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PLANET CDC- Explainer:
A Journey to a world devoid of either logic or
concern for Homo sapiens.
Once upon a time, Mrs. Polly Murray and Dr. Willy Burgdorfer
discovered a spirochetal illness in Lyme, CT. Along came a
rheumatologist who acquired epidemiology training to avoid
the draft and ended up in New Haven, CT. After that we're not
sure what happened...
J Clin Invest 1986 Oct;78(4):934-9
Antigens of Borrelia burgdorferi recognized during Lyme
disease. Appearance of a new immunoglobulin M response
and expansion of the immunoglobulin G response late in
the illness., Craft JE, Fischer DK, Shimamoto GT, Steere
AC.
"Using immunoblots, we identified proteins of Borrelia
burgdorferi bound by IgM and IgG antibodies during Lyme
disease. In 12 patients with early disease alone, both
the IgM and IgG responses were restricted primarily to a
41-kD antigen. This limited response disappeared within
several months. In contrast, among six patients with
prolonged illness, the IgM response to the 41-kD protein
sometimes persisted for months to years, and late in the
illness during arthritis, a new IgM response sometimes
developed to a 34-kD component of the organism. The IgG
response in these patients appeared in a characteristic
sequential pattern over months to years to as many as 11
spirochetal antigens. ***The appearance of a new IgM
response and the expansion of the IgG response late in
the illness, and the lack of such responses in patients
with early disease alone, suggest that B. burgdorferi
remains alive throughout the illness.*** PMID: 3531237
So, we see antigenic variation and a delayed antibody
response. Okay, we think that was real. Since it
matches spirochete biology...
Then, in 1993, because Lyme was a terrible illness that
caused devastating neurological disease similar to Multiple
Sclerosis, CDC decided to say it was an arthritis.
The antibody response in Lyme arthritis patients is
about 4 times that in neurological patients. People
with MS- like symptoms are now told they have CFIDS
or FM or Depression. Sometimes these things happen
in "science": A disease with a known etiology becomes
a disease with an unknown etiology, or something seen
by many physicians as not an illness at all...
And the standard for serodiagnosis became the arthritis
serology.
And the insurance companies rejoiced, for most people
infected with Borrelia burgdorferi and mostly
neurologic symptoms, then, don't have "Lyme disease" and
therefore don't qualify for treatment.
And the vaccine manufacturers rejoiced, because they
could throw out data they didn't like.
Soon, 1994, CDC decided to invite several lab diagnostic
researchers to a conference and asked them to please
submit their interpretations for what is positive
Lyme serology, after they already decided Lyme would
be the arthritis serology.
And CDC said unto these researchers, "Nevermind. We
will use the serology calculated to be 95% accurate
based on a calculation of what would be 95% accurate
from strain G39/40, but don't use strain G39/40 because
it doesn't express enough antigen of diagnostic value.
And thanks for coming to our Dearborn Conference."
Dressler/Steere- The CDC's IgG reference
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8380611&dopt=Abstract
J Infect Dis 1993 Feb;167(2):392-400, Western blotting
in the serodiagnosis of Lyme disease., Dressler F,
Whalen JA, Reinhardt BN, Steere AC., Division of
Rheumatology/ Immunology, Tufts University School
of Medicine, New England Medical Center, Boston,
Massachusetts 02111.
Dearborn Booklet
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00038469.htm
Second National Conference on Serologic Diagnosis of
Lyme Disease, October 27-29, 1994. The Association of
State and Territorial Public Health Laboratory Directors,
CDC, the Food and Drug Administration, the National
Institutes of Health, the Council of State and Territorial
Epidemiologists, and the National Committee for Clinical
Laboratory Standards
The accuracy of CDC IgG in the field:
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8748261&dopt=Abstract
J Clin Microbiol 1996 Jan;34(1):1-9, Evolution of the
serologic response to Borrelia burgdorferi in treated
patients with culture-confirmed erythema migrans. Aguero-
Rosenfeld ME, Nowakowski J, Bittker S, Cooper D, Nadelman
RB, Wormser GP., Department of Pathology, New York Medical
College, Valhalla, USA. "Although 89% of the patients
developed IgG antibodies as determined at a follow-up
examination, ***only 22% were positive by the IgG IB
criteria of the Centers for Disease Control and Prevention-
Association of State and Territorial Public Health
Laboratory Directors.***
And all was good. For rOspA's future.
The attempt at validating Dressler/Steere was shown to
be that band intensity was a valid quality of the serology
(Weinstein), even though the objective in Lyme diagnosis
is for increased sensitivity. (Psssst. Minor detail: blot
intensity is the inverse of the measure of sensitivity.
The goal is actually to be able to detect the smallest
quantity of a specific antibody. That's what sensitivity
means.)
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8053960&dopt=Abstract
"CONCLUSION. Band intensity analysis increases the
objectivity and accuracy of Western blot interpretation
for the diagnosis of Lyme arthritis."
Now, the second half of the Explainer of PLANET CDC on
Lyme is that there are other Borrelia besides burgdorferi
in the United States. And what does CDC do about the
serodiagnosis of those? Nothing.
Anyway, we *do* have these others to contend
with (at least):
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11427560&dopt=Abstract
J Clin Microbiol 2001 Jul;39(7):2500-2507, Genetic
Heterogeneity of Borrelia burgdorferi Sensu Lato in the
Southern United States Based on Restriction Fragment
Length Polymorphism and Sequence Analysis., Lin T, Oliver
JH Jr, Gao L, Kollars TM Jr, Clark KL., Institute of
Arthropodology and Parasitology, Department of Biology,
Georgia, Southern University, Statesboro, Georgia 30460-8056.
Borrelia ~miyamotoi
http://www.yale.edu/opa/v29.n29/story8.html
Yale Bulletin and Calendar, May 4, 2001Volume 29,
Number 29, "Fish says the organism, as yet unnamed,
closely resembles a spirochete found in ticks in Japan,
Borrelia miyamotoi, and is a close cousin to Borrelia
burgdorferi, the spirochete that causes Lyme disease."
Borrelia lonestari
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11384533&dopt=Abstract
Emerg Infect Dis 2001 May-Jun;7(3):471-3, Borrelia
lonestari DNA in adult Amblyomma americanum ticks,
Alabama., Burkot TR, Mullen GR, Anderson R, Schneider
BS, Happ CM, Zeidner NS., Centers for Disease Control
and Prevention, Fort Collins, Colorado, USA.
September, 2001- For the Return Journey to Earth
from PLANET CDC, IgM is again a treatable case:
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11526153&dopt=Abstract
J Clin Microbiol 2001 Sep;39(9):3213-21, Use of Serum
Immune Complexes in a New Test That Accurately Confirms
Early Lyme Disease and Active Infection with Borrelia
burgdorferi., Brunner M, Sigal LH., Department of Medicine,
UMDNJ-Robert Wood Johnson Medical School, New Brunswick,
New Jersey. "In addition, EMIBA more accurately differentiated
seropositivity in patients with active ongoing infection
from seroreactivity persisting long after clinically
successful antibiotic therapy; i.e., EMIBA identified
seroreactivity indicating a clinical circumstance requiring
antibiotic therapy. Thus, EMIBA is a promising new assay
for accurate serologic confirmation of early and/or active
LD."
Now you are back to 1986, J Clin Invest 1986 Oct;78(4):934-9,
Steere... "The appearance of a new IgM response and the
expansion of the IgG response late in the illness, and the
lack of such responses in patients with early disease alone,
suggest that B. burgdorferi remains alive throughout the illness."
<One of the hazards of Space Travel.>
Little has been learned about Lyme disease in the past
25 years, since the illness has not been give full
consideration of its status as a spirochetal infection.