Topic: Please Respond to Dr. Donohue Column: "Hysteria," "Grave doubts mother-to-child trans
Sammi
Frequent Contributor (1K+ posts)
Member # 110
posted
Someone in Florida sent me this column from the Fort Lauderale Sun-Sentinel. I found it on-line from a Detroit paper and am posting it below. Pay particular attention to the third paragraph of his reply.
This doctor is a nationally syndicated columnist. I believe his response is ignorant and dangerous. If you agree, please write to him and/or the paper that published the column.
Thursday, September 11, 2008 Dr. Paul Donohue: Your health Symptoms of Lyme disease
Dear Dr. Donohue: My daughter has been very ill since 1994. She suffers every day from pain in almost every part of her body. She is only 40. She went to a naturopathic doctor who just recently was knighted for her work with autistic children. When my daughter saw her, the doctor knew immediately that my daughter suffers from Lyme disease.
Research states that if you become pregnant while infected, it is likely the parasite will affect the child. My grandson has many Lyme symptoms. He is only 9. What do you know about Lyme disease? What can be done to get rid of the parasite that causes it? Is there someone in her area who can treat it?
G.P.
Dear G.P.: Lyme disease is an infection transmitted to humans by ticks infected with a bacterium called Borrelia burgdorferi. It was only in the mid-1970s that the relationship between humans, ticks and the Borrelia bacterium was established in children on the East Coast who were mistakenly diagnosed as having arthritis. The outbreak centered in Lyme, Conn., and that's how it came by its name.
Lyme disease goes through stages. The earliest stage is heralded by a distinctive skin rash -- erythema migrans -- which consists of a red circular patch that grows to at least 2 inches in diameter and can attain a diameter of 6 inches. Often, the center clears and gives it a bull's-eye appearance. Untreated Lyme features many symptoms -- sore joints, achy muscles, fatigue, neurologic signs, heart-rhythm abnormalities and pain. Treatment consists of antibiotics, and the ones often used are doxycycline or amoxicillin. Almost all patients make a full recovery.
Much of what is written and said about Lyme disease is generated by hysteria, and not founded on facts. Your information on what happens in pregnancy is an example. Most authorities have grave doubts that mother-to-child transmission occurs.
Your daughter lives only 70 miles from the largest city in her state, where there is an excellent medical school and an excellent department of infectious diseases. She should see one of the doctors in that department.
Write to Dr. Paul Donohue at P.O. Box 536475, Orlando, FL 32853-6475.
Posts: 4682 | Registered: Oct 2000
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AliG
Frequent Contributor (1K+ posts)
Member # 9734
posted
Send the ignoramus studies on mosquito transmission too.
Better yet send him all the studies that refute that there are no studies. He should have fun reading some 12,000 studies.
He should probably also be made aware of the CT AG's RICOH investigation of the authors of the ILADS guidelines & the fact that those guidelines are being reevaluated.
I really hate when people speak authoritatively from a place of ignorance.
-------------------- Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner. Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006
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posted
Someone should tell him to see the move or send him a copy of the movie "Under Our Skin". I just saw it this week....masterfully done!! I highly recommend it!
Posts: 56 | From Downingtown, PA | Registered: Jun 2007
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Melanie Reber
Frequent Contributor (5K+ posts)
Member # 3707
posted
Hi there Sam-I-Am!
Hope you are doing wonderfully, my old friend! Also hope the below citations will help:
....
Gestational Lyme borreliosis. Implications for the fetus. MacDonald AB. Rheum Dis Clin North Am, 15(4):657-77. 1989.
Autopsy and clinical studies have associated gestational Lyme borreliosis with various medical problems including fetal death, hydrocephalus, cardiovascular anomalies, neonatal respiratory distress, hyperbilirubinemia, intrauterine growth retardation, cortical blindness, sudden infant death syndrome, and maternal toxemia of pregnancy.
Borrelia burgdorferi in a newborn despite oral penicillin for Lyme borreliosis during pregnancy. Weber K, Bratzke HJ, Neubert U, Wilske B, Duray PH. Pediatric Infectious Disease Journal, 7:286-9. 1988.
Congenital infections and the nervous system. Bale JF Jr, Murph JR. Pediatr Clin North Am Aug;39(4):669-90 1992
Despite vaccines, new antimicrobials, and improved hygienic practices, congenital infections remain an important cause of death and long-term neurologic morbidity among infants world-wide. In addition, several other agents, such as the varicella zoster virus, human parvovirus B19, and Borrelia burgdorferi, can potentially infect the fetus and cause adverse fetal outcomes.
Maternal-fetal transmission of the Lyme disease spirochete, Borrelia burgdorferi. Schlesinger PA, Duray PH, Burke BA, Steere AC, Stillman MT. Ann Intern Med. 1985 Jul;103(1):67-8. PMID: 4003991
We report the case of a woman who developed Lyme disease during the first trimester of pregnancy. She did not receive antibiotic therapy. Her infant, born at 35 weeks gestational age, died of congenital heart disease during the first week of life. Histologic examination of autopsy material showed the Lyme disease spirochete in the spleen, kidneys, and bone marrow.
"Transplacental infection by Borrelia burgdorferi (Bb), the agent of Lyme Borreliosis (LB), has recently been documented (L.E. Markowitz, et al; P.A. Schlesinger, et al). Fetal infection confirmed by culture has been reported by A.B. MacDonald (in press) from a highly endemic region (Long Island, NY).
We report a culture positive neonatal death occurring in California, a low endemic region. The boy was born by C-section because of fetal distress. He initially appeared normal. He was readmitted at age 8 days with profound lethargy leading to unresponsiveness. Marked peripheral cyanosis, systemic hypertension, metabolic acidosis, myocardial dysfunction, & abdominal aortic thrombosis were found. Death ensued. Bb was grown from a frontal cerebral cortex inoculation. The spirochete appeared similar to the original Long Island tick isolate. Silver stain of brain & heart was confirmatory of tissue infection.
The infant was the second born to a California native. The 20 m/o sibling was well. The mother had been having migratory arthralgias and malaise since experiencing horse fly & mosquito bites while camping on the Maine coast in 1971. The family was seronegative for LB by ELISA at Yale. Cardiolipin antibodies were also not found."
Stillbirth following maternal Lyme disease. MacDonald AB, Benach JL, Burgdorfer W. N Y State J Med, Nov;87(11):615-6 1987
The infectious origins of stillbirth. Goldenberg RL, Thompson C. Am J Obstet Gynecol. 2003 Sep; 189(3):861-73. 2003. PMID: 14526331
Toxoplasma gondii, leptospirosis, Listeria monocytogenes, and the organisms that cause leptospirosis, Q fever, and Lyme disease have all been implicated as etiologic for stillbirth.
Lyme disease during pregnancy. Markowitz LE, Steere AC, Benach JL, Slade JD, Broome CV. JAMA Jun 27;255(24):3394-6. 1986.
Of the 19 pregnancies, five had adverse outcomes, including syndactyly, cortical blindness, intrauterine fetal death, prematurity, and rash in the newborn. Adverse outcomes occurred in cases with infection during each of the trimesters. Although B burgdorferi could not be implicated directly in any of the adverse outcomes, the frequency of such outcomes warrants further surveillance and studies of pregnant women with Lyme disease.
Infections in Obstetrics: Lyme disease during Pregnancy Helayne M. Silver, MD Infectious Disease Clinics of North America Vol 11 Number 1 1 March, 1997
The infant had severe congenital cardiac defects resulting in neonatal death at 39 hours of life. The neonatal autopsy revealed hypoplastic left side of heart and other cardiac anomalies. Spirochetes compatible with B. burgdorferi were found in the spleen, kidneys, and bone marrow; however, no inflammatory response to the organisms was seen.
Human fetal borreliosis, toxemia of pregnancy, and fetal death. MacDonald AB. Zentralbl Bakteriol Mikrobiol Hyg [A]. Dec; 263(1-2):189-200. 1986. PMID: 3554838
Congenital relapsing fever (Borrelia hermsii). William A. Dittman Sr, Sacred Heart Medical Center, Spokane, WA. Blood, 15 November 2000, Vol. 96, No. 10, pp. 3333-3333
A 35-week infant was delivered by cesarean section because of fetal distress. Her mother presented to Sacred Heart Medical Center early because of decreased fetal movement. At delivery, the child demonstrated respiratory depression requiring intubation and manual resuscitation. Apgar scores were 1 at one minute and 5 at five minutes. The "admitting" diagnosis was sepsis with shock. Cord blood counts revealed a white blood cell count at 8.2/�L, hemoglobin level at 16.4g/dL, hematocrit level at 48.8%, and platelet count at 8/�L. Nucleated red blood cells were 88 per 100 white blood cells. During verification of the platelet count with the blood film, multiple spirochetes were seen (A), many in clumps (B). These spirochetes were further classified and confirmed by immunofluorescent antibody staining as Borrelia hermsii.
No organisms were seen on multiple blood films of the mother. Although the placenta was grossly and microscopically normal, silver stains demonstrated spirochetes.
A review of the prenatal history identified an episode of fever, chills, aching, headache, and fatigue which occurred at week 16 of the pregnancy. The mother recalled a similar one-day illness at week 19. There were no other untoward events until presentation.
The child was treated with fluids for the septic shock. Ampicillin and cefotaxime were given initially, and erythromycin was added when the spirochetes were found. Dexamethasone was administered for the septic shock and thrombocytopenia. Improvement was progressive until day 9 when hypotension, pallor, and abdominal distension occurred. Autopsy revealed bleeding into a liver abscess with subsequent rupture of a subcapsular hematoma. No organisms were found in the abscesses at autopsy.
Relapsing fever (tick-borne borrelia hermsii) is endemic to the western United States. It is transmitted by the Ornithodoros hermsii tick.
Tick-borne relapsing fever and pregnancy outcome in rural Tanzania. Jongen VH, van Roosmalen J, Tiems J, Van Holten J, Wetsteyn JC. Acta Obstet Gynecol Scand. Oct; 76(9):834-8. 1997. PMID: 9351408
The impact of tick-borne relapsing fever (TBRF) on pregnancy outcome was investigated in a case-control study of 137 pregnant women and 120 non-pregnant women infected with this condition and treated at a rural hospital in Tanzania's Tabora region during 1985-95. The risk of premature delivery during TBRF was 58%, with a perinatal mortality of 436 per 1000 births. Total pregnancy loss, including abortions, was 475 per 1000. The case-fatality rate was 1.5% in pregnant women compared with 1.7% in non-pregnant controls. The relapse rate was 3.6% in pregnant women and 1.7% in controls. Pregnant women with TBRF had higher densities of spirochetes than controls, and the risk of delivery during an attack was significantly correlated with increasing spirochete density and gestational age.
Complications of pregnancy and transplacental transmission of relapsing-fever borreliosis. Larsson C, Anderson M, Guo BP, Nordstrand A, Hagerstrand I, Carlsson S, Bergstrom S. J Infect Dis. 2006 Nov 15;194(10):1367-74. Epub 2006 Oct 3. PMID: 17054065
Relapsing-fever borreliosis caused by Borrelia duttonii is a common cause of complications of pregnancy, miscarriage, and neonatal death in sub-Saharan Africa.
.....
The only thing gravely misrepresented here, is his understanding of these deadly diseases,
posted
I saw it the Providence Journal and a Massachusetts newspaper. Was disgusted by the widespread distribution of his column.
Thought I would write him and maybe send a little reading material along for his education.
And I can't address the letter, "Dear Nitwit" so I thought if I waited for my anger to subside it might be a better and more compelling letter.
Posts: 79 | From Rhode Island | Registered: Jun 2008
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Sammi
Frequent Contributor (1K+ posts)
Member # 110
posted
I hear you Tick Tock!
I sent him a letter with back-up research. It was very hard not to give him a piece of my mind, but I managed!
Posts: 4682 | Registered: Oct 2000
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TBRF contacted during pregnancy can cause spontaneous abortion, premature birth, and neonatal death (Melkert and Stel 1991). The maternal-fetal transmission of Borrelia is believed to occur either transplacentally (Steenbarger 1982) or while traversing the birth canal. In one study, perinatal infection with TBRF was shown to lead to lower birth weights, younger gestational age, and higher perinatal mortality (Jongen, van Roosmalen et al. 1997).
In general, pregnant women have higher spirochete loads and more severe symptoms than nonpregnant women. Higher spirochete loads have not, however, been found to correlate with fetal outcome.
CDC's website about lyme:
Lyme disease and pregnancy In rare cases, Lyme disease acquired during pregnancy may lead to infection of the fetus and possibly to stillbirth, but adverse effects to the fetus have not been conclusively documented. The Centers for Disease Control and Prevention (CDC) maintains a registry of pregnant women with Lyme disease to advance the understanding of the effects of Lyme disease on the developing fetus.
FUNNY HOW THEIR WEBSITE CAN SAY ONE BORRELIAL INFECTION CAN CAUSE FETAL DEATH AND ANOTHER HASN'T BEEN "CONCLUSIVELY DOCUMENTED".
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