Medicine
10 Shattuck St.
Boston, MA, 02115-6094


Emily Tsao,
Associated Press
55 Farmington Ave.
Hartford, CT 06105
860-246-6876


Ellen Freeman,
New York Times
229 West 43rd St
New York, NY 10036-3959
212-556-1234


Dr. Duane Gubler,
Centers for Disease Control & Prevention
Box 2087
Fort Collins Co 80522-2087


Dennis Dixon,
National Institutes of Health
6003 Executive Blvd. Rm 3A06
Rockville, MD 20852-3823



=====*=====


IV.   INT J FOOD MICROBIOL: Borrelia burgdorferi: Another Cause of
     Foodborne Illness?
------------------------------------------------------------------
AUTHORS: Farrell GM  Marth EH
REFERENCE: Int J Food Microbiol 1991 Dec;14(3-4):247-60
ABSTRACT:


Borrelia burgdorferi was identified as the etiological agent of Lyme
disease in 1982.  This Gram-negative spirochete is classified in the
order Spirochaetales and the family Spirochaetaceae.  The pathogen
is fastidious, microaerophilic, mesophilic and metabolises glucose
through the Embden-Meyerhof pathway.  A generation time of 11 to 12 h
at 37 degrees C in Barbour-Stoenner-Kelly medium has been reported.
Lyme disease, named after Lyme in Connecticut, is distributed
globally.  It is the most commonly reported vector-borne disease in
the United States, where the incidence is highest in the eastern and
midwestern states.  Since establishment of national surveillance in
1982, there has been a nine-fold increase in the number of cases
reported to the U.S. Centers for Disease Control.  The deer tick of
the genus Ixodes is the primary vector of Lyme borreliosis.  The tick
may become infected with B. burgdorferi, by feeding on an infected
host, at any point in its 2-year life cycle which involves larval,

nymphal and adult stages.  The infection rate in deer ticks may be
as high as 40% in endemic areas.  The primary vertebrate reservoirs
for Ixodes are the white-footed mouse (Peromyscus leucopus) and the
white-tailed deer (Odocopileus virginianus).  Dairy cattle and other
food animals can be infected with B. burgdorferi and hence some raw
foods of animal origin might be contaminated with the pathogen.  
Recent findings indicate that the pathogen may be transmitted orally
to laboratory animals, without an arthropod vector.  Thus, the
possibility exists that Lyme disease can be a food infection.
In humans, the symptoms of Lyme disease, which manifest themselves
days to years after the onset of infection, may involve the skin,
cardiac, nervous and/or muscular systems, and so misdiagnosis can
occur.



=====*=====


V.    ABOUT THE LYMENET NEWSLETTER
----------------------------------
For the most current information on LymeNet subscriptions,
contributions, and other sources of information on Lyme disease,
please refer to the LymeNet Home Page at:
                  http://www.lymenet.org
-----------------------------------------------------------------------
To unsubscribe from the LymeNet newsletter, send a message to:
                   listserv@lehigh.edu
On the first line of the message, write:  unsub lymenet-l
-----------------------------------------------------------------------
LymeNet - The Internet Lyme Disease Information Source
-----------------------------------------------------------------------
Editor-in-Chief: Marc C. Gabriel <a229@Lehigh.EDU>
           FAX (for contributions ONLY): 908-789-0028
Contributing Editors: Carl Brenner <cbrenner@postoffice.ptd.net>
                     John Setel O'Donnell <jod@Equator.com>
                     Frank Demarest <76116.2065@CompuServe.com>
Advisors: Carol-Jane Stolow, Director <carol_stolow@lymenet.org>

         William S. Stolow, President <bill_stolow@lymenet.org>
         The Lyme Disease Network of New Jersey
-----------------------------------------------------------------------
WHEN COMMENTS ARE PRESENTED WITH AN ATTRIBUTION, THEY DO NOT
NECESSARILY REPRESENT THE OPINIONS/ANALYSES OF THE EDITORS.
-----------------------------------------------------------------------
THIS NEWSLETTER MAY BE REPRODUCED AND/OR POSTED ON BULLETIN BOARDS
FREELY AS LONG AS IT IS NOT MODIFIED OR ABRIDGED IN ANY WAY.
-----------------------------------------------------------------------
SEND ALL BUG REPORTS TO a229@Lehigh.EDU
-----------------------------------------------------------------------


Home | Flash Discussion | Support Groups | On-Line Library
Legal Resources | Medical Abstracts | Newsletter | Books
Pictures | Site Search | Links | Help/Questions
About LymeNet


© 1994-1999 The Lyme Disease Network of New Jersey, Inc.
All Rights Reserved.
Use of the LymeNet Site is subject to the Terms of Use.