THE EYE AND TICK-BORNE DISEASE
The eye and tick-borne disease in the United States Sathiamoorthi, Saraniya; Smith, Wendy M. Abstract Purpose of review:Tick-borne diseases are increasing in incidence and geographic distribution. Several diseases endemic to the United States have ophthalmic manifestations, including the most common tick-borne disease, Lyme borreliosis. As ocular complaints may lead a patient to seek medical evaluation, it is important to be aware of the systemic and ophthalmic manifestations of tick-borne diseases in order to make the correct diagnosis. Recent findings:Vision-threatening ophthalmic manifestations are relatively common in Lyme disease and Rocky Mountain spotted fever. Ocular involvement is rare in babesiosis, tick-borne relapsing fever, Powassan encephalitis, ehrlichiosis, anaplasmosis, and Colorado tick fever.There are clear guidelines for diagnosis and treatment of Lyme disease; however, confusion and misinformation among the general public as well as controversy about chronic or late-stage Lyme disease can impact the evaluation of ophthalmic disease. Furthermore, there are many gaps in our knowledge regarding the pathophysiology of ocular borreliosis although it seems likely that Lyme uveitis is rare in the United States. Summary:Knowledge of systemic and ophthalmic manifestations combined with an understanding of the epidemiology of disease vectors is crucial for the diagnosis of tick-borne diseases. http://journals.lww.com/co-ophthalmology/Abstract/2016/11000/The_eye_and_tick_borne_disease_in_the_United.10.aspx Interesting observations have been made by Dr Daniel Cameron in his all things Lyme blog http://danielcameronmd.com/growing-list-eye-problems-lyme-disease/ The authors described patients with tick-transmitted diseases presenting with the following ophthalmologic findings: Follicular conjunctivitis Periorbital edema and mild photophobia Bell’s palsy, cranial nerve palsies and Horner syndrome Argyll Robertson pupil Keratitis Optic neuritis, papilledema, papillitis and neuroretinitis Myositis of extraocular muscles and dacryoadenitis Episcleritis, anterior and posterior scleritis Anterior, intermediate, posterior and panuveitis...TICK-BORNE DISEASES SYMPOSIUM 2016
I know one or two of you will be interested to hear how the Vis-a-vis symposium went om Saturday 01.10.16. Brilliant, is probably the best way I would describe it – by far one of the best conferences/symposiums I have been to on Lyme Disease in the UK. Perhaps the best bit was knowing there were Doctors, Consultants, Researchers and Veterinarians all listening attentively (and some taking copious notes) to the excellent presentations. Prof Hany Elsheikha, Veterinary Parasitology/Human/animal/Public Health from UK, gave an informative presentation, encouraging the audience to understand the clear and abundant presence of Ticks and the complexity of the numbers of pathogens they are able to transmit. The problems over testing and difficulties with diagnosis. Dr Jack Lambert Infectious and Tropical Diseases doctor from Ireland gave an outstanding presentation telling the audience the situation – how in other infectious diseases they acknowledged the limitations of testing and often treated empirically which is what he has been doing with considerable success with his suspected Lyme Disease patients. He talked about a study of 100 patients and how many had a good response to treatment in the just over 60% patients who chose to have the antibiotics or combination antibiotics he recommends (not everyone will opt for antibiotics, the patient has choices to make). It was so refreshing to hear so many positive comments about supporting this patient section. He also discussed a long list of suggested testing for a number of tick associated infections and immune markers plus the usual blood tests. Dr Carsten Nicolaus, Internal Medicine and Tick Borne Diseases from Germany, gave...DRUG COMBINATIONS FOR BORRELIA PERSISTERS
A Drug Combination Screen Identifies Drugs Active against Amoxicillin-induced Round Bodies of Borrelia burgdorferi Persisters from an FDA Drug Library Jie Feng1, Wanliang Shi1, Shuo Zhang1, David Sullivan1, Paul Auwaerter2 and Ying Zhang1* 1Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, USA 2Fisher Center for Environmental Infectious Diseases, School of Medicine, Johns Hopkins University, USA Although currently recommended antibiotics for Lyme disease such as doxycycline or amoxicillin cure the majority of the patients, about 10-20% of patients treated for Lyme disease may experience lingering symptoms including fatigue, pain, or joint and muscle aches. Under stress conditions such as starvation or antibiotic exposure, Borrelia burgdorferi can develop round body forms, which are a type of persister bacteria that are not killed by current Lyme antibiotics. To identify more effective drugs that are active against the round bodies of B. burgdorferi, we established a round body persister model induced by amoxicillin and screened the Food and Drug Administration (FDA) drug library consisting of 1581 drug compounds and also 22 drug combinations using the SYBR Green I/propidium iodide (PI) viability assay. We identified 23 drug candidates that have higher activity against the round bodies of B. burgdorferi than either amoxicillin or doxycycline. Eleven of these scored better than metronidazole and tinidazole which have been previously described to be active against round bodies. While some drug candidates such as daptomycin and clofazimine overlapped with a previous screen against stationary phase B. burgdorferi persisters, additional drug candidates active against round bodies we identified include artemisinin, ciprofloxacin, nifuroxime, fosfomycin, chlortetracycline, sulfacetamide, sulfamethoxypyridazine and sulfathiozole. Two triple drug combinations had...DEPT. HEALTH TO COMMISSION 3 REVIEWS ON LYME DISEASE
Today’s House of Commons debates – Tuesday 10 May 2016 Lyme Disease 4. Andrew Stephenson (Pendle) (Con): What progress has been made on improving diagnosis and treatment of Lyme disease.[904940] The Parliamentary Under-Secretary of State for Health (Jane Ellison): Lyme disease is a complex infection, so we recognise that there are real challenges in diagnosis and treatment. In the light of this, I am pleased to say that the Department plans to commission three reviews on the diagnosis, treatment and transmission of Lyme disease to inform future decision making. Andrew Stephenson: A constituent in Earby was struck down with a debilitating illness several years ago, which has totally destroyed her quality of life. Since then, I have been visiting her regularly at home every few months, as she has fought to get a diagnosis. Over recent months, all the evidence has started to point towards Lyme disease, but there seems to be precious little support out there for people with this condition. What more can my Hon. Friend do to support constituents like mine? Jane Ellison: In addition to the reviews that the chief scientific adviser is overseeing, we have commissioned the National Institute for Health and Care Excellence to develop a new evidence-based guideline for care, specifically to respond to the sort of situation that my Hon. Friend describes with his constituent. That is for publication in 2018 and it is being prioritised because of the interest in this area. https://hansard.parliament.uk/Commons/2016-05-10/debates/16051027000003/OralAnswersToQuestions Here is the link to the actual announcement in parliament. You need to select 09.47.07 on the RH side. http://www.parliamentlive.tv/Event/Index/fbd45ac2-43c6-41c0-b2d0-48a9f49b3b0b...
