What if some Lyme isn't really Lyme?

[Guest guest]

" ...it could also be a bacteria or a virus or any number of other

things, " ...

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What if some Lyme isn't really Lyme?

By SHAWNE K. WICKHAM, Sunday News Staff

The Union Leader - Manchester,NH,USA - October 9, 2005

http://www.theunionleader.com/articles_showfast.html?article=61552

What if the debilitating illness that sickens hundreds of New

Hampshire residents every year comes from a different strain of

bacteria than the one that causes Lyme disease in other states?

Could that help resolve the ongoing controversy over testing and

treatment of an illness that often continues even after patients are

treated with antibiotics?

Some medical experts say it's possible.

Dr. Montero, state epidemiologist at the Department of Health

and Human Services, said there are many diseases that can cause

similar symptoms and even cross-react in diagnostic tests — such as

West Nile virus, Eastern equine encephalitis and St. Louis

encephalitis, which are all transmitted by mosquitoes.

" It may be in the realm of possibility that something similar may be

happening to these particular patients, " he said, referring to Lyme

disease patients who have chronic symptoms, even after treatment. " It

may be that we are missing some other thing that looks similar and

causes a similar illness but as yet has not been identified. "

Indeed, scientists have discovered that some patients who get Lyme

disease also become co-infected — apparently from the same tick bite —

with other tick-borne diseases, including babesiosis and

erlichiosis. Such co-infections can make diagnosis and treatment more

problematic, doctors say.

Different types of Lyme?

Dr. Rex Carr, a Lebanon physician who treats numerous Lyme disease

patients, noted there are different strains of the " borrelia "

spirochete that causes Lyme disease; Europe sees different strains

than the one identified as the cause of illness in Lyme, Conn., he

said.

Here's his theory about why some New Hampshire patients test negative

for Lyme disease, despite having numerous symptoms of the

illness: " There's probably more than one bacteria causing the disease

that we're seeing. In other words, it may not be Lyme, Connecticut,

Lyme disease, and that's why the disparity in the testing. "

He noted several years ago, health department officials in Missouri

began tracking an illness that looked a lot like Lyme disease, with a

similar rash and flu-like symptoms. But patients tested negative for

Lyme disease; the look-a-like illness became known as Master's

disease, after the family doctor who first started studying it.

The CDC refers to this new illness as " Southern tick-associated rash

illness " (STARI), and attributes it to the bite of the lone star tick

in southeastern and south-central states. The agency, on its Web

site, notes that a spirochete, distinct from the one that causes Lyme

disease, has been detected using DNA analysis.

Different spirochetes

Meanwhile, a study published in an obscure medical journal — Vector-

Borne Zoonotic Diseases — in the spring of 2001 reported the

discovery of " a species of Borrelia spirochetes previously unknown

from North America has been found to be transmitted by Ixodes

scapularis ticks. " Those are the black-legged ticks that transmit

Lyme disease in Eastern states, including New Hampshire.

The study found the spirochete was distinct from the one that causes

Lyme disease, but closely related to a group of spirochetes found in

similar ticks in Japan. The study found the new spirochete in ticks

from Connecticut, Rhode Island, New York and New Jersey.

The study concluded that " further work is needed to determine the

potential health significance of yet another zoonotic agent

transmitted by this tick species. "

Other possibilities

Mead, a medical epidemiologist at the Centers for Disease

Control, said he can't rule out the possibility that another bacteria

is causing a Lyme-like illness in New Hampshire.

But he said the antibody testing done to detect Lyme disease

would " likely " still turn up positive for another strain of the

bacteria. " One of the strengths of serologic testing is that it can

produce cross-reactions, so if you are infected with a closely

related organism you will often test positive, " he said.

" Now, is it possible that there's some borrelia which is a very weird

mutant and quite a bit different and causing these symptoms? It's

possible, but it could also be a bacteria or a virus or any number of

other things, " he said.

Copyright 2005 The Union Leader Corporation All rights reserved.

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