Four Factors Required To Prevent Lyme Disease

Prevention of Lyme disease depends on 4 factors:  preventing tick bites, removing the ticks and prophylactic treatment with antibiotics if you have been bitten by a tick and finally it is important to maintain a healthy immune system.

1.   Prevent Tick Bites

 Wear Protective Clothing

Prevention of Lyme disease involves efforts to prevent tick bites. If walking or tramping in endemic areas, it is important to wear protective clothing such as long-sleeved shirts, hats, and long pants tucked into long socks and/or tramping boots. Check carefully for ticks not only when you get home but frequently while still outside.

Have a Shower and Change Clothes

My sister and brother-in-law, who live in a high-risk Lyme-bearing tick area in California, advise their visitors to have a shower and wash their hair ASAP after a walk or hike or other activities on their land or in their area. They live on a rural block in Salmon Creek where deer roam widely.

They also advise that you check for ticks regularly and to have someone check your back for ticks.  Don't put same clothing on after shower because ticks can hide in the fabric.  They recommend washing your clothes worn on the hike including underwear because ticks can hide in the clothing and bite later.

Either wash clothes or at least put them through a drier because ticks are intolerant to being dried out.

Insecticides

Also, apply insecticides on the skin and/or on the outside of clothing to prevent ticks attaching. For example permethrin or DEET, a slightly yellow oil intended to be applied to the skin or clothing, provides protection against all sorts of biting insects including ticks. For a more natural insecticide use oil of lemon eucalyptus which also repel ticks

Pesticides

Pesticides can also be used to reduce tick numbers in scrub in endemic areas. Products meant for widespread application such as permethrin and its derivatives are preferred. They are available as a liquid concentrate and as granules. If liquid insecticides are used, application should be by fogging, not by coarse sprays. Apply these products in a strip a few feet wide at the perimeter of the lawn at any areas adjacent to woods and underbrush. Also treat any ornamental shrubs near the house that may serve as a habitat for small animals. The best time to apply these products is in late spring and early fall. In every case, professional application is recommended.

Keep the area around your home clear of rubbish

At home remove wood piles, rock walls, and bird feeders as these attract tick-carrying small animals and can increase the risk of acquiring Lyme

Ensure live-stock and pets are treated for ticks as well. Check that pets don’t bring ticks into the house by examining them for ticks if they have been to an endemic area. If you live in the bush, fence off an area around your home so that deer etc. cannot roam too close and ensure you have a suitable rodent eradication program.

Reduce the Natural Reservoir

A community can reduce the incidence of endemic Lyme disease by reducing the numbers of the animals which act as a natural reservoir on which the ticks depend, such as rodents, other small mammals, and deer. Even though deer ticks acquire Lyme disease pathogens from rodents rather than from the deer themselves, Lyme and all other deer tick-borne diseases can be prevented on a regional level by reducing the deer population on which the ticks depend on for their reproductive life cycle.

2.   Removal of Ticks

Ticks must be removed as soon as you notice a bite because the risk of   transmission of Lyme disease increases with the duration of tick attachment. Remember, the sooner the tick is removed, the less likely it is that you will develop and infection.

Most publications suggest that for Lyme disease to be transmitted the tick needs to be attached for 36 to 48 so that the infectious agent has time to travel from within the tick into its salivary glands. Ticks that have been attached that long will be engorged and full of blood. Some say that if a tick is attached for less than 24 hours, infection is unlikely.

However ILADS suggests that transmission may take place in as little as 4 hours of attachment.

The problem is that many people do not realise they have been bitten due to the small size of the nymphs and the analgesic effect of the bite itself, so removal is not an option. The tick eventually drops off after feeding is completed.

Ticks can be removed with tweezers. The best method is to pull the tick out with tweezers as close to the skin as possible. DO NOT twist, crush or squeeze the body of the tick as this may cause the tick to inject more bacteria into the wound. Also be careful not to accidently remove the body leaving the head still attached. It is a good idea to apply a local antiseptic to the area once the tick is removed.

Tape the tick to a card and record the date and location of the bite so it can be used later in diagnoses.

Warning: The Australian Society of Clinical Immunology warns of the dangers of using tweezers especially in people who are allergic to tick bites because you may cause the allergen containing and/or pathogen containing saliva to be injected into the bite. They say the tick should be killed and removed by a medical professional.

3.   Prophylactic Treatment With Antibiotics

There is controversy about prophylactic treatment with antibiotics. Some schools say that if you have removed a blood filled tick then a single dose of doxycycline administered within the 72 hours after removal may reduce the risk of Lyme disease. It is not generally recommended by this school, however, as development of infection is rare. They say that about 50 people would have to be treated this way to prevent one case of infection. Others have a more rigid approach.

IDSA Recommendations

Although routine preventive antibiotic administration is not recommended for individuals with tick bites and no symptoms of disease, the IDSA’s preventative treatment recommendation is that some selected, high-risk tick bites may be treated with a single dose of the antibiotic doxycycline for people who are eligible for the drug. Eligibility criteria for preventive Lyme disease treatment with doxycycline include:

• The attached tick can be reliably identified as an Ixodes scapularis tick that is estimated to have been attached for 36 hours or longer
• Preventive treatment can be started within 72 hours of the time the tick was removed
• Ecologic information indicates that the local rate of infection of these ticks with Borrelia burgdorferi bacteria is 20 percent or greater

ILADS Recommendations

ILADS advises that prophylactic antibiotic treatment (full dose) upon a known tick bite is recommended for those people who fit the following categories:

• People at higher health risk bitten by an unknown type of tick or tick capable of transmitting Borrelia burgdorferi, e.g., pregnant women, babies and young children, people with serious health problems, and those who are immune-deficient.
• Persons bitten in an area highly endemic for Lyme Borreliosis by an unidentified tick or tick capable of transmitting B. burgdorferi.
• Persons bitten by a tick capable of transmitting B. burgdorferi, where the tick is engorged, or the attachment duration of the tick is greater than four hours, and/or the tick was improperly removed. This means when the body of the tick is squeezed upon removal, irritated with toxic chemicals in an effort to get it to back out, or disrupted in such a way that its contents were allowed to contact the bite wound. Such practices increase the risk of disease transmission.
• A patient, when bitten by a known tick, clearly requests oral prophylaxis and understands the risks. This is a case-by-case decision.

Note: The physician cannot rely on a laboratory test or clinical finding at the time of the bite to definitely rule in or rule out Lyme disease infection, so must use clinical judgment as to whether to use antibiotic prophylaxis. Testing

the tick itself for the presence of the spirochete, even with PCR technology, is helpful but not 100% reliable.

ILADS believe that an established infection by B. burgdorferi can have serious, long-standing or permanent, and painful medical consequences, and be expensive to treat. Since the likelihood of harm arising from prophylactically administered anti-spirochete antibiotics is low, and since treatment is inexpensive and painless, it follows that the risk benefit ratio favors tick bite prophylaxis.

4.   Maintain a Healthy Immune System

The key to preventing Lyme disease from becoming chronic is having a strong immune system. People with a healthy immune system generally have minimal symptoms at initial infection and never develop chronic disease. Have a good diet, plenty of sleep and exercise.

Find out more about "What Is Lyme Disease" 

Is Lyme Disease Present in Beautiful New Zealand (NZ)?

I recently returned home to NZ the land of my birth and the country where I studied and practised most of my Microbiology. As I wondered through the beautiful bushland, farmlands, forests and country side I thought I had better update my knowledge about Lyme disease in NZ. In my days working in medical labs in NZ we certainly did not test for it and it was not recognised as a cause of concern. But has the situation changed?

Apparently not, because the Ministry of Health in NZ is not aware of any cases of people catching a disease from a tick bite in New Zealand. They state that the main diseases of concern in some other countries are not currently present in New Zealand. In some countries ticks have transmitted diseases such as: Theileriosis, caused by a protozoan pathogen (Theileria sp.); Lyme disease, caused by Borrelia bacteria, and Spotted fever, caused by Ricketsia bacteria.

The Ministry of health in NZ reiterates that these diseases are NOT actually present in NZ at the current time. So the risk of getting a disease from a tick bite in New Zealand is therefore very low, but there is the potential for this to change – for example, if disease carrying ticks arrive on travellers to New Zealand who have been in countries where they are present.

In NZ, the only cases of Lyme disease have been reported in people that have recently travelled from an endemic area.

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Ticks in NZ

New Zealand has endemic ticks which are native to NZ. They are found in NZ and nowhere else in the world. These species are host-specific and infest mainly birds. Endemic NZ ticks generally do not transmit diseases to humans. Ticks native to NZ are not thought to carry the Borrelia spp bacteria that causes Lyme disease.

However there are also introduced species of tick in NZ – the brown cattle tick (Haemaphysalis longicornis), which can infest warm-blooded mammals (such as cattle or humans). In some parts of the world the cattle tick is known as vector of animal and human diseases, such as tick borne fever, Japanese (Oriental) spotted fever, Russian spring-summer encephalitis. However, these diseases are not present in NZ.

The ticks found in NZ definitely have the ability to transmit pathogens, such as bacteria, protozoa and viruses. Fortunately, these tick borne pathogens are rare in NZ. However, since travellers could introduce tick borne diseases to NZ, there is a small risk that the ticks currently present in NZ could spread introduced diseases.

To date there is no evidence of Lyme disease borne endemically NZ. This land of All Blacks, sheep and hobbits is not yet the home of Lyme disease. But like everything else bad in this tiny land of glory (rats, possum, plant diseases) it could be introduced and medics need to be on the alert for emerging diseases.

Can Chronic Lyme disease or MSIDS be Cured with a 16 Point Plan?

Dr Horowitz who has treated thousands of patients for chronic Lyme disease has come up with a  16 point map for diagnosing and treating people with chronic Lyme disease, which he refers to as  MSIDS (refer to my previous post on this). MSIDS is a term which is not yet accepted by mainstream medical practitioners.

According to Dr Horowitz, MSIDS stands for Multiple Systemic Infectious Diseases Syndrome. He believes that chronically ill, complex patients, no matter which diagnosis they have, often have simultaneous multiple bacterial, parasitic, viral, and fungal infections which complicate their illnesses and the diagnosis of that illness.

He also believes that these people have associated immune dysfunction, large environmental toxin loads, hormonal disorders, mitochondrial dysfunction, allergies, functional metabolic abnormalities, sleep problems, and underlying psychological disorders. All these conditions need to be assessed and treated in order to get a full recovery.

In order to cure these complex cases Dr Horowitz has devised a 16 point MSIDS map model which systematically identifies and treats all the related conditions associated with the chronic infection. The MSIDS map looks at and treats the 16 simultaneous reasons why these patients are suffering and not getting better with traditional treatment. Many patients suffer from many overlapping factors identified in the map and this of course complicates the clinical symptoms and diagnosis of the illness.

He has used his model to successfully cure people suffering from chronic illnesses which to date have been diagnosed as some sort of non-specific condition such as CFS Chronic Fatigue Syndrome. He reports he has already had huge success treating patients with these conditions.

His 16 point differential diagnostic map and treatment plan goes into more detail in his book: "Why Can't I Get Better". He advocates that each point in his plan is investigated step by step. If the patient is suffering from symptoms related to the step, then treat the underlying cause and then move to the next step. The 16 steps he discusses in his book are:

1.    Lyme and co-infections

2.    Immunity

3.    Inflammation

4.    Environmental toxins

5.    Nutrition

6.    Mitochondria

7.    Endocrine system

8.    Neuro-generative disorders

9.    Mental state

10.  Sleep

11.  Autonomic nervous system and POTS

12.  Allergies

13.  Stomach issues

14.  Liver

15.  Pain

16.  Exercise

He has proven that his model can be applied to individuals with complex chronic medical disorders, to help solve the mystery of their illness, as well as providing treatment options that have not been available before. His goal in presenting the MSIDS map is to offer sufferers a broad based solution for Lyme disease and the related co-infections that provides a bridge for the two opposing medical groups (IDSA and ILADS) so that they can join together and help all of these patients.

Click here to find out more about these controversial theories 

Dr Horowitz believes that people with chronic conditions such as Lyme disease, CFS, fibromyalgia, multiple sclerosis, rheumatoid arthritis, and Lupus etc would all benefit from a treatment plan using his 16 point map model. All these patients have similar symptoms such as have fatigue, trouble sleeping, neurological systems, poor memory, joint and muscle pain, environmental toxins, food sensitivities and allergies, hormonal imbalances and so on. These diseases all mimic each other. It is just that the root cause for each disease has not yet been identified.

He states that the one common denominator for chronic Lyme disease, chronic fatigue, fibromyalgia and other related conditions is inflammation. The MSIDS model is still applicable if you do not have Lyme because it is still the same inflammatory problem at the core. These patients may have the same symptoms whether they have Borrelia or not. If they have not got Borrelia then they have non-Lyme MSIDS. Dr Horowitz has found that the most common infections which cause patients to remain chronically ill are Lyme disease, Babesia, Bartonella and mycoplasma. These can persist despite seemingly adequate therapy.

Dr Horowitz says that if we look at all the medical causes for chronic illness on the MSIDS map, we see that it can be bacterial infections, viral infections, parasitic infections, or a candida/fungal infection, but since Chronic Fatigue Syndrome and Fibromyalgia are heterogeneous states, you may find each person has a different combination of infections, different viruses, different toxins, different hormone imbalances and so on, even though you are labelling it as Lyme disease, MSIDS, non-Lyme MSIDS, CFS fibromyalgia or whatever else it still results in the same or similar symptoms with the same inflammatory pathway causing the symptoms.

Once the infection is treated properly, food sensitivities and allergies removed, mineral deficiencies replaced, hormones rebalanced, inflammation and cytokines decreased, and   patients detoxed using glutathione, they are going to feel a lot better. The key is always going back to the MSIDS map and determining how many overlapping factors may be causing the clinical symptoms of the illness.

Dr Horowitz believes that if we were to apply the 16 point MSIDS map to these chronic patients who do not respond to usual treatment, and see how many abnormalities they have, we might find that each one is different, but if we get them to sleep, take away their food sensitivities, pull out the heavy metals, replace any mineral deficiencies (like zinc), balance their hormones, and adequately treat all the infections which drive inflammation, they will probably feel a whole lot better.

Dr Horowitz plan uses combinations of antibiotics to reduce bacterial load and target all the different forms of the Borrelia infection (cell wall, intracellular, cystic forms, also targeting biofilms). Anti- parasite and anti-viral drugs also need to be given when appropriate. The key is to rotate treatment protocols and use the 16 point plan to reduce inflammation so that antibiotics can be given for a lesser time. Most patients with a history of persistent Lyme symptoms then need to stay on an effective herbal protocol for months to years after traditional treatment protocols or they will relapse.

The MSIDS model ensures that all sources of inflammation are being addressed. Whilst infections clearly play one of the largest roles in keeping people sick, the "sickness syndrome" of fatigue, joint pain, muscle pain, brain fog and mood disorder is primarily due to inflammatory cytokines, and can be caused by multiple overlapping factors on the MSIDS model. 

A patient will not get better unless you can get patients to sleep, clear up the nutritional deficiencies, remove their sensitive/allergic foods, balance their hormones, address their dysautonomia and mitochondrial dysfunction, detoxify them from neurotoxins as well as environmental toxins, and decrease their associated inflammation. All of these are part of the    16 point MSIDS model, which is highly recommend it to any patient with chronic persistent symptoms who has failed traditional therapies.

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.Addressing all 16 points on the map will reduce the symptoms and send the Lyme disease into remission. It is possible to cure early Lyme disease so it is critical seek treatment ASAP if you think you may have it. But chronic Lyme disease is more difficult to cure. However, we live with viruses and bacteria in our bodies all the time and our immune system keeps them in check. It is a matter of finding balance, and getting the infectious load down to a point where your immune system takes over, and keeps these symptoms at bay. 

Click here to find out more about these controversial theories 

What is MSIDS ?

MSIDS is a term put forward by Dr Horowitz to describe the multiple co-infections commonly experienced by patients with Lyme disease. He defines MSIDS as Multi Systemic Infectious Disease Syndrome. The symptoms associated with MSIDS are so variable and mimic so many other diseases that it is difficult to diagnose. It is difficult to determine exactly which infectious agent(s) are responsible for the symptoms.

MSIDS is often misdiagnosed as chronic inflammatory diseases such as Fibromyalgia, Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS) or Polymyalgia Rheumatica. Because the symptoms of these chronic nonspecific illnesses are shared with many other diseases—and because many of these conditions lack a diagnostic test or bio-marker—unraveling which diseases are present can be difficult. Some patients actually receive diagnoses for multiple conditions.

But all these illnesses have one thing in common. They all cause chronic pain and fatigue; they all affect multi-organs and they all can be triggered by an infection. Each of these disease has the same inflammatory cytokines processes and inflammation is the number one cause of these chronic illness. Dr Horowitz talks about the THREE I's – Infection, Inflammation and Immune dysfunction as the trigger for the symptoms associated with MSIDS as well as these other chronic diseases.

Or does the initial infection cause an abnormal immune response which sets up an auto-immune like reaction and/or allows opportunistic infections to establish and cause the symptoms described as MSIDS? Persisting Lyme disease and co-infections suppress the immune system and leave the body vulnerable to infection with opportunistic pathogens. Other factors can also play a role in suppressing our immune response.

It has been suggested by some that the name MSIDS be attributed to all of these related diseases. Some researchers have shown that long term antibiotic therapy for Lyme disease has significantly improved the symptoms of people suffering from these chronic diseases and the question therefore has to be asked is: "are these diseases related and do they have a root cause such as Borrelia which are then complicated by co-infections such as described in Lyme disease?"

So how are all these diseases similar? Below is a description of each of the chronic diseases. You can see that they all seem to have very similar and related symptoms which definitely makes you think that perhaps they are all related to MSIDS – perhaps in time a common denominator will be found as suggested above and the root cause can then be treated and/or controlled to bring relief to the sufferers of these very debilitating chronic diseases?

• Fibromyalgia 
• Myalgic Encephalomyelitis (ME), Chronic Fatigue Syndrome (CFS) 
• Polymyalgia Rheumatica 
• MSIDS - Co-Infections with Lyme Disease 

To find out more about Lyme Disease click on this link


Fibromyalgia is a condition in which people describe symptoms that include widespread pain and tenderness in the body, often accompanied by extreme fatigue, cognitive disturbance, increased responsiveness to sensory stimuli such as cold, heat and light, problems with sleep and emotional distress. The symptoms of fibromyalgia can vary from mild to severe. The cause is unknown but like the other diseases in this group it is thought that among other things it could be triggered by an initial infection, injury, allergy, stress or substance abuse. Fibromyalgia can be very difficult to diagnose as it does not cause any inflammation or damage, but testing can eliminate other causes.

Myalgic encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS), also known chronic fatigue and immune dysfunction syndrome (CFIDS), is a complex and debilitating chronic disease with a serious impact on one’s quality of life. On Feb. 10, 2015, the Institute of Medicine released a landmark report that contained a series of recommendations for ME/CFS, one of which called for the name to be changed to Systemic Exertion Intolerance Disease (SEID). This name has not yet been formally adopted by world and federal health agencies yet.

M.E. is a neurological disease which is a debilitating and complex disorder characterized by intense fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. It results from an injury to the Central Nervous System and may be triggered by an infectious disease such as a viral infection, or by chemicals which over stimulate the immune system. M.E. is a multi-system disease, affecting not only the neurological system but also the immune, musculoskeletal, endocrine (hormonal) and cardiovascular systems.

It causes a range of symptoms including post exertional malaise, unrefreshing sleep, concentration problems and pain in muscles, joints and headaches.

M.E. may or may not be the same as CFS (Chronic Fatigue Syndrome). This is because there are currently 10 different interpretative criteria for CFS, some with a psychiatric and others with an immunological specification. If the CFS criteria used involves damage to the Central Nervous System, then it could well be the same disease as M.E. Other CFS criteria used, especially the Oxford criteria, focus on patients whose fatigue could be of psychiatric origin and this is not M.E.

The term CFS can be harmful as a label to M.E. sufferers because it can exclude pathological findings. Sometimes, however, researchers and medical staff use the term CFS to mean M.E. So the situation is unacceptably confusing. M.E. is a more specific name implying the pathology which has been found in association with the disorder.

Polymyalgia rheumatica is a rheumatic disorder associated with moderate-to-severe musculo-skeletal pain and stiffness in the neck, shoulder, and hip area.. Stiffness is most noticeable in the morning or after a period of inactivity. This disorder may develop rapidly; in some people it comes on literally overnight. But for most people, polymyalgia rheumatica develops more gradually.

The cause of polymyalgia rheumatica is not known. But it is associated with immune system problems, genetic factors, and an event, such as an infection, that triggers symptoms. The fact that polymyalgia rheumatica is rare in people under the age of 50 and becomes more common as age increases, suggests that it may be linked to the aging process. Polymyalgia rheumatica usually resolves within 1 to several years.

Like the other diseases described above, Lyme disease can affect any part of the body and cause many different symptoms. The commonest symptoms relate to the person feeling unwell, having flu-like symptoms, extreme tiredness, muscle pain, muscle weakness, joint pain, upset digestive system, headache, disturbances of the central nervous system and a poor sleep pattern. In some cases a characteristically shaped, expanding ‘bull’s eye’ rash appears on the skin.

Many patients who suffer from Lyme disease, are also infected with a host of associated tick-borne infections, such as Borrelia hermsii (relapsing fever), Babesia, Bartonella, Mycoplasma, Chlamydia, Rocky Mountain spotted fever, Q-fever, Ehrlichia or Anaplasma. Rarely, patients also have Tularemia and Brucellosis. To see Borrelia burgdorferi by itself is unusual.

This collection of bugs and associated illness explains why the standard treatment protocol (consisting of 30 days antibiotic therapy) doesn't offer the cure for most sufferers. Detoxification, hormone balancing, heavy metal removal and ramping up immune function are equally important.

Dr. Horowitz has come up with holistic approach, a 16 step road map, for treating Lyme disease, other tick borne illness, related co-infections and offers insight into the root causes for the chronic illnesses described above. I will discuss his road map to recovery in my next blog.

WHAT ARE THE CO-INFECTIONS ASSOCIATED WITH LYME DISEASE ?

As well as transmitting Lyme disease to people, when ticks bit you they often also transmit other diseases which are referred to as co-infections.  Co-infections exacerbate Lyme disease symptoms as well as exhibit symptoms of their own. Concurrent infections frequently occur.

Most people who have Lyme disease tend to suffer from one or more co-infections as well. Ticks carry several other infectious micro-organisms in addition to the Borrelia bacteria that cause Lyme disease. These co-infections include Babesia, Bartonella, Rickettsia, Ehrlichia, Mycoplasma and HGA.

Co-infections are relatively common when you have Lyme disease. A recently published Lyme disease organisation surveyed over 3,000 patients with chronic Lyme disease and found that over 50% had at least one coinfections and 30% of those people had two or more coinfections. The most common coinfections were Babesia (32%), Bartonella (28%), Ehrlichia (15%), Mycoplasma (15%), Rocky Mountain Spotted-Fever (6%), Anaplasma (5%), and Tularemia (1%).

Co-infections complicate both the diagnoses and the treatment of Lyme disease.  The organisms which cause co-infections cause their own set of symptoms and some like Rocky Mountain Spotted-Fever cause primary symptoms and others such as some Mycoplasma species are opportunistic pathogens which wait until the immune system is damaged by Lyme disease before they are able to establish themselves and cause symptoms.

However, the importance of identifying and treating polymicrobial infections is critical in getting a patient well. Many of the organisms causing the co-infections require alternative antibiotics to cure them. The existence of these co-infections may explain why some people with Lyme disease remain chronically ill even after treatment. Doctors should consider co-infections in the diagnosis when a patient’s symptoms are severe, persistent, and resistant to antibiotic therapy. 

Babesia

Babebiosis is a parasitic infection, a protozoa belonging to the genus Babesia, which affects the red blood cells similar to a malarial parasite. It is transmitted through the bite of a deer tick. People who contract Babebiosis suffer from malaria-like symptoms. As a result, malaria is a common misdiagnosis for the disease.

Bartonella

Bartonella are bacteria which cause a disease known as bartonellosis. Bartonellosis is usually a mild, acute, and self-limiting illness. Early signs of bartonellosis include fever, fatigue, headache, poor appetite, and an unusual streaked rash that resembles stretch marks during pregnancy. ( see picture) Swollen glands are typical, especially around the head, neck and arms and many have neurological symptoms including psychiatric manifestations. 

Rickettsia

Rickettsia are very small intra-cellular bacteria which require a host cell in order to survive. Rickettsia species are carried by many vectors such as chiggers, lice, fleas and ticks. They cause a wide variety of diseases in humans, including typhus fever, rickettsial-pox, Boutonneuse fever, African tick bite fever, Rocky Mountain spotted fever, Flinders Island spotted fever and Queensland tick fever. Several different species of Rickettsia have been identified as causing infection. Rickettsial infections are classified into three groups, Spotted fever; Typhus; and Scrub typhus (Now reclassified as a new genus – Orientia) 

Ehrlichia

Ehrlichia are small, gram-negative bacteria. The two known primary agents of human Ehrlichiosis are Ehrlichia chaffeensis which typically invades mononuclear phagocytes, such as monocytes and macrophages, causing Human Monocytic Ehrlichiosis (HME); and Ehrlichia ewingii which invade neutrophils causing Human Ewingii Ehrlichiosis (HEE)

Typically Ehrlichiosis strikes older people probably due to immunological host factors but severe and even fatal cases have also been reported in children and young adults. Most patients develop symptoms 1-2 weeks after the tick bite, and over 70% will have fever, chills, severe headache and myalgia. Less common symptoms include nausea and vomiting, as well as confusion. A rash can also occur. As with many other tick-borne diseases, the symptoms are largely non-specific, thus confounding diagnosis.

Mycoplasma

Mycoplasma are very small intra-cellular bacteria which lack a cell wall and has to live within a host cell in order to replicate. The type species, Mycoplasma pneumoniae, which causes atypical pneumonia. In one study, as many as seventy five percent of Lyme patients also have a Mycoplasma infection, which suggests that Mycoplasma is the number one cause of co-infections with Lyme disease, surpassing Bartonella and Babesia. 

Like other tick borne infections the symptoms can vary and include night sweats, fibromyalgia, fatigue, headaches, fevers, memory loss, skin rashes, diarrhea, abdominal bloating, depression, and bronchitis as well as serious neurological manifestations. 

Human Granulocytic Anaplasmosis (HGA)

HGA is a tick-associated disease caused by a species of bacteria called Anaplasma phagocytophilum which affect the white blood cells specifically the neutrophils. 

The clinical course of HGA varies widely, ranging from asymptomatic infection to fatal disease. The most common symptoms are headache, fever, chills, muscle pain and fatigue similar to the symptoms of influenza. The person has a low white cell count and a low platelet count. Gastrointestinal symptoms are seen in less than 50% of the patients and a skin rash is noticed in only about 10% of the patients.

Chronic Viral Infections and Opportunistic Pathogens

Whilst not transmitted by ticks, chronic viral infections such as herpes, HHV-6, CMV, and EBV, may become active in the chronic patient, due to their weakened immune response.

Opportunistic pathogens may also become infective if a person has a weakened immune system. An opportunistic pathogen is a microbe which would not normally cause an infection but can do so if conditions in the body become favourable for it to invade.

Chronic Yeast Infections

Because patients with chronic Lyme disease have weakened defences, and are taking long term antibiotics which wipes out their normal flora they are prone to develop an overgrowth of yeast usually Candida albicans. This often begins in the mouth or vagina, and then spreads to the intestinal tract..

 

To find out more read my book "What is Lyme Disease?" You can currently borrow it from Amazon. 

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14 Facts About Lyme Disease

ILADS recently published these statistics and facts about Lyme disease:

1)      According to the CDC, LYME DISEASE is the fastest growing vector-borne infectious disease in the USA.  

2)      The number of cases reported annually has increased 25 times since national surveillance began in 1982

3)      There are 5 subspecies of BORRELIA BURGDORFERI; over 100 strains in the USA, and 300 strains worldwide.

This diversity is thought to contribute to its ability to evade the immune system and antibiotic therapy, leading to chronic infection. It could also be why the tests for Lyme disease are so unreliable.

4)      CDC reports: Lyme disease infects 300,000 people in the USA per year. This is 10 times more Americans than previously reported.

This new preliminary estimate confirms that Lyme disease is a tremendous public health problem in the United States,” says Dr. Paul Mead, chief of epidemiology and surveillance for CDC’s Lyme disease program.

5)      NEW LYME DISEASE CASES IN USA (CDC ESTIMATE)

Cases per month: 25,000
Cases per week: 5,770
Cases per day: 822
Cases per hour: 34

6)      There are no accurate tests available to indicate that the patient is cured or if the organism has been eradicated from the body

7)      Fewer than 50% of patients with Lyme disease recall a tick bite

8)      Fewer than 50% of patients recall any rash

9)      The ELISA SCREENING TEST is unreliable.

The common Elisa test you receive at your doctor's office misses 35% of culture proven Lyme disease. Some studies indicate up to 50% of the patients tested for Lyme disease receive false negative results.

10)   Up to 50% of  TICKS in Lyme endemic areas are infected

11)   The onset of Lyme disease symptoms can be easily mistaken for other illnesses. Once symptoms are more evident the disease may have already entered the central nervous system, and could be hard to cure.

12)   About 40% of LYME PATIENTS end up with long term health problems

13)   The average patient sees 5 doctors over nearly 2 years before being diagnosed

14)   SHORT TREATMENT COURSES  have resulted in  upwards of a 40% RELAPSE RATE, especially if treatment is delayed

There has never been a study demonstrating that 30 days of antibiotic treatment cures chronic Lyme disease. However there is much documentation demonstrating that short courses of antibiotic treatment fail to eradicate the spirochete which causes Lyme disease.

To find out more about the controversies surrounding Lyme disease CLICK HERE 

Why is Lyme disease not officially recognized by authorities in Australia?

Lyme disease syndrome has been reported in Australia since 1982 (Hunter Valley, NSW) and yet the authorities still do not recognize that it is endemic in Australia and it is not recognized as a notifiable disease in Australia. However The Australian Government is monitoring Lyme disease, in consultation with the states and territories, through the Communicable Diseases Network Australia. The public health department set up a Clinical AdvisoryCommittee on Lyme Disease (CACLD). They reported back in July 2014 that there were 2 schools of thought about whether Lyme existed in Australia:

1.       Those who believe that an indigenous form of Lyme disease exists in AustraliaT
2.     Those who are not prepared to exclude the existence of an indigenous form but who require proof of its existence. Proof would be in the form of  identifying and characterising the causative microorganism; and also  identifying the indigenous blood feeding vector

Following on from that the University of Sydney, Departmentof Medical Entomology conducted a survey to ascertain whether Lyme disease occurs in the southern hemisphere in general, and in Australia in particular.

Is there atick vector of Lyme disease in Australia?

Problems with Diagnosis.

Some of the skepticism around Lyme disease in Australia is because of the difficulty in diagnosing the disease and the general controversy around which tests are best to use.

Serological testing using current methods to detect antibodies against Lyme disease are acknowledged to have limitations due to the general lack of sensitivity and specificity.  Serological tests can give false negative results especially in the early stages of the disease and because of the degree of cross reactivity of the Borrelia sp. The percent of false positive results is very high. A two tiered approach is adopted by most countries which uses the ELISA test as a screening test and positives are then followed up with the more specific Western Bloc technique.

In Australia this testing regimen is further complicated because there has been no isolation of the causative organism of Lyme disease in Australia so the antigen used in the testing to date if from the USA and Europe and may not be suitable for Australian conditions. But until the causative organism has be isolated in Australia the test using overseas antigens may not be sensitive or specific enough.

The sensitivity of serological testing for Lyme disease depends on the strain of Borrelia used in the testing and this affects results in Australia, where no local spirochete has been isolated for use as a reference antigen. This means that testing is done using.  North American and European strains of Borrelia which may not be suitable for Australian testing.

 Members of the Advisory Committee were pushing for Australian testing capability to focus more on the detection of the causative agent itself, either by cultural techniques or by detecting the causative organisms' DNA using nucleic acid amplification techniques.

In Australia, not all labs have the capability nor accreditation required to test for Lyme disease and results of the same blood being sent to various labs come up with different results many. Many pro Lyme doctors send the samples overseas for testing.

Over the past 6 years there has been an increase in serological testing for Lyme disease in Australia. However most patients request the test themselves on the basis of tick exposure and symptoms which suggest Lyme disease such as myalgia, arthralgia without objective evidence of joint disease, neurological symptoms such as frequent headaches, inability to concentrate and impairment of memory, and syndromes resembling chronic fatigue syndrome. Some have positive screening serology but many have not been confirmed with a more specific western bloc test.

None of the testing on local patients done at Westmead hospital who were positive for Lyme disease screening tests done in Australia to date have produced results that conform with internationally accepted criteria for a positive Western Bloc test. The positive screening tests are likely to be due to cross reactivity, or maybe due to the fact that the "Australian antigen" has not yet been isolated and used in testing. 

However these false positive screening tests casts doubt on whether Lyme disease has been confirmed in Australia. The diagnosis of Lyme disease outside of known endemic areas cannot be based solely on serological tests especially when they fail to conform with internationally accepted criteria, because of the high incidence of false positive results.

Problems with identifying typical skin rash, and clinical diagnosis

A few cases of Erythema Migrans rash have been reported from South-Eastern Australia. However, diagnosis can be confusing because of the erythematous hypersensitivity reaction to the bite of I. holocyclus, the most common tick biting humans.  There has been no isolation of Borrelia from skin lesions of local Australian patients. 

A clinical diagnosis in a non-endemic disease area especially in the later stages, is difficult to support without isolation of the causative agent from the patient, from other patients with similar illness or from a known vector in the region. So until diagnosis is confirmed with "concrete" evidence the symptoms of Lyme disease will not be recognized in Australia.

The proponents of long term infection and the existence of dormancy rely on the acceptance of specific bacterial pleomorphism for Borrelia species

Problems with treatment

The advisory committee say that the development of an Australian treatment protocol rests on an accepted diagnostic pathway plus a clinical evaluation of the patients with long term manifestations after an initial diagnosis of Lyme disease in Australia. It is not currently possible with the available diagnostic assays, including nucleic acid amplification assays, to determine if long term infection and disease exists in Australia. 

Vector and reservoir host Investigations – Australia

No ticks of the I. persulcatus complex which are the principal vectors of Lyme disease to humans in the northern hemisphere and in Eurasia, occur in Australia.  However, a possible vector which could transmit Lyme disease from its natural reservoir to humans has been identified in Eastern Australia. A species of tick known as I. holocyclus, which has a wide host range, is the most common tick biting humans.  But I. holocyclus, is unable to transmit the North American strain of B.burgdorferi. However the question remains as to whether there is a so far undiscovered Australian spirochete responsible for Lyme disease in Australia.

  

A natural reservoir for Lyme disease has not been identified in Australia. None of the mammal species identified as reservoir hosts in the northern hemisphere are present in Australia. There are reports of spirochetes being isolated from Australian native animals, and a local mammal could be a reservoir host for an Australian spirochete that occasionally infects humans through a tick vector and produces a clinical syndrome similar to Lyme disease; however, no spirochetes were detected in the 12,000 ticks or animals processed in a recent survey.

In this survey of over 12,000 ticks and a handful of native animals, researchers failed to identify Borrelia. Testing was done by 3 methods:

1. 1     Dark field microscopy of the tick's gut content
2. 2.       Culture to  isolate grow the causative organism
3. 3.       Detection of Borrelia genes by PCR technology (the primers were sourced from overseas and may not be specific for Australia.

Summary

The existence of Lyme disease in Australia will remain controversial until an organism is isolated from a local patient and fully characterized, or until a tick-borne organism can be shown to be responsible for the human infection. If it exists it shares few of the epidemiological or clinical characteristics of US or European patterns of Lyme disease. And this is why is Lyme disease is not officially recognized by authorities in Australia.

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