Monthly Meeting Report
January 2013 Monthly Meeting Report
Report by Michael Filosa
Photos by Morton Z. Hoffman
 
If the January Meeting is a foreshadowing, we can expect a very interesting year of NESACS monthly meetings. Cathy Costello, the NESACS Chair-Elect for 2013 is the program chair for 2013. For the first seminar of the year, she asked her long-time professional colleague, Dr. Allen C. Steere of Harvard Medical School to speak at our first monthly meeting of the year about “The Elucidation of Lyme Disease.” The meeting was hosted in the 14th floor Hiebert Lounge at the Boston University School of Medicine of which Dr. Costello is a member of the faculty.
As Nucleus editor, I am involved in the publicizing of meetings and need information from the program chair for publication in the Nucleus. As I was waiting for biographical information, I decided to Google Dr. Steere and soon found that although his work is very well accepted by the scientific and medical establishment, there is a “Lyme disease counter culture” that is highly critical of the accepted treatment protocols for Lyme disease and question the fundamental science and the history of the origins of Lyme disease.
There are a large number of patients who believe they suffer from “Chronic Lyme Disease” and that they need to have continuous treatment of antibiotics to prevent the recurrence of symptoms. They claim the bacterium can adopt a slow growing form which hides undetected in the body and bursts forward in a relapse of symptoms (which can be extremely debilitating and life-threatening) once antibiotic treatment is stopped.
There are a number of physicians and politicians who support these patients and there have been laws passed in a number of states as a consequence of their advocacy to allow these treatments, which in general, are not supported by the scientific medical establishment or the insurance companies that have to pay for these treatments.
The scientific consensus is that a relatively long, single or double treatment of antibiotics kills the bacteria and stops the infection. The long-term effects suffered by some patients are a result of an auto-immune response to protein debris from the first infection or from a reinfection by another tick bite. Other explanations for the longterm symptoms exhibited by some patients are chronic fatigue syndrome, fibromyalgia, or psychiatric illnesses which are not a consequence of ongoing, resistant spirochete infection.
In addition to a history of the elucidation of Lyme disease, the recently demonstrated inflammatory properties of the protein debris from the infecting bacteria was a significant focus of Dr. Steere’s talk to about 50 NESACS members at our January Meeting.1
After reading a New York Times article from 2001 entitled “Stalking Dr. Steere over Lyme Disease,”2 I was concerned that this meeting might be disrupted by the groups critical of Dr. Steere’s science. This elicited a substantial discussion before the meeting to make the section leadership aware of the potential for disruption.
I also, because of constraints posed by the publication deadline of the Nucleus, decided unilaterally to leave out the notice that “The Public is Invited” which has accompanied every meeting announcement published in the Nucleus for as long as I can remember.
The “Public is Invited” notification in our meeting notices became a subject of discussion at our board meeting prior to the evening event. The NESACS Board voted that the “Public is Invited” to all of our monthly meetings and struggled to understand what the concern was for the upcoming talk by Dr. Steere. It was commented that science is often controversial.
In the week or so before the meeting, announcements of Dr. Steere’s upcoming talk were noticed by local (New Hampshire) Lyme disease activists and our secretary was emailed concerning the “controversial” nature of his talk and presented references counter to Dr. Steere’s work.3,4
After dinner, Dr. Steere was introduced by Dr. Costello and began his talk. It was a fascinating history about Lyme disease and its elucidation. He showed an idyllic river scene from Lyme, Connecticut and compared it to the Charles River in Dover, Sherborn and Medfield. He showed a fascinating map from the early days in which Lyme disease was discovered and its primary incidence in the Northeast and Midwest. The markers showing the occurrences were relatively scattered with the majority being in the Northeast. Near the end of the talk, he showed a truly frightening map5 produced by the Center of Disease Control (CDC) which showed Lyme disease had spread exponentially since the late 1970’s and now blanketed most of the Northeast and upper Midwest and he predicted that the map would be filled in before too long along the Great
Lakes including Illinois, Indiana and Ohio.
The cause of this spread was attributed to two factors. Deer were hunted to near extinction in the continental US as we entered the 20th century. As deer populations have thrived, Lyme disease has returned with a vengeance. In addition, a virulent form of the Borrelia burgdorferi bacterium is present in the Northeast which is particularly prone to induce the severe side-effects of the infection.6
The ancient nature of the disease was highlighted by a picture of the “iceman,” Ötzi, the 5300 year-old mummy found frozen in a melting glacier in the Tyrolean Alps in 1991.7.8 Ötzi was found through DNA analysis to have suffered from Borrelia infection.
As an example of a consequence of this inexorable spread, Medfield (the author’s home town) created a “Lyme Disease Advisory Committee” a few years ago and started a program at the end of 2011 to cull the deer population by bow hunting from its current 25 per square mile down to a safer 7-8 per square mile9.
The highlight of Dr. Steere’s talk was a slide summarizing his collaboration with Dr. Costello which identified, using tandem mass spectrometry, peptide factors from patients’ synovia produced by the infection. These factors were then synthesized and triggered an inflammatory reaction when reacted with the matching patient’s peripheral blood mononuclear cells. Even in a pre-inflammatory state in infected patients these factors were shown to have an enhanced inflammatory effect when compared to control cells from uninfected subjects.1
After Dr. Steere’s initial description of the identification of an unknown tick-borne disease in Lyme he then talked about the difficulty of identifying the pathogen. It took a number of years before reknowned researcher Willy Burgdorfer was able to successfully dissect Ixodes ticks and show convincing microscopic evidence of the Borrelia burgdorferi spirochete in the gut of the ticks. A scanning electron microscopic image of the spirochete obtained from one such dissection was another of the key scientific advances presented by Dr. Steere.
While Dr. Steere was praising the skill and experience of Dr. Burgdorfer in identifying the Lyme disease pathogen through his unparalleled skill and experience, a spectator in the back suddenly interjected (paraphrasing), “But you don’t tell the whole story of how Burgdorfer in 1952 and 1956 did experiments to introduce Borrelia into ticks.” He was asked to identify himself.
He gave his name, and said he was a filmmaker exposing the truth about Lyme disease.
As he was escorted out, he shoutedout a brief verbal attack against Dr. Steere and the effect of Lyme disease on his family.
The rest of the talk proceeded peacefully. Fortunately, unlike some of Dr. Steere’s presentations to Congress, our meeting was not packed with the
opposition desiring to shout him down and contest his science. However, those in attendance did get a flavor of what Dr. Steere has faced the last 20 years for sincerely presenting his best science as he understands it.
It takes a pretty extreme and cynical view of science and government to believe that the tick-borne infections in Lyme, Connecticut are a product of biowarfare research gone wrong10 or that the bulk of scientific presentations by the “establishment” are a vast conspiracy to cover up the “truth” about Lyme disease.
Regardless of the exact “truth” about Lyme infections, tick-borne infections by Borrelia burgdorferi spirochetes are a huge public health menace and tick-borne infections must be dealt with aggressively through education and reduction of tick populations by a variety of means.
Many thanks to Dr. Steere and Cathy Costello for this stimulating and fascinating topic and to Boston University School of Medicine for hosting the first monthly meeting of 2013.

References
1 Drouin, Elise E.; Seward, Robert J.; Strle, Klemen; McHugh, Gail; Katchar,
Kianoosh; Londono, Diana; Yao, Chunxiang; Costello, Catherine E.; Steere, Allen C. , Arthritis & Rheumatism (2013), 65(1), 186-196.
2 David Grann, New York Times, June 17, 2001. http://www.nytimes.com/2001/06/17/magazine/17LYMEDISEASE.html?pa gewanted=all
3 Carl Tuttle, The Lancet Infectious Diseases (2012) 12(5), 362. http://www. thelancet.com/journals/laninf/article/PIIS 1473-3099%2812%2970054-3/fulltext
4 Raphael B. Stricker, Lorraine Johnson, Future Microbiol. (2012), 7(11) 1243-
1246.
5 A 2006 version of the CDC map can be seen at Todar’s Online Textbook of Bacteriology, http://textbookofbacteriology.net/Lyme_2.html
6 Borrelia burgdorferi RST1 (OspC type A) genotype is associated with greater
inflammation and more severe Lyme disease, Strle, Klemen; Jones, Kathryn L.;
Drouin, Elise E.; Li, Xin; Steere, Allen C. American Journal of Pathology (2011), 178(6), 2726-2739.
7 Stephen S. Hall, National Geographic, February 2013. http://ngm.nationalgeographic.com/2011/11/iceman-autopsy/hall-text
8 Ewen Callaway, nature.com, February 28, 2012. http://www.nature.com/news/iceman-s-dna-reveals-health-risks-andrelations-1.10130
9 James O’Brien, Boston.com, October 11, 2011. http://www.boston.com/news/local/articles/2011/10/16/deer_hunt_in_medfield_takes_aim_at_lyme_disease/
10 Michael Braverman, Germs Gone Wild: The Horrific Secrets of Plum Island
http://www.trutv.com/conspiracy/government-lies/plum-island/lyme-disease.html

Click here for photos from the meeting