Volume: 6 Table of Contents: I. LYMENET: Burrascano 12th edition of Guidelines Now Available on LymeNet II. NIH: Notice of Call for Nominations for the Director's Council of Public Representatives III. J INFECT DIS: Borreliacidal antibody production against outer surface protein C of Borrelia burgdorferi. IV. ACTA MED AUSTRIACA: Cardiac manifestations of Lyme borreliosis with special reference to contractile dysfunction. V. EPIDEMIOL INFECT: Transmission risk of Borrelia burgdorferi sensu lato from Ixodes ricinus ticks to humans in southwest Germany. VI. ABOUT THE LYMENET NEWSLETTER Newsletter: *********************************************************************** * The National Lyme Disease Network * * http://www.LymeNet.org/ * * LymeNet Newsletter * *********************************************************************** Volume 6 / Number 12 / 14-DEC-98 INDEX I. LYMENET: Burrascano 12th edition of Guidelines Now Available on LymeNet II. NIH: Notice of Call for Nominations for the Director's Council of Public Representatives III. J INFECT DIS: Borreliacidal antibody production against outer surface protein C of Borrelia burgdorferi. IV. ACTA MED AUSTRIACA: Cardiac manifestations of Lyme borreliosis with special reference to contractile dysfunction. V. EPIDEMIOL INFECT: Transmission risk of Borrelia burgdorferi sensu lato from Ixodes ricinus ticks to humans in southwest Germany. VI. ABOUT THE LYMENET NEWSLETTER =====*===== I. LYMENET: Burrascano 12th edition of Guidelines Now Available on LymeNet ------------------------------------------------------------------ Date: December 6, 1998 The 12th edition of Dr. Joseph J. Burrascano's protocol for the diagnosis and treatment of Lyme disease and related tick borne illnesses is now available on LymeNet. The web address for the document is: http://guidelines.LymeNet.org =====*===== II. NIH: Notice of Call for Nominations for the Director's Council of Public Representatives -------------------------------------------------------------------- Date: November 18, 1998 On September 23, 1998, the NIH Director chaired a meeting on public participation in NIH activities (FR Doc. 98-24463 Filed 9-10-98; 8:45 a.m.). At the meeting, 23 individual public participants invited by the NIH discussed future activities and responsibilities of the proposed NIH Director's Council of Public Representatives (COPR), which will serve as a forum for discussing issues and concerns and exchanging viewpoints that are important to NIH policies, programs, and research priorities. The individual participants at the meeting also discussed the processes, mechanisms, and criteria that should be used for identifying appropriate candidates to serve on the COPR. A notice about the creation of the COPR was published in the Federal Register on November 17, 1998 (FR Doc. 98-30695 Filed 11-16-98; 8:45 a.m.). The COPR will help bring to NIH the concerns and interests of the many external publics that have a stake in the agency's activities, programs, policies, and research. In addition to serving as a forum, the COPR will assist the NIH in enhancing the participation of the public in myriad NIH activities that have an impact upon the public, in increasing public understanding of the NIH and its programs, and in bringing important matters of public interest forward for discussion in public settings. The COPR will consist of up to 20 individuals who have an interest in the NIH's mission. The NIH will bring together these individuals from diverse backgrounds approximately twice each year, enabling them to interact directly with NIH leaders on a wide range of programs and issues. In addition to these two meetings annually, the COPR may suggest other activities, subject to approval by the Chair of the COPR, the Director of the NIH. Members of the first COPR will serve one, two, or three-year terms. In subsequent years, members will serve three-year terms. More information is available at: http://www.nih.gov/welcome/publicliaison/frnpublic.htm =====*===== III. J INFECT DIS: Borreliacidal antibody production against outer surface protein C of Borrelia burgdorferi. ------------------------------------------------------------------- AUTHORS: Rousselle JC, Callister SM, Schell RF, Lovrich SD, Jobe DA Marks JA, Wieneke CA ORGANIZATION: Department of Infectious Diseases, Gundersen Lutheran Medical Center, University of Wisconsin-La Crosse, 54601 REFERENCE: J Infect Dis 1998 Sep;178(3):733-41 ABSTRACT: Early Lyme borreliosis sera with significant titers of anti-outer surface protein C (OspC) borreliacidal antibodies were identified. Human anti-OspC borreliacidal antibodies could be either IgM or IgG. Significant concentrations of borreliacidal activity were detected after vaccination of mice with OspC. Detection of anti-OspC borreliacidal activity was dependent on surface expression of OspC by Borrelia burgdorferi isolate 50772. The ability of OspC to induce borreliacidal antibodies in vivo and after vaccination offers another possible explanation for the ability of vaccination with OspC to protect against infection with B. burgdorferi. Furthermore, detection of anti-OspC borreliacidal antibodies, especially IgM antibodies, in early Lyme borreliosis sera provides additional evidence that borreliacidal antibody detection may be useful for the serodiagnosis of early Lyme borreliosis. =====*===== IV. ACTA MED AUSTRIACA: Cardiac manifestations of Lyme borreliosis with special reference to contractile dysfunction. -------------------------------------------------------------------- AUTHORS: Seinost G, Gasser R, Reisinger E, Rigler MY, Fischer L Keplinger A, Dattwyler RJ, Dunn JJ, Klein W ORGANIZATION: Klinischen Abteilung fur Kardiologie, Medizinischen Universitatsklinik Graz, Osterreich. [email protected] REFERENCE: Acta Med Austriaca 1998;25(2):44-50 ABSTRACT: Borrelia burgdorferi infection (BBI) is suggested to be associated with dilated cardiomyopathy (IDC). Stanek et al. were able to cultivate Borrelia burgdorferi (BB) from myocardial biopsy tissue of a patient with longstanding dilated cardiomyopathy. Here we present a study in which we examined the effect of standard antibiotic treatment on the left ventricular ejection fraction (LV-EF) in patients with dilated cardiomyopathy associated with BBI. In this study we assessed the serum (IgG, IgM ELISA; Western Blot) and the history of 46 IDC-patients with specific respect spect to BBI (mean LV-EF: 30.4 +/- 1.3%; measured by cardiac catheterisation and echocardiography--length-area-volume method). All 46 patients received standard treatment for dilated cardiomyopathy: ACE-inhibitors, digitalis and diuretics. 11 (24%) patients showed positive serology and a history of BBI; 9 of these also had a typical history of tick bite and erythema chronicum migrans (ECM) and/or other organ involvement, 2 had no recollection of tick bite or EMC, but showed other BB-associated disorders (neuropathy, oligoarthritis). These 11 patients with BBI received standard antibiotic treatment with intravenous ceftriaxone 2 g bid for 14 days. 6 (55%) recovered completely and showed a normal LV-EF after 6 months, 3 (27%) improved their LV-EF and 2 (18%) did not improve at all. This amounts to 9 (82%) recovery/improvement in the BB-group. The 35 patients who did not show positive serology or a history of BBI did not receive antibiotic treatment. In this group without BBI 12 (26%) showed recovery/improvement following the standard treatment of dilated cardiomyopathy (see above). Our results indicate that BBI could play a decisive role in the development of dilated cardiomyopathy, especially in a geographical region as Graz, where BB is endemic. While aware of the small number of BB-patients in this study, we nevertheless conclude that, in a remarkable number of patients with signs of BBI, dilated cardiomyopathy could be reversed and LV-EF improved upon standard antibiotic treatment. =====*===== V. EPIDEMIOL INFECT: Transmission risk of Borrelia burgdorferi sensu lato from Ixodes ricinus ticks to humans in southwest Germany. ----------------------------------------------------------------- AUTHORS: Maiwald M, Oehme R, March O, Petney TN, Kimmig P, Naser K Zappe HA, Hassler D, von Knebel Doeberitz M ORGANIZATION: Hygiene-Institut der Universitat, Abt. Hygiene und Med. Mikrobiologie, Heidelberg, Germany. [email protected] REFERENCE: Epidemiol Infect 1998 Aug;121(1):103-8 ABSTRACT: The risk of Borrelia burgdorferi infection and the value of antibiotic prophylaxis after tick bite are controversial. In this study, performed in two areas of southwestern Germany, ticks were collected from 730 patients and examined by the polymerase chain reaction (PCR) for B. burgdorferi. To assess whether transmission of B. burgdorferi occurred, the patients were clinically and serologically examined after tick removal and during follow-up examinations. Data from all tick bites gave a total transmission rate of 2.6% (19 patients). Eighty-four ticks (11.3%) were PCR positive. Transmission occurred to 16 (26.7%) of 60 patients who were initially seronegative and could be followed up after the bite of an infected tick. These results indicate that the transmission rate from infected ticks in Europe is higher than previously assumed. Examination of ticks and antibiotic prophylaxis in the case of positivity appears to be indicated. =====*===== VI. 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