An Unusual Case of Serologically Confirmed Post-Partum Lyme Disease Following an Asymptomatic Infection Acquired during Pregnancy and Lacking Vertical Transmission in Utero.

In this report, we describe a 23-year-old female who, while pregnant, was exposed to but did not develop significant signs or symptoms (joint pain, arthritis) of Lyme disease until shortly after delivering a healthy child at term. Serologic testing confirmed infection with . A 3-week course of treatment with doxycycline was completely curative.

The major epidemiologic, microbiologic, immunologic, and clinical aspects of Lyme disease that form the basis for a newly developed vaccine that may become available soon for human use.

Working together, two major pharmaceutical companies have developed a Lyme disease vaccine consisting of recombinant-derived outer surface protein A (OspA) of the etiologic agent . Multiple clinical trials have shown the vaccine to have good safety and efficacy results, and it is hoped that it would become available for human use at least by the year 2025 after receiving approval from the U.S.

Lessons learned from the successful polio vaccine experience not learned or applied with the development and implementation of the COVID-19 vaccines.

The eradication of polio during the latter half of the 20th century can be considered one of the greatest medical triumphs in history. This achievement can be attributed to the development of vaccines that received the public's almost unwavering acceptance of them, especially by parents who had been waiting/hoping for a medical breakthrough that would ensure that their children would not succumb to the devastating effects of infantile paralysis. Sixty years later, the worldwide population was now confronted with an equally devastating disease - Covid-19 - which by the 2020-2021 time period had reached pandemic levels not seen since the flu outbreak of 1918.

Use of the Western blot technique to identify the immunogenic proteins of Borrelia burgdorferi for developing a Lyme disease vaccine.

Background: Lyme disease is a serious infectious disease having a restricted worldwide distribution for which there is no vaccine available for human use.

Objective: This study was designed to determine common reactive antigens involved in Borrelia burgdorferi (Bb) infection that are recognized in mammalian sera that may be useful for vaccine development.

Methods: Blood samples were collected from patients with documented Lyme disease, and from rabbits and mice experimentally infected with either tick-transmitted or culture-grown Borrelia burgdorferi.

Pasteur, Vaccines, and the Refusal to Become Fully Vaccinated in the Midst of the COVID-19 Pandemic.

Vaccines are one of the most effective public health measures that are designed to prevent serious illness caused by a wide variety of infectious agents, which have become especially important in light of the coronavirus disease 2019 (COVID-19) pandemic. Despite the favorable outcomes associated with vaccine development and use, a new wave of hesitancy to get vaccinated has emerged that threatens the control or quick elimination of the highly contagious and life-threatening infection caused by SARS-CoV-2. At the forefront of the current anti-vaccine movement is the dissemination of false and misleading information.

Hesitancy to get vaccinated against COVID-19 and how it might be overcome.

The hesitancy and resistance to get vaccinated against COVID-19, by a relatively small but significant part of the general population, has become a serious worldwide problem, and particularly in the United States, despite a vigorous and highly organized governmental advertising campaign promoting vaccination. The unwillingness to get vaccinated has its roots in mostly the spreading of non-scientific, unproven or misleading information. This chapter explains many of the reasons, including an historical connection, behind this anti-vaccine movement, and proposes several possible and feasible remedies to counter this sentiment.

COVID-19 vaccines for high risk and immunocompromised patients.

The availability of multiple versions of vaccines designed to help prevent COVID-19 has offered an opportunity to at least control the current pandemic, and possibly to quickly eradicate this disease fully, along with the implementation of other preventive measures. In order to accomplish this feat more effectively, as many people as possible need to be vaccinated, especially for high-risk groups having co-morbid conditions such as diabetes, obesity and old age, and possibly those with various forms of immunodeficiencies, such as HIV/AIDS. This chapter focuses primarily on some of the basic biomedical aspects on vaccine design and use, and any possible concerns that need to be considered in getting people in the high-risk category vaccinated and monitored thereafter for their continuous health and well-being.

Lack of Convincing Evidence That Borrelia burgdorferi Infection Causes Either Alzheimer Disease or Lewy Body Dementia.

The role that microorganisms might have in the development of Alzheimer disease is a topic of considerable interest. In this article, we discuss whether there is credible evidence that Lyme disease is a cause of Alzheimer disease and critically review a recent publication that claimed that Borrelia burgdorferi sensu stricto infection, the primary cause of Lyme disease in the United States, may cause Lewy body dementia. We conclude that no convincing evidence exists that Lyme disease is a cause of either Alzheimer disease or Lewy body dementia.

COVID-19 Vaccines for HIV-Infected Patients.

Nearly 40 years have passed since the initial cases of infection with the human mmunodeficiency virus (HIV) were identified as a new disease entity and the cause of acquired immunodeficiency disease (AIDS). This virus, unlike any other, is capable of causing severe suppression of our adaptive immune defense mechanisms by directly infecting and destroying helper T cells leading to increased susceptibility to a wide variety of microbial pathogens, especially those considered to be intracellular or opportunistic. After T cells are infected, HIV reproduces itself via a somewhat unique mechanism involving various metabolic steps, which includes the use of a reverse transcriptase enzyme that enables the viral RNA to produce copies of its complementary DNA.

The evolution of rapid antigen detection systems and their application for COVID-19 and other serious respiratory infectious diseases.

Making the correct diagnosis of a patient seeking medical attention is the ultimate goal of a practicing physician, irrespective of whether the cause of the patient's condition is infectious or non-infectious. Antigen detection tests can be used to aid in the diagnosis of various infectious-related disorders including COVID-19 where it has become especially important due to the serious nature of this disease and its worldwide prevalence. These tests closely mimic one of the earliest prototypes - the urine pregnancy test - and as a result they have gained wide acceptance based on their overall simplicity, low cost and relative accuracy.

Passive immunization and its rebirth in the era of the COVID-19 pandemic.

The COVID-19 pandemic, caused by SARS-CoV-2, has led to a rapid search for therapeutic and preventive measures because of the potentially severe course of infection. The antiviral drug, remdesivir, and the anti-inflammatory agent, dexamethasone, have shown beneficial effects. As the current COVID-19 vaccines are not yet fully available to everyone, or they may not be readily and universally accepted, various treatment options are being evaluated and will still be needed under these conditions.

COVID-19: Is there a role for Western blots and skin testing for determining immunity and development of a vaccine?

Infection with the virus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) stimulates an immune response which can serve as a marker for current or past exposure to this pathogen, and possibly for resistance to re-infection. This response to COVID-19 can be monitored based on the production of antibodies, and thus, serologic tests have become available for diagnostic purposes. Despite progress in this area, concerns have been raised that too many of the commercially available serologic detection systems are not completely reliable.

Clinical implications of nicotine as an antimicrobial agent and immune modulator.

Nicotine is perhaps the most important and potent, pharmacologically active substance in tobacco products. This commentary examines the possible effects that nicotine has on microbial viability and also on the host's immune system as it responds to the indigenous microflora (the microbiome) due to nicotine-induced changes to the indigenous microbial environment and any associated antigenic stimulation / immunization that may occur. To our knowledge, the analysis of such profound microbiologic changes attributable to a tobacco-related product, such as nicotine, has not been fully explored in the context of its consequences on the viability of the microbiome/microbiota and on some of the host's basic physiologic processes, such as the immune response, and its possible association on the induction and persistence of certain immunologically related diseases.

Transfusion-Associated Lyme Disease - Although Unlikely, It Is Still a Concern Worth Considering.

Even though hematogenous spread of the Lyme disease spirochete, , has been well documented, and there are more than 300,000 cases per year of Lyme disease in the United States, no evidence (anecdotal or published) of transfusion-associated Lyme disease has been reported. Such a possibility would seem to exist but various factors, as discussed in this perspective, make this less likely to occur. Nonetheless, if not done already, safeguards need to be put in place at blood collection and dispensing facilities, possibly with the assistance of diagnostic microbiology and immunology laboratories, to ensure that the potential for the transfer of the Lyme disease spirochete through a blood transfusion remains a theoretical consideration rather than a real possibility.

Was it authentic Lyme disease or some other disorder?

We compared the evidence presented recently that challenges the long-standing belief that, in 1922, two French physicians reported the first case of neurological Lyme disease with a further analysis of the original findings that were translated and re-published in 1993. Alternative possibilities are offered that could explain these discrepant interpretations on what was considered to be a landmark clinical case of historical significance.

A Gram Stain Hands-On Workshop Enhances First Year Medical Students' Technique Competency in Comprehension and Memorization.

Background: Laboratory diagnostic tests have an essential role in patient care, and the increasing number of medical and health professions schools focusing on teaching laboratory medicine to pre-clinical students reflects this importance. However, data validating the pedagogical methods that best influence students' comprehension and interpretation of diagnostic tests have not been well described. The Gram stain is a simple yet significant and frequently used diagnostic test in the clinical setting that helps classify bacteria into two major groups, Gram positive and negative, based on their cell wall structure.

Culture of the entire mouse to determine whether cultivable Borrelia burgdorferi persists in infected mice treated with a five-day course of Ceftriaxone.

Although controversial, it has been suggested that antibiotic treatment of laboratory animals infected with Borrelia burgdorferi often leads to the persistence of residual spirochetes that are claimed to be viable but noncultivable. If viable cells of B. burgdorferi do persist following antibiotic therapy, one possible explanation for the lack of cultivability is that too few organisms persist in any given tissue site that might be sampled and cultured.

Failure of topical antibiotics to prevent disseminated Borrelia burgdorferi infection following a tick bite in C3H/HeJ mice.

A prior study in mice has shown that the timely application of topical antibiotics to the skin at the tick bite site could eradicate Borrelia burgdorferi infection. That study, however, did not evaluate antibiotic preparations that are considered suitable for use in humans. In this murine study, topical application of 2% erythromycin and 3% tetracycline preparations that are acceptable for use in humans was found to be ineffective in eliminating B.

Growth inhibition of a spectrum of bacterial and fungal pathogens by sulforaphane, an isothiocyanate product found in broccoli and other cruciferous vegetables.

In addition to its documented antitumor effects, previous in vitro and in vivo infectivity experiments have shown that sulforaphane (SFN), an isothiocyanate compound found abundantly in broccoli and other cruciferous vegetables, inhibits the growth of the bacterial pathogen Helicobacter pylori. No recent evidence exists, however, on the possible microbial activity of SFN against a broader range of microorganisms, including those that may develop resistance to conventional antibiotics. The aim of this study was to determine the in vitro susceptibility patterns of SFN against a wide variety of bacterial and fungal pathogens.