In his interview with Terry Gross on Fresh Air, journalist Michael Specter says that patients are desperate and that “chronic Lyme” is “more comforting” for them to grab onto than a vague, incurable diagnosis of post-treatment Lyme disease, the preferred IDSA terminology – and a concept that is “recognized,” he points out. He thinks he is being sympathetic and doesn’t seem to realize how condescending and very offensive this sounds to Lyme patients.

It has long been known that ticks harbor Bartonella and that humans who have Lyme disease may also have Bartonellosis. However, the actual transmission of Bartonella from tick to host has not been demonstrated until a mouse study by Drs Reis and colleagues was published in May 2011. The study is available free on line for those interested. “This work represents the first in vivo demonstration of a Bartonella sp. transmission by ticks. It . . . corroborate[s] a prospect that ticks play a role in the natural cycles of some of the bartonellae including those pathogenic for humans. Consequently, bartonelleosis should be included in the differential diagnosis for patients exposed to tick bites.”

Michael Kruse says he thinks people “should be looking at all of the evidence, not just the few studies that agree with an opinion that moves us emotionally.” Then he bases his argument on evidence that agrees with an opinion that moves him emotionally.

I thought I would share a few prevention practices identified at the Institute of Medicine Lyme disease workshop as effective by Dr. Mathew Liang of Harvard Medical School. One idea focused a study in Nantucket by Daltroy (2007) on an educational outreach method. The 5-year study randomized 29,000 people traveling by ferry to Nantucket and exposed the study group to an entertainment-based information session about Lyme disease and steps to prevent it. Participants also received a card with a Braille dot on it the size of a tick and a plastic shower card similar to those used for breast self-exam, tweezers, and a map of the island where ticks were prevalent. The study showed a reduction in Lyme disease in the group who received the message, both among year round residents and among visitors, who constitute a high-risk population.

One of the hot topics in Lyme disease is whether the bacteria that causes Lyme disease persists. There are a lot of factors that go into proving this, but one is whether there is a “plausible biological mechanism for persistence.” What this means is whether there is a mechanism in biology that might allow the bacteria to survive. Simply put, the Infectious Diseases Society of America says there isn’t and other researchers disagree. The most recent article on this subject is from Straubinger, who is best known for his research on persistence in dogs. The highlights of the study after the jump. . .

Researchers have recently discovered that another species of Borrelia transmitted by deer ticks causes illness. The species, Borrelia miyamotoi, was discovered in Japan in 1995, but occurs in Asia, Europe and North America as well. A new study confirms that B. miyamotoi causes human disease "including relapsing disease that may last for months and may not respond to inappropriate antimicrobial drug therapy." Because B. miyamotoi is transmitted by an array of ixodid ticks and can be passed via the ovaries from one tick generation to the next, it "greatly expands the potential geographic distribution of this disease". The study notes that further investigation of possible B. miyamotoi infection in humans is warranted wherever I. pacificus, I. persulcatus, I. ricinus, and I. scapularis ticks are found.