Syphilis of the Forest"
Borrelia burgdorferi : in Germany the most common tick-borne pathogens.
© Sebastian Schreiter / Springer Verlag
ERFURT .
Because of the multitude of possible long-term consequences , the tick-borne Lyme disease is considered as a syphilis from the forest. Many diseases are thereby being mimicked, especially autoimmune diseases. One reason is the rich and varied appearance and distribution pattern of the causative Borrelia.
ERFURT .
Because of the multitude of possible long-term consequences , the tick-borne Lyme disease is considered as a syphilis from the forest. Many diseases are thereby being mimicked, especially autoimmune diseases. One reason is the rich and varied appearance and distribution pattern of the causative Borrelia.
There are several Borrelia species which belong to the B. burgdorferi senso lato- complex, and which are occasionally found in symptomatic patients , reported Professor Christian Peronne from Paris at the Annual Meeting of the German Borreliosis Society ( DBG ) in Erfurt.
These include B. spielmanii in early skin lesions , as lonestari could be responsible for a Lyme disease - like illness , B. lusitaniae has been found in vasculitis patients.
It was only recently discovered as miyamotoi , which is responsible for recurrent attacks of fever or Lyme disease - like illness in Asia, Europe and North America - to name just a few.
In addition, further transmitted when a tick bite bacteria , viruses or parasites might be relevant to whether and what symptoms occur . Thus it has been found in the U.S. in two to twelve percent of Lyme disease patients , a human granulocytic anaplasmosis , two to 40 percent of a triggered by Babesia malaria - like illness .
So let's talk for Lyme disease across many different diseases, it is in fact a syndrome ? This is already possible , says Professor Karl Bechtel from Ulm, one of the organizers of the DBG Congress.
He recalled that infection does not mean the same disease , "Any infectious disease also depends on the host , whose genetic endowment , the current state of his immune system and other infections that have occurred previously or not. "
Pathogens survive and defy antibiotics
If you look at the capabilities of the pathogen to , it must be noted that we are dealing with a very tricky opponent . He likes to retreat to bradytrophic tissue and changes its shape so that it is often not recognized under the microscope .
The Borrelia form cysts and can survive as such for a long time and defy antibiotics. Furthermore, they show a kind of swarm behavior . A high-resolution atomic force microscope Professor Eva Sapi from New Haven has been observed in the USA " live " as the Borrelia form up within a few days to symmetric structures and form a biofilm .
This describes Sapi as " city-like " structure with supply and disposal channels. In vitro, these biofilms were with various combinations of antibiotics not to crack , possibly the bacterial load was curb .
How does that represent in vivo is not yet clear , but there are indications that also in vivo, these biofilms are formed. The routine diagnostic tools to identify such a flexible pathogen have been described in the DBG Congress unanimously as totally inadequate.
The ELISA was simply not suitable as a screening test . Peronne cited several studies in which the sensitivity of the assays offered commercially by 37-70 percent , was located 20-98 percent and 34-59 percent times .
Urgently needed better diagnostic tests
" Sometimes it's not the composition of the test problems , but the type of conduct in the labs ," criticizes DBG CEO Professor Hartmut Prautzsch . And Bechtel adds that the manufacturers simplify the scientifically developed test partially , which further adversely affects the sensitivity .
Which laboratory test which applies , the delegator doctor knows anyway - it would hardly help him . Even today, it would be possible to improve the assay , experts say. But part of the manufacturers seem to it to be no interest.
And in terms of antibody in the Western blot evidence applies : you can only see what you know. Although the Western blot has a slightly higher sensitivity than the ELISA. But even in the early stages of Lyme disease must be considered in about 20 percent of cases of seronegativity , in the late phase are up to 50 percent seronegative !
The diagnostic tools require so much of improvement. Appropriate research should be supported by public money , call Bechtel and others. This will only happen if the disease has been recognized as a significant health problem.
In the U.S., there is more . The Centers for Disease Control and Prevention (CDC ) stated in August 2013 that Lyme disease was a " huge public health problem ," because the actual number of new patients per year apparently was ten times higher than the number of reported new cases .
