|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
|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
|After reading a New York
Times article from 2001 entitled “Stalking Dr. Steere
over Lyme Disease,”
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
|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.
|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
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.
|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
|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.
|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
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
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 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 wrong
that the bulk of scientific presentations by the “establishment”
are a vast conspiracy to cover up the “truth” about
|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.
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
3 Carl Tuttle, The Lancet Infectious Diseases (2012)
12(5), 362. http://www. thelancet.com/journals/laninf/article/PIIS
4 Raphael B. Stricker, Lorraine Johnson, Future Microbiol.
(2012), 7(11) 1243-
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
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
|Click here for photos from the meeting