@Lymenews The largest study, on which the CDC based its recommendation, showed one thing—a single dose of doxycycline reduced the incidence of rash in a small group of people. That’s it. (Nadelman 2001) 2/ @Lymenews End point: "Erythema migrans occurred at the site of the tick bite in 8 of the 247 subjects in the placebo group (3.2 percent), as compared with 1 of the 235 subjects in the doxycycline group (0.4 percent, P<0.04)" Seven fewer rashes! nejm.org/doi/10.1056/NE…

New | Lyme arthritis: linking infection, inflammation and autoimmunity. #LymeDisease (a thread) 1/
nature.com/articles/s4158… "In the USA, B. burgdorferi often disseminates in the blood during the first few weeks of infection in a process that requires the binding of Borrelia surface adhesins to host integrins on the vascular endothelium28–30. " 2/

Thread: A major barrier to progress in understanding the neurologic manifestations of #LymeDisease has been a lack of a tractable laboratory animal model to evaluate the mechanisms of central nervous system pathogenesis.

https://twitter.com/LonnieRhea/status/1356823740584054786

For decades we have seen study after study of Lyme arthritis. As it turns out the most frequently reported Lyme symptoms are neurological symptoms: memory loss and cognitive impairment, sleep impairment, psychiatric manifestations, headaches, neuropathy and more. 2/

In an encouraging development yesterday @CDC_NCEZID representative Ben Beard made an important announcement--a new "national strategy" for vector-borne diseases. I'll explain in a thread 1/n
lymedisease.org/framework-vect… via @Lymenews The Kay Hagan Tick Act, passed in 2019, called for @hhs to develop a national strategy to address issues related to vector-borne diseases. The Lyme community fought hard for the passage of the #TICKact lymedisease.org/tick-act-appro… via @Lymenews 2/

The geothermal features in Yellowstone are amongst my top 10 favorite sites on this planet. Here’s a bit of #microbio history on the PCR test I’d like to share.
Pictured: Grand Prismatic at the Midway Geyser Basin @YellowstoneNPS “Until the 1980s, our ability to study DNA was limited. Things we take for granted today such as DNA fingerprinting to identify criminals, DNA medical diagnoses, DNA-based studies of nature, and genetic engineering did not exist.”

What has the #Lyme community learned from the #COVID19 pandemic?
thread...
lymedisease.org/bureaucratic-d… (1) In a matter of weeks, the federal government can allot trillions of dollars to one disease.

Thread. @Sermo survey of 6,227 physicians worldwide: 85% of US physicians report #COVID19 testing takes 2-5 days or longer, while nearly half of international physicians report testing is completed within just 24 hours. Survey @Sermo says, 91% of US physicians and 83% of international physicians say the status of #COVID19 testing is far below what is needed.

Thread:
Fantastic Coronavirus Disease (COVID-19) – Research and Statistics. #COVID19 via @OurWorldInData

Why it is so important to #SlowTheSpread The WHO described the #symptoms of 55,924 laboratory confirmed cases of #COVID19 in China in the period up to February 20.
The visualization here shows this data.

Another eye opening read: "Rickettsiosis Subcommittee Report to the TBDWG" hhs.gov/ash/advisory-c… Six common tick species are now involved in the transmission of Rocky Mountain spotted fever and/or other agents of the spotted fever group Rickettsiae in the United States (R. rickettsii, R. parkeri, R. massiliae, and R. 364D are proven human pathogens)

Borrelia burgdorferi DO NOT secrete toxins or other virulence factors. Lyme disease is both proinflammatory also immunomodulatory & immunosuppressive. What causes #LymeDisease is the immune response to the bacteria, not the bacteria itself.

https://twitter.com/LonnieRhea/status/1219011555989213184?s=20

The difference in severity and spectrum of #LymeDisease varies among patients. The reasons for this variation include different tropisms among B.b. strains and differences in the host immune responses. 👇

My thoughts on late manifestations of Lyme disease (Stage 3 "Chronic Lyme") & major histocompatibility complex (MHC) Expression of MHC decrease in Langerhans' cells in the skin of patients with acrodermatitis chronica atrophicans #LymeDisease onlinelibrary.wiley.com/doi/abs/10.104…

NEW| @NIH Strategic Plan For Tickborne Disease Research.
niaid.nih.gov/sites/default/… @NIH "The 2018 (TBDWG) report also called for developing an NIH strategic plan to coordinate a trans-NIH research effort to address TBD research priorities."

New @NIH Strategic Plan for TBD Research. 👇

New | Changing of the guard: How the Lyme disease spirochete subverts the host immune response. jbc.org/cgi/content/lo… via @jbiolchem @jbiolchem "One of the many fascinating features of this unique pathogen is an elaborate system for antigenic variation whereby the sequence of the surface-bound lipoprotein VlsE is continually modified through segmental gene conversion events." #LymeDisease

New | Regulation of macrophage activity by surface receptors contained within Borrelia burgdorferi-enriched phagosomal fractions.

"The common gamma chain mediates the phagocytosis..." dx.plos.org/10.1371/journa… via @PLOSPathogens @PLOSPathogens "Thus, the overall signature response to a specific pathogen is dictated by the addition of the signals initially emanating from surface receptors, further modulated by the interaction of intracellular signals generated as a result of the internalization of the pathogen. "

Thread:
Heartbroken to hear former US Senator Kay Hagan, of North Carolina, has died, following a three-year struggle with encephalitis caused by tick-borne Powassan virus. lymedisease.org/tick-borne-pow… Powassan is a Flavivirus (related to Zika, Dengue, West Nile, and tick-borne encephalitis virus) carried by the same black-legged tick that transmits Lyme disease. Flaviviridae are a deadly family of viruses known to cause brain swelling. /2 lymedisease.org/lyme-sci-powas…

New | A Multiplexed Serologic Test for Diagnosis of Lyme Disease for Point-of-Care Use. #LymeDisease jcm.asm.org/content/early/… New microfluidic assay (mChip-Ld) detects B.b. antigens: VlsE and a proprietary synthetic 33-mer peptide (PepVF) to capture sensitivity in all disease stages, and OspC for early Lyme disease. Provides results in as little as 15 minutes. #LymeDisease

Susan Green, PC @NatCapLyme | Legislation-The Perfect Storm. @liv_lyme #LivLymeSummit
IDSA guidelines: “First time I’ve seen all the Lyme group’s come together” @NatCapLyme @liv_lyme Green | “We VOTE and We CARE! This is a call to action.” @liv_lyme #LivLymeSummit

Jyotsna Shah, PhD, CCLD, MBA @IgenexI | High prevalence of tick-borne co-infections: Why it is important to include testing for Lyme and co-infections in patients w/ Lyme-like symptoms, and why a panel approach is necessary. @liv_lyme #LivLymeSummit @IgenexI @liv_lyme Shah | 1° finding Babesia as co-infection, TBRF, then Bartonella. However not finding Bartonella in ticks. Lyme disease is most prevalent tick-borne infection. #LivLymeSummit

Kristen Honey, PhD, PMP @Stanford @HHSCTO | Lyme Innovation: Every Included. “we need to listen to patients” “we need to tip the odds in our favor.” #LivLymeSummit @liv_lyme @Stanford @HHSCTO @liv_lyme Honey @khoney | when you account for medical care, lost wages... estimates are in the 10’s of billions of dollars for the costs to society of Lyme disease. #LivLymeSummit

Jayakumar Rajadas, PhD @StanfordMed | use of Disulfiram for the treatment of unresolved Lyme infections and associated detrimental host immune response. A silver bullet? #LivLymeSummit @liv_lyme @StanfordMed @liv_lyme Rajadas | Identification of new drug candidates against Borrelia burgdorferi using high-throughput screening. #LivLymeSummit ncbi.nlm.nih.gov/pmc/articles/P…

Adrian Baranchuk, MD, FCCS @adribaran @QueensUCanada @QueensUGME | Lyme Carditis: Manifestations of Lyme disease in the electrical system. #LivLymeSummit @liv_lyme @adribaran @QueensUCanada @QueensUGME @liv_lyme Baranchuk | The only way we're going to make progress is if we all work together. We need better education and more awareness. #LivLymeSummit