Elena Cook 4 hours ago I think it is time for medical and other health professionals to know the facts regarding this excellent and much-maligned Borrelia culture test. The warning published by Dr Barbara Johnson, along with various EIS officers at CDC in their bulletin MMWR is based on Dr Barbara Johnsons own paper condemning the test in the Journal of Clinical Microbiology in August 2013. Dr. Johnsons paper, on close examination, raises great concerns of its own. One of the main tenets of Johnsons argument was that the results published by Dr Sapi must have been due to contamination of her cultures by lab control strains. CDCs Dr Ben Beard (co-author of the MMWR warning) was unaware at the time that the two sets of material were 200 miles away from each other , when CDC made this allegation. Yet he refused to have CDC retract it after being informed. Dr Johnson alleged that only contamination could explain the large number of American patients samples which grew Borrelia garinii on culture, citing the fact that CDC has always maintained that the only species of Lyme Borrelia infecting US patients in Borrelia burgdorferi sensu stricto. (B. garinii is well-known in Europe and Asia). This ignores not only the the fact that Americans travel abroad to tick-ridden areas, but more significantly, the following: It has now been clearly established in the peer-reviewed literature that the US is home to other human-pathogenic Borrelia causing a clinical picture identical to Lyme ,and that some of these (eg B. miyamotoi) are not even part of the Bb sensu lato group, never mind restricted to one strain within it (Bb sensu stricto). New evidence suggests B. garinii, which is highly associated with neurological disease and with birds as tick hosts, may well be in North America. In addition Borrelia are notorious for the number of DNA recombinational events far in excess of the mutation rate. This could in theory result in a pyrG sequence which matched a different strain, such as garinii. What is not widely known is that Dr Johnson HERSELF, in a patent published just weeks before her 2013 paper condemning the culture test as invalid because it found many garinii-positive US patients, wrote the following: B. garinii has been found in pelagic bird colonies off the coast of North America, so there may be potential for infection by this agent in North America. (See Patent WO 2013110026 A1 google/patents/WO2013110026A1?cl=en ). Having written that in her own patent (published July 2013), it was surely the height of hypocrisy to then condemn Dr Sapi et al for reporting having cultures B. garinii from US patients blood. Spanish researcher Dr Elena Gomez-Diaz of Spain studied Borrelia garinii strains across a huge geographical area, from a very wide range of ticks, including seabird ticks (well-known vector of B. garinii) She used multi-locus sequence typing which included a portion of DNA was from the same part of the pyrG gene used by Dr Sapi used in her study, and which CDC have indicated render Dr sapis published results invalid, by stating that that the degree of identity between that portion of DNA sequence in the patients sera and in the control strains was implausible, unless contamination had occurred. But in fact Dr Gomez-Diaz found large numbers of B. garinii strains which had a 99% DNA match to each other at that locus - yet they were all distinct strains, some from seabird ticks, some from Ixodes ricinus (European sheep tick), and from locations as far apart as France and the far eastern part of Russia which is of course not so far away from Alaska and the west coast of US.) To add insult to injury, in Dr Johnsons 2013 paper, she published data relating to portions of pyrG which she stated she had sequences and deposited in Genbank. However a search for the accession numbers she gave by Dr Alan Macdonald, who was involved in developing the culture test, revealed that there were no such sequences present in Genbank at the time of publication. Therefore it is not possible that a comprehensive peer-review could have occurred without such key data so central to the accusation of contamination. After Dr Macdonald flagged up the absent DNA sequences in an open letter to CDCs Dr Ben Beard, the sequences finally appeared in Genbank - though somewhat different to what had been published in the paper. I am sorry to say that CDC and their Epidemic Intelligence Service (EIS) officers have seriously lost the plot. By condemning a sound culture test, they have slammed the door of hope shut on thousands of patients suffering chronic Lyme disease. CDC themselves recently admitted their published incidence rate for Lyme Disease does not reflect the number of cases diagnosed in the US, and that their figure was off by a factor of ten. One would hope they would reflect on the damage done by this gross under-estimation of an epidemic that is spiralling out of control. Instead, they prefer to shoot the messenger, trying to discredit an excellent test which could aid diagnosis and see patients treated. A recent FOIA request revealed CDC and Dr Allen Steere collaborating to bury data which showed the current CDC-recommended testing protocol, based on a two-tier serology test, to be unreliable. (I have archived it here - elenacook.org/cdc_johnson_buries_lyme_data.html) Can anyone have any trust in CDC any more? I would like to add that I have no connection whatsoever with the Advanced Labortory company and do not benefit financially in any way from the culture test. My interest stems from my advocacy for Lyme Disease patients. Elena Cook medscape/viewarticle/823840
Posted on: Fri, 18 Apr 2014 22:22:06 +0000
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