Wednesday, October 3, 2012

YES LYME DISEASE EXISTS IN AUSTRALIA


Dr Peter James Mayne

1.
LYME DISEASE (Chronic)

Dr Mayne has always had an intense interest in the early initial infection that goes on to cause Chronic Lyme Disease, starting in 1992. This interest was sharpened by the dermatology diploma he did in 2005 in terms of early recognition of the disease and also the unique skin manifestation that can occur much later in the disease.

In October 2009 he was approached by a patient who was quite desperate with an advanced presentation after 102 tick bites in one day some years before. Her treatment (specialist directed) was failing after some initial success. Could he help? Could he take on the task of up skilling himself in this sad neglected area of medicine in Australia, where most doctors don't believe the disease exists?

The many pages to follow explore these questions with remarkable findings for both patients and doctors. For the latter this will be mainly for the medical gatekeeper, the patients GP. It is not intended that a patient will necessarily be able to understand the information presented within for doctors.

LYME DISEASE - FOR PATIENTS
LYME DISEASE - FOR DOCTORS
WANTED DOCTORS WHO HAVE HAD ERYTHEMA MIGRANS OR LYME DISEASE Either contracted in Australia or overseas - please email me at LMC@medemail.com.au

2.

LYME DISEASE INFORMATION FOR DOCTORS IN AUSTRALIA


Lyme disease in Australia can now be proven by nested PCR to both

Borrelia burgdorferi (Bb)
and Borrelia Garinii (Bg)

2 Proofs on this link, one by blood the other by tissue

ILADS The International Lyme and Associated Disease Society

Here is the main link to the society
http://www.ilads.org/

and this link is their treatment guidelines page
http://www.ilads.org/files/ILADS_Guidelines.pdf

A key Board member of ILADS is Joseph Burruscano MD a physician. He is the author of

"Advanced topics in Lyme disease"

The 2005 edition is available free on the net at ILADS
http://www.ilads.org/files/burrascano_0905.pdf

The 2008 edition you will have to pay for. I will be using information from the 2008 edition only, so sometimes it may not be in the 2005 edition.

I am going to attempt to give a brief overview on Lyme information. The topic is vast with many tangents and it takes very many hours to integrate this information into a sensible synthesis. I will heavily rely on the above information. Medical Practitioners have enough to do without taking on this subspecialty with its extreme time consumption, unless particularly motivated to learn more. The aim is to arm you with enough information to suspect this diagnosis.

Please follow these links
The precursor erythema migrans. Diagnosis and management from a
dermatological viewpoint.

The disease and its Co-infections. What we are seeing in Australia.
Patient History
Making the diagnosis - a clinical one
Confirmatory Lab tests
Treatment principles and options
Monitoring for successful treatment
Is there an endpoint?"

3.
ERYTHEMA MIGRANS - Its Diagnosis and Treatment

From a dermatological viewpoint this illness is very poorly identified by Australian General Practice. I have to admit I was one of those before 1992.

Forget the classic bulls eye - if you see one of those good luck to you. Borrelia infection following a tick bite is slow to develop, usually taking some 48 hours to produce erythema. Bear in mind your patient probably hasn't noticed it in this time if in less obvious places.

Unfortunately a large majority of bite reactions are described as ALLERGY in Australia. This is rather woeful. An urticarial rash of any description must be gone completely in 24 hours. Even if another forms. That is the fundamental definition of acute urticaria. Now your patient might have a local toxic reaction as in most insect bites, or even a small round induration suggesting trivial infection.

BUT if the lesion around the bite is more than 2cm and persistent more than 2 days then in our country it is either

BORRELIA INFECTION or

QUEENSLAND TICK TYPHUS


And definitely not ALLERGY.

Please review this brief CASE HISTORY presented at Cardiff University in 2004 regarding the distinction.

Induration is also a marked feature and if you remember the early phase of a BCG reaction then it is hard like that.

Removal of a tick within 24 hours is believed to prevent infection with Borrelia, but best within 12 hours.

Safest course of action is to prescribe the correct antibiotic immediately at presentation no matter how long after a tick bite. The case history reviews the use of tissue PCR but also recently I have found sampling the bite site after removal of the tick can return a positive PCR to Borellia
Treatment protocol (ILADS 2008)

Adults the standard is 200mg doxycycline for 28 days, alternatively amoxil 1gm tds for 28 days
Children Amoxycillin at standard dose for age 28 days
In pregnancy use erythromycin 500mg qid for 28days"


4.
DISEASE PRESENTATION

What I see in practice

Two strains of Borrelia are positively identified in the practice case load, Burgdorferi and Garinii. As to whether there is any difference in symptomatology I can not comment. The former is the predominant organism.

There is no arthritic disease as in North America. Rather we follow a disease pattern of marked neurological symptomatology which is the European and Asian pattern of the disease. There is also a biotoxin (refer Burruscano document) produced by the Borrelia which produces sometimes marked asymmetric muscle spasm and twitching. Cranial nerve involvement followed by upper cervical nerves accounts for most symptomatology.

In the same way as AIDS reduces the C3-8 cells there is a specific marker for Lyme disease CD57 (Burruscano again). Only Lyme disease suppresses this marker and like AIDS there is a marked propensity to harbour other important chronic infections in this state.

In practice I am finding Mycoplasma and Chlamydia Pn in a majority of patients. In the US there is quite a long list but I will just present these two here. It is most essential to look for these in every suspect case of Lyme disease. Even the standard IgG and M markers can be negative but the PCR's will be positive.

These infections are called Co-infections and most are believed to be transmitted with the tick bite."

5.
PATIENT HISTORY

A striking feature of Lyme disease is that a lot of patients either don't recall ever having a tick bite or report yes they have had a tick bite in the distant past and removed it themself or had it removed. These patients are not able to describe ever having the large local reaction after a bite that we know as erythema migrans.

The number of of doctors seen and the number or diagnosis made will be proprtional to the time interval of chronic symptoms. I had one at 7 years and another at 10 years. The last had a very impressive list of medical attendances but no mention of possible Lyme disease. She found her diagnosis herself on the Net. Past diagnosis will often revolve around CFS and fibromaylgia. This of course is not to suggest that Lyme is the fundamental underlying cause of these conditions.

Cardinal symptoms of Lyme Disease
Lethargy
Swollen glands – particularly neck
Sore throat
Thoracic wall pain
Dyspnoea
Cough
Myalgia
Muscle spasms- tetany type or twitching
Muscle cramps
Occulomotor abnormalities particularly with retro orbital pain. Also lateral object fixation at speed painful or impossible. Also can induce nausea like nystagmus reaction.
Hyperacusis
Headache
Creaking neck +/- stiffness

Common
Pyrexias – more at night
Abdominal pain
Palpitations
Paraesthesia
Facial paralysis (Bell’s Palsy)
Visual deficit

Less Common
Tinnitus
Vertigo
Imbalance
Gait disturbance
Arthralgia

More general symptoms

Presyncope, tremors, confusion, disorientation, disorientation, memory loss, mood changes, depression, insomnia, irritability"

LINKS TO OTHER PAGES
Making diagnosis
Confirmatory lab tests
Treatment options
Monitoring
Endpoint
Proofs


Dr Peter James Mayne

MBBS Sydney University 1973
DPD (Dermatology) Cardiff University 2005
IDD International Dermoscopy Diploma Graz University 2008 - Distinction
FACRRM Fellow Australian College Rural and Remote Medicine
Certificate Course Diabetes Management Monash University 2000
Honorary Tutor Dept Medicine Cardiff University (Dermatology and Dermoscopy)

Our Contact Information
Telephone 61 2 65599277
FAX 61 2 65597344

Postal address
89 Bold St Laurieton 2443 NSW Australia
Electronic mail
General Information and
Reception e-mail:
frontdesk.LMC@medemail.com.au
Dr Mayne LMC@medemail.com.au

Lyme pages are under development over many months from March 2010
Last update 10th July 2010"

First quote from website http://www.drmayne.com/Lyme.htm

Second quote from website http://www.drmayne.com/Fordoctors.htm

Third quote from website http://www.drmayne.com/em.htm

Fourth quote from website http://www.drmayne.com/disease_presentation.htm

Fifth quote from website http://www.drmayne.com/patient_history.htm

11 comments:

  1. USE PYRETHRIN!
    As someone who was diagnosed with Lyme here in the US, and quickly got treatment, it saddens me to see such reluctance in Australia to diagnose Lyme and at least give a short course of antibiotics. I got diagnosed a week after I was bitten, and I’m 100% healthy again. The key is quick treatment and awareness of symptoms. Naturally doctors here were on the lookout since they know Lyme is in the area, but there’s no reason why the same awareness couldn’t exist in Australia.

    Since then, I’ve been extremely careful about covering up with Pyrethrin treated clothing when doing ANY outdoor activity. I wear an Under Armour (skin tight sweat wicking clothing) tops and bottoms. I also treated my shoes with Pyrethrin. Pyrethrin is so toxic to ticks, that they will actively crawl away from clothing treated with it even a month ago (I have tested it)! Since I began doing this, and treating my dog’s hair with Pyrethrin I have not found even a single tick on myself. I should have been doing this before, but you live and learn.

    Moral of the story, cover up with PYRETHRIN treated clothing, do it NOW before you get bit by some tick with an evil disease. Don’t depend on the medical profession to heal you after the fact, because they MIGHT NOT! The Australian Lyme association needs to update their webpage with good PREVENTION tips.

    By the way, can you purchase Pyrethrin in Australia? You can buy it any outdoor store here in the US.

    ReplyDelete
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  3. COMPLETE CURE TO LYMES: My brother was infected by a lyme disease for 10 years, it started with Rash, Fever, Fatigue and Head ache, It then later worsened (Chronic). I have tried many treatment suggested by the Guru which include Antibiotics, and more other medicine prescribed but all to no avail. Lately I was directed to a Doctor called William, who provided solution to the problem. Do not be discourage, it is a permanent treatment/cure to Lyme Disease, Contact him with this email for more info: (drwilly37@ gmail. com)

    ReplyDelete
  4. ALL THANKS TO DR WILLIAMS FOR CURING ME FROM THIS DEADLY DISEASE TINNITUS.
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    ReplyDelete
  5. I am sophie from Canada, I once suffered from a terrible and Chronic tinnitus ,in 2016, the doctor told me it has no permanent cure i was given medications to slow down its progress, i constantly felt my health was deteriorating as i constantly go out of breath,and this noise was really terrible especially when am sleeping, i have this constant ringing in my ears for about 8 months, this was really a terrible noise ,on thin one day that i was going through the internet,and i came across a post of Mrs Kate on how she was been cured from tinnitus through dr Williams herbal product, I contacted this herbal doctor via his email and explain everything to him and make purchase of his product,few days later he sent me the herbal medicine through courier service, when i received the herbal medicine i used it for 3 weeks as prescribed and i was totally cured of tinnitus within those week of usage,on thin now i have not hear anything ringing in my ears.if you need his help you can Contact this herbal doctor via his email drwilliams098765@gmail.com for help

    ReplyDelete
  6. I have been in the tinnitus community for a while now and I have experience what you are going though with tinnitus , I do know people that have got
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    interested you can contact Dr William herbal remedies that what I take that stop the ringing in my ear that was really driving me crazy, don't Lose hope .,I have found a solution for my fellow citizens . If you haven't I would suggest trying Dr William herbal supplement. Again, this is a thing that takes time and usually requires time and patience for it to work WITH no side effects. But I'm not hear to sell you the product, I'm only hear to tell you that it works, but it is a journey and can be difficult. I hope at this point in want away on it own. Good luck . his email address drwilliams098765@gmail.com for advice and for his product

    ReplyDelete
  7. ALL THANKS TO DR WILLIAMS WITH HIS HERBAL PORTION I WAS COMPLETELY CURED FROM A TERRIBLE TINNITUS.
    How can I ever stop thanking Dr William for the great deed he have done for me, i got an accident when I was 27 years old, from that day on i started experience ringing ear (tinnitus) i have taken all the western drugs prescribe by various doctor but to no avail . my tinnitus was very loud in the afternoon and I sleep less at night because of this problem i stop my work, few days later i was going through the Internet and I saw a post of so many people testifying about Dr William herbal remedies on how they was being cure for over many years suffering from tinnitus the story Really motivated me that I have to speak with my husband about it, and he said i should give him a try, i contacted Dr William and explain all i have be facing in my life. He assured me that everything is going to be fine if only I can get his herbal portion, i said yes and I requested for it, few days later the herb was sent to me in Kuwait,i started using it as instructed by Dr William for me to take it for 21 Days which I did, can you imagine after talking Dr William herbal medicine for just two weeks i started experience results, it was like a miracle,and now i am permanently cure from this terrible tinnitus, i promise that am going to publish his herb on thing my last breath for the great deed he have done for me. For those with similar ear problem should please contact him on his email address drwilliams098765@gmail his a good man and am proud of him.

    ReplyDelete
  8. I am sophie from Canada, I once suffered from a terrible and Chronic tinnitus ,in 2016, the doctor told me it has no permanent cure i was given medications to slow down its progress, i constantly felt my health was deteriorating as i constantly go out of breath,and this noise was really terrible especially when am sleeping, i have this constant ringing in my ears for about 8 months, this was really a terrible noise ,on thin one day that i was going through the internet,and i came across a post of Mrs Kate on how she was been cured from tinnitus through dr Williams herbal product, I contacted this herbal doctor via his email and explain everything to him and make purchase of his product,few days later he sent me the herbal medicine through courier service, when i received the herbal medicine i used it for 3 weeks as prescribed and i was totally cured of tinnitus within those week of usage,on thin now i have not hear anything ringing in my ears.if you need his help you can Contact this herbal doctor via his email drwilliams098765@gmail.com for help

    ReplyDelete
  9. ALL THANKS TO DR WILLIAMS WITH HIS HERB I WAS CURED FROM A TERRIBLE TINNITUS.
    . Is my pleasure to comment on this site and i thank the admin of this site for his/her great work so far. I really don’t know how to thank DR WILLIAMS for helping me get cured for over 20 year of suffering from a terrible tinnitus, my tinnitus started when i was 28 year i thought is going to end one day but even get worse as days went by,i have tried all western drugs prescribed by doctors but to no avail i lost total concentration, even at night i screams even more because the sounds become louder because everywhere is quiet. i came across DR WILLIAMS contact through a headline news on internet about how DR WILLIAMS have help so many people to get cured of tinnitus and so many other with similar body problem ,i contacted him and he told me how to get his herb,few day later he sent me the herbal portion which i take every morning for 21 days, and his medicine was able to restore me back to normal and now am very okay without any side effects whatsoever If you have Tinnitus, you can contact him on his email address drwilliams098765@gmail.com for help

    ReplyDelete
  10. hello every one my name is Justin Leo i am from Japan, i have been suffering from tinnitus disease for the last Three years and had constant sound, especially in my right ear. During the first year, I had faith in God that i would be healed someday.The ringing sound started getting worse each and everyday that comes to pass, and i have been taking treatment from my doctor, few weeks ago i was searching on the internet if i could get any information concerning the prevention of this disease, on my search i saw a testimony of someone who has been healed from tinnitus by this Man Dr Williams and she also live the email address of this great man that he would be of help for so many others suffering from this, so i wrote to Dr. Williams telling him about my tinnitus he told me not to worry that everything is going to be fine!! i never believed it,, well after sending me the drugs and i follow all the procedures on how he instructed me to be taking the medicine, few weeks later i started experiencing changes all over me, after all i went to my doctor to confirmed if i have be finally healed behold it was true,right now am one of the happiest man on earth,if you have such sickness or any other at all you can email Dr. William on drwilliams098765@gmail.com

    ReplyDelete
  11. Wow: who will ever believe that a natural herb can cure tinnitus, i never believe that this will work i have spend a lot when getting drugs from the hospital to keep me healthy,i went to many hospitals for cure but there was no solution, One day I was in the office going through the internet when i see so many people testifying about Dr Williams herbal medicine on how they where been cured from tinnitus and so many other similar body problem, so i mail him.He told me all the things I need to do and also give me instructions to take, which I followed properly. Before I knew what is happening after two weeks To my greatest surprise after patiently going according to instruction given to me by Dr Williams, all the ringing in my ears stop gradually and up thing this moment i have not experience anything ringing in my ears. I want to say a big thanks to Dr Williams who God have sent to heal his people with his natural medicine i pray that God will bless you for the good work you are doing.for all who are still suffering from this disease, you can also contact Dr Williams through his email address on;drwilliams098765@gmail.com

    ReplyDelete