Info about (mainly) B Afzelii

Topics with information and discussion about published studies related to Lyme disease and other tick-borne diseases.
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Info about (mainly) B Afzelii

Post by X-member » Thu 5 Jan 2012 21:21

Here you can post every kind of info or studies you can find about this!

I will later give you the info I have found about B Afzelii!
Last edited by X-member on Fri 6 Jan 2012 1:38, edited 1 time in total.

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Re: Info about B Afzelii

Post by X-member » Thu 5 Jan 2012 21:37

And the winner is.....

..in Sweden:

"Tick-borne infections - interaction between vector, pathogen and human"

http://www.hu.liu.se/ike/forskare-vid-i ... g-pia?l=en
So far, we have determined a total of six different Borrelia species; B. afzelii (61%), B. garinii (21%), B. valaisiana (12 %), B. burgdorferi senu stricto (2 %), B. lusitaniae (2 %), and B. miyamotoi-like (2 %). Three percent of the ticks were shown to be co-infected with multiple strains of Borrelia species. (Wilhelmsson, P., P. Forsberg, L. Fryland, J. Nordgren, S. Börjesson, C. Ekerfelt, J. Ernerudh, S. Bergström, and P-E. Lindgren. Prevalence and diversity of Borrelia species in ticks that have bitten humans in Sweden. To be published).
And the winner is....

....in Norway (sorry have no link to give you):
Prevalence of Borrelia burgdorferi in Ixodes ricinus ticks collected
from moose (Alces alces) and roe deer (Capreolus capreolus) in southern
Norway.

Kjelland V, Ytrehus B, Stuen S, Skarpaas T, Slettan A

Ticks Tick Borne Dis 2011 06; 2 (2): 99-103

As part of a larger survey, ears from 18 roe deer (Capreolus capreolus)
and 52 moose (Alces alces) shot in the 2 southernmost counties in Norway
were collected and examined for Ixodes ricinus ticks. Seventy-two adult
ticks, 595 nymphs, and 267 larvae from the roe deer, and 182 adult
ticks, 433 nymphs, and 70 larvae from the moose were investigated for
infection with Borrelia burgdorferi sensu lato (s.l.). The results
showed the presence of B. burgdorferi s.l. DNA in 2.9% of the nymphs
collected from roe deer and in 4.4% of the nymphs and 6.0% of the adults
collected from moose. The spirochetes were not detected in adult ticks
from roe deer, or in larvae feeding on roe deer or moose. In comparison,
the mean infection prevalences in questing I. ricinus collected from the
same geographical area were 0.5% infection in larvae, 24.5% in nymphs,
and 26.9% in adults. The most prevalent B. burgdorferi genospecies
identified in ticks collected from roe deer was B. afzelii (76.5%), fo
llowed by B. garinii (17.6%), and B. burgdorferi sensu stricto (5.9%).
Only B. afzelii (76.7%) and B. garinii (23.3%) were detected in ticks
collected from moose. The present study indicates a lower prevalence of
B. burgdorferi infection in I. ricinus ticks feeding on roe deer and
moose compared to questing ticks. This is the first study to report B.
burgdorferi s.l. prevalence in ticks removed from cervids in Norway.
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Re: Info about B Afzelii

Post by X-member » Thu 5 Jan 2012 23:22

Now you have had info about how common B Afzelii is in Sweden and in Norway!

And now over to some of the problems we have in Sweden.

"Comparison of Findings for Patients with Borrelia garinii and Borrelia afzelii Isolated from Cerebrospinal Fluid"

http://cid.oxfordjournals.org/content/43/6/704.full.pdf

From the link above:

Duration of illness at time of lumbar puncture, a median duration (range):

B Garinii: 19 days (1 day to 21 months)

B Afzelii: 7.5 months (4 days to 6 years)

And here you have two Swedish neuroborreliosis-experts "answer" to the article A Critical Appraisal of “Chronic Lyme Disease”:

"Neuroborrelios i vanrykte"

http://www.lakartidningen.se/engine.php?articleId=8371

PubMed:

http://www.ncbi.nlm.nih.gov/pubmed?term ... reputation
Lakartidningen. 2007 Nov 28-Dec 4;104(48):3621-2.
[Neuroborreliosis with bad reputation. This is no mystical, difficult-to-treat infection!].
[Article in Swedish]
Hagberg L, Dotevall L.
SourceSahlgrenska Universitetssjukhuset/Ostra, Göteborg
First I give you their definition of the word chronic:
kronisk neuroborrelios (obehandlad infektion med duration mer än 6 månader)
Translation (with google translate):
chronic neurological Lyme disease (untreated infection with duration of more than 6 months)
But this article is mainly on, as I wrote in another topic:
I talk about studies! Because most cases who get a B Garinii-neuroborreliosis are diagnosed early, the studies are not done on cases with late borreliosis!
So those Swedish experts answer with the wrong info, and totally forget what is typical for B Afzelii.

They don't talk about ACA or arthritis at all in this "answer" to the article A Critical Appraisal of “Chronic Lyme Disease”!

But as you can see (in my first post) B Afzelii is more common than B Garinii!

Why don't they talk about B Afzelii??

Why only talk about (mainly) early neuroborreliosis?
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Re: Info about B Afzelii

Post by X-member » Thu 5 Jan 2012 23:31

There is another explanation to WHY those Swedish neuroborreliosis-experts wrote the article, and that is that very many people in Sweden "think" that neuroborreliosis (=stage 2) is another word for late borreliosis (=stage 3).

And I understand that the Swedish neuroborreliosis-experts don't want to held responsible for late B Afzelii, too!


I have to add:

But those who didn't understand the Swedish article correct, actually thought that this was an article about late borreliosis, and they was really angry!
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Re: Info about B Afzelii

Post by X-member » Thu 5 Jan 2012 23:44

It is easy to see in the Swedish recommendations that early neuroborreliosis is easier to cure (when it comes to treatment).

Neuroborreliosis (=stage 2 in most cases): 14 days oral Doxy 200 mg/day

ACA (=stage 3): 3 weeks of oral Doxy 200 mg/day

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Re: Info about B Afzelii

Post by X-member » Thu 5 Jan 2012 23:56

But many people "think" since they don't have ACA, it can not be B Afzelii!

That is because most info only have this single symptom (ACA) mentioned.

But a disseminated B Afzelii-infection can give a lot of symptoms, and you don't even have to have ACA.

http://cid.oxfordjournals.org/content/43/6/704.full.pdf

Symptoms for B Afzelii (from the link above):

Fatigue 80% of the cases
Malaise 80% of the cases
Sleepiness 30% of the cases
Memory disturbances 40% of the cases
Concentration disturbances 50% of the cases
Paresthesia 60% of the cases
Dizziness 60% of the cases
Nausea 30% of the cases
Vomiting 30% of the cases
Pains 90% of the cases (more detailed info on the site)
Temperature over 38 C 10% of the cases
Meningeal signs 10% of the cases
Peripheral facial palsy 10% of the cases
Arthritis 10% of the cases
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Re: Info about B Afzelii

Post by X-member » Fri 6 Jan 2012 0:13

But is really 3 weeks of oral Doxy enough maybe you ask?

I give you one of the studies (from the Swedish recommendations):

http://www.ncbi.nlm.nih.gov/pubmed/3056202
Antibiotic therapy of early European Lyme borreliosis and acrodermatitis chronica atrophicans.
Weber K, Preac-Mursic V, Neubert U, Thurmayr R, Herzer P, Wilske B, Schierz G, Marget W.

Department of Microbiology, University of Munich, Federal Republic of Germany.

Abstract
In a study on 121 consecutive patients with erythema migrans, 65 patients obtained oral penicillin, 36 tetracyclines, and 20 amoxicillin-clavulanic-acid. Follow-up was carried out for a median of 29, 17, and 7 months, respectively. In another limited trial on 29 patients with acrodermatitis chronica atrophicans (ACA), 14 patients received oral penicillin, 9 parenteral penicillin, and 6 tetracyclines. There was no statistically significant difference among treatment groups in both therapeutic trials, with the exception of different follow-ups due to the nonrandomized study design and different occurrence of the Jarisch-Herxheimer reaction in patients with erythema migrans. Later extracutaneous manifestations developed in 27% of the patients with erythema migrans and in 47% of the patients with ACA despite antibiotic therapy. We could not prove the superiority of any antibiotic tested in either early or late European Lyme borreliosis.
The answer (according to the info above) is that it is enough in 53% of the cases, but not in 47% of the cases.

But if you are not cured, they answer you with info based on the article from US. (see my earlier posts)

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Re: Info about B Afzelii

Post by X-member » Fri 6 Jan 2012 0:17

I wrote:
But if you are not cured, they answer you with info based on the article from US. (see my earlier posts)
Soo now I am very curious, is the article A Critical Appraisal of “Chronic Lyme Disease”, really supposed to be used when it comes to a late B Afzelii-infection?

And that is what I tried to point out in another topic!


I have to add:

This is how the Swedish specialists use the term chronic (again):

Quote (from the Swedish article):
untreated infection with duration of more than 6 months
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Re: Info about B Afzelii

Post by X-member » Fri 6 Jan 2012 1:30

I also give you a translated part of a comment from the Swedish article (this comment is from another physician):

http://www.lakartidningen.se/includes/0 ... =8371#1087
The authors write that "neuro-borreliosis in Sweden are treated effectively with oral doxycycline 200-400 mg / day for 10-14 days."
It may be appropriate that the authors clarify what you mean by "effective" (hardly 100%, or?) And it would also be interesting to take part of the treatment studies behind the statement that it is enough with 10-14 days of treatment.
Statements and treatment recommendations from the 'heavy' representatives in the specialty of infection may have a significant impact and should be evidence-based, ie based on controlled studies in accordance with modern quality. If not, it should be apparent that the recommendation rests on a shaky foundation.
And a part of a comment from a patient:
The famous two-week treatment was started in New Year's Eve. Was slightly better, but the pain was (still) there.

Cerebrospinal fluid samples in January, and neuro-Lyme disease was found. A new two-week course was given. Immediately after spinal cord sample rapidly (got) worse with extreme pain in the head, in bed five days.

Unable to work, sick leave, (as) it turned out, (for) 18 months.

(Then) underwent a quadruple regimen for 3 months and was significantly better, could begin to live and work again.
This patient was not cured and developed what IDSA say don't exist!

Ps! The translations are not perfect, but I hope you understand it anyway! And it is me that have put in some missing word in the text. The person that wrote the comment used a "simplified" Swedish. Ds.

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Re: Info about (mainly) B Afzelii

Post by X-member » Fri 6 Jan 2012 1:55

From the comment (in the post above):
Unable to work, sick leave, (as) it turned out, (for) 18 months.
This was not an early (neuro-) borreliosis any longer! It was a late borreliosis!

And how is it when it comes to studies on this? Do they exist?

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