Den neste HIV-epidemien?

Etter å ha lese mykje om borrelia i det siste, er det noko som slår meg som spesielt skremmande. Nemleg at borreliapasientar vert rekna som friske nok til å gje blod etter berre seks månader etter behandling.  Om du berre har bitt biten av flått, men ikkje har påvist borrelia, får du berre fire vekers karantene (Folkehelseinstituttet 2010). Dette synest eg er særs urovekkjande, særleg sidan det  ved mange legekontor virkar til å herske ei misoppfatning om at ein må ha eit stort utslett etter flåttbit for å kunne vere smitta av borreliabakterien. Dermed kan mange unnlate å teste seg for borrelia etter flåttbit, og vere bærarar av bakterien.

For kva kan det vel ikkje få å seie for ein stakkar sjuk pasient, som gjerne har svekka immunforsvar, om han får pumpa inn store mengder blod som kan innehalde borreliabakteriar? Forskninga til bioingeniørane Øystein Brorson og Per Bjark og  viser at desse  lumske bakteriane kan innta cysteform, og gå i dvale i kroppen i fleire  år før dei blussar opp att. Særleg om ein berre har hatt korte antibiotikakurar på fjorten dagar.

Også den svenske professoren Sven Bergström forska på korleis borreliabakterien kan gå i dvale, for så å reaktivere seg og på ny føre til sjukdom og skader på kroppen igjen:

 "The main aim of this project was to gain knowledge of the interactions between Borrelia spirochetes and the host during infection. We have been using both the Lyme borreliosis and the relapsing fever borreliosis spirochetes as model organisms. We have particularly investigated how the Borrelia spirochetes can circumvent the immunological defence, how they spread form the infectious focus, reach various sites in the mammalian body, and how the spirochetes can live in these tissues at a dormant state, reactivate, return to the circulatory system and cause acute disease again. We also aimed to characterize and define the components involved in the interactions between Borrelia and human cells, including the cells of the innate and adaptive immunity." (Les meir her: )

Det er med andre ord all grunn til at styresmaktene bør endre retningslinene for blodgjevarar som har bitt bitne av flått.

Vanskeleg å oppdage

Sjukdommen er  vanskeleg å oppdage, sjølv for dei som har bitt bitne av flått. For dei som ikkje har bitt bitne, men fått smitta anten gjennom blod, sex eller fødsel er det jo nærast håplaust å finne ut kva som feiler ein! Særleg når testane ein har i dag ikkje er 100 prosent pålitlege .

- Ingen av testane er 100 prosent til å stole på. Skal ein testast skikkeleg, treng ein meir enn ein test fordi det er mange ulike bakterietypar og fordi bakterien i periodar kapslar seg inn og går i dvale. Køyrer du ein dårleg test då er det berre 20 prosent sjanse for at du får utslag. Tek du ein god test, vil du få 80 prosent sjanse til å få utslag, seier borreliaeksperten Øystein Brorson i eit intervju med nrk puls. (Sjå heile innslaget HER)

 Falske negative testar

 Det er også fleire årsaker til at ein kan få falske negaitve prøvesvar på borreliatestar. Har ein gått på betennelsesdempade medisinar mot artrittar/leddplager, kan desse undertrykkje immunforsvaret slik at dette ikkje lenger produserer antistoff mot borrelia-bakterien.  Dette er også tilfelle om ein har gått på antibiotikakur.

• The lyme Disease Foundation (LDF), in their brochure entitled "LDF Frequently Asked Questions About lyme Disease" lists the following nine reasons for false negative lyme disease test results:
  
  (NOTE: The standard tests for lyme Disease do not look for the bacteria, but rather the immune system's response to the bacteria. The ELISA and Western Blot both test for antibodies which is what the immune system produces when infection is present. Because the tests look for this indirect measure of infection, false negatives are not uncommon.)
  
  A. Antibodies against Bb are present, but the laboratory is unable to detect them. [Borrelia burgdorferi (Bb) is the lyme disease bacteria.]
  
  B. Antibodies against Bb may not be present in detectable levels in patients with lyme disease. Reasons are listed below.
  
  1. The patient is currently on, or has recently taken, antibiotics. The antibacterial effect of antibiotics can reduce the body's production of antibodies.
  
  2. The patient is currently on or has previously taken anti-inflammatory steroidal drugs (such as those taken to treat rheumatoid arthritis) or certain anticancer drugs. These can suppress a person's immune system, thus reducing or preventing an antibody response.
  
  3. The patient's antibodies may be bound with the bacteria with not enough free antibodies available for testing. [I think this reason is very important and prevalent. For this reason, some of the worst cases of lyme disease test negative - too much bacteria for the immune system to handle.]
  
  4. The patient could be immunosuppressed for a number of other reasons and the immune system is not reacting to the bacterium.
  
  5. The bacterium has changed its makeup (antigenic shift) limiting recognition by the patient's immune system.
  
  6. The patient's immune response has not been stimulated to produce antibodies, i.e., the blood test is taken too soon after the tick-bite (2-6 weeks). Please do not interpret this statement as implying that you should wait for a positive test to begin treatment.
  
  7. The laboratory has raised its cutoff so high that a patient's previously positive test is now borderline or negative.
  
  8. The patient is reacting to the lyme bacterium, but is not producing the "right" bands to be considered positive.
  
  Kjelde: lyme Disease Foundation

 Om ein mistenkjer at ein har borrelia, men får negativt testresultat er det difor viktig at ein krev å få ta fleire testar.

 Ein ny epidemi på linje med HIV?

Eg meiner at det er på høg tid at norske helsemyndigheiter vaknar opp, og tek tak i dette før vi får ein ny epidemi på linje med HIV. Særleg må helsestyremaktene setje fokus på at borrelia-bakterien KAN smitte gjennom blod, sex og graviditet. Ungar fortener ein god og trygg start på livet, utan borreliabakterier i blodet.

I USA derimot, er dette retningslinene ved ein klinikk som har teke borrelia hjå gravide på alvor:

1. A pregnant woman who presents with a deer tick bite in an endemic area for Lyme disease is treated as if she had Stage 1 Lyme disease.  We would treat with one to two months of oral antibiotics, such as Amoxicillin or Ceftin. (Tetracycline and Doxycycline are contraindicated in pregnancy.)

2. A pregnant woman with an EM rash should receive three to four weeks of intravenous Claforan, Rocephin or aqueous penicillin.  We have evidence that even without constitutional symptoms the Lyme spirochete may have spread throughout the mother’s body by the fifth day after an infected tick bite.  As noted above, treatment failure with oral penicillin has been reported.

3. Pregnant women who are diagnosed as having Lyme by symptoms and blood tests, who do not have a clear history of a tick bite or EM rash, and have not yet been treated, should be treated with intravenous antibiotics.  Here, since the length of infection is unknown, we must assume that the spirochetes have spread throughout the mother’s body.  It has generally been assumed that it is only possible to culture the Lyme spirochete from the blood only in the early stages of Lyme disease, so that a woman in the later stages of Lyme is safe from having blood-borne spirochetes reaching and crossing the placenta to the fetus.  Yet unpublished data suggests that blood drawn from chronic Lyme patients during the afternoon, when they usually spike a mild fever, may yield spirochetes, using a specially modified BS Kelly culture Medium.  Animal studies with chronically infected dogs show that when their immune systems are suppressed by injecting them with dexamethasone, a steroid similar to prednisone, it is possible to culture the Lyme spirochete from their blood the day after the injection.  It may be possible that the state of pregnancy, which is also immunosuppressive, may induce the spirochete to enter the bloodstream and reach the placenta.

4. We recommend that pregnant women with active Lyme, or a history of treated Lyme, have monthly urine antigen tests for Lyme until the seventh month of pregnancy.  There is some evidence that during the 3^rd trimester, false positive urine tests may occur.

5. When the baby is delivered, we recommend that the placenta be examined for spirochetes.  If spirochetes are demonstrated in the placenta, the baby should be treated with intravenous antibiotics.

I must again stress that these are guidelines that we use in our own practice.  I realize that many physicians might criticize them fro being an over-reaction and too aggressive: however, I have seen a number of babies born with congenital Lyme, and am quite aware of the devastating effects it can cause.  Following the recommendations I’ve outlined above, we have had normal outcomes in all the pregnant women whom we have treated."

KJELDE: Written by John Drulle, M.D. in December, 1990 and reprinted by the John Drulle, MD Memorial Lyme Fund, Inc. in 2006. (Les heile saka HER )

OM dette vart litt mykje å lese, kan du sjå ein video frå ei av talene til DR Joseph Burrascano jr på ILADS sin konferanse i 2011. Han fortel om kva borrelia er, korleis det smittar og korleis ein behandlar det. Verd å sjå!

Og HER kan du lese ein artikkel om korleis immunrespoins hjå borreliapasientar kan komme i bølgjer.