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Lymenet Newsletter

Volume: 1
Issue: 24
Date: 25-Oct-93

Table of Contents:

Prehistoric Lyme
(The History of Lyme Disease)

Newsletter:

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* LymeNet Newsletter *
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Volume 1 - Number 24 - 10/25/93

SPECIAL REFERENCE ISSUE
PREHISTORIC LYME

I. Special Section
II. Jargon Index
III. How to Subscribe, Contribute and Get Back Issues


I. ***** SPECIAL SECTION *****

From: Frank Demarest <76116.2065@CompuServe.COM>
Subject: Prehistoric Lyme

We recently found an interesting publication which included the early
history of Lyme Disease.

Acta Pediatrica Vol 82, Feb 1993, Supplement 386 (75 pages, 356 references).
"Epidemiology and Clinical Manifestations of Lyme Borreliosis in Childhood
- A Prospective Multicentre Study with Special Regard to Neuroborreliosis"

The following information is from Table 1 and the text. The reference numbers
correspond to the original, and are in the bibliography which follows.

[[ Editorial comments in brackets ]]
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Year Ref
1883 42 Acrodermatitis chronica atrophicans (ACA)
1902 120 ACA
1910 7 Erythema Chronicum Migrans (ECM) after tick bite (Afzelius)
1913 178 ECM after tick bite
1922 88 Deltoid paralysis after tick bite and ECM
1930 119 Erythema Migrans and Lymphocytic Meningitis
1941 22 Lymphocytic meningoradiculitis (Bannwarth)
1942 230 Allergic meningitis
1943 19 Lymphadenosis benigna cutis (LABC)
1946 355 Chronic allergic meningitis
1949 266 Chronic aseptic meningitis
1946 316 ACA - Penicillin therapy
1949 319 ACA - Penicillin therapy
1951 127 Erythema migrans / meningitis - Penicillin therapy
1954 94 ACA - transmission in humans
1955 95 ACA - transmission in humans
1955 38 ECM - transmission in humans
1957 225 LABC - Transmission in humans
1955 116 ACA after tick bites
1966 129 ACA and peripheral neuropathy
1966 265 Lymphocytic meningitis after tick bite and ECM
1973 212 International symposium on arboviruses
"Nearly the entire clinical spectrum of the disease
known today as Lyme borreliosis was presented"
1973 130 International symposium on arboviruses
1976 304 Lyme arthritis after tick bite and ECM (Steere)

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The following information is from abstracts of Dr. Steere's papers:

Year Ref
1977 305 EM rash, arthritis, suspected arthropod vector.
1977 S1 EM rash, arthritis, malaise, fatigue, chills and fever, headache,
stiff neck, backache, myalgias, nausea, vomiting, and sore throat,
neurologic abnormalities, myocardial conduction abnormalities.
1978 S2 Has since been found elsewhere and may be caused by a virus
transmitted by ticks. Symptomatic treatment only is advised,
except in the rare instances of severe neurologic complications
or myocardial conduction abnormality.
1978 S3 Findings support the hypothesis that erythema chronicum migrans
and Lyme arthritis are tick-transmitted, specifically by
I. scapularis.
1979 S4 Defined by erythema chronicum migrans and sometimes followed by
neurologic, cardiac, or joint involvement. Distribution
correlates closely with that of Ixodes dammini and Ixodes
pacificus.
1980 S5 Erythema chronicum migrans and its associated symptoms resolved
faster in patients given penicillin or tetracycline.
1983 S6 Recovered spirochetes from the blood, skin lesions or
cerebrospinal fluid of 3 of 56 patients with Lyme disease and
from 21 of 110 ticks.
1983 S7 Reported studies done in 1980-81. For early Lyme disease,
tetracycline appears to be the most effective drug, then
penicillin, and finally erythromycin. Nearly half had later
symptoms.
1983 S8 High-dose intravenous penicillin for neurologic abnormalities of
Lyme disease.
1984 S9 Confirmed spirchetal cause of LD with experiments on rabbits.
1984 S10 Lyme disease long recognized in Europe but only recently
recognized in the United States. Compared DNA of 10 strains.
1985 S11 A double-blind placebo-controlled trial carried out from 1980 to
1982, patients with established Lyme arthritis, 20 treated with
penicillin weekly for three weeks and 20 received saline. Seven
of the 20 penicillin-treated patients (35%) had complete
resolution of arthritis soon after the injections and have
remained well during a mean follow-up period of 33 months. All 20
patients given placebo continued to have attacks of arthritis.
In 1983, of 20 patients treated with daily intravenous penicillin
G for 10 days, 11 (55 per cent) had complete resolution of
arthritis and have remained well since.
1987 S12 To determine the clinical evolution of Lyme arthritis, 55
patients who did not receive antibiotic therapy for erythema
chronicum migrans were followed longitudinally for a mean
duration of 6 years.

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[[ Note that Dr. Steere studied the problem for about 3 years before
reporting on trying antibiotics, then waited 3 more years, until Dr.
Burgdorfer discovered the spirochete, before agressively using antibiotic
treatment. Then the next year he mentions that the disease has long been
recognized in Europe. It would be interesting to know if the study reported
in 1987 continued after 1983, when the spirochete was discovered. It is
apparent that Dr. Steere has done a lot of research, and his main talent is
as an academic researcher, not as a clinician. ]]

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7 Afzelius A.
Verhandlungen der dermatologischen Gesellschaft zu Stockholm.
Arch Dermatol Syph 1910;101:404
19 Bafverstedt B.
Uber Lymphadenosis benigna cutis.
Eine klinische und pathologisch-anatomische Studie.
Acta Derm Venereol (Stockh) 1943;23 (Supl 11):1-202
22 Bannwarth A.
Chronische lymphocytare Meningitis,
enzundliche Polyneuritis und "Rheumatismus".
Arch Psychiatr Neurvenkr 1941;113:284-376
38 Binder E, Doepfmer R, Hornstein O.
Experimentelle Ubertragung des erythema chronicum migrans
von Mensch zu Mensch.
Hautarzt 1955;6:494-6
42 Buchwald A.
Ein Fall von diffuser idiopathischer Haut-Atrophie.
Arch Derm Syph 1883;15:553-6
88 Garin CH, Bujadoux CH.
Paralysie par les tiques
J Med Lyon 1922;71:765-7
94 Gotz H.
Die Acrodermatitis chronica atrophicans Herxheimer
als Infektionskrankheit.
Hautarzt 1954;5:491-504
95 Gotz H.
Die Acrodermatitis chronica atrophicans Herxheimer
als Infektionskrankheit (Erganzung zur l. Mitteilung).
Hautarzt 1955;6:249-52
116 Hauser W.
Zur Kenntnis der Acrodermatitis chronica atrophicans.
Arch Derm Syph 1955;199:350-93
119 Hellerstrom S.
Erythema chronicum migrans Afzeli.
Acta Derm Venereol (Stockh) 1930;11:315-21
120 Herxheimer K. Hartmann K.
Uber Acrodermatitis chronica atrophicans.
Arch Derm Syph 1902;61:57-76,255-300
127 Hollstrom E.
Successful treatment of erythema migrans Afzelius.
Acta Derm Venereol (Stockh) 1951;31:235-43
129 Hopf HC.
Acrodermatitis chronica atrophicans (Herxheimer) und Nervensystem.
Monographien aus dem Gesamtgebiet der Neurollogie und Psychiatrie.
Heft 114. Berlin Heidelburg New York: Springer; 1966
130 Hopf HC.
Epidemiologie der Radikulomyelomeningitis mit Erythem
nach ZeckenbiB in der Umbebung von Gottingen.
In: Muller WK, Schaltenbrand G eds
Arboviruserkrankungen des Nervensystems in Europa.
Stuttgart: Thieme; 1975;253-4
178 Lipschutz B.
Uber eine seltene Erythemform (Erythema chronicum migrans).
Arch Derm Syph 1913;118:349-56
212 Muller WK, Schaltenbrand G eds
Arboviruserkrankungen des Nervensystems in Europa.
Stuttgart: Thieme; 1975
225 Paschoud JM.
Die Lymphadenosis benigna cutis als ubertragbare Infektionskrankheit.
Hautarzt 1957;8:197-211
230 Pette H.
Die akut entzundlichen Erkrankungen des Nervensystems.
Leipzig: Thieme; 1942;302-5
265 Schaltenbrand G.
Durch Arthropoden ubertragene Erkrankungen der Haut und des
Nervensystems. MMW 1966;108:1557-62
266 Schaltenbrand G.
Chronische aseptische Meningitis.
Nervenarzt 1949;20:433-42
304 Steere AC, Malawista SE, Snydman DR, Andiman WA.
A cluster of arthritis in children and adults in Lyme, Connecticut.
Arthritis Rheum 1976;19:824
305 Steere AC, Malawista SE, Snydman DR, Shope RE, Andiman WA,
Ross MR, Steele FM.
Lyme arthritis: an epidemic of oligoarticular arthritis in children
and adults in three Connecticut communities.
Arthritis Rheum 1977;20:7-17.
316 Svartz N.
Penicillinbehandling vid dermatitis atrophicans Herxheimer.
Nord Med 1946;32:2783
319 Thyresson N.
The penicillin treatment of acrodermatitis atrophicans
chronica (Herxheimer).
Acta Derm Venereol (Stockh) 1949;29:572-621
355 Zellweger H.
Uber die chronische allergische Meningitis.
Helv Paediatr Acta 1946;1:417-26

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S1 Steere AC Malawista SE Hardin JA Ruddy S Askenase W
Andiman WA
Erythema chronicum migrans and Lyme arthritis. The enlarging clinical
spectrum.
Ann Intern Med 1977 Jun;86(6):685-98
S2 Steere AC Hardin JA Malawista SE
Lyme arthritis: a new clinical entity.
Hosp Pract 1978 Apr;13(4):143-58
S3 Steere AC Broderick TF Malawista SE
Erythema chronicum migrans and Lyme arthritis: epidemiologic evidence
for a tick vector.
Am J Epidemiol 1978 Oct;108(4):312-21
S4 Steere AC Malawista SE
Cases of Lyme disease in the United States: locations correlated with
distribution of Ixodes dammini.
Ann Intern Med 1979 Nov;91(5):730-3
S5 Steere AC Malawista SE Newman JH Spieler PN Bartenhagen NH
Antibiotic therapy in Lyme disease.
Ann Intern Med 1980 Jul;93(1):1-8
S6 Steere AC Grodzicki RL Kornblatt AN Craft JE Barbour AG
Burgdorfer W Schmid GP Johnson E Malawista SE
The spirochetal etiology of Lyme disease.
N Engl J Med 1983 Mar 31;308(13):733-40
S7 Steere AC Hutchinson GJ Rahn DW Sigal LH Craft JE DeSanna ET
Malawista SE
Treatment of the early manifestations of Lyme disease.
Ann Intern Med 1983 Jul;99(1):22-6
S8 Steere AC Pachner AR Malawista SE
Neurologic abnormalities of Lyme disease: successful treatment with
high-dose intravenous penicillin.
Ann Intern Med 1983 Dec;99(6):767-72
S9 Kornblatt AN Steere AC Brownstein DG
Experimental Lyme disease in rabbits: spirochetes found in erythema
migrans and blood.
Infect Immun 1984 Oct;46(1):220-3
S10 Schmid GP Steigerwalt AG Johnson SE Barbour AG Steere AC
Robinson IM Brenner DJ
DNA characterization of the spirochete that causes Lyme disease.
J Clin Microbiol 1984 Aug;20(2):155-8
S11 Steere AC Green J Schoen RT Taylor E Hutchinson GJ Rahn DW
Malawista SE
Successful parenteral penicillin therapy of established Lyme
arthritis.
N Engl J Med 1985 Apr 4;312(14):869-74
S12 Steere AC Schoen RT Taylor E
The clinical evolution of Lyme arthritis.
Ann Intern Med 1987 Nov;107(5):725-31
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II. ***** JARGON INDEX *****

Bb - Borrelia burgdorferi - The scientific name for the LD bacterium.
CDC - Centers for Disease Control - Federal agency in charge of tracking
diseases and programs to prevent them.
CNS - Central Nervous System.
ELISA - Enzyme-linked Immunosorbent Assays - Common antibody test
EM - Erythema Migrans - The name of the "bull's eye" rash that appears in
~60% of the patients early in the infection.
IFA - Indirect Fluorescent Antibody - Common antibody test.
LD - Common abbreviation for Lyme Disease.
NIH - National Institutes of Health - Federal agency that conducts medical
research and issues grants to research interests.
PCR - Polymerase Chain Reaction - A new test that detects the DNA sequence
of the microbe in question. Currently being tested for use in
detecting LD, TB, and AIDS.
Spirochete - The LD bacterium. It's given this name due to it's spiral
shape.
Western Blot - A more precise antibody test.


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Editor-in-Chief: Marc C. Gabriel <mcg2@Lehigh.EDU>
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Contributing Editors: Carl Brenner <brenner@ldeo.Columbia.EDU>
John Setel O'Donnell <jod@Equator.COM>
Frank Demarest <76116.2065@CompuServe.COM>
Advisors: Carol-Jane Stolow, Director
William S. Stolow, President
The Lyme Disease Network of New Jersey (908-390-5027)
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