Carter Blakey
I write to support the inclusion of the ILADS Lyme Disease
Objectives for inclusion in Healthy People 2020.
ILADS is an international society of physicians, researchers,and concerned
health care professionals whom are expert in the theory and in the practice
of Lyme Disease and Related Disorders ( Co-Infections which exist simultaneously
in some Lyme Patients). Lyme Disease has the potential to cause tissue
in multiple organ systems of the human body. The first systems to be recognized
namely skin [Erythema Migrans], Joint [Lyme arthritis] , nervous system
[Borrelia meningitis and Borrelia induced Bell's {facial nerve} Palsy], and
Cardiac [ Borrelia induced Bradycardias and Tachycardias- with or without
Atrioventrio-ventricular conduction system "Heart block"] were all described
in the Pre Spirochetal Era [ in the era 1975-1980] before Dr Willy Burgdorfer
described the etiologic infectious agent of Lyme disease, namely Borrelia
burgdorferi. The expansion of Medical complications of Lyme disease
has burgeoned in the Post-Spirochetal Era to now include such diseases as
Mononeritis mutiplex, a Lyme Multiple Sclerosis-like demyelination illness,
a Lyme Amytrophic Lateral Sclerosis-like Motor Neuron Disease, Lyme
disease in pregnancy with transplacental transmission of the spirochete
across the placenta from Mother to unborn fetus causing Miscarriage , stillbirth
at term pregnancy, and linked to several congenital malformations in the
developing fetus, Lyme disease associated Neurocognitive disorders including
a Lyme disease Dementia closely resembling Alzheimer's disease, Lyme Disease
Parkinson's disease like illness, Lyme disease Cardiomyopathy, Lyme disease
Temporal arteritis-like illness with blindness, Lyme disease of the Eye with Uveitis,
Optic neuritis, and Ossifying myositis of the extra ocular muscles of the eye,
Lyme disease related Malignant lymphomas [similar in evolution to the
Lymphomas consequent to chronic Helicobacter pylori infection of the gastric
mucosa] , Lyme disease Autonomic Nervous System Dysfunction, Lyme Disease
Endocrine dysfunction, Specially prominent in the thyroid gland and in the
Pituitary Adrenal Gland systems, Lyme Disease related Chronic Fatigue Illness,
Lyme Disease Myalgic Encephalomyelitis, Lyme disease Transverse Myelitis,
Lyme disease Muscle wasting Illness,Lyme Disease related Hepatitis, Lyme disease associated Hepatitis, Lyme Disease associated Destructive and deforming arthritis, Lyme Disease associated Squamous cell Carcinoma as a consequence of Acrodermatitis chronica Atrophicans, and Lyme Disease Neuropsychiatric Disorders.
Investigators in China have published evidence that the Lyme Disease spirochete
[chinese strain] is recoverable from some cases of Sarcoidosis in Chinese patients.
Investigators in Europe have published evidence that Lyme disease associated
Abdominal Aortic aneurysm exists in Europe.
Lyme Disease is more properly called Lyme borreliosis, because a variety of Borrelia
strains from all continents [except Antarctica] are now isolated, each with a different
strain name and each with a different potential to cause disease and or death
in human and mammalian patients.
Babesia infections [similar to Malaria- but tick transmitted] are co-travellers with
Lyme borreliosis. Borrelia exist as different strains, each with a potential to threaten
the safety of the human blood supply. Babesia infections may be diagnosed by blood smear examination by an expert pathologist. Alternatively, the detection of
antibodies which are specific to each of the strains of Babesia is possible if and only
if the test kits utilized are a perfect match for the suspected Babesia strain,based
on the geographic location where Tick transmitted Babesia infection was acquired.
For example, in the United States of America, Babesia infections on the East coast
are usually Babesia Microti, and on the West Coast Babesia duncani. In Missouri, babesia infections are Babesia strain MO. In Europe, Babesia infections may be due to a number of strains such as[but not limited to] Babesia strain Eo, strain divergens, and strain bigemina. In detection of blood antibodies - which are strain specific, the use of the proper test kit [ kit specificity restricted to one strain at a
time] is essential to avoid missing the diagnosis of Babesiosis. For example,
test kits designed to detect antibodies to Babesia microti will produce NEGATIVE
results if the patient has Babesia Duncani in his/her blood. Undetected Babesia in Blood bank units , when transfused into human hosts may produce Fatal results. A
Registry of human fatalities due to Transfusion transmitted Babesiosis is on file
at the Centers for Disease Control and prevention. Over 100 cases of transfusion
transmitted babesiosis with a Fatal outcome in the recipients have been recorded
in a 10 year interval by the CDC.Ongoing surveillance for contamination of Blood
donor units from Asymptomatic Blood donors is aggressively being conducted
in New York State . Other States in the USA may have an unrecognized
threat to the blood supply because Babesiosis screening programs are not
in place in All of the 50 states. It is well known that residents of the USA
relocate their residence to other states every 6-7years. It is therefore a real concern that Babesia infections acquired in one state may produce potential blood supply
safety issues when Blood donors relocate their residence.
In addition to Babesiosis ,other Lyme Disease complex co-infections include:
Anaplasmosis,Human granulocytic Ehrlichiosis, Human Monocytic Ehrlichiosis,
Bartonellosis (various strains), and for the Amblyomma american tick [Lone Star Tick] vector: Francisella tularenesis {Tularemia}, Rocky Mountain spotted Fever, Coxiella burnetti infection.
Tick Transmitted infections to man are the fastest growing category of
infectious diseases in the United States of America today. The Statistical
compilation of such infections, by the CDC, is admittedly an underestimate
of the true numbers of Tick tick transmitted infections in USA citizens and
in immigrants to the USA.
Respectfully,
Alan B. MacDonald MD, FCAP, FASCP
November 9,2012
Objectives for inclusion in Healthy People 2020.
ILADS is an international society of physicians, researchers,and concerned
health care professionals whom are expert in the theory and in the practice
of Lyme Disease and Related Disorders ( Co-Infections which exist simultaneously
in some Lyme Patients). Lyme Disease has the potential to cause tissue
in multiple organ systems of the human body. The first systems to be recognized
namely skin [Erythema Migrans], Joint [Lyme arthritis] , nervous system
[Borrelia meningitis and Borrelia induced Bell's {facial nerve} Palsy], and
Cardiac [ Borrelia induced Bradycardias and Tachycardias- with or without
Atrioventrio-ventricular conduction system "Heart block"] were all described
in the Pre Spirochetal Era [ in the era 1975-1980] before Dr Willy Burgdorfer
described the etiologic infectious agent of Lyme disease, namely Borrelia
burgdorferi. The expansion of Medical complications of Lyme disease
has burgeoned in the Post-Spirochetal Era to now include such diseases as
Mononeritis mutiplex, a Lyme Multiple Sclerosis-like demyelination illness,
a Lyme Amytrophic Lateral Sclerosis-like Motor Neuron Disease, Lyme
disease in pregnancy with transplacental transmission of the spirochete
across the placenta from Mother to unborn fetus causing Miscarriage , stillbirth
at term pregnancy, and linked to several congenital malformations in the
developing fetus, Lyme disease associated Neurocognitive disorders including
a Lyme disease Dementia closely resembling Alzheimer's disease, Lyme Disease
Parkinson's disease like illness, Lyme disease Cardiomyopathy, Lyme disease
Temporal arteritis-like illness with blindness, Lyme disease of the Eye with Uveitis,
Optic neuritis, and Ossifying myositis of the extra ocular muscles of the eye,
Lyme disease related Malignant lymphomas [similar in evolution to the
Lymphomas consequent to chronic Helicobacter pylori infection of the gastric
mucosa] , Lyme disease Autonomic Nervous System Dysfunction, Lyme Disease
Endocrine dysfunction, Specially prominent in the thyroid gland and in the
Pituitary Adrenal Gland systems, Lyme Disease related Chronic Fatigue Illness,
Lyme Disease Myalgic Encephalomyelitis, Lyme disease Transverse Myelitis,
Lyme disease Muscle wasting Illness,Lyme Disease related Hepatitis, Lyme disease associated Hepatitis, Lyme Disease associated Destructive and deforming arthritis, Lyme Disease associated Squamous cell Carcinoma as a consequence of Acrodermatitis chronica Atrophicans, and Lyme Disease Neuropsychiatric Disorders.
Investigators in China have published evidence that the Lyme Disease spirochete
[chinese strain] is recoverable from some cases of Sarcoidosis in Chinese patients.
Investigators in Europe have published evidence that Lyme disease associated
Abdominal Aortic aneurysm exists in Europe.
Lyme Disease is more properly called Lyme borreliosis, because a variety of Borrelia
strains from all continents [except Antarctica] are now isolated, each with a different
strain name and each with a different potential to cause disease and or death
in human and mammalian patients.
Babesia infections [similar to Malaria- but tick transmitted] are co-travellers with
Lyme borreliosis. Borrelia exist as different strains, each with a potential to threaten
the safety of the human blood supply. Babesia infections may be diagnosed by blood smear examination by an expert pathologist. Alternatively, the detection of
antibodies which are specific to each of the strains of Babesia is possible if and only
if the test kits utilized are a perfect match for the suspected Babesia strain,based
on the geographic location where Tick transmitted Babesia infection was acquired.
For example, in the United States of America, Babesia infections on the East coast
are usually Babesia Microti, and on the West Coast Babesia duncani. In Missouri, babesia infections are Babesia strain MO. In Europe, Babesia infections may be due to a number of strains such as[but not limited to] Babesia strain Eo, strain divergens, and strain bigemina. In detection of blood antibodies - which are strain specific, the use of the proper test kit [ kit specificity restricted to one strain at a
time] is essential to avoid missing the diagnosis of Babesiosis. For example,
test kits designed to detect antibodies to Babesia microti will produce NEGATIVE
results if the patient has Babesia Duncani in his/her blood. Undetected Babesia in Blood bank units , when transfused into human hosts may produce Fatal results. A
Registry of human fatalities due to Transfusion transmitted Babesiosis is on file
at the Centers for Disease Control and prevention. Over 100 cases of transfusion
transmitted babesiosis with a Fatal outcome in the recipients have been recorded
in a 10 year interval by the CDC.Ongoing surveillance for contamination of Blood
donor units from Asymptomatic Blood donors is aggressively being conducted
in New York State . Other States in the USA may have an unrecognized
threat to the blood supply because Babesiosis screening programs are not
in place in All of the 50 states. It is well known that residents of the USA
relocate their residence to other states every 6-7years. It is therefore a real concern that Babesia infections acquired in one state may produce potential blood supply
safety issues when Blood donors relocate their residence.
In addition to Babesiosis ,other Lyme Disease complex co-infections include:
Anaplasmosis,Human granulocytic Ehrlichiosis, Human Monocytic Ehrlichiosis,
Bartonellosis (various strains), and for the Amblyomma american tick [Lone Star Tick] vector: Francisella tularenesis {Tularemia}, Rocky Mountain spotted Fever, Coxiella burnetti infection.
Tick Transmitted infections to man are the fastest growing category of
infectious diseases in the United States of America today. The Statistical
compilation of such infections, by the CDC, is admittedly an underestimate
of the true numbers of Tick tick transmitted infections in USA citizens and
in immigrants to the USA.
Respectfully,
Alan B. MacDonald MD, FCAP, FASCP
November 9,2012
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