How to Diagnose if Lyme Disease is Affecting the Heart and How to Best Treat It

Adrian Baranchuk, MD

Ticktective Podcast Transcript

 

Dr. Adrian Baranchuk, Professor of Medicine at Queen’s University in the Division of Cardiology in Ontario, Canada discusses his screening process for identifying Lyme infections in the heart and how to treat these patients without unnecessary pacemakers. He has published research and spoken on the topic of Lyme carditis at numerous conferences. He is passionate in his efforts to educate doctors on diagnosing Lyme-related AV heart block. Dr. Baranchuk joined Bay Area Lyme Advisor Lia Gaertner to discuss the cardiological manifestations of Lyme disease, Lyme Carditis and specific cases that illustrate his approach.

Lia Gaertner: Welcome to the Ticktective podcast and video series, a program of the Bay Area Lyme Foundation, where our mission is to make Lyme disease easy to diagnose and simple to cure. I’m your host, Lia Gaertner. Lyme disease is the most common vector-borne disease in the USA and is a global issue. This podcast includes interviews with the researchers we fund, as well as other interesting people in the Lyme scientific community. We are a nonprofit foundation based in Silicon Valley. Thanks to a generous grant that covers all of our overhead, 100% of all donations go directly to support research and prevention programs. You can find out more or donate@bayarealyme.org. Thank you for joining the Ticktective video and podcast series, Dr. Baranchuk

Adrian Baranchuk: Thank you very much for having me.

Lia Gaertner: Dr. Baranchuk, a native of Buenos Aires, Argentina, completed his training in internal medicine in cardiology, along with clinical fellowship in cardiac electrophysiology. Dr. Baranchuk is a tenured professor of medicine at Queen’s University in the division of cardiology in Ontario, Canada. He is the editor-in-chief of the Journal of Electrocardiology, as well as a member of numerous editorial boards and a reviewer for several medical journals. Dr. Baranchuk has authored eight books and published more than 700 articles in prestigious international journals, as well as 54 book chapters, and he’s presented more than 270 abstracts around the world. He is the vice president of the International Society of Halter and Non-Invasive Electrocardiology, and the Secretary of the Inter-American Society of Cardiology. He’s also the past president of the International Society of Electrocardiology. He’s been elected as a member of the Electrophysiology Leadership section of the American College of Cardiology, and is the recipient of several teaching awards as well as being voted one of the 10 most influential Hispanics in Canada.

Adrian Baranchuk: Thank you very much for the invitation. I am so pleased to be here with you today.

Lia Gaertner: I’d like to start with a case study published in the Canadian Medical Association Journal (CMAJ). It reads:

“A fatal case of Lyme disease in a previously healthy 37-year-old man illustrates the challenges of diagnosing Lyme disease in the absence of classic symptoms. The patient originally presented to his family doctor with flu-like symptoms, including fever, sore throat, nasal congestion, and migratory joint pain. Several weeks earlier, he had been in contact with ticks but didn’t recall removing one. His physician suspected a viral infection and the patient’s symptoms resolved. However, weeks later, he developed heart palpitations, shortness of breath, and chest discomfort for which he was sent to the emergency department. Lyme disease was suspected as the ECG showed complete heart block. He was admitted to the hospital and started treatment for Lyme carditis. But his condition unfortunately worsened quickly. Clinicians were unable to reverse the course of his illness, and he died. Serology results confirmed Lyme disease and an autopsy showed Lyme carditis.” 

Research funded by Bay Area Lyme Foundation provides most comprehensive and geographically widespread whole genome sequencing of Lyme bacteria

Jacob Lemieux, MD, DPhil and Pardis Sabeti, MD, DPhil

FOR IMMEDIATE RELEASE

 

Research funded by Bay Area Lyme Foundation provides most comprehensive and geographically widespread whole genome sequencing of Lyme bacteria

Results may help inform future research and how physicians treat Lyme disease 

PORTOLA VALLEY, Calif., August 31, 2023—Bay Area Lyme Foundation, a leading sponsor of Lyme disease research in the US, today announced the results of the most comprehensive whole genome sequencing study of Borrelia burgdorferi, the bacteria that causes Lyme disease—a condition affecting nearly 500,000 new patients annually. Published in the peer-reviewed journal PLOS Pathogens, the study is the first to define the connection between genomic markers and symptom severity, confirming that RST1 OspC type A strains, which are the most common type of Borrelia bacterial strains found in the Northeast, are associated with more disseminated infection and thus more severe Lyme disease. These new discoveries will help inform physicians that different strains of the Lyme disease bacteria in the US may cause more severe Lyme disease symptoms, which may include joint swelling, debilitating fatigue, memory loss, headaches and serious inflammation of the heart and brain.

“Dissemination from the site of inoculation to organs such as the heart, brain and joints is a key step in the development of severe Lyme disease. Up until now, the bacterial genes and plasmids associated with dissemination in humans had not yet been identified,” said first author Jacob Lemieux, MD, DPhil, Bay Area Lyme Foundation Emerging Leader Award winner, an infectious disease staff physician at Massachusetts General Hospital and Assistant Professor at Harvard Medical School and an Associate Member of the Broad Institute of MIT and Harvard. “This work provides important clues into the bacterial genetic basis of dissemination and therefore suggests candidates for further study, including proteins to target for therapeutics and vaccines aimed at preventing dissemination.”

The new study also identifies the genetic changes that distinguish more virulent strains, including an enlarged genome size, a unique set of plasmids, and an expanded set of surface-exposed lipid-modified proteins called lipoproteins.

Pardis Sabeti, MD, DPhil, professor at Harvard University, Institute member of the Broad Institute of MIT and Harvard, a Howard Hughes Medical Investigator and co-lead author added, “This research will lay the foundation for developing sensitive diagnostics for Lyme disease and help physicians refine treatment plans, arming them with a better understanding of Lyme disease bacterial strains and their clinical manifestations.”

Biosafety is Key to Our Future: The Truth About Germs, Lab Leaks, and Information Warfare

Raina MacIntyre, MD, PhD

Ticktective Podcast Transcript

 

In this episode of Ticktective™, Dana Parish talks with Raina MacIntyre (MBBS Hons 1, M App Epid, PhD, FRACP, FAFPHM) about how lab safety lapses are still leading to frequent undocumented lab leaks, her concerns over Long Covid and the ongoing dangers of the pandemic, and how public health agencies use information warfare to keep everyone in the dark about what is happening at the forefront of biomedical investigations, especially in the field of experimental gain of function research. Raina MacIntyre is Head of the Biosecurity Program, Kirby Institute, University of New South Wales (UNSW), Australia, and author of Dark Winter. She has over 450 peer-reviewed publications, has received many awards including the Sir. Henry Wellcome Medal from the Association of Military Surgeons of the US and is a member of the WHO COVID-19 Vaccine Composition Technical Advisory Group and WHO Smallpox and monkeypox working group.

Dana Parish: Welcome to the Ticktective podcast, a program of the Bay Area Lyme Foundation, where our mission is to make Lyme disease easy to diagnose and simple to cure. I’m your host Dana Parish, and I’m the co-author of the book Chronic and I sit on the advisory board of Bay Area Lyme Foundation. This program offers insightful interviews with scientists, clinicians, patients, and other interesting people. We’re a nonprofit based in Silicon Valley, and thanks to a generous grant that covers a hundred percent of our overhead, all of your donations go directly to our research and prevention programs. For more information about Lyme disease, please visit us@bayarealyme.org.

Dana Parish: Hi, I’m Dana Parish and I’m thrilled today to welcome Dr. Raina McIntyre. Let me tell you a little bit about her. Raina McIntyre, MBBS is head of the Biosecurity program, Kirby Institute, UNSW. She leads research on prevention of epidemic infections, including EPI watch, an AI-driven early warning system for serious outbreaks. She has over 450 peer reviewed publications. She’s received many awards including the SIR Henry Welcome Medal from the Association of Military Surgeons of the US. She was on a US National Academies of Science Engineering Medicine Pandemic Consensus Committee, and she’s a member of W’S Covid 19 Vaccine Composition Technical Advisory Group and WHO Smallpox and Monkeypox Working Group. Has written over 450 publications and I am really pleased to have met you through this new nonprofit that we’re both a part of called BiosafetyNow.org. You know, it’s an honor to be able to learn from you and meet you, and I’d love to talk a little bit about your background and what it means to be a biosecurity expert and an MD and a PhD in your area of expertise.

Raina MacIntyre: I started my career as a medical doctor and I was going to be a cardiologist because I’d done a lot of cardiology, in my specialist physician training and wanted to do cardiology. But I was also interested in epidemiology. I saw an ad for this Master of Applied Epidemiology, which is the Australian Field Epidemiology Training Program, which is a type of hands-on training in outbreak investigation that was pioneered by the US CDC called the Epidemic Intelligence Services. And in some countries when you do it, you get a degree. So, I decided to do that degree and it was quite life-changing for me because it was a new way of learning where you do just short bursts of classroom learning, but then you go out in the field, you investigate outbreaks and you apply the learning that you had in the classroom to practical problems in the field where you’re investigating outbreaks, trying to work out: What is this? Where did it start? How can it be stopped?

The Long and Winding Road: The Story of Bay Area Lyme’s Multi-Year Quest to Identify Treatments for Lyme Patients

West Coast Clinical Trial Story

BAL Leading the Way Series

 

“The opening of a network of Lyme disease clinics is the culmination of many years of tireless work and the vision of a small group of determined women over 10 years ago. We are extremely optimistic that the Lyme Clinical Trials Network will accelerate the development of new treatments for patients with post-treatment and persistent Lyme disease.”

—Linda Giampa, Executive Director, Bay Area Lyme Foundation

 

When Bay Area Lyme Foundation (BAL) was formed a decade ago, its mission was clear: to make Lyme disease easy to diagnose and simple to cure. “And that’s still our goal,” emphasizes BAL co-founder Bonnie Crater, as she reflects on the last 10 years. However, appreciating the magnitude of the Foundation’s audacious mission requires an understanding of two complex—yet inextricably linked—medical domains: the world of diagnostics, and the world of therapeutics.

Bonnie Crater
Bay Area Lyme Co-Founder Bonnie Crater

The ‘Holy Grail’ for Lyme disease is an accurate diagnostic test—or better yet a suite of specifically designed tests for the different stages of acute and persistent Lyme disease. Although great strides are being made in understanding the infection and the disease’s progression, the ‘silver bullet’ of accurate diagnostic tests continues to elude us. The current diagnostics for acute Lyme (a two-step process with an ELISA either followed by a Western blot or another ELISA) are fraught with problems. These tests may miss up to 70% of acute Lyme cases or deliver false negative results. They are unreliable for detecting acute Lyme and are ineffective indicators for anyone with a persistent/chronic tick-borne infection. (Watch or listen to our Ticktective with Brandon Jutras, PhD, to learn why the current direct detection tests for Lyme are so inaccurate.)

Add to this the fact that FDA-approved therapeutics—or ‘cures’—have not evolved much in 10 years either and foment controversy. A quick internet search on ‘How to treat Lyme disease’ will offer information from the IDSA (Infectious Diseases Society of America) stating that a 10-14-day course of oral antibiotics, such as amoxicillin or doxycycline, will do the job for someone with an EM (Erythema migrans) rash who has early/acute Lyme. But anyone who has had Lyme disease, been treated, and then experienced a continuation of symptoms knows that this recommended course of intervention often fails to clear the infection, leaving some persistent Lyme patients in limbo, and health care providers without an approved treatment protocol. Simply put, this is the continuing underlying treacherous terrain of Lyme, throwing up challenges in both diagnostics and therapeutics.

Bay Area Lyme Foundation Celebrates Its 10th Anniversary with a Convergence of Scientists, Clinicians, Patients and Celebrity Talent

LymeAid 2023

FOR IMMEDIATE RELEASE

 

Bay Area Lyme Foundation Celebrates Its 10th Anniversary with a Convergence of Scientists, Clinicians, Patients, and Celebrity Talent

BAL honors the 2023 Younger Family Emerging Leader Award Winner, announces iHeartRadio partnership and acknowledges the perseverance of patients with persistent Lyme disease

PORTOLA VALLEY, Calif., June 13, 2023—Bay Area Lyme Foundation, a leading sponsor of Lyme disease research in the US, celebrated its 10th anniversary in May at LymeAid ®, its preeminent annual fundraising event, and announced Andriy Batchinsky, MD, as the winner of a $150,000 Younger Family Emerging Leader Award. A supportive audience of scientists, clinicians, patients, and philanthropists celebrated progress and commitment to ongoing research into tick-borne diseases, and iHeartRadio announced a partnership in honor of beloved DJ and radio host Jeffrey Vandergrift (“JV”), who passed away with Lyme disease earlier this year. LymeAid raised $683,000 of which 100 percent goes directly to fund scientific research, education, and prevention programs for Lyme disease, a potentially disabling infection that impacts an estimated half a million Americans each year.

Emmy-award winning comedian Dana Carvey, Master of Ceremonies for the event, was joined by The Bacon Brothers and local San Francisco band Pop Rocks, who were the musical guests for this evening of laughter, dining, and dancing to support cutting-edge discoveries and scientific breakthroughs. The fund-a-need for this event was Lyme Disease Biobank, a Bay Area Lyme Foundation program initiated in 2014 to collect and distribute blood, urine, and tissue samples for investigators working on developing diagnostics and treatment for tick-borne diseases.

“This is an amazing time for infectious disease research, offering great hope for patients. While we have made strides, our work is not done. We need to figure out the underlying cause of persistent Lyme disease and find a solution,” said keynote speaker Bill Robinson, MD, PhD, chief of the Division of Immunology and Rheumatology at Stanford University, who shared ongoing research exploring ways to weaponize antibodies against persistent Lyme disease.

On the Front Lines of Lyme Treatment: A Conversation with Pioneer Kenneth Liegner, MD

Kenneth Liegner, MD

Ticktective Podcast Transcript

 

In this conversation between Ticktective™ host Dana Parish and pioneering physician Kenneth Liegner, MD, the discussion focuses on how Dr. Liegner, frustrated and perplexed by the lack of options for persistent/chronic Lyme, came to prescribe disulfiram—a drug intended to treat alcoholics—as an off-label therapeutic for his Lyme patients. He recounts what happened next, and reflects on the impact of his bold experiment, plus they touch on how a Covid infection may impact Lyme patients, causing a resurgence of latent symptoms. They also explore the history of tick-borne diseases and the lack of recognition among clinicians, the government, and insurance companies for these insidious infections that cause chronic suffering for many. Note: This transcribed podcast has been edited for clarity.

Dana Parish: Welcome to the Ticktective Podcast, a program of the Bay Area Lyme Foundation, where our mission is to make Lyme disease easy to diagnose, and simple to cure. I’m your guest host today, Dana Parish. I’m the co-author of the book Chronic, and I’m on the advisory board of Bay Area Lyme Foundation. This program offers insightful interviews with clinicians, scientists, patients, and other interesting people. We’re a non-profit foundation based in Silicon Valley, and thanks to a generous grant that covers a hundred percent of our overhead, all of your donations go directly to our research and our prevention programs. For more information about Lyme disease, please visit us at bayarealyme.org.

In the Crucible of Chronic Lyme Disease, Collected Writings and Associated MaterialsDana Parish: I’m so thrilled to be guest hosting Ticktective for you today on behalf of Bay Area Lyme Foundation. I’m here with a dear friend and a brilliant Lyme physician, internist, author, Dr. Kenneth Liegner. Dr. Kenneth Liegner is a board-certified internist with additional training in pathology and critical care medicine, practicing in Pawling, New York. He’s the author of an extraordinary documentarian history of Lyme called In the Crucible of Chronic Lyme Disease, Collected Writings and Associated Materials. We’ll talk about that more later. Dr. Liegner is also the first to apply disulfiram in the treatment of Lyme, and he published his experience in the peer-reviewed journal Antibiotics. Thank you so much for being here with me today, Dr. Liegner.

Bay Area Lyme Foundation Celebrates Department of Defense CDMRP Tick-borne Disease Awardees

CDMRP

Bay Area Lyme Foundation Celebrates Department of Defense CDMRP Tick-borne Disease Awardees

Projects of three awardees to be enabled by Lyme Disease Biobank samples

PORTOLA VALLEY, Calif., March 23, 2023—Bay Area Lyme Foundation, a leading sponsor of Lyme disease research in the US, announces that two projects it has previously funded have now received Department of Defense Congressionally Directed Medical Research Programs (CDMRP) Tick-Borne Disease awards. Three of the six recently announced CDMRP awardees will be using biological samples from Bay Area Lyme Foundation’s Lyme Disease Biobank to enable their research into diagnostics and therapeutics for tick-borne diseases, including Lyme disease—which infects half a million people each year. 

“Government awards like CDMRP help propel much needed research on tick-borne illnesses forward, and, with three diagnostics projects using Biobank samples, we are honored to play a part in making this important research possible,” said Liz Horn, PhD, MBI, Principal Investigator, Lyme Disease Biobank, which provides researchers with access to reliable biological samples to enable research toward better diagnostics and treatments for these complex diseases. “If researchers don’t have access to well-characterized blood samples with robust testing and medical information, they can’t build the necessary research programs to develop better diagnostics, which are urgently needed for these complex diseases,” added Dr. Horn.

National Lyme Clinical Trials Network Gains Its First West Coast Center, Thanks to $1M+ Donation from Bay Area Lyme Foundation

Lyme Clinical Trials Network

FOR IMMEDIATE RELEASE

 

National Lyme Clinical Trials Network Gains Its First West Coast Center, Thanks to $1M+ Donation from Bay Area Lyme Foundation

The University of California San Francisco Lyme Clinical Trials Center will support innovative clinical trials to develop treatments for patients with persistent Lyme disease

Portola Valley, CA, March 09, 2023—Bay Area Lyme Foundation, a leading sponsor of Lyme disease research in the US, announces it has awarded more than $1M to the University of California San Francisco (UCSF) for the development of a Lyme Clinical Trials Center. This new center will become the first West Coast site of the Lyme Clinical Trials Network. The Network aims to address the need for high quality, innovative clinical trials to develop evidence-based treatments for patients with persistent Lyme symptoms following initial antibiotic treatment—a population that has grown to more than two million Americans and continues to increase.

“The founding of the UCSF Lyme Clinical Trials Center provides a unique opportunity for Lyme patients to participate in the next generation of therapeutic trials to combat this devastating disease,” said Charles Chiu, MD, PhD, of the University of California San Francisco who will lead the UCSF Lyme Clinical Trials Center. “Very few clinical trials have been initiated to investigate therapeutic solutions to address persistent symptoms of Lyme disease, and we hope to change this.” 

UCSF will join the Lyme Clinical Trials Network led by Columbia University, which includes Children’s National Hospital (part of the National Institutes of Health), and Johns Hopkins University. This important effort is funded by the Steven & Alexandra Cohen Foundation.

One Lyme Patient’s Challenging Quest to Donate Her Body to Science in Her Final Days

Cornell University 1997

BAL Spotlight Series

 

In Puerto Rico, Donating Your Body to Science is Almost Impossible

Luisette Mauras Rodriguez working in the lab at Cornell
Working in the lab at Cornell in 1997

Luisette Mauras Rodriguez is lying in bed at home in Guyana, Puerto Rico, waiting to die. She’s 46 years old, her body ravaged by Lyme, numerous tick-borne coinfections, and a multitude of other hits caused by environmental exposure to toxins like black mold, fungus, mycoplasma, and chikungunya virus. Family members do not understand her illness and laugh at her ‘exaggerations.’ Her husband left her because he fears getting sick and his religious convictions cause him to question the validity of her condition. Her mother, formerly a registered nurse, has abandoned her to her fate. Whenever Luisette gets desperate for help and goes to the ER, they refer her to the psych ward saying her illness is fabricated.

Cornell University
Cornell University and the surrounding woods where she was bitten

A former professional lab technician who worked in pharmaceutical development with US companies like Wyeth, SmithKline Beecham, and IPR Pharmaceuticals, Luisette has one dying wish: to donate her body to the Lyme Disease Biobank (LDB) so that samples from her brain, joints, organs, and tissues will be used to fuel much-needed research into Lyme and tick-borne diseases. She has registered with the National Disease Research Interchange (NDRI) in Philadelphia to have her body collected after her death, but as of writing this article, staff there are unable to find any medical professional on the island willing to partner with them to ensure this happens.

“We have been unsuccessful in securing anyone for recovery for the donor located in Puerto Rico. It has been very difficult getting anyone to follow up with us on top of the language barrier. We were trying to give the pathology department at the University time to get back to us but they seem to be very busy. The complexity of the recovery also makes it more difficult as well.” — Wauchita Green, Manager, Organ & Tissue Source Sites, NDRI, The National Disease Research Interchange

Bay Area Lyme Foundation Researcher Validates New Approach to Overcome Challenges of Lyme Disease Diagnosis in the Lab

Artem Rogovskyy, PhD, DVM, receiving the ELA award at LymeAid

FOR IMMEDIATE RELEASE

Bay Area Lyme Foundation Researcher Validates New Approach to Overcome Challenges of Lyme Disease Diagnosis in the Lab

Using samples from the Lyme Disease Biobank, Raman spectroscopy is identified as a potentially more sensitive test for diagnosing Lyme disease

Portola Valley, CA, February 9, 2023 — Bay Area Lyme Foundation, a leading sponsor of Lyme disease research in the US, today announced results of a laboratory study published in the peer-reviewed journal Frontiers in Cellular and Infection Microbiology that identifies Raman spectroscopy as a promising diagnostic approach for Lyme disease, a condition that affects nearly 500,000 new patients annually. Conducted by one of Bay Area Lyme Foundation’s Emerging Leader Award winners, Artem Rogovskyy, PhD, DVM, along with researchers from Texas A&M University, the study identified Borrelia infection with 88% accuracy, 85% sensitivity, and 90% specificity using Raman spectroscopy, a light-based test commonly used in chemistry labs, to evaluate human blood samples provided by Bay Area Lyme Foundation’s Lyme Disease Biobank. 

“By identifying a unique spectrum fingerprint to detect Lyme borreliosis faster, Raman spectroscopy has the potential to diagnose the disease earlier,” said Dr. Rogovskyy, associate professor of Veterinary Pathobiology at the School of Veterinary Medicine and Biomedical Sciences at Texas A&M University. “We hope that developing an effective, robust, and rapid diagnostic test will help overcome current challenges in Lyme disease diagnosis.”

The study aims to address the immediate need for more sensitive diagnostics in Lyme disease as the current gold standard diagnostic has been shown to be insensitive in up to 60% of early-stage patients and up to 30% of late-stage patients.

“The lack of an accurate diagnostic test is not only a challenge for clinicians trying to properly diagnose and treat patients, but also makes clinical trials for new treatments difficult,” said Linda Giampa, executive director, Bay Area Lyme Foundation. “Our hope is that new approaches like this one will allow for early detection and treatment of all patients with Lyme disease.”