LymeNet Newsletter Volume 6 Issue 02

Volume: 6
Issue: 02
Date: 18-Feb-98

Table of Contents:

I. AP: 1999 may be year of high Lyme disease risk in Northeast II. J CLIN MICROBIOL: First isolation and cultivation of Borrelia burgdorferi sensu lato from Missouri. III. CLIN DIAGN LAB IMMUNOL: Heat shock protein 70 of the agent of human granulocytic ehrlichiosis binds to Borrelia burgdorferi antibodies. IV. EMERG INFECT DIS: Prevalence of Tick-Borne Pathogens in Ixodes scapularis in a Rural New Jersey County. V. DTSCH MED WOCHENSCHR: Meningitis after acute Borrelia burgdorferi infection in HIV infection. VI. ABOUT THE LYMENET NEWSLETTER

Newsletter:

*********************************************************************** * The National Lyme Disease Network * * http://www.lymenet.org/ * * LymeNet Newsletter * ***********************************************************************

Volume 6 / Number 02 / 18-FEB-98 INDEX

I. AP: 1999 may be year of high Lyme disease risk in Northeast II. J CLIN MICROBIOL: First isolation and cultivation of Borrelia burgdorferi sensu lato from Missouri. III. CLIN DIAGN LAB IMMUNOL: Heat shock protein 70 of the agent of human granulocytic ehrlichiosis binds to Borrelia burgdorferi antibodies. IV. EMERG INFECT DIS: Prevalence of Tick-Borne Pathogens in Ixodes scapularis in a Rural New Jersey County. V. DTSCH MED WOCHENSCHR: Meningitis after acute Borrelia burgdorferi infection in HIV infection. VI. ABOUT THE LYMENET NEWSLETTER

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I. AP: 1999 may be year of high Lyme disease risk in Northeast ----------------------------------------------------------------- By PAUL RECER AP Science Writer DATE: 13-FEB-1998

WASHINGTON (AP) -- A big acorn crop last fall could mean a major outbreak of Lyme disease next year, according to a study that linked acorns, mice and deer to the number of ticks that carry the Lyme disease parasite.

Based on the study, researchers at the Institute of Ecosystem Studies in Millbrook, N.Y., say that 1999 may see a dramatic upswing in the number of Lyme disease cases among people who visit the oak forests of the Northeast.

"We had a bumper crop of acorns this year, so in 1999, two years after the event, we should also have a bumper year for Lyme disease," said Clive G. Jones, a researcher at the Institute of Ecosystem Studies in Millbrook, N.Y. "1999 should be a year of high risk for Lyme disease."

A report on the Lyme disease study will be published Friday in the journal Science.

Lyme disease is caused by a bacterium carried by ticks. The ticks normally live on mice and deer, but they can bite humans. Lyme disease first causes a mild rash, but left untreated can damage the heart and nervous system and cause a type of arthritis. Connecticut and Rhode Island usually report the most cases per capita. The national rate for Lyme disease is 6.2 cases per 100,000 people, compared with nearly 95 cases per 100,000 in Connecticut, and nearly 54 cases per 100,000 in Rhode Island.

Jones, along with researchers at the University of Connecticut, Storrs, and Oregon State University, Corvallis, found that the number of mice, the number of ticks, the deer population and even the number of gypsy moths are linked directly to the production of acorns in the oak forest. "When you get a lot of acorns, you get a lot of white-footed mice," said Jones.

Jones said that in years following a big acorn crop, the number of tick larvae are eight times greater than in years following a poor acorn crop. Additionally, he said, there are about 40 percent more ticks on each mouse.

The researchers tested the effect of acorns by manipulating the population of mice and the availability of acorns in forest plots along the Hudson River. Jones said the work, extended over several seasons, proved the theory that mice and tick populations rise and fall based on the availability of acorns.

For instance, he said, a large crop of acorns occurred in 1994. Two years later, 1996, was the record year for Lyme disease, said Jones.

[...]

Jones said no practicable way exists to lower the risk of Lyme disease by manipulating the natural population swings of mice and ticks. He said this could disrupt other natural cycles in the forest.

Instead, he said, it may be possible eventually to post warnings about the level of Lyme disease risk based on the population of mice.

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II. 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. [email protected] REFERENCE: J Clin Microbiol 1998 Jan;36(1):1-5 ABSRACT:

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.

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III. CLIN DIAGN LAB IMMUNOL: Heat shock protein 70 of the agent of human granulocytic ehrlichiosis binds to Borrelia burgdorferi antibodies. ------------------------------------------------------------------- AUTHORS: Ijdo JW, Zhang Y, Anderson ML, Goldberg D, Fikrig E ORGANIZATION: Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06520-4080, USA. REFERENCE: Clin Diagn Lab Immunol 1998 Jan;5(1):118-120 ABSRACT:

We describe a patient with human granulocytic ehrlichiosis (HGE), a diagnosis confirmed by PCR and immunoblot analysis. Unexpectedly, immunoglobulin G (IgG) directed towards an 80-kDa ehrlichial antigen (without detectable IgM) was present in the patient's serum in the first week of illness. Lyme disease immunoblots were reactive for IgG (but not IgM), a result indicative of prior exposure to the Lyme disease spirochete. Amino-terminal sequencing revealed that the 80-kDa ehrlichial antigen was an HSP-70 homolog similar to Borrelia burgdorferi HSP-70. We conclude that antibodies against B. burgdorferi HSP-70 may cross-react with the ehrlichial heat shock protein and that this possibility must be considered when serologic test results for HGE and Lyme disease are interpreted.

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IV. EMERG INFECT DIS: Prevalence of Tick-Borne Pathogens in Ixodes scapularis in a Rural New Jersey County. -------------------------------------------------------------------- AUTHORS: Varde S, Beckley J, Schwartz I ORGANIZATION: New York Medical College, Valhalla, New York, USA; and Department of Health, County of Hunterdon, Flemington, New Jersey, USA REFERENCE: Emerg Infect Dis 1998 Jan;4(1):97-99 ABSTRACT:

To assess the potential risk for other tick-borne diseases, we collected 100 adult Ixodes scapularis in Hunterdon County, a rapidly developing rural county in Lyme disease endemic western New Jersey. We tested the ticks by polymerase chain reaction for Borrelia burgdorferi, Babesia microti, and the rickettsial agent of human granulocytic ehrlichiosis (HGE). Fifty-five ticks were infected with at least one of the three pathogens: 43 with B. burgdorferi, five with B. microti, and 17 with the HGE agent. Ten ticks were coinfected with two of the pathogens. The results suggest that county residents are at considerable risk for infection by a tick-borne pathogen after an I. scapularis bite.

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V. DTSCH MED WOCHENSCHR: Meningitis after acute Borrelia burgdorferi infection in HIV infection. ----------------------------------------------------------------------- AUTHORS: Dudle G, Opravil M, Luthy R, Weber R ORGANIZATION: Abteilung Infektionskrankheiten und Spitalhygiene, Universitatsspital Zurich. REFERENCE: Dtsch Med Wochenschr 1997 Sep 26;122(39):1178-1180 ABSTRACT:

HISTORY AND CLINICAL FINDINGS: A 39-year-old HIV positive patient developed myalgia, headache and cough 4 weeks after a tick bite. His temperature was 37.4 degrees C and a circular pale erythema was noted over the left lower leg. INVESTIGATIONS: C-reactive protein was raised to 120 mg/l, white blood cell count was 5860/microliter, CD4-lymphocyte count 250/microliter. The chest radiogram showed pneumonitic infiltration in the left lower lobe. There were IgM antibodies against Borrelia burgdorferi. TREATMENT AND COURSE: Left lower lobe pneumonia and chronic erythema migrans were diagnosed and he was given oral azithromycin (500 mg on the first day and 250 mg for 4 days). The pneumonia cleared up, but 2 weeks later he developed symptoms of meningitis (496 cells per microliter, 87% lymphocytes, positive Borrelia burgdorferi antibody titer), which quickly and lastingly responded to ceftriaxon (2 g daily by brief infusion for 14 days). CONCLUSION: This immune-compromised HIV-infected patient developed
disseminated borreliosis with CNS involvement 2 weeks after the occurrence of chronic erythema migrans. The initial treatment of the latter with azithromycin was unable to prevent the meningitis. It is unlikely that there was a causal connection between the borreliosis and the pneumonia.

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