LymeNet Home Page LymeNet Flash Discussion LymeNet Support Group Database LymeNet Literature Library LymeNet Legal Resources LymeNet Medical & Scientific Abstract Database LymeNet Newsletter Home Page LymeNet Recommended Books LymeNet Tick Pictures Search The LymeNet Site LymeNet Links LymeNet Frequently Asked Questions About The Lyme Disease Network LymeNet Newsletter Volume 5 Issue 11 LymeNet Home Page LymeNet Flash Discussion LymeNet Support Group Database LymeNet Literature Library LymeNet Legal Resources LymeNet Medical & Scientific Abstract Database LymeNet Newsletter Home Page LymeNet Recommended Books LymeNet Pictures Search The LymeNet Site LymeNet Links LymeNet Frequently Asked Questions About The Lyme Disease Network LymeNet Home LymeNet Newsletter Library

Volume: 5
Issue: 11
Date: 10-Nov-97


Table of Contents:

I.    LYMENET: New LymeNet Law System Generates Interest
II.   SCRIP: Lyme disease vaccines - a mixed blessing?
III.  FOLIA PARASITOL: Role of grey squirrels and pheasants in
      the transmission of Borrelia burgdorferi sensu lato, the
      Lyme disease spirochaete, in the U.K.
IV.   EUR J CLIN MICROBIOL INFECT DIS: In vitro activity of
      trimethoprim against Borrelia burgdorferi
V.    NEUROLOGY:  Interleukin-6 is expressed at high levels in
      the CNS in Lyme neuroborreliosis.
VI.   About The LymeNet Newsletter


Newsletter:

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


IDX#                Volume 5 / Number 11 / 10-NOV-97
IDX#                            INDEX
IDX#
IDX#  I.    LYMENET: New LymeNet Law System Generates Interest
IDX#  II.   SCRIP: Lyme disease vaccines - a mixed blessing?
IDX#  III.  FOLIA PARASITOL: Role of grey squirrels and pheasants in
IDX#        the transmission of Borrelia burgdorferi sensu lato, the
IDX#        Lyme disease spirochaete, in the U.K.
IDX#  IV.   EUR J CLIN MICROBIOL INFECT DIS: In vitro activity of
IDX#        trimethoprim against Borrelia burgdorferi
IDX#  V.    NEUROLOGY:  Interleukin-6 is expressed at high levels in
IDX#        the CNS in Lyme neuroborreliosis.
IDX#  VI.   About The LymeNet Newsletter
IDX#



I.    LYMENET: New LymeNet Law System Generates Interest
--------------------------------------------------------
DATE: November 6, 1997


The new design of the LymeNet web site is demonstrating that breaking
down information bottlenecks on the Internet has real benefits.
Interest in the new LymeNet Law pages has soared, with hit counts
up over 400% since the changes went into effect.


Ira M. Maurer, an attorney who specializes in Lyme related legal
matters, is now free to quickly and easily publish information on
the LymeNet Law Site.  The content ranges from descriptions of
malpractice and insurance company cases, explanations of relevant
laws, and pointers to other sites for further research.  


Prior to the upgrade, his information was trapped in the slow and
complex traditional Internet publishing methods.  Now, he can make
information available in minutes.


"The new LymeNet Law system is very exciting," Maurer said.  "I now
have the ability to modify the Law Pages from either my office or
home without having to send the material to the Webmaster.  This change
gives me the freedom to make breaking legal information available to
the world as soon as I obtain it."


The LymeNet Law Pages are available at:  http://law.lymenet.org/


=====*=====


II.   SCRIP: Lyme disease vaccines - a mixed blessing?
------------------------------------------------------
DATE: October 10, 1997
From SCRIP World Pharmaceutical News, No S00555414 F


Vaccines against Lyme disease, which could be available in the US by
next year, may confuse or hinder the accurate diagnosis and
treatment of tick-borne diseases, one expert said at the recent
ICAAC meeting in Toronto.


The vaccines - being developed by Pasteur Merieux Connaught and
SmithKline Beecham (Scrip No 2269, p 25) - will protect approximately
80% of individuals against Lyme disease.  However, the 20% failure
rate could cause problems, said Dr David Persing of the Mayo Clinic
in Rochester, Minnesota.  These patients will test positively for
Lyme disease antibodies, as will those who have been infected, but
could go on to contract the disease.  As they believe themselves
to be protected, any cases of Lyme disease are likely to be
missed, or diagnosis delayed.  In such cases late-stages symptoms
can include cardiac arrhythmias, facial paralysis and arthritis.


An additional concern is that vaccinated people, feeling protected,
will stop checking for tick bites, thereby risking exposure to other
emerging tick-borne diseases, including babesiosis, ehrlichiosis and
other as yet unrecognised rickettsia-like agents.  Patients failing
antibiotic therapy for Lyme disease will need to be evaluated for
secondary pathogens, Dr Persing said.


[...] Over the past few years, a curious convergence of pathogens
has been recognised in areas already endemic for [Lyme] disease.
Babesia microti, a blood parasite related to the organism which
causes malaria, is now frequently found along with the Lyme
disease spirochaete (Borrelia burgdorferi) in mice.  Ehrlichiosis
has also been associated with transmission by deer ticks.  Human
infections with these other organisms, both alone and in
combination with Lyme disease, are now being described, and
successful treatment may rest on proper and timely diagnosis.


Non-specific febrile illness is characteristic of all three tick-borne
diseases, alone or in combination.  The long-term impact of babesiosis
is not well established, but initial studies have indicated elevated
liver enzymes and some haematological abnormalities, Dr Persing noted.
Little is known about ehrlichosis.


PMC's director of corporate research, Dr Zahradnick, told Scrip that
there is evidence that people can be infected with Lyme disease more
than once, suggesting that any immunity acquired from prior exposure
to the disease is sub-optimal and short-lived. Alternatively, this
phenomenon could be caused by early antibiotic treatment, which
prevents the patient from mounting a full antibody response. Either
way, "a lot more work needs to be done on the natural history of
these diseases before we can speculate on any negative impact of
the vaccine", he said.


Faced with the possibility of co-infection in endemic areas, doctors
should switch from using the standard therapy for Lyme disease -
beta-lactam antibiotics such as ampicillin - to doxycycline or
tetracycline, which are also effective against Borrelia and Erhlichia
species, Dr Persing believes.


In the case of concurrent infection with Lyme disease and babesiosis,
treatment is complicated because doxycycline is thought to have
limited activity against the latter, he said.  The currently
recommended therapy for acute babesiosis - iv clindamycin plus
quinine - is not recommended for mild or subclinical cases, nor is it
indicated for Lyme disease.


In the absence of new treatments, much of the short-term focus will
have to be on new methods for pathogen identification and discovery,
such as PCR and direct DNA sequence analysis, Dr Persing said.
These techniques will help to improve the identification of pathogens
transmitted by deer ticks, with the aim of clarifying the role of
known and unknown organisms involved in the transmission cycle of
Lyme diseases. As well as aiding diagnosis, such techniques also
may provide potential new targets for drug therapy.



=====*=====


III.  FOLIA PARASITOL: Role of grey squirrels and pheasants in the
     transmission of Borrelia burgdorferi sensu lato, the Lyme
     disease spirochaete, in the U.K.
------------------------------------------------------------------
AUTHORS: Craine NG, Nuttall PA, Marriott AC, Randolph SE
ORGANIZATION: Department of Zoology, University of Oxford, UK.
REFERENCE: Folia Parasitol (Praha) 1997;44(2):155-60
ABSTRACT:


In Britain, grey squirrels (Sciurus carolinensis Gmelin) and
pheasants (Phasianus colchicus Linnaeus) are important hosts of larvae
and nymphs of Ixodes ricinus L., the principal European vector of the
Lyme disease spirochaete, Borrelia burgdorferi sensu lato.  To test
whether squirrels are competent hosts of B. burgdorferi s.l., three
females were trapped in the wild and then held in captivity.  
Following treatment, each animal was exposed to uninfected
xenodiagnostic I. ricinus ticks.  Squirrel A (an adult) which was
inoculated experimentally with B. burgdorferi s.l., transmitted the
infection to xenodiagnostic ticks.  In contrast, squirrel B (a
juvenile that was not inoculated) - showed no evidence of infection.
Xenodiagnostic ticks that fed on control squirrel C (an adult) became
infected and subsequently transmitted the infection experimentally to
an uninfected hamster.  The results indicated that squirrel C had a
disseminated infection acquired in the wild and which persisted for
at least 11 weeks.  These data clearly demonstrate that grey squirrels

are amplifying and reservoir hosts of B. burgdorferi s.l.  The strain
associated with squirrels was related to the B. afzelii genotype.  Two
observations implicated pheasants in a similar role: (i) a high
prevalence of infection in engorged larvae collected from trapped
pheasants, and (ii) the detection of B. burgdorferi s.l. (B. garinii
genotype) in the wattle of 1/10 pheasants using PCR.  Xenodiagnostic
experiments similar to those undertaken with the squirrels are needed
to confirm the role of pheasants in the transmission cycle of Lyme
disease spirochaetes.



=====*=====


IV.   EUR J CLIN MICROBIOL INFECT DIS: In vitro activity of
     trimethoprim against Borrelia burgdorferi
-----------------------------------------------------------
AUTHORS: Reisinger EC, Wendelin I, Gasser R,
ORGANIZATION: Department of Medicine, Karl-Franzens University,
             Graz, Austria.
REFERENCE: Eur J Clin Microbiol Infect Dis 1997 Jun;16(6):458-60
ABSTRACT:


A new culture medium has been developed to evaluate the activity of
trimethoprim and sulfamethoxazole against Borrelia burgdorferi in
vitro.  In this specially modified Barbour-Stoenner-Kelly medium, in
which antagonizing substances were reduced to a minimum, trimethoprim
was more active against Borrelia burgdorferi than against a sensitive
strain of Escherichia coli, but sulfamethoxazole was not active
against Borrelia burgdorferi.



=====*=====


V.    NEUROLOGY:  Interleukin-6 is expressed at high levels in
     the CNS in Lyme neuroborreliosis.
--------------------------------------------------------------
AUTHORS: Pachner AR, Amemiya K, Delaney E, O'Neill T, Hughes CA,
        Zhang WF
ORGANIZATION: Department of Neurology, Georgetown University School of
             Medicine, Washington, DC 20007, USA.
ABSTRACT:


In patients with Lyme neuroborreliosis, inflammation and symptoms of
fatigue and malaise occur out of proportion to the relatively low
number of spirochetes present.  Previous studies have identified
interleukin-6 (IL-6) as a candidate molecule for amplification of
CNS inflammation in this disease.  We pursued this possibility by
measuring cytokine gene expression by reverse-transcriptase polymerase
chain reaction (RT-PCR) in the brain of rhesus macaques actively
infected with Borrelia burgdorferi.  Samples of brain tissue were
screened for IL-6 and interferon gamma using RT-PCR-ELISA, a
technique that uses RT-PCR, subsequent hybridization of the PCR
product with a biotinylated probe, and capture and ELISA readout of
hybridization product.  The number of copies in positive samples was
then quantitated using qRT-PCR-ELISA, in which wild-type cytokine cDNA
competes with recombinant competitor DNA in the PCR.  Elevated levels
of IL-6 cDNA and, to a lesser extent, interferon gamma were detected
in three of three nonhuman primates with persistent infection with

B burgdorferi, whereas the brains of three uninfected animals and
undetectable levels of gene expression of these cytokines.  These data
support the hypothesis that cytokines such as IL-6 are important
amplification molecules for CNS inflammation in Lyme neuroborreliosis.



=====*=====


IV.   ABOUT THE LYMENET NEWSLETTER
----------------------------------
For the most current information on LymeNet subscriptions,
contributions, and other sources of information on Lyme disease,
please refer to the LymeNet Home Page at:
                  http://www.lymenet.org
-----------------------------------------------------------------------
To unsubscribe from the LymeNet newsletter, send a message to:
                   listserv@lehigh.edu
On the first line of the message, write:  unsub lymenet-l
-----------------------------------------------------------------------
LymeNet - The Internet Lyme Disease Information Source
-----------------------------------------------------------------------
Editor-in-Chief: Marc C. Gabriel <a229@Lehigh.EDU>
           FAX (for contributions ONLY): 908-789-0028
Contributing Editors: Carl Brenner <cbrenner@postoffice.ptd.net>
                     John Setel O'Donnell <jod@Equator.com>
                     Frank Demarest <76116.2065@CompuServe.com>
Advisors: Carol-Jane Stolow, Director <carol_stolow@lymenet.org>

         William S. Stolow, President <bill_stolow@lymenet.org>
         The Lyme Disease Network of New Jersey
-----------------------------------------------------------------------
WHEN COMMENTS ARE PRESENTED WITH AN ATTRIBUTION, THEY DO NOT
NECESSARILY REPRESENT THE OPINIONS/ANALYSES OF THE EDITORS.
-----------------------------------------------------------------------
THIS NEWSLETTER MAY BE REPRODUCED AND/OR POSTED ON BULLETIN BOARDS
FREELY AS LONG AS IT IS NOT MODIFIED OR ABRIDGED IN ANY WAY.
-----------------------------------------------------------------------
SEND ALL BUG REPORTS TO a229@Lehigh.EDU
-----------------------------------------------------------------------


Home | Flash Discussion | Support Groups | On-Line Library
Legal Resources | Medical Abstracts | Newsletter | Books
Pictures | Site Search | Links | Help/Questions
About LymeNet


© 1994-1999 The Lyme Disease Network of New Jersey, Inc.
All Rights Reserved.
Use of the LymeNet Site is subject to the Terms of Use.