Friday, April 4, 2014

Antibiotic Treatment of Arthritis:

The Road Back and MIRA Therapy 

© Liz Schmitz, Georgia Lyme Disease Association, 4.4.14 




Thomas McPherson Brown, MD
1906-1989

When Dr. Thomas McPherson Brown appeared on a television interview with Joan Lunden in 1988, she said that his antibiotic arthritis treatment protocol was “turning the medical world upside down.”  Quietly, he replied, “I’m trying to turn it right side up.” 

Dr. Brown was working at the Rockefeller Institute just before World War II when he discovered something interesting in the joint fluid of an arthritic patient – an ”L-form” bacteria-like agent.  (It was later identified as a cell-wall-deficient organism now known as, mycoplasma.)   Thus, Dr. Brown wondered whether an infection might be causing the woman’s arthritis.  He began treating her and other arthritis patients with low-level doses of the antibiotic tetracycline, later turning to doxycycline and minocycline instead.  Remarkably, he reported that while the antibiotic therapy wasn’t a cure, it was an effective treatment for about 90% of the patients he treated, as long as they "stuck with it." Other medical providers who tried Brown's protocol with their arthritic patients reported similar results. 

As head of the arthritis research program at the Veteran’s Administration, medical consultant to the White House and Dean of Medicine at George Washington University Medical School, Dr. Brown was well-respected.  In fact, because his treatment helped so many, he became so popular among patients that they formed a vocal advocacy group of over 10,000 people.  They were known as "Doctor Brown's Army."  Still (or maybe because of this), he and his antibiotic therapy were sharply criticized by many in the medical community.  Finally, following his death, the results of a National Institutes of Health clinical trial supported Brown’s claims - his treatment protocol was indeed effective.  Over half the patients enrolled in the NIH “Minocycline in Rheumatoid Arthritis” (MIRA) study had improvement in joint pain and swelling.  An even greater number showed objective improvement in their blood test results. 

There have now been more than seven major studies published about Brown's antibiotic arthritis therapy.  Described in the book The Road Back: Rheumatoid Arthritis, Its Cause and Its Treatment, Dr. Brown’s protocol has benefited thousands of suffering people worldwide.  It continues to be used successfully today (often with rave reviews) and not only by arthritis patients, but by people with other inflammatory connective tissue diseases such as lupus, fibromyalgia and scleroderma, as well.  

For more information, visit the website:  http://www.Roadback.org  and read the book The Arthritis Breakthrough by Henry Scammell.

GALDA Note: Since Lyme disease can lead to arthritis, many won’t be surprised to learn that Lyme Borreliosis patients can often be found visiting RoadBack’s online forums and chat rooms.  For more information about Lyme disease, visit Georgia Lyme Disease Association www.GeorgiaLymeDisease.org or visit us on Facebook.

Wednesday, June 5, 2013





© Georgia Lyme Disease Association, www.GeorgiaLymeDisease.org


COMMON LONE STAR TICK IMPLICATED IN

LYME DISEASE BACTERIA FOUND IN SOUTHERNERS


Dr. Clark's Research May Help Millions


For the first time ever, University of North Florida's Dr. Kerry Clark and colleagues reported finding two species of Lyme disease bacteria previously unknown to infect humans, Borrelia americana and Borrelia andersonii, in symptomatic patients living in the Southeastern USA. Importantly, the commonly found lone star tick, formerly believed by many to be incapable of transmitting Lyme disease, was implicated in some of these cases.

The research, published in the May issue of The International Journal of Medical Sciences, is extremely significant for several reasons.  First, only one Lyme bacterial species, Borrelia burgdorferi sensu stricto (Bbss), was previously recognized to cause disease in North America.  Current testing methods and interpretation criteria, designed to detect just one species,  may explain many of the complaints involving the unreliability of Lyme disease tests in the USA.

In addition, the belief  that only black-legged "deer" ticks can transmit Lyme disease has been widely publicized for decades.  Lyme disease risk has been calculated largely based upon the prevalence and infection rate of these "deer" ticks,  Ixodes scapularis.  In fact, Yale University recently released a new Lyme Disease Risk Map funded by a $2.9 million CDC grant which was highly contested by many. (They only tested a total of nine black-legged ticks from a few southern states.)   Yale's map, based solely on "deer" ticks,  shows little risk to people living outside the Northeastern USA.  Clark's findings, together with past studies implicating lone star ticks associated with Lyme disease (Masters, Rawlings, Felz, Feir, etc.), strongly suggest otherwise. 

Dr. Clark and his team identified lone star ticks, Amblyomma americanum,  removed from humans who tested positive for Lyme bacteria, including the species of Borrelia burgdorferi, Bbss, already known to cause the disease in North AmericaSome of the ticks removed from the patients tested positive, too. 

Lone star ticks are the most commonly found species biting humans in the Southeastern United States.  These aggressive ticks are found almost halfway across the nation - from the deep South and as far north as Canada. This groundbreaking research may clarify why so many humans living outside of the Northeastern USA claim they have contracted Lyme disease** regardless of the absence or low prevalence rate of  infected black-legged "deer" ticks. 

The new findings significantly expand the geographic area where Lyme disease should be considered by medical providers and citizens alike.  As Georgia Lyme Disease Association president Liz Schmitz remarked, "If only one percent of these ticks are able to transmit Lyme disease, it poses a tremendous threat to public health because lone star ticks are known to bite humans so frequently."
 
Dr. Clark's work may help millions of chronically ill people living in areas where Lyme disease wasn't previously recognized.  Called The New Great Imitator, Lyme disease is often mistaken for illnesses such as Fibromyalgia, Chronic Fatigue Syndrome, Lupus, Multiple Sclerosis, Rheumatoid arthritis, Lou Gehrig's disease, Parkinson's, ADHD, and even Alzheimer's.

Georgia Lyme Disease Association is proud to have provided both technical assistance and funding in support Dr. Clark's important research.

 ** For decades, public health officials and Lyme disease groups and organizations have heard from thousands of patients living outside known "endemic" areas who claim they and/or their family members contracted Lyme disease with no travel history.  With 715 cases on record, Georgia was the 4th highest state in the nation in CDC-reported Lyme cases in 1989 but reported only 10 by 2010.  Most cases of southern Lyme disease now  go unreported due to the different regional surveillance guidelines used.  Southern cases are often dismissed as "false positives."


New! GALDA campaign to fund the work of Dr. Kerry Clark & colleagues:  Please help us support the ongoing research efforts of  Dr. Kerry Clark by making a tax-deductible donation to GALDA's new fundraising campaign.  GALDA is an all-volunteer, non-profit 501(3)c organization.  All proceeds of this campaign will go directly to support the important work of Dr. Clark and his colleagues.

Five...ten... twenty dollars...every bit helps!  Let's speed up our understanding of Lyme disease by working together to unlock Borrelia burgdorferi's secrets!  Patients and citizens everywhere will benefit.   Thank you for your generosity.  Click here to support this great work.




www.GeorgiaLymeDisease.org
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Thursday, August 30, 2012

Undisclosed Flaws in CDC National Lyme Disease Case Map Limit Chances of Early Diagnosis and Treatment for Southern Patients


Click here to see larger image.

 

by Georgia Lyme Disease Association

Today during Senator Blumenthal's hearing on Lyme Disease, Southern Lyme disease patients and their family members heard something that sounded to them like nails on a chalkboard.  One of the speakers mentioned that there aren't many Lyme disease cases in the Southern USA.  Well, we will excuse him since he doesn't live here and isn't actually witnessing what we're seeing.  But since we've heard this myth time after time, we thought we'd set the record straight. 

For many years, patient advocates have heard from thousands of people who report that they have contracted Lyme disease in the Southern USA. Many of these patients have no travel history, produce positive laboratory results, and have a history of tick bite, rash and compatible Lyme disease symptoms. 

This is not a new occurrence, as if Lyme disease is slowly creeping down here, but it's something that has been happening for decades.  Many of the cases date back to the late 1980's and early 1990's.

It seems almost everyone in the South knows somebody who has contracted Lyme disease and many people know of several cases.  Patients include doctors, nurses, attorneys, political representatives, and other credible community members.

So...why doesn't the rest of the nation know this? 


Because looking at the CDC's National Lyme Disease Case Map, one would never suspect that there are so many Lyme disease cases occurring in the South. 



What's wrong with this picture?


We couldn't understand why we hear from so many Southerners with Lyme disease when so few Southern cases appear on the CDC's National Lyme Disease Case Map.  It didn't make sense!  So we did a little checking and, guess what?  In the states we checked, COMPLETELY different reporting practices were used, much different than those employed in the Northeastern United States!  And, apparently federal officials are fully aware of this, but somehow, they fail to note these incredibly significant discrepancies on the National Case Map.


Comparing Apples to Oranges


The CDC's National Case Definition for Lyme Disease (Reporting Guidelines) from 1995 - 2008 instructed states to count Lyme disease cases by county.  The CDC guidelines said that once a county documented two or more lab-confirmed Lyme disease cases or found an infected known tick vector, that county could be declared endemic for Lyme disease.  Once endemic, erythema migrans (EM)  rashes ALONE were reportable as cases, no tick bite or positive test required.  This is because erythema migrans (EM) is diagnostic for Lyme disease and if Lyme was documented in that county in two people confirmed by tests, there were no qualms about counting subsequent rashes as Lyme disease cases.  Everyone knows at the time of the rash, most patients won't test positive yet, so reporting only those with positive test results wouldn't really work to calculate the magnitude of the Lyme disease epidemic.  So rashes alone were reportable....in the Northeastern USA.  Numbers in Northeastern states skyrocketed. 



An Institute of Medicine Report estimates that

SEVENTY PERCENT

of all reported Lyme disease cases are  

erythema migrans rashes alone.




But there's one big problem...

In the Southern states highlighted in green in the map above, rashes alone weren't reportable.  (And we strongly suspect the same in other states, as well.)  So, how can we possibly compare statistics? 

We found hundreds of counties across the Southeastern United States that have had two or more cases documented in them over the years, and no proof that they are all due to travel.  (In fact, the Centers for Disease Control (CDC)  reported native Lyme disease cases in 27 Georgia counties and others in Florida and Alabama in the late 1980's Click here.)  Infected tick vectors have been found in southern counties, too.  Yet these southern counties were not declared endemic, so rashes alone could not be reported.

We often hear about southern Lyme disease cases with tick bite, rash, symptoms and positive test results that are dismissed as "false positives" instead of reported!  Federal public health officials encourage this and discourage testing outside current "endemic" areas despite Lyme bacteria being documented in the South for over 25 years.

Without investigation, cases in the South are routinely dismissed as the mysterious, unreportable "STARI", Southern Tick Associated Rash Illness, which  nobody can seem to put their finger on despite the hundreds of  Lyme bacteria strains discovered in the South. (Once a suspect, a Relapsing Fever spirochete called Borrelia lonestari has now been discarded by officials as the cause of so-called "STARI.") 

In 2008 and again in 2011, the CDC's National Lyme Disease Case Definition changed.  Now, areas that are not already declared "endemic" officially have a completely different set of reporting rules, not the same at all as what are used in the Northeastern USA. (It doesn't really matter since the old national guidelines were only adhered to in certain states, anyway.)   Now, the reporting guidelines are far more restrictive, requiring positive lab results outside "endemic" areas - yet, remember, it's estimated that seventy percent of reported cases in the Northeast never had to have positive lab results, only rashes! Rashes alone are still not reportable in the South, but are in "endemic" areas of the North.

To add insult to injury, officials refer to the Southern USA as "nonendemic" and put forth new, more restrictive reporting rules for most states outside the NE USA to follow, even though hundreds of Southern counties already qualified long ago to be endemic by their own previous definition they would have been endemic, had we been playing by the same rules!  

So how could anyone hold up a National Lyme Disease Case Map as if it is an accurate portrayal of Lyme disease infection rates in this country?  We can't compare what's occurring from state to state or region to region.  Federal officials are fully aware of these different reporting practices.  These disparities must be stressed and noted so that those in the Southern USA and any other area of the country where this may be happening are not lulled into complacency.

The Truth


Because Southern Lyme disease cases have been dismissed as "false positives" or "STARI"  instead of reported,  the truth is, we have no idea how prevalent Lyme disease really is in the Southern United States.  But we hear from Southerners who report that they have contracted Lyme disease two and even three times and families who tell us they have multiple members infectedThis doesn't occur in a region when a disease is "rare."

The CDC's National Lyme Disease Case Map misleads the public and medical providers.  These important differences are not disclosed, causing citizens and medical professionals to assume that Lyme disease is rare in their areas by comparing their state or regional case numbers to those in the Northeastern USA where rashes alone are reportable.  When doctors think a disease is "rare,"  it's not on their diagnostic radar screen.  This adds to the lack of recognition, diagnosis and early treatment of Lyme disease, potentially causing thousands if not millions of patients to needlessly suffer permanent damage and/or persistent infection.

Remember these differences when you look at the CDC's National Lyme Disease Case Map.  Remember that Lyme Borreliosis is being found worldwide. Understand that more Lyme Borrelia species (7) and strains (hundreds) have been documented in the Southeastern USA than in any other region of the country.  And if you develop a rash or symptoms following a tick bite, seek immediate, adequate medical treatment no matter where you live.  (By the way, we do not support the use of the 1 or 2 doses of doxycycline; it left the majority of mice infected in a study).


Case numbers cannot be compared when what is reportable as a case in the Northeastern USA is routinely dismissed in the Southern USA.  Don't let the maps fool you.









What You Need To Know About Lyme Disease in the Southern USA: 


Borrelia burgdorferi sensu stricto?              


Check.  50+ Bbss strains documented by Georgia Southern University's Dr. Jim Oliver.

In fact, Lyme disease bacteria, Borrelia burgdorferi (Bb) have been documented in THOUSANDS of tick and animal specimens and in many humans from across the South in published studies spanning more than two decades.  More importantly, more Lyme disease bacteria species and strains have been documented in the Southeastern United States than in any other region of the country (see our website NEWS page for details).  The fact that there are more numerous and varied Bb strains in the South, suggests to scientists that Lyme disease bacteria were actually in the Southern United States first, giving the bacteria time to diversify into so many different species and strains, before moving North.


Competent Animal Reservoir in the South?    


Check.  The cotton mouse, cotton rat and wood rat are all competent reservoirs for Borrelia burgdorferi.  The white-footed mouse is also found in some areas.  Gray squirrels, chipmunks and shrews are now being investigated as reservoirs, as well.  Even birds and some lizards may be reservoirs.


Infected Ixodes scapularis, black-legged "deer" ticks?  


Check.  And evidence suggests these ticks moved from South to North, not that they are now "expanding their range" down to the South.



Do black-legged "deer" ticks bite humans in the South?


Check.  In fall and winter months, adult Ixodes scapularis "deer" ticks feed on humans on warmer days so humans are exposed year 'round due to our warm climate. 



And lest you believe that old myth, "Only nymphal ticks are attached long enough to transmit Lyme disease because bigger ticks are more easily spotted and removed quickly" ...here's an important study published in 1996:  


Duration of tick bites in a Lyme disease-endemic area, Am. J. Epidemiol. 143: 187-192.

The authors (Falco, Fish, and Piesman) reported that 26.8% of I. scapularis nymphs removed from people were attached >48 hours, while 23.3% of adults were attached >48 hours. 


There's not a very significant difference between the number of nymphs and adults attached for over 48 hours, is there?  Adult ticks can easily be missed on a person's back or scalp. 


Do People in the Southern USA Test Positive for Lyme Disease?


Check.  Some Southerners do indeed test fully "CDC-reportable" positive for Lyme disease using the very strict 2-tier test methodology.  This indicates that these patients are infected with a Borrelia burgdoreri sensu stricto B31 type strain or one closely-related, known to cause Lyme disease in the Northeastern US.  These and many other strains of the species Bb sensu stricto have been documented in the Southern USA.  Additionally, other diverse Lyme Borrelia species and strains are found in the South and some are newly discovered. 

As in the Northern USA, western blot lab results for some Southern patients don't meet CDC guidelines, however, they show various positive bands, some highly specific for Borrelia burgdorferi.  That all Southern patients' labs do not meet strict CDC guidelines meant for reporting purposes isn't surprising in the least.  A recent Johns Hopkins study of Lyme patients proved that current tests were unreliable in detecting a huge percentage of patients tested from Maryland and Pennsylvania.  Why would Southern patients be expected to always have "CDC-reportable" lab results when Northern patients do not?  

A study of southern erythema migrans (EM) rash patients published years ago concluded that Southern Bb strains are so genetically different, the South needs its own Lyme disease testing system!  We still await these tests.  Many Southern Lyme disease cases are likely missed using the current unreliable tests which are designed to detect a few strains of a single Bb species.



Until next time, please remember to do a tick check daily...even in the winter months especially in warmer climates.

-GALDA


Don't miss our upcoming series: 





   "STARI":  Is It Really Just Lyme Disease? An Evidence-Based Evaluation.




For more information, visit our website at www.GeorgiaLymeDisease.org

 

Follow Georgia Lyme Disease Association on Facebook and Twitter.