scholarly journals Development and Validation of a Serologic Test Panel for Detection of Powassan Virus Infection in U.S. Patients Residing in Regions Where Lyme Disease Is Endemic

mSphere ◽  
2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Angela M. Thomm ◽  
Anna M. Schotthoefer ◽  
Alan P. Dupuis ◽  
Laura D. Kramer ◽  
Holly M. Frost ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Virus Infection ◽  
Clinical Symptoms ◽  
Diagnostic Testing ◽  
Chronic Fatigue ◽  
The United States ◽  
Full Spectrum ◽  
Persistent Symptoms ◽  
Powassan Virus ◽  
Tick Borne Disease

Approximately 100 cases of POWV disease were reported in the United States over the past 10 years. Most cases have occurred in the Northeast (52) and Great Lakes (45) regions (https://www.cdc.gov/powassan/statistics.html). The prevalence of POWV in ticks and mammals is increasing, and POWV poses an increasing threat in a greater geographical range. In areas of the Northeast and Midwest where Lyme disease is endemic, POWV testing is recommended for patients with a recent tick bite, patients with Lyme disease who have been treated with antibiotics, or patients with a tick exposure who have tested negative for Lyme disease or other tick-borne illnesses and have persistent symptoms consistent with posttreatment Lyme disease. Testing could also benefit patients with tick exposure and unexplained neurologic symptoms and chronic fatigue syndrome (CFS) patients with known tick exposure. Until now, diagnostic testing for Powassan virus has not been commercially available and has been limited to patients presenting with severe, neurologic complications. The lack of routine testing for Powassan virus in patients with suspected tick-borne disease means that little information is available regarding the overall prevalence of the virus and the full spectrum of clinical symptoms associated with infection. AsIxodes scapularisis the tick vector for Powassan virus and multiple other tick-borne pathogens, including the Lyme disease bacterium,Borrelia burgdorferi, the clinical presentations and long-term outcomes of Powassan virus infection and concurrent infection with other tick-borne disease pathogens remain unknown.

scholarly journals Lyme Disease and Oncothermia

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Ortwin Zais
Keyword(s):  
Lyme Disease ◽  
Clinical Symptoms ◽  
Chronic Phase ◽  
Chronic Fatigue ◽  
Multiple Organ ◽  
Human Immune System ◽  
Fatigue Syndrome ◽  
Therapeutic Principles ◽  
Organ Failures ◽  
Tick Borne Disease

Lyme disease is a tick-borne disease with multiple organ failures, and systemic disorders. Dramatic change becomes apparent in the chronic phase of the disease. Chronic fatigue syndrome, lapse of concentration, depression, joint pain, and muscle pain are a few, but major clinical symptoms characterizing the disease. The human immune system is defenseless. Borrelia uses various mechanisms to escape from immunoattacks or antibiotic therapies. This “stealth phenomenon” needs new therapeutic principles to be interrupted. Our objective in this paper is to study the effect of oncothermia, which is a well-established oncological therapy, on Lyme disease. First, in our present work, we definitely concentrate on the quality of life of the patients.

scholarly journals Human Coinfection withBorrelia burgdorferiandBabesia microtiin the United States

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Kristen L. Knapp ◽  
Nancy A. Rice
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Causative Agent ◽  
Ixodes Scapularis ◽  
Immunological Response ◽  
The United States ◽  
Babesia Microti ◽  
Current State ◽  
Tick Borne Disease ◽  
Multiple Pathogens

Borrelia burgdorferi, the causative agent of Lyme disease, andBabesia microti, a causative agent of babesiosis, are increasingly implicated in the growing tick-borne disease burden in the northeastern United States. These pathogens are transmitted via the bite of an infected tick vector,Ixodes scapularis, which is capable of harboring and inoculating a host with multiple pathogens simultaneously. Clinical presentation of the diseases is heterogeneous and ranges from mild flu-like symptoms to near-fatal cardiac arrhythmias. While the reason for the variability is not known, the possibility exists that concomitant infection with bothB. burgdorferiandB. microtimay synergistically increase disease severity. In an effort to clarify the current state of understanding regarding coinfection withB. burgdorferiandB. microti, in this review, we discuss the geographical distribution and pathogenesis of Lyme disease and babesiosis in the United States, the immunological response of humans toB. burgdorferiorB. microtiinfection, the existing knowledge regarding coinfection disease pathology, and critical factors that have led to ambiguity in the literature regarding coinfection, in order to eliminate confusion in future experimental design and investigation.

scholarly journals Powassan Virus Encephalitis Following Brief Attachment of Connecticut Deer Ticks

2020 ◽  
Author(s):  
Henry M Feder ◽  
Sam Telford ◽  
Heidi K Goethert ◽  
Gary P Wormser
Keyword(s):  
United States ◽  
Lyme Disease ◽  
The United States ◽  
Tick Bite ◽  
Molecular Testing ◽  
Tick Bites ◽  
Epidemiologic Evidence ◽  
Powassan Virus ◽  
Tick Attachment ◽  
Virus Subtype

Abstract Background Powassan virus (POWV) is a tick-transmitted pathogen that may cause severe encephalitis; experimentally, it can be transmitted within just 15 minutes following a tick bite. The deer tick virus subtype of POWV (DTV) is transmitted by the deer tick and is the likely cause of the increase in the number of POWV cases reported in the United States. However, DTV has only been definitively documented in 6 patients by molecular analysis of the virus. Methods Two patients from Connecticut with encephalitis, who had a recent deer tick bite, were evaluated by the relevant serologic tests to determine if they had been infected with POWV. Evaluation also included molecular testing of an adult deer tick that had been removed from one of the patients. Results We documented neuroinvasive POWV infection in 2 children from Connecticut. Based on the results of testing the tick removed from case 2, this patient was infected by DTV, representing the 7th reported case and the first documented case of DTV infection in a child. Of note, the duration of the tick bites in both cases was very short. Conclusions We provide the first clinical and epidemiologic evidence that POWV/DTV can be rapidly transmitted to a human host, that is, within hours of tick attachment, which is distinctive when compared to other deer tick-transmitted infections such as Lyme disease.

scholarly journals Recent Progress in Lyme Disease and Remaining Challenges

2021 ◽  
Vol 8 ◽  
Author(s):  
Jason R. Bobe ◽  
Brandon L. Jutras ◽  
Elizabeth J. Horn ◽  
Monica E. Embers ◽  
Allison Bailey ◽  
...  
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Molecular Mechanisms ◽  
The United States ◽  
Persistent Symptoms ◽  
Number Of Patients ◽  
Vector Borne ◽  
The Many ◽  
Long Term Impact ◽  
Patients Experience

Lyme disease (also known as Lyme borreliosis) is the most common vector-borne disease in the United States with an estimated 476,000 cases per year. While historically, the long-term impact of Lyme disease on patients has been controversial, mounting evidence supports the idea that a substantial number of patients experience persistent symptoms following treatment. The research community has largely lacked the necessary funding to properly advance the scientific and clinical understanding of the disease, or to develop and evaluate innovative approaches for prevention, diagnosis, and treatment. Given the many outstanding questions raised into the diagnosis, clinical presentation and treatment of Lyme disease, and the underlying molecular mechanisms that trigger persistent disease, there is an urgent need for more support. This review article summarizes progress over the past 5 years in our understanding of Lyme and tick-borne diseases in the United States and highlights remaining challenges.

scholarly journals Baptism of fire: Modeling the effects of prescribed fire on tick-borne disease

2022 ◽  
Author(s):  
Emily Guo ◽  
Folashade B. Agusto
Keyword(s):  
Lyme Disease ◽  
Prescribed Fire ◽  
High Intensity ◽  
The United States ◽  
Impulsive System ◽  
Fire Intensity ◽  
Tick Population ◽  
Prescribed Burns ◽  
Tick Borne Disease ◽  
Cost Efficient

Recently, tick-borne illnesses have been trending upward and are an increasing source of risk to people's health in the United States. This is due to range expansion in tick habitats as a result of climate change. Thus, it is imperative to find a practical and cost-efficient way of managing tick populations. Prescribed burns are a common form of land management that can be cost efficient if properly managed and can be applied across large amounts of land. In this study, we present a compartmental model for ticks carrying Lyme disease and uniquely incorporate the effects of prescribed fire using an impulsive system to investigate the effects of prescribed fire intensity (high and low) and the duration between burns. Our study found that fire intensity has a larger impact in reducing tick population than the frequency between burns. Furthermore, burning at high intensity is preferable to burning at low intensity whenever possible, although high intensity burns may be unrealistic due to environmental factors. Annual burns resulted in the most significant reduction of infectious nymphs, which are the primary carriers of Lyme disease.

scholarly journals A Distinct Microbiome Signature in Posttreatment Lyme Disease Patients

mBio ◽  
2020 ◽  
Vol 11 (5) ◽  
Author(s):  
Madeleine Morrissette ◽  
Norman Pitt ◽  
Antonio González ◽  
Philip Strandwitz ◽  
Mariaelena Caboni ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Diagnostic Tool ◽  
Gut Microbiome ◽  
Underlying Mechanism ◽  
Chronic Fatigue ◽  
The United States ◽  
Neurological Complications ◽  
Diagnostic Tools ◽  
Sequencing Data ◽  
Healthy Control

ABSTRACT Lyme disease is the most common vector-borne disease in the United States, with an estimated incidence of 300,000 infections annually. Antibiotic intervention cures Lyme disease in the majority of cases; however, 10 to 20% of patients develop posttreatment Lyme disease syndrome (PTLDS), a debilitating condition characterized by chronic fatigue, pain, and cognitive difficulties. The underlying mechanism responsible for PTLDS symptoms, as well as a reliable diagnostic tool, has remained elusive. We reasoned that the gut microbiome may play an important role in PTLDS given that the symptoms overlap considerably with conditions in which a dysbiotic microbiome has been observed, including mood, cognition, and autoimmune disorders. Analysis of sequencing data from a rigorously curated cohort of patients with PTLDS revealed a gut microbiome signature distinct from that of healthy control subjects, as well as from that of intensive care unit (ICU) patients. Notably, microbiome sequencing data alone were indicative of PTLDS, which presents a potential, novel diagnostic tool for PTLDS. IMPORTANCE Most patients with acute Lyme disease are cured with antibiotic intervention, but 10 to 20% endure debilitating symptoms such as fatigue, neurological complications, and myalgias after treatment, a condition known as posttreatment Lyme disease syndrome (PTLDS). The etiology of PTLDS is not understood, and objective diagnostic tools are lacking. PTLDS symptoms overlap several diseases in which patients exhibit alterations in their microbiome. We found that patients with PTLDS have a distinct microbiome signature, allowing for an accurate classification of over 80% of analyzed cases. The signature is characterized by an increase in Blautia, a decrease in Bacteroides, and other changes. Importantly, this signature supports the validity of PTLDS and is the first potential biological diagnostic tool for the disease.

scholarly journals Limitations and Confusing Aspects of Diagnostic Testing for Neurologic Lyme Disease in the United States

2018 ◽  
Vol 57 (1) ◽  
Author(s):  
Elitza S. Theel ◽  
Maria E. Aguero-Rosenfeld ◽  
Bobbi Pritt ◽  
Patricia V. Adem ◽  
Gary P. Wormser
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Diagnostic Testing ◽  
The United States ◽  
Passive Diffusion ◽  
Serum Antibodies ◽  
Laboratory Findings ◽  
Content Type ◽  
Paired Serum ◽  
Positive Results

ABSTRACTIn the United States, laboratories frequently offer multiple different assays for testing of cerebrospinal fluid (CSF) samples to provide laboratory support for the diagnosis of central nervous system Lyme disease (CNSLD). Often included among these diagnostic tests are the same enzyme immunoassays and immunoblots that are routinely used to detect the presence of antibodies toBorrelia burgdorferiin serum. However, performing these assays on CSF alone may yield positive results simply from passive diffusion of serum antibodies into the CSF. In addition, such tests are only U.S. Food and Drug Administration cleared and well validated for testing serum, not CSF. When performed using CSF, positive results from these assays do not establish the presence of intrathecal antibody production toB. burgdorferiand therefore should not be offered. The preferred test to detect intrathecal production of antibodies toB. burgdorferiis the antibody index assay, which corrects for passive diffusion of serum antibodies into CSF and requires testing of paired serum and CSF collected at approximately the same time. However, this assay also has limitations and should only be used to establish a diagnosis of CNSLD in conjunction with patient exposure history, clinical presentation, and other laboratory findings.

scholarly journals Practical Guide to Trapping Peromyscus leucopus (Rodentia: Cricetidae) and Peromyscus maniculatus for Vector and Vector-Borne Pathogen Surveillance and Ecology

2020 ◽  
Vol 20 (6) ◽  
Author(s):  
Erika T Machtinger ◽  
Scott C Williams
Keyword(s):  
United States ◽  
Lyme Disease ◽  
Small Mammals ◽  
Ixodes Scapularis ◽  
The United States ◽  
Eastern United States ◽  
Ixodes Pacificus ◽  
Tick Borne Disease ◽  
Vector Borne ◽  
Pathogen Surveillance

Abstract Arthropods pests are most frequently associated with both plants and vertebrate animals. Ticks, in particular the blacklegged ticks Ixodes scapularis Say and Ixodes pacificus Cooley & Kohls (Acari: Ixodidae), are associated with wildlife hosts and are the primary vectors of Lyme disease, the most frequently reported vector-borne disease in the United States. Immature blacklegged ticks in the eastern United States frequently use small mammals from the genus Peromyscus as hosts. These mice are competent reservoirs for Borrelia burgdorferi, the causative agent of Lyme disease, as well as other tick-borne pathogens. To conduct surveillance on immature ticks and pathogen circulation in hosts, capture and handling of these small mammals is required. While protocols for rearing and pest surveillance on plants are common, there are very few protocols aimed at entomologists to conduct research on vertebrate–arthropod relationships. The goal of this manuscript is to provide a practical template for trapping Peromyscus spp. for vector and vector-borne pathogen surveillance and ecology for professionals that may not have a background in wildlife research. Important considerations are highlighted when targeting P. leucopus Rafinesque and P. maniculatus Wagner. Specifically, for tick and tick-borne disease-related projects, materials that may be required are suggested and references and other resources for researchers beginning a trapping study are provided.

scholarly journals Impact COVID-19 Infection and Persistent Lingering Symptoms on Patient Reported Indicators of Nutritional Risk and Malnutrition

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 213-213
Author(s):  
Rachel Deer ◽  
Christopher Messenger ◽  
Blair Brown ◽  
Maria Swartz ◽  
Justin Seashore
Keyword(s):  
Clinical Symptoms ◽  
Caloric Intake ◽  
Chronic Fatigue ◽  
Nutritional Risk ◽  
Common Symptom ◽  
Dietary Recommendations ◽  
Persistent Symptoms ◽  
Gi Symptoms ◽  
Patient Reported ◽  
The Impact

Abstract Objectives This study investigated the impact of COVID-19 infection and its persistent lingering symptoms on known risk factors for malnutrition. Methods Patients with confirmed history of COVID infection and persistent symptoms were referred to the Post-COVID Recovery Clinic. Standardized telehealth screening included: Patient Generated Subjective Global Assessment (PG-SGA), Shortness of Breath (SOBQ), Patient Health Questionnaire (PHQ9), CDC 18 common symptom COVID, Generalized Anxiety Disorder (GAD7), and (Instrumental) Activities of Daily Living (I)ADL. Results Eighty-six patients were evaluated in the first 2.5 months. Average age was 52 years (23–90), 67% were female, and 58% Caucasian. COVID+ test to clinic visit was 49 days (14–140). Forty eight percent did not require hospitalization, 62% were obese, and 73% had ≥1 comorbidity. At infection onset, 80% complained of GI symptoms (75% loss of taste, 61% loss of smell, 59% diarrhea, 57% nausea). At the telehealth visit, 51% reported lingering GI symptoms (45% taste, 41% smell, 41% diarrhea, 36% nausea). Other common symptoms were: dyspnea on exertion, chronic fatigue, cough, and weakness. Survivors required referrals for the following specialty services: 84% pulmonary, 77% physical/occupational therapy, 73% behavioral health, and 51% registered dietitian consult. Average PG-SGA score was 5.7 ± 5.02 with sub-scores: weight 1.37 ± 1.65, food 0.58 ± 0.64, symptoms 2.19 ± 3.30, activities/function 1.59 ± 0.93. Preliminary analysis of 2-day 24h dietary recalls of a subset of clinic patients (n = 33) found >50% of COVID survivors failed to meet basic dietary recommendations. Daily caloric intake was low, protein intake was below 0.8 g/kg, and the daily distribution of protein skewed towards a single meal. Conclusions We found that the clinical symptoms experienced by COVID survivors, particularly fatigue, dyspnea, and eating difficulties (nausea, vomiting, changes in smell and taste, trouble breathing) created difficulties in maintaining an adequate nutritional intake. This is concerning because malnutrition, specifically inadequate protein, leads to weaker immune function, slower recovery from illness, and loss of lean body mass. Funding Sources NIA Pepper OAIC, CTSA NCATS

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