Eyes on the IDSA

Live hearings will be conducted July 30 to review the 2006 guidelines for Lyme and other tick-borne diseases published by the Infectious Diseases Society of America. The review by an impartial panel is the result of a legal agreement between the IDSA and the attorney general of Connecticut, following an investigation into alleged improprieties and conflicts of interest on behalf of the guidelines authors. The panel will hear testimony from clinicians, researchers, and others who espouse various opinions on the proper diagnosis and treatment of tick-borne disease.

The hearings will be made public through a live feed on July 30, 8-5, at http://www.idsociety.org/WorkArea/showcontent.aspx?id=14974 and then will be archived on the IDSA website.

The legal agreement can be found at http://www.ct.gov/ag/lib/ag/health/idsaagreement.pdf

and the press release about the agreement is at http://www.ct.gov/ag/cwp/view.asp?Q=414284&A=2795

This hearing will be the confluence of many current medical issues: conflicts of interest, patients' rights, generalizing research, the weight given guidelines by insurance companies and clinicians, emerging infectious disease, evidence-based medicine, and the standard of care. As the US government looks to improve access to quality healthcare, I hope these issues are reflected on by researchers, clinicians, and legislators alike.

Best Lyme Information of 2008

Happy New Year and Happy Inauguration Day. As I look forward to new and better days, I also looked back to see what information objects had the most impact on the understanding of tick-borne disease. Information can come from many sources: research, discussion, observation, or performance, to name only a few. But when that information is put into a tangible form and is made accessible, it becomes a resource that can be examined over and over again for further insight.

Here, then, are some resources from 2008 that are contributing to our collected knowledge of tick-borne disease and the people who endure it. In no particular order, they are:

http://www.cdc.gov/eid/content/15/1/66.htm?s_cid=eid66_e
Isolation of Candidatus Bartonella Melophagi from Human Blood
The discovery of a new Bartonella infection in humans, indicating that we haven't yet discovered every tick-borne disease there is.

http://jcm.asm.org/cgi/content/abstract/JCM.01183-08v1
Borrelia Carolinensis Sp.Nov. - A New (14th) Member of Borrelia Burgdorferi Sensu Lato Complex from the Southeastern United States
A new Borrelia species that infects humans is discovered.

http://www.pnas.org/content/early/2008/12/05/0810519105.abstract
NKT Cells Prevent Chronic Joint Inflammation after Infection with Borrelia Burgdorferi
An indication that NKT cells may make a difference in inflammation and the disease itself.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)74639-0/fulltext?_eventId=login
Chronic Lyme Disease: The Debate Goes On.
Overview of the unresolved problem of chronic Lyme disease.

http://www.lymerights.org/html/house_debate_on_lyme_bill.html
A heated discussion on the floor of the House about not moving forward on the Lyme bill, HR741.

http://www.ncbi.nlm.nih.gov/pubmed/18971914?dopt=AbstractPlus
Severity of Lyme Disease with Persistent Symptoms
This double-blind placebo-controlled study indicated that treating Lyme for 3 months of oral antibiotics improved the quality of life.

http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppat.1000169
Molecular Mechanisms Involved in Vascular Interactions of the Lyme Disease Pathogen in a Living Host
The discovery of how Lyme bacteria move and anchor themselves to blood vessel walls. Includes charts, images, tables, and videos.

http://www.plospathogens.org/article/fetchArticle.action?articleURI=info:doi/10.1371/journal.ppat.1000090
Real-Time High Resolution 3D Imaging of the Lyme Disease Spirochete Adhering to and Escaping from the Vasculature of a Living Host
The description and images of live, infectious Borrelia burgdorferi spirochetes disseminating in the blood and through mouse tissues. Includes charts, illustrations, images, and videos.

http://www.jneuroinflammation.com/content/pdf/1742-2094-5-40.pdf
Persisting Atypical and Cystic Forms of Borrelia Burgdorferi and Local Inflammation in Lyme Neuroborreliosis
Cyst, round, and granular forms of Borrelia burgdorferi were induced in cultures, rat and human nerve tissue, and found in the brain tissue of humans infected with Lyme disease. Includes images.

http://jcm.asm.org/cgi/reprint/46/9/2856
Bartonella Sp. Bacteremia in Patients with Neurological and Neurocognitive Dysfunction
A study producing evidence that Bartonella may produce chronic symptoms.

http://aac.asm.org/cgi/reprint/AAC.01050-07v1
Persistence of Borrelia burgdorferi Following Antibiotic Treatment in Mice
A mouse study that showed that Lyme bacteria can persist following "adequate" antibiotic treatment.

http://www.ct.gov/ag/lib/ag/health/idsaagreement.pdf
An Agreement between the Attorney General of the State of Connecticut and the Infectious Diseases Society of America
A legal document spelling out a systematic review of the IDSA Lyme treatment guidelines by an impartial panel.

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0001633
Clocking the Lyme Spirochete
Borrelia burgdorferi moves faster than any other spirochets, and faster than the blood cells which kill it.

Cure Unknown by Pamela Weintraub. A book that chronicles the politics behind the discovery, diagnosis, and treatment of Lyme disease.

Under Our Skin
A documentary film showing the severity of Lyme and the controversies involved with treating it.