Health Through Knowledge

The Serano Group


Thursday, August 20, 2009

Borreliosis Questions Needing Answers

Borreliosis is grossly understudied. Most existing research force fits evidence into a conceptal model of "Lyme disease", which has become increasingly remote from the realities of infection with the bacterium Borrelia burgdorferi. Too much research has been dedicated to supporting unsuccessful vaccine attempts and justification of unacceptable test routines. In August, 2009, the National Library of Medicine’s PubMed service lists 8681 medical journal papers related to "Lyme disease". The search term “Borrelia” produces 8070 papers. Very few of these papers address the essential questions of diagnosis and treatment.

Meaningful research is needed to answer the following questions:


Symptoms

Which symptoms are most indicative of borreliosis?

How much symptom overlap is there with other diseases and conditions?

What percentage of people with Bb have an EM rash?

What percentage of people without EM rash have Bb?

What does an untreated case look like?

Does a new Bb infection look different than a relapse?

Can symptom changes indicate a Bb infection is under control?

How can other illnesses be ruled out?

What percentage of people with working diagnoses of other illnesses actually have Bb?

Tests

How sensitive are the tests?

How specific is a positive test to Bb infection?

How many strains are detected by available tests?

How do test results change during the course of infection?

How do test results change during the course of treatment?

What is the best strategy for ordering tests during the course of illness or treatment?

Coinfections

How many types of coinfections are there?

How do coinfections interact with Bb?

What could lead to missing one or more of these coinfections?

What other infections or illnesses is a person with Bb or coinfections likely to have?

How does Bb interact with other infections?


Treatment

Which treatments are most effective for Bb?

Which treatments are most effective for Babesia?

Which treatments are most effective for Bartonella?

Which treatments are most effective for Anaplasma?

Which approaches are best for one or more infections?

Do treatments affect only the specific targeted pathogen?

Can genetic factors affect the course of the illness?

Can infected people recover?

How much function can infected people regain?

What is the range and types of Herxheimer reactions?

Is Bb ever completely eliminated?

What harm is caused to the individual by antibiotics?

What harm is caused to society by antimicrobial treatments?

Transmission

Besides ticks, what other routes (means) of transmission are there?

What is the geographic range in mammals?

What is the prevalence (continuing cases) in humans?

What is the incidence (new cases) of infections?

What causes the difference in disease course in individuals?

What causes the change from latent to acute infection?

Basic Microbiology

What are the mechanisms of persistence?

How does Bb resist antimicrobial treatment?

What is the importance of cyst forms?

How many strains of Bb are there?

How similar is Bb infection to syphilis?

How many strains of each co-infection are there?

How does Bb infection differ from syphilis?

How many animal vectors are there?

Do these infections turn on or off expression of genetic factors?

Posted by Joel Spinhirne
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