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30 juillet 2017 7 30 /07 /juillet /2017 08:21

Encore deux mutations, et la souche H7N9, déjà souvent meurtrière, pourrait devenir encore plus virulente pour l’homme, selon le magazine de vulgarisation scientifique New Scientist

Dans le même article, le magazine prédit l’arrivée possible d’une pandémie et s’inquiète des freins à la recherche sur de potentiels vaccins mis en place par l’administration Trump aux États-Unis.

Le fort potentiel pandémique de H7N9 était déjà pressenti en 2013, année où le virus a pointé son nez en Chine.

Celui-ci a resurgi l'année dernière, tuant 714 Chinois depuis octobre dernier, soit un tiers des personnes contaminées.

Selon le graphique publié par le New Scientist, 2017 sera une année-record. Nouvelle intrusion dans la vie privée des minorités musulmanes du Xinjiang Après le fichage génétique, c’est une application, véritable outil de surveillance et de censure, que les autorités chinoises imposent aux habitants du Xinjiang.

Ceux-ci ont l’obligation d’installer une application intitulée Jingwang sur leur téléphone portable.

Les instructions de la police – reproduites par le site d’information Mashable – ont été envoyées via le réseau de messagerie WeChat, en chinois et en ouïghour.

Une fois téléchargée, l’appli exercera une véritable surveillance de masse. Son fonctionnement rappelle celui d’un logiciel de filtrage parental, selon le site Radio Free Asia. Et aussi...

« Comme dans Minority Report ».

Le gouvernement chinois a énoncé son ambition il y a quelques jours : devenir le "leader de l’intelligence artificielle d’ici 2030".

Pour en savoir plus, l’article publié sur notre site. Grippe aviaire suspectée.

Le virus H7N9 sévit au-delà des frontières chinoises.

Le Cambodge, bien que n’ayant encore recensé aucun cas d’infection humaine, surveille ses frontières et ses marchés, et enjoint sa population à ne pas consommer de poulet, d’après Radio Free Asia.

Par ailleurs:

Épidémie de dengue sans précédent au Sri Lanka : 300 morts à ce jour, qui ont déclenché un dispositif d’urgence dans tout le pays. Le virus a muté, et l’immunité de la population n’est plus assurée, selon un responsable de la Croix-rouge.

L'épidémie qui vient : Encore deux mutations, et la souche H7N9, déjà souvent meurtrière, pourrait devenir encore plus virulente pour l’homme.
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30 juillet 2017 7 30 /07 /juillet /2017 08:11

Des spécialistes contestent la décision de l’Agence du médicament de baisser la dose maximale du traitement contre l’alcoolisme.

De quoi s’agit-il?

Mardi, l’Agence du médicament (ANSM) prenait la décision de réduire la dose autorisée de baclofène, un médicament initialement prescrit contre les spasmes musculaires de certaines maladies neurologiques mais aussi efficace pour réduire la consommation d’alcool.

Or le baclofène ne bénéficie pas d’une autorisation de mise sur le marché contre l’alcoolisme.

Le 14 mars 2014, l’ANSM lui avait donné une recommandation temporaire d’utilisation (RTU) pour 300 mg maximum par jour. L’ANSM a remis en cause cette décision en abaissant la dose à 80 mg.

C’est ce choix que contestent vivement des médecins et, mardi, ils ont adressé une tribune à la ministre de la Santé, Agnès Buzyn.

Elle est signée par douze spécialistes dont Philip Gorwood et Bernard Granger, professeurs de psychiatrie à l’université Paris-Descartes, mais aussi Michel Reynaud, professeur émérite de psychiatrie et d’addictologie à Paris Sud, Benjamin Rolland, maître de» conférences en addictologie à l’université Lyon 1, et Didier Sicard, professeur émérite de médecine interne à l’université Paris-Descartes, président honoraire du Comité consultatif national d’éthique, ainsi que Nicolas Simon, professeur de pharmacologie à l’université Aix-Marseille.

Il ne s’agit donc pas que de fervents défenseurs du baclofène qui se sont unis face à une décision qu’ils jugent inique. «La décision de l’ANSM, faite sans concertation avec les spécialistes de terrain, ne nous paraît pas adaptée: elle est source d’une perte de chance pour de nombreux patients», écrivent-ils.

L’option d’une riposte par voie judiciaire est actuellement à l’étude.

Nicolas Simon critique une «décision à l’emporte-pièce» de l’ANSM, «pas bien orchestrée» et ne s’expliquant «que par la trouille».

Celle de se voir reprocher de n’être pas assez précautionneux.

Michel Reynaud à présent.

Il n’est pas un militant du baclofène et pourtant, il relève que «devant la faiblesse de notre arsenal thérapeutique dans l’alcoolodépendance, nous n’avons pas les moyens de nous passer d’un médicament efficace».

Selon lui, «il faut mettre un coup d’arrêt à cette mesure qui telle qu’elle est prise est dangereuse pour certains patients».

Il note cependant qu’au-delà de 80 mg, «il ne paraît pas raisonnable d’autoriser une libre prescription sans limites et sans contrôles ni suivi rigoureux».

«Pas de raison de douter»

Sollicitée, l’ANSM justifie sa décision:

«À partir du moment où l’agence a connaissance de nouveaux risques, il relève de sa responsabilité de prendre les décisions visant à garantir la sécurité des patients.»

Le ministère de la Santé indique de son côté ne «pas avoir de raison de douter de cette décision».

Quelle urgence y avait-il à ordonner cette réduction de dose en plein été?

Comment les patients au-delà de 80 mg vont-ils être sevrés quand le pharmacien refusera de leur délivrer leur dosage habituel?

Comment adapter le traitement alors que les médecins sont en vacances?

L’ANSM aura-t-elle à répondre des rechutes des patients?

Baclofène, l'exaspération des médecins monte d'un cran contre Agnès Buzyn.
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30 juillet 2017 7 30 /07 /juillet /2017 07:53

L'hypoxie dans les psychoses exogènes aiguës et son traitement.

Kondrashenko VT. Zh Nevropatol Psikhiatr Im S S Korsakova. 1980.

Le document concerne un examen de la respiration externe et des fonctions d'oxygène du sang chez 82 patients atteints de délire alcoolique et chez 44 patients atteints du syndrome délirant en raison d'un empoisonnement aigu par le monoxyde de carbone.

Il a été démontré que l'hypoxie est un lien important dans la pathogenèse des psychoses d'intoxication aiguë.

Un rôle important dans la formation de la symptomatologie psychotique est joué par le degré et le type d'hypoxie.

Tous les patients ont reçu de l'oxygène par voies d'administration différentes: sous-cutanée (28 cas), par inhalation à la pression barométrique normale (60 cas), par oxygénation hyperbare (39 cas).

Il a été démontré que la méthode la plus efficace pour arrêter l'hypoxie de toute origine est l'oxygénation hyperbare qui peut être recommandée pour le traitement des psychoses aiguës de monoxyde d'alcool et de carbone.

PMID 7415713 [PubMed -

indexé pour MEDLINE]

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30 juillet 2017 7 30 /07 /juillet /2017 07:47

Effets de l'oxygénothérapie hyperbare sur la dépression et l'anxiété chez les patients atteints d'une lésion de la moelle épinière incomplète

(article conforme à STROBE).

Essai contrôlé randomisé Feng JJ, et al. Médecine (Baltimore). 2017.

Peu de recherches ont été faites sur les effets de l'oxygène hyperbare (HBO) sur la dépression et l'anxiété après une lésion de la moelle épinière (SCI).

L'objectif de cette étude était d'étudier les effets de HBO sur les problèmes psychologiques résistants, et en particulier sur la dépression et l'anxiété chez les patients atteints de SCI incomplet (ISCI).

Les patients isolés avec ISCI combinant dépression et anxiété ont été répartis au hasard dans le groupe HBO ( 20 cas), groupe de psychothérapie (20 cas) et groupe de contrôle de réadaptation classique (20 cas).

Tous les patients ont reçu une thérapie de rééducation de routine.

Cependant, dans le groupe HBO et le groupe de psychothérapie, les patients ont également reçu une HBO et une psychothérapie, respectivement.

Ces traitements ont duré 8 semaines (une fois par jour et 6 jours par semaine).

Avant et après 8 semaines de traitement, la dépression et l'anxiété, la fonction nerveuse et les activités de la vie quotidienne ont été évaluées selon l'échelle de Hamilton (HAMD), l'échelle de l'anxiété de Hamilton (HAMA), le score de l'American Spinal Injury Association et l'indépendance fonctionnelle Mesure le score chez tous les patients.

Après 8 semaines de traitement, le score HAMD a été significativement plus faible chez le groupe HBO et le groupe de psychothérapie que dans le groupe témoin (tous P

Le score HAMA était significativement plus faible dans le groupe HBO que dans le groupe témoin (P

Après 8 semaines de traitement, l'Association américaine des lésions rachidiennes et les scores de la mesure d'indépendance fonctionnelle étaient significativement plus élevés dans le groupe HBO que dans les groupes psychologiques et de contrôle, et aussi plus élevés dans le groupe de la psychothérapie que dans le groupe témoin (tous P

Les effets de HBO sur la dépression et l'anxiété est semblable à celui de la psychothérapie. HBO peut améliorer considérablement la fonction nerveuse et les activités de la vie quotidienne chez les patients atteints d'ISCI, plus que la thérapie (psychothérapie) ou la rééducation de routine, et ne peut pas être substituée.

PMID 28723746 [PubMed - indexé pour MEDLINE]

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30 juillet 2017 7 30 /07 /juillet /2017 06:23

Facebook a censuré 70,000 comptes critiquant Emmanuel Macron pendant les élections présidentielles

OSTED BY LA RÉDACTION ON 28TH JUILLET 2017

BREIZATAO – POLITIKEREZH (28/07/2017)

En avril dernier, Facebook avait annoncé la suppression surprise de 30,000 comptes en France qui publiaient « du spam, de la désinformation ou d’autres contenus trompeurs ».

Une décision opaque et unilatérale qui a très souvent touché des comptes orientés à « droite » regroupant des critiques de l’immigration, de l’islamisme, du multiculturalisme, etc.

Nombreux sont les utilisateurs du réseau qui, depuis plusieurs mois, ont ainsi vu leurs comptes supprimés sans préavis alors qu’ils animent des pages identitaires.

Une politique qui a par exemple frappé le Youtubeur Majid Oukacha, très critique de l’islam.

Ou le blogueur algérien « Aldo Sterone », également critique de l’islam.

Des comptes catholiques ou ont aussi été affectés, ceux-ci étant fermés sans aucun avertissement préalable.

Tout comme des pages soutenant la candidate du Front National.

Reuters est revenu, dans sa version en langue anglaise, sur cette politique.

Facebook a expliqué que l’entreprise avait en fait agi dans le cadre des élections présidentielles françaises, prétextant lutter contre des « agents russes ».

Rien de moins : Facebook a joué un rôle clef dans l’identification et l’arrêt de l’interférence russe durant les récentes élections françaises, a révélé un parlementaire américain.

Pendant l’attaque, des agents du renseignement russe ont tenté d’espionner la campagne d’Emmanuel Macron en se présentant comme des amis de Macron afin de tenter de collecter des informations.

Des faits se conjuguant avec l’interférence russe précédemment rapportée où des espions avaient utilisé de faux comptes Facebook pour répandre de fausses informations à propos des élections françaises.

L’article poursuit : S’exprimant auprès de Reuters, Facebook a confirmé qu’il avait détecté ces comptes suspects et les avaient fermé durant le premier tour des élections présidentielles […]

Durant la même conversation avec Reuters, le géant des réseaux sociaux déclare qu’il a suspendu 70,000 comptes en France qui faisaient de la propagande ou du spam, avec la majorité de ces cas liés à l’élection.

C’est la première fois que Facebook confirme le caractère politique de cette vague de fermetures.

En résumé : Facebook a fermé des comptes de manière unilatérale en affirmant, sans en apporter la moindre preuve, que les 70,000 comptes supprimés faisaient de la « propagande » au détriment d’Emmanuel Macron.

Des comptes « suspectés » de défendre des positions critiques ou différentes de celles du candidat ont ainsi été censurées, le prétexte russe étant brandi pour légitimer l’opération.

Il s’agit, à ce stade, de la seule interférence avérée dans le processus électoral français et il n’émane pas de la Russie mais bien de l’entreprise américaine.

Une politique qui a par obligation été menée en étroite concertation avec le gouvernement français et la présidence Hollande mais aussi, c’est l’évidence, avec le candidat Macron.

Facebook helped blunt Russian meddling in French elections Better automated detection tech and more employees on the case resulted in swift action.

Tom Regan 07.27.17 in Politics

Facebook played a key role in identifying and stopping Russian interference in the recent French election, a US congressman has revealed.

During the attack, Russian intelligence operatives attempted to spy on Emmanuel Macron's election campaign by posing as friends of Macron's and attempting to glean information.

This was in conjunction with the previously reported Russian interference, where spies also used fake Facebook accounts to spread misinformation about the French election.

Speaking to Reuters, Facebook confirmed that it detected these suspect accounts and shut them down during the first round of the French Presidential elections.

With Facebook often coming under fire for not being quick enough to act in matters of fake news, election fraud, and social media manipulation, the networking company claimed that it was able to deal with these accounts swiftly thanks to its improved automated detection tech. Facebook also reveals that it has stepped up its human efforts to track down sophisticated attacks too, making high-level fraud investigations a priority at the company. In the same conversation with Reuters, the social networking behemoth states that it suspended 70,000 accounts in France for promoting propaganda or spam, with the majority of those cases being related to the election.

This is significantly larger than the mere 30,000 French account suspensions that Facebook confirmed just before the end of the election, in April.

Thankfully, Facebook acted swiftly, with the company stating that the spies did not have the chance to get their intended targets to reveal personal information or download malicious software.

These Russian intelligence agents reportedly used the same tools previously used by Russia's GRU military intelligent unit, who have been blamed previously for hacking the Democratic National Committee in last year's U.S election.

Despite the interference, Macron went on to win the French election with a landslide victory in May. Russia is, unsurprisingly, denying any involvement in the election fraud.

Source: Reuters In this article: ElectionFraud, facebook, france, hacking, politics, RussianSpies

Facebook a censuré 70,000 comptes critiquant Emmanuel Macron pendant les élections présidentielles.
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30 juillet 2017 7 30 /07 /juillet /2017 06:15

Le gouvernement signe un énorme coup d’arrêt au développement de l’agriculture bio

Le gouvernement a décidé de ne plus soutenir le développement de l’agriculture bio. Les aides à la conversion seront tout simplement supprimées.

Une triste nouvelle pour l’écologie.

L’agriculture et l’alimentation doivent se réformer de façon urgente pour produire mieux et de façon plus respectueuse de l’environnement.

La tenue des états généraux de l’alimentation constituait un signal plutôt positif de la part du gouvernement d’avancer dans le sens de la transition écologique de l’agriculture.

Or le Ministre de l’Agriculture vient de porter un coup d’arrêt au développement de l’agriculture bio en supprimant les aides à la conversion dans les trois prochaines années.

“Jeudi noir” pour l’agriculture bio

Ce sont les mots de la FNAB, Fédération Nationale de l’Agriculture Biologique, porte-parole des producteurs bio et interlocuteur du gouvernement.

Les producteurs regrettent amèrement la décision du ministre, dénonçant un “renoncement politique historique“.

Plus aucune aide pour la conversion à l’agriculture bio

La conversion à l’agriculture bio est un choix qui demande souvent un engagement à la fois financier et moral de la part des agriculteurs.

C’est une décision qui demande d’être accompagnée, et l’aide financière aux conversions décidait bon nombre de producteurs à s’engager.

Leur suppression portera un coup d’arrêt au développement de l’agriculture bio, pourtant en belle hausse depuis plusieurs années, suivant la demande toujours en hausse exponentielle.

” Cette décision vient contredire les promesses de campagne du Président de la République sur les paiements pour services environnementaux (PSE) et l’introduction de produits bio dans les cantines “ dénonce Stéphanie PAGEOT, Présidente de la FNAB.

” Cela témoigne d’un manque criant de courage politique face à l’agro-industrie et l’agro chimie “.

Un renoncement en effet vécu de façon très brutale par les promoteurs de l’agriculture bio, qui avaient lancé une pétition pour maintenir les aides à la bio il y a quelques jours, que nous avions relayée sur les réseaux sociaux.

“La “révolution” promise par le candidat Macron dans son livre-programme n’aura pas lieu : c’est un rendez-vous historique que vient de manquer le gouvernement français“, dénonce amèrement la Fnab dans son communiqué.

Effectivement, un bien triste “jeudi noir” en plein été pour l’agriculture française… Par Pauline Petit

Le gouvernement signe un énorme coup d’arrêt au développement de l’agriculture bio.
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29 juillet 2017 6 29 /07 /juillet /2017 21:18

Particules fines, les véhicules essence ne font pas mieux que les diesels.

Les particules fines, l’étendard de la pollution liée aux véhicules motorisés et, surtout, diabolisation du diesel. Seulement voilà, les véhicules essence ne sont pas épargnés.

Pis ils suivent une relation inverse au diesel.

En effet, si on s’intéresse uniquement à la pollution des particules fines, plus les diesel sont anciens et plus ils sont polluants (en conditions optimales d’utilisation*).

* toutes données d’émissions des polluants restent indicatives. Dès 2014, bien avant le dieselgate de Volkswagen, l’Ademe indiquait que « le cycle NEDC utilisé pour la vérification du respect des normes Euro, n’est pas représentatif des émissions des véhicules lors de leur usage réel, ce qui conduit à sous-estimer les émissions (…) »

La norme euro 5 marque un tournant avec la généralisation des filtres à particules (mise en circulation à partir du 1er janvier 2011).

Pour les essence, c’est l’exact contraire, les anciens véhicules dotés d’un moteur à injection indirecte étaient nettement moins polluants que les nouveaux moteurs à injection directe.

Pourtant les médias se font discrets sur le sujet. Scandale à venir ou fuite en avant ?

Le premier article traitant de ce sujet date d’avril 2014, paru dans Le Point « Pollution: la bombe à retardement du moteur essence« .

Il mentionnait les résultats d’une étude réalisée, à l’époque par le laboratoire allemand TÜV Nord, pour le compte de l’ONG Transport&Environnement.

« L’ONG bruxelloise a sélectionné trois berlines compactes animées par des moteurs à injection directe d’essence – la Ford Focus Tourer 1.0 Ecoboost, la Hyundai i40 Kombi 1.6 GDI et la Renault Mégane 1.2 TCE – pour en mesurer les émissions polluantes. Le résultat est édifiant : sur le cycle NEDC d’homologation actuel, ces voitures essence émettent entre 4 et 8 fois plus de particules (en nombre) que la norme autorisée actuellement… pour les moteurs diesel.

Et même jusqu’à dix fois plus pour le moteur Renault 1.2 TCE lorsqu’il est mesuré sur le cycle américain US 06, plus réaliste que l’européen NEDC.

Cela en toute légalité, puisque les moteurs à essence n’auront à satisfaire une norme aussi sévère que les moteurs diesel dans le domaine des particules qu’en 2017.

» Puis en juin 2014, l’Agence de l’environnement et de la maîtrise de l’énergie publiait dans « Les avis de l’ADEME » les mêmes constats.

En mars 2015, soit quasiment un an plus tard, Challenges reléguait la même étude que celle paru dans Le Point, son titre « Particules : l’essence et l’hybride pires que le Diesel »

La révision de la norme Euro 6 a, à nouveau, permis de mettre le sujet sur la table. Juillet 2016, UFC Que Choisir embrayait « Filtre à particules.

Les moteurs essence aussi« . Puis en septembre 2016, l’Usine Nouvelle poursuivait « Pollution automobile : faut-il avoir peur des moteurs à injection directe essence?« .

Enfin en octobre 2016, Le Monde clôturait les interrogations « Pollution : après le diesel, les moteurs à essence au cœur d’une nouvelle bataille européenne« . Alors, en avez-vous, même vaguement, entendu parler?

Le lynchage du diesel a été tellement efficace, que la vente de véhicules diesel est passée sous la barre des 50%.

Tenu seul responsable de cette pollution aux particules, alors que la combustion de biomasse (chaudières, cheminées…) est à moitié, voire responsable des 3/4 des émissions dans certaines régions.

Le diesel représentait, pour le mois de janvier 2017, 46,6 % des ventes de voitures neuves en France, soit 474.000 voitures.

En 2015, ils représentaient 57% des ventes et en 2012 64%.

D’ailleurs en 2012, plus d’une voiture sur trois, en circulation, était un diesel (source: France Inter).

Retour sur un compromis impossible

Qu’on se le dise, les véhicules motorisés, peu importe leur gabarit ou leur motorisation, polluent.

D’un côté, on s’inquiète des émissions à effet de serre, responsable du réchauffement climatique, de l’autre, la pollution atmosphérique, responsable d’impacts sanitaires délétères.

Les véhicules diesel ont été largement plébiscités après la ratification du protocole de Kyoto.

L’objectif de ce protocole, réduire les émissions de gaz à effet de serre.

Or les véhicules diesel émettent en moyenne 20% de moins de CO2 que les véhicules essence, d’où leur fameuse étiquette verte et le bonus écologique, lancé en 2007.Eco2

Tout en consommant entre 20 et 25% de carburants en moins, comparés aux moteurs essence de même performance, les diesels ont, en plus, l’avantage d’émettre moins d’hydrocarbures imbrûlés et moins de monoxyde de carbone (source : IFP énergies nouvelles).

Par contre, les diesel constituent une source majeure des émissions de NOx (oxydes d’azote).

Or améliorer la combustion diminue, d’une part, les émissions de particules, mais augmente, d’autre part, les émissions de NOx. A contrario les essence, à injection indirecte, émettaient beaucoup moins de particules, notamment la fraction PM2,5, la plus problématique d’un point de vue sanitaire.

Mais ils n’étaient pas du tout « pro-lutte contre les émissions de gaz à effet de serre ».

Du coup pour réduire leur émission de CO2, les moteurs essence ont évolué, se calquant sur les moteurs diesel et la balance s’est inversée, moins de CO2, plus de PM.

Particules fines, les véhicules essence ne font pas mieux que les diesels.
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29 juillet 2017 6 29 /07 /juillet /2017 20:50

CRISPR/Cas9 : comment modifier les génomes va changer la société 4 octobre 2016,•Mis à jour le 27 juillet 2017,

Solveig Fenet, François Hirsch et Hervé Chneiweiss

L’ADN, pas si court que ça.

Révolution en cours pour les biotechnologies : la technique d’édition des génomes CRISPR/Cas9 pourrait permettre de grandes avancées dans les domaines de la médecine, de l’agriculture, et, plus largement, impacter la société tout entière.

Qu’est-ce que CRISPR/Cas9 et comment cela fonctionne ?

Le ruban d’ADN de 3 milliards de lettres et 1 mètre de long qui porte le patrimoine génétique d’un être humain est une chose fragile, sans cesse rompu par les multiples stress que subit une cellule.

Heureusement de puissants mécanismes de réparation veillent et œuvrent, parfois mis en défaut et c’est la maladie, cancers ou vieillissement accéléré.

À partir de découvertes sur les mécanismes de réparation de l’ADN, les chercheurs ont tenté depuis longtemps de mimer cette fonction.

Mais les techniques développées jusque-là étaient coûteuses, peu efficaces, peu précises et fastidieuses.

CRISPR/Cas9, ce sont deux éléments biologiques : CRISPR et Cas9.

CRISPR – pour Clustered Regularly Interspaced Short Palindromic Repeats- est un système naturel utilisé par les bactéries pour se protéger des infections virales.

Quand une bactérie est attaquée par un virus, elle se protège en découpant son ADN et en garde la mémoire en conservant quelques fragments.

CRISPR est une sorte de disque dur pour stocker ces fragments.

Quand la bactérie est de nouveau attaquée par le même virus elle possède alors sa « fiche d’identité » stockée dans CRISPR.

Les fragments « mémoire » vont agir comme un aimant en reconnaissant l’ADN du virus et permettre l’intervention d’un ciseau moléculaire,

Cas9, qui découpe et détruit le virus. La bactérie est ainsi protégée du virus.

En 2012, plusieurs équipes ont adapté le principe aux cellules animales et développé des systèmes CRISPR/Cas9 pouvant être programmés pour cibler n’importe quel gène.

Grâce à de multiples variants, naturels ou bricolés par des ingénieurs en biotechnologie, il est devenu possible non seulement de couper un gène mais aussi de le réparer, de le modifier ou d’en moduler l’expression, en l’augmentant ou en la diminuant.

La méthode est redoutablement efficace, relativement simple, très rapide et peu coûteuse.

Une révolution biotechnologique est en marche. Quelles sont les applications de CRISPR/Cas9 ?

Comme on le devine, les possibilités d’application de CRISPR/Cas9 sont multiples, voire infinies en biologie et en médecine.

Cette technique s’applique à n’importe quelle espèce, à toute la biodiversité du vivant sur la planète.

En juin 2016, l’Institut National américain de la Santé (NIH) a donné son accord pour porter le premier essai clinique utilisant CRISPR/Cas9 sur l’humain, pour créer en laboratoire des cellules immunitaires génétiquement modifiées afin de combattre trois types de cancer.

Le cancer se produit lorsque les cellules ne meurent plus et se multiplient tout en se cachant du système immunitaire.

Avec CRISPR, les scientifiques pourraient modifier en laboratoire des cellules immunitaires de notre organisme, une fois réinjectées dans notre corps, ces cellules génétiquement modifiées seraient alors capables de combattre les cellules cancéreuses.

Ainsi, CRISPR pourrait aussi nous débarrasser du virus VIH et d’autres rétrovirus qui se cachent dans l’ADN humain, comme le virus de l’herpès.

CRISPR/Cas-9 contre les virus. CRISPR/Cas9 offre aussi beaucoup d’autres espoirs sur le plan thérapeutique pour guérir les maladies rares et héréditaires.

De ce fait, la technique intéresse beaucoup les associations de patients atteints de maladies rares et héréditaires (l’Alzheimer, maladies de Parkinson, de Huntington, etc.).

Avec cette technique, la modification du génome de cellules germinales (les cellules sexuelles) et de l’embryon devient accessible à tous.

Sur les animaux, la technique de CRISPR/Cas9 peut être utilisée pour les rendre plus résistants aux maladies, mais aussi pour augmenter la production de viande en les rendant plus corpulents.

En Australie, CRISPR a également été testé pour modifier le gène responsable de l’allergie aux œufs de poule et rendre alors les œufs hypoallergéniques.

On envisage aussi d’utiliser CRISPR/Cas9 pour modifier les moustiques Anopheles, qui transmettent le paludisme.

Par la technique du « gene drive » ou « forçage génétique », on pourrait modifier des milliers de moustiques Anopheles pour les empêcher d’être vecteur de parasites.

Ceci devrait permettre d’éradiquer en quelques générations les maladies affectant essentiellement les populations des pays aux économies les plus fragiles. Sur les plantes,

CRISPR/Cas9 viendrait remplacer les OGM, les herbicides et pesticides.

Au lieu d’injecter un composant étranger, on pourrait directement modifier l’ADN de toute son espèce pour la rendre définitivement résistante aux maladies, comme le mildiou, ou pour la rendre plus productrice.

Sur les micro-organismes, des scientifiques essaient de modifier le génome de certaines levures pour qu’elles puissent produire des biocarburants.

À ce propos, la firme Monsanto vient de signer le premier accord de licence industrielle avec le Broad Institute d’Harvard qui possède les brevets déposés par l’équipe de Feng Zhang, concurrent des co-découvreuses Jennifer Doudna et Emmanuelle Charpentier.

Quelles sont les enjeux techniques et éthiques de CRISPR/Cas9 ?

Le principal enjeu technique de CRISPR/Cas9 est qu’on ne connaît pas encore suffisamment le rôle de tous les gènes, et donc les conséquences à long terme de telles modifications sur le génome, que ce soit chez l’être humain, les animaux, les plantes.

La modification du génome peut juste se transmettre sans variation mais elle pourrait dans certains cas entraîner une réaction en chaîne de changements dans l’ADN qu’on ne saurait contrôler.

La technique du « gene drive » modifierait-elle seulement le génome de la population visée ou pourrait-elle être transmise à d’autres espèces ?

La disparition d’une population jugée nuisible entraînerait-elle le déséquilibre de tout un écosystème ?

Sur le plan sécuritaire et militaire, la technique est simple et à faible coût, ce qui la rend accessible à tous les scientifiques et amateurs de « biologie dans un garage », soulevant des questions sécuritaires nationales non négligeables à l’heure du terrorisme.

CRISPR a été déclarée découverte scientifique de l’année 2015, mais a aussi été classée au rang des armes de destruction massive par les Agences de sécurité américaines.

Déjà d’autres techniques de modification du génome ont été développées depuis CRISPR/Cas9.

Ainsi, ce n’est pas la technique en elle-même qui soulève le plus de questions éthiques, mais la possibilité de pouvoir modifier simplement et de créer le vivant à façon, ouvrant par exemple la porte à un eugénisme sans limite.

Cette découverte s’inscrit dans un débat plus large sur notre société, agitant des questions relevant du transhumanisme, de l’expérimentation animale et de la protection de l’environnement.

La science a dépassé la fiction : n’avons-nous pas déjà accepté la pré-sélection de nos bébés avec le dépistage précoce de la trisomie 21 ?

Quelle est la limite à ne pas dépasser, en sachant qu’aujourd’hui nous sommes capables de réaliser les fantasmes les plus fous de nos aïeux ?

Quelles sont les applications des techniques de modifications du génome que nous pouvons autoriser et celles que nous devons interdire, et celles que nous pouvons autoriser, contrôler et surveiller ?

Tel est le débat d’ores et déjà engagé par de nombreuses institutions publiques françaises dont l’Inserm, et étrangères tel l’institut Harvard.

Par exemple, les chercheurs de Harvard, dans leur accord avec Monsanto, ont imposé à cette compagnie des restrictions éthiques d’utilisation de CRISPR (interdiction de créer des semences stériles, limitation de la manipulation des feuilles de tabac…).

Seule une recherche importante et dynamique pourra répondre aux multiples questions scientifiques ouvertes, permettre d’élaborer les outils d’évaluation de la sécurité de la méthode et ainsi éclairer le public et les décideurs politiques pour autoriser ou non le transfert vers des applications utiles et sures.

CRISPR/Cas9 : comment modifier les génomes va changer la société.

CRISPR contre les virus : video

https://youtu.be/lQaWh8VLkiU

CRISPR et vieillissement

Vidéo

https://youtu.be/5zHyUI13NDg

Qu'est-ce que CRISPR ?

Video

https://youtu.be/O3e2_Ctty_M

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29 juillet 2017 6 29 /07 /juillet /2017 19:30

«Le gouvernement Macron fait le choix de l’agro-business»

Secrétaire général de la Fédération nationale de l’agriculture biologique (Fnab), Guillaume Riou est agriculteur polyculteur éleveur dans les Deux-Sèvres où il exploite 120 hectares, dont 90 de cultures céréalières et 30 de rotation consacrés à l’alimentation de sa trentaine de vaches limousine.

Il officie depuis 2008 en bio après avoir été précédemment en agriculture conventionnelle.

Il répond aux questions de Libération sur la décision de Stéphane Travert, nouveau ministre de l’Agriculture, de geler les aides à la production de l’agriculture biologique, annoncée jeudi.

Quand vous dites que la décision de Stéphane Travers ne prévoit aucun budget pour les aides à l’agriculture bio dans les trois prochaines années, vous vous montrez direct.

Juste?

Ou pessimiste?

Ce qui nous met surtout en danger, ce sont les aides au maintien au bio, plus que les aides à la conversion.

A l’heure où le ministère de l’Agriculture dit qu’il lui faut trouver 850 millions d’euros d’économie par an, nous savons que nous avons besoin de 250 millions d’euros annuellement pour soutenir la filière et la développer.

Car nous progressons en France de 15% par an sur l’agriculture biologique en conversion.

Il y a une forte demande des agriculteurs conventionnels pour passer au bio.

Donc les budgets dédiés seront insuffisants pour y parvenir.

Quand on sait qu’il y a besoin de 450 millions d’euros pour soutenir l’agriculture de montagne et des zones difficiles qu’il faut évidemment soutenir, il y a fort à parier qu’il n’y aura pas d’argent pour le soutien et le développement du bio.

Cet arbitrage ministériel, en plus d’être décevant pour les intérêts que vous défendez, est-il une surprise pour vous?

Non. Pas véritablement.

Nous connaissions cette date butoir au 1er août qui signifiait des arbitrages du côté du ministère de l’Agriculture.

Ce sont autant des choix politiques que budgétaires.

7,50 milliards sont utilisés par an pour la PAC en France.

Le choix de conforter les exploitations les plus grandes à caractère plutôt céréalier a été fait mais cela révèle un certain nombre d’intérêts économiques de certains groupes de pression.

A quels lobbys pensez-vous?

Il y a la grande machinerie du fret maritime, des grands ports français…

Il ne faut pas oublier que le Premier ministre, Edouard Philippe, a été le premier édile du Havre.

On connaît aussi les affinités du Président sur les questions d’exportations.

Mais de là à penser que le système agricole français est apte à absorber les chocs internationaux et une vision mondialisée de l’agriculture, c’est à notre sens une erreur fondamentale.

Et l’agriculture française ferait mieux de se concentrer sur la production d’une agriculture de qualité.

Ces arbitrages sont d’autant plus étonnants que vous participez aux Etats généraux de l’alimentation.

Lors de leur lancement, le Premier ministre et le ministre de l’Agriculture ont affirmé leur volonté de changer de politique de production et de dialogue entre les différentes filières…

Il est difficile de penser que Stéphane Travert n’est pas sous la pression de lobbies, de groupes de pression et d’intérêts économiques.

Le gouvernement de Macron fait clairement le choix de l’agrobusiness.

Si l’on rajoute à cela que, bien souvent, les décideurs agricoles de notre pays sont aussi partie prenante de la gestion des exportations et présents aux conseils d’administration des grands ports français exportateurs…

Cela conforte une forme de conflits d’intérêts assez évidente…

Avec un blé à 140 ou 150 euros la tonne, cela permet difficilement de vivre sur une exploitation céréalière.

Mais des choix de productivisme ont été faits en développant cette grande idéologie de nourrir le monde.

Ils ne rémunéreront pas demain plus qu’aujourd’hui les agriculteurs de notre pays Jugez-vous que ces arbitrages vous sont moins favorables que ceux pris par Stéphane Le Foll, le prédécesseur de Stéphane Travert?

L’ancien ministre avait eu l’ambition de doubler le niveau d’aide à l’agriculture bio. Il y avait un plan plutôt courageux, il faut le dire, auquel nous avons participé, nommé «Ambition 2017».

Il est aujourd’hui difficile de présager ce que Stéphane Travert nous réserve pour le futur en plus de ces dernières décisions…

Avez-vous rencontré le ministre avant qu’il rende ses arbitrages?

Absolument. C’était mercredi matin.

Avez-vous le sentiment de ne pas avoir été entendus? Sinon, trahi?

Ce n’est pas de l’ordre de la trahison.

Nous essayons de participer à la prise de décision politique.

Décision que nous regrettons et dénonçons.

Mais pour autant, nous souhaitons construire l’agriculture biologique de demain qui est attendue par beaucoup de nos concitoyens.

Cet arbitrage ne vous semble-t-il pas en contradiction avec les vœux formulés lors du lancement des Etats généraux de l’alimentation?

Evidemment que ces choix sont paradoxaux.

L’Etat continue de soutenir cette agriculture industrialisée et dans le même temps propose un Grenelle de reconstruction de l’alimentation.

C’est pour le moins contradictoire. Comment l’expliquez-vous?

Nous connaissons la capacité de paralysie du réseau routier français par la FNSEA.

Peut-être le courage politique pourrait-il se révéler un peu plus…

Car le seul secteur agricole qui se développe est celui du bio avec 20% de croissance par an.

Philippe Brochen libération.fr

«Le gouvernement Macron fait le choix de l’agro-business» .
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29 juillet 2017 6 29 /07 /juillet /2017 06:58

Is there hope for Lyme patients? Interview with dr. Richard Horowitz "Is there hope for Lyme patients?" One of the top Infectious Diseases doctors answers to this urgent question for many. This is the first publication of the 'Teike takes on Lyme' research project. Can you please begin by introducing yourself? My name is Dr. Richard Horowitz. I am a board-certified internist. I have treated over 12.000 people with chronic Lyme disease in the United States, and I am the medical director of the Hudson Valley Healing Arts Center. I opened our center approximately 20 years ago to meet the needs of all these chronically ill patients that had a difficult time getting access to care in the US. I heard you were in Toronto, for what occasion where you there? I was teaching at a Lyme conference. I met with government officials and one of the members of parliament. There was a gala for young children called 'Lyme Out Loud Canada.' It was for children who did not have access to care, who couldn't afford treatments and who are sick in Canada. I also gave a talk to doctors the day afterwards. It was a four-hour lecture on the science of Lyme disease and tick-borne infections, and how we treat these multiple infections in the United States. You have treated more than 12.000 patients, how are they now? MSIDS model Fortunately, the vast majority of them are doing quite well. Over the past 30 years I've developed a model that is a 16-point health care map that I call MSIDS: Multiple Systemic Infectious Disease Syndrome. What I found for those who are chronically ill who come to see me is that they don't just have Lyme disease. They usually have co-infections like Babesiosis which is a malaria-like parasite, and many have Bartonella which is a form of cat scratch fever. We also find that people usually have other overlapping causes of inflammation apart from chronic infections. For example, they may suffer from chronic insomnia, be eating the wrong diet, i.e., eating allergic foods which causes an inflammatory response, or they may be deficient in essential minerals like zinc, which can increase inflammatory molecules in the body. These can result in chronic fatigue, headaches, joint and muscle pain, nerve pain, memory and concentration problems, and sleep disorders. So, we have discovered that there are up to 16 factors keeping these people sick apart from Lyme disease. Once we adequately treat all the forms of Lyme disease, as well as associated co-infections, food sensitivities, mineral deficiencies, sleep disorders, mitochondrial dysfunction, hormone dysregulation, POTS (Postural Orthostatic Tachycardia Syndrome)/with imbalances of the autonomic nervous system, and treat internal and external toxins and imbalances with the microbiome of the gut, the majority of our chronically ill patients improve. PLEASE-study Unfortunately, many of the double-blind studies on Lyme disease that have been done in the United States and in Europe like the PLEASE study don't adequately address all the overlapping causes of illness that we see in our patients that I previously discussed, especially the co-infections. They also did not integrate any of the new scientific research on Lyme “persister” cells in the body, or borrelia biofilms. We find that when we treat chronically ill patients with combination antibiotic regimens that include novel persister drugs like Dapsone, with biofilm busters, and simultaneously treat co-infections and abnormalities on the 16-point MSIDS map, these can make a big difference in getting people better. Persister Protocols I published two articles in the scientific literature last year about persister drugs for borrelia, which are essentially using old mycobacterium drugs like Dapsone and pyrazinamide for treating Lyme. To answer how are they doing: many people who had failed prior treatments are now doing much better with these new protocols which target the different persister forms of Lyme disease and multiple co-infections. We are very excited that we are finding new protocols to help patients who are chronically ill. What do you think is the importance of these persister-studies and are you able to help patients with these new insights? Research of Kim Lewis and Ying Zhang It is quite important. There were several breakthroughs in the medical research during the past couple of years. One came from dr. Kim Lewis at Northeastern University. The other came from Dr Ying Zhang and his colleagues at John Hopkins University. They are well respected PhD researchers, and they both found that there are persister cells that exist in Lyme disease, as there are in other chronic infections. We used to think that it was just the cystic forms of borrelia that were responsible for persistent and relapsing infections. Now we know that there are heterogeneous dormant persister cells that exist in biofilms, and borrelia can be in different stages of replication. Results in the laboratory Dr. Lewis did research in his laboratory which showed that when he used ceftriaxone for Borrelia in culture it would kill off 99% of the bacteria, but once he stopped it the bacteria would grow back. Dr. Zhang from John Hopkins also discovered that Borrelia persisted after standard antibiotics used for Lyme, like doxycycline and ceftriaxone, and that various antibiotic combinations had different effects against these persister cells. How many people have been infected with Lyme disease? I don't think we know how far this epidemic has really spread. The CDC in the United States says that they have underestimated the numbers by 10-fold, so in 2013 the numbers went from 30.000 per year to over 300.000 per year. It is now being estimated that it is about 400.000 cases per year in the United States. We know from the WHO figures in Europe we are dealing with over a million cases in just Eastern Europe alone. This was published a couple of years ago. In 2015 there was a publication in Emerging Infectious Diseases that there was a 320% increase in the number of counties affected by Lyme disease in the US. Migratory birds are spreading the ticks from county to county. This is also why the disease is spreading through Europe, and at this point it has also spread to China and many other countries worldwide. CFS & Fibromyalgia Lyme mimics other diseases: for example, 3.5% of the US population has Chronic Fatigue Syndrome (Myalgic Encephalomyelitis / S.E.I.D.), and 1.5% of the US population has Fibromyalgia. That means that approximately 5% of the 350 million people in the United States have a chronic fatiguing, musculo-skeletal illness. That translates into roughly 18 million people with Chronic Fatigue and Fibromyalgia, and we know that they are clinical diagnoses. There are no blood tests for these conditions. So, if you have fatigue, aches and pains, memory problems and you can't fall asleep and your doctor does an insensitive ELISA test (which misses about half of the cases of Lyme disease), you could be diagnosed with Chronic Fatigue Syndrome or Fibromyalgia. Auto-immune Illnesses We also know that approximately 50 million people are diagnosed with auto-immune illnesses in the United States, and Lyme imitates rheumatoid arthritis, lupus and multiple sclerosis. The vast majority of the people that I have seen with MS actually have Lyme disease. We can get many of them off their MS drugs by treating Lyme and overlapping sources of inflammation on the 16-point MSIDS map. Alzheimer’s We are having a dementia epidemic in the United States and worldwide. Every 67 seconds in the United States someone is diagnosed with Alzheimer’s disease. We now know that Borrelia spirochetes are found in the brains of Alzheimer patients. Many researchers from across the world have published this in the medical literature, including Dr Judith Miklossy from Switzerland and Dr Alan McDonald from the US. Recently, researchers from Drexel University in Pennsylvania published that they are finding Lyme spirochetes in biofilms of the brains of people with Alzheimer's disease. Lyme is “The Great Imitator” The reason we can’t estimate the true number of cases is because Lyme is imitating a broad range of other diseases, including Alzheimer's, autoimmune disease, as well as Chronic Fatigue Syndrome/S.E.I.D. (Systemic Exertional Intolerance Disease) and Fibromyalgia. When you put the number of people affected by all those diseases together, we could be dealing with millions of cases of Lyme and associated tick-borne disease in the United States alone. Of course, that is an estimate. When the CDC estimated their numbers, they were using the two-tiered protocol of using an ELISA followed by an Western Blot, which will only pick up about 50% of the cases of Lyme disease. You advocate personalized treatment and take into consideration multiple causes for one disease manifestation. How is your approach different than the current medical paradigm and their approach of diseases such as Lyme? ILADS and IDSA Guidelines There are two sets of medical guidelines for treating Lyme disease. You have the IDSA, the Infectious Diseases Society of America, which in essence says Lyme is easy to diagnose and easy to treat. The IDSA guidelines, which are no longer on the US government's website (The National Guidelines Clearinghouse), were taken off because they are 10 years old, and not up to date with the new science that has emerged. The ILADS guidelines however are still listed on the US government's website. I was one of the founding members of ILADS, and was one of the authors of the first ILADS guidelines. The recent ILADS guidelines were published by Dr Daniel Cameron, and met the Institute of Medicine’s highest standards for guideline development. The Annals of Internal Medicine published an article several years ago which looked at the IDSA guidelines, and found that at least 50% of the recommendations were the authors opinions, and not based on strong levels of scientific evidence. For example, the IDSA guidelines say that antibiotics don’t help those with chronic Lyme disease, but when you look at the three-double blind placebo controlled studies that where done by the NIH, in two out of the three studies the people got better. In the Krups study which was published several years ago, their fatigue got better, and in Dr Brian Fallon's study, published in Neurology in 2008, the patient’s cognitive issues got better. Their PET scans lit up on ceftriaxone, showing that the drug was having an effect. The problem is that they didn't stay better because they stopped the treatment after several months, and Lyme can be a persistent infection when not caught early. New Borrelia species One of the other problems that we are facing is that there are different emerging species of Borrelia. There have been at least 15 new species of Borrelia reported in the medical literature in the last 20 years. That is almost 1 new species per year. For example, Borrelia miyamotoi, which is a relapsing fever spirochete, is spreading in up to 15% of the ticks in the United States and in Europe, and tests for Lyme disease will not pick up that particular strain of Borrelia. So, you could get an EM rash. You could have Bell’s Palsy. You could have a meningitis and encephalitis and be quite ill and the doctor may suspect Lyme disease, but the testing comes back negative for Borrelia burgdorferi, the agent of Lyme disease, because it is due to a different borrelia species, and therefore the physician may choose not to treat. That would lead to long term medical problems and potential disability. So, the guidelines are not taking into account all of these emerging species. We know that in Europe for example, Borrelia afzelii will cause an acrodermatitis chronicum atrophicans (ACA) rash. Borrelia garinii on the other hand, can cause neuroborreliosis. Then you have other species in Europe like Borrelia Valaisiana as well as other borrelia species that also cause illness, and the standard testing will not pick them up. Co-infections We need to look at emerging borrelia species as well as other associated tick-borne co-infections to help patients that are ill. In the past two years, peer-reviewed medical articles have shown that over 80% of the time Babesia is transmitted at the same time as Lyme disease. That is like getting malaria with Lyme. We found that these malarial-like parasites are important in keeping people ill, and they also can suppress the immune system. That makes it more difficult to get rid of other parasitic infections when you have Babesia. Similarly, Bartonella will also suppress immunity (just like Lyme does). We see a lot of people with Lyme disease who have Chronic Variable Immune Deficiency (CVID) where their immune systems are not functioning properly. In these cases, you can give antibiotics for prolonged periods of time, but the immune deficiency interferes with treatment and clearing the bacteria from the body. Similarly, if you don't properly treat the co-infections, and other overlapping causes of illness/inflammation on the 16-point MSIDS map, such as internal and external toxins, detoxification problems, food allergies and sensitivities, mitochondrial dysfunction, hormonal dysregulation and sleep disorders, people will not completely get better. Health Care Costs Health care costs are rising globally, and that is why we need a paradigm shift in how we practice medicine. Not just for Lyme, but for all chronic diseases. 86% of the health care costs, and 70% of the deaths in the United States are due to chronic disease, yet we don't even have a model for treating chronic disease? Every world government is trying to figure out how to lower healthcare costs and yet we are not looking at the underlying causes of what is causing chronic disease. The 16-point MSIDS model is a personalized, precision medical model that has helped thousands with chronic illness that have failed traditional approaches, and 19% of the people in the United States are disabled. I know in Europe you are struggling with the same problem. We need to look at other ways to treat these chronic diseases, and I believe that the MSIDS model is a good start. Lyme is not a new disease. How long has it been going on for, as what do you see is needed to make progress? Old bacteria Lyme has been around for a very long time. They found evidence for Borrelia spirochetes in Ötzi the Neanderthal man over 5000 years ago. They have found Babesia in fossilized specimens. These organisms have been around for millions of years. So, although these bacteria and parasites are not new, people have been increasingly moving into wooded areas, and imbalances in the ecosystems are leading to an increase in mice populations, contributing to an expansion of these tick-borne infections. We are seeing a rise in Ehrlichiosis, Anaplasmosis, Babesiosis, and more ticks are containing the Powassan virus, the Tickborne Encephalitis Virus, the Heartland virus, Bourbon virus, as well as rickettsial infections... many of these tick-borne infections are spreading. Some of these organisms have not only been around for a long period of time, but their numbers are also now increasing in the ticks, and we can get multiple infections with just one tick bite, leading to disabling symptoms. Environmental toxins I am also seeing a lot of environmental toxins like heavy metals and mold toxins getting into people. According to research by the CDC and Environmental Protection Agency (EPA), we are all exposed to hundreds of toxins every day, and these toxins can accumulate in the body because they are fat soluble and bind tightly to tissues. These toxins have recently been found to be linked to autoimmune reactions and multiple autoimmune diseases. Lyme disease can also trigger autoimmune reactions. Environmental toxins combined with some of these tick-borne infections are responsible for some of the chronic disease manifestations that we are now seeing in the 21st century. That is why we need to change how we approach healthcare, and shift the paradigm of how we practice medicine. We can’t just be looking for one cause for one illness. We need to look at multifactorial causes of illness, such as chronic infections, environmental toxins, and how the detoxification systems of the body are functioning. We should be especially careful because some of these infections, as well as environmental toxins, can be passed from a mother to a child. Studies from Harvard and UC California Davis are showing that these environmental toxins are now showing up in children diagnosed with Autism Spectrum Disorder (ASD). We know that doctors in Europe, who treat Lyme disease, are seeing some of these children with developmental delays and ASD, get better by treating infections and toxins. Modes of transmission We know that Lyme can be transmitted from a mother to her fetus, as can other tick-borne infections like Babesia, Bartonella and Rickettsial infections. Babesia, Anaplasma and Bartonella are also in the blood supply, and these, as well as relapsing fever borrelia can be transmitted by blood. We therefore have to be careful because there are multiple modes of transmission possible. I don't think most pregnant women are aware that they can have miscarriages and pass on these infections and toxins to their children. To protect our future generations, we need to pay attention to these potential infections and multiple environmental toxins that are now getting into the body, which can be transmitted from generation to generation. You have been collaborating with a team on a report for the World Health Organization (WHO). What is the significance of this report? Insurance coverage Insurance companies are oftentimes restricting access to proper care for those suffering with Lyme disease and associated co-infections. This is because they have adopted the IDSA guidelines, which unfortunately do not work in clinical practice for those suffering with chronic manifestations of Lyme disease. I have patients that have been to 10-20 doctors before seeing me, and are still ill, because those physicians were using IDSA guidelines which say that the blood testing is reliable, and that Lyme disease is easy to cure. Nothing could be farther from the truth. The standard two-tiered testing for Lyme disease is unreliable, and misses approximately half of those with the disease. If they do happen to be diagnosed, using one month of antibiotics will not help the majority of those with chronic Lyme/Post Treatment Lyme Disease Syndrome. We need to improve the guidelines and coding for those with chronic Lyme disease, to help prevent long term suffering and disability. WHO ICD coding We looked at the WHO guidelines and ICD 9 coding. We realized that there are no adequate codes for people who have chronic Lyme disease. There are many different manifestations for borreliosis, and many of the codes for these manifestations were not in the ICD9, ICD10 or ICD11 coding that is about to be released. We therefore created a document which expanded the coding for the clinical manifestations of Lyme, and organized a meeting in Geneva with the rapporteur from the WHO. Adhoc Committee Doctors, researchers and scientists from different countries across the world came together to review the scientific literature. We put together a document for the WHO, which expanded the coding for Lyme disease. The WHO is concerned with human rights and access to care, especially for those who are disadvantaged. Chronic Lyme patients are not having proper access to care because of inadequate diagnostic and therapeutic protocols for treating the disease. We hope this will help expand care, create better access to care, and help those who are suffering worldwide. For the people who are not getting better with the treatments available to them now, is there hope in the future? New solutions I have been working on solutions for Lyme disease now for 30 years. When I wrote my first book: “Why Can't I Get Better?” I would say that approximately 90-92% of the people got help using the 16-point MSIDS model that was described in my first book. In my new book “How Can I Get Better?” which was released in February of 2017, we included information on the new persister protocols that I published in the scientific literature last year. We are finding that among the 8-10% of people who were still ill using the MSIDS model described in my first book, approximately 2/3 of them are now getting better using the persister protocols that I have published in my second book: “How Can I Get Better?”. I do not have to put a PICC-line in or use IV ceftriaxone in many of these people because the dapsone protocol combined with doxycycline and rifampin is turning out to be an excellent protocol. It gets good penetration into the central nervous system. Many of my patient’s symptoms are getting better with this protocol, including resistant fatigue, joint/muscle and nerve pain, memory and concentration problems, as well as their sleep and mood disorders. There is hope There is hope for Lyme patients. They should never give up! We find that it sometimes however takes years to see improvement in the most difficult cases. I just had a young man who was in a wheelchair for 2,5 years unable to walk with Lyme and Parkinsonism’s, but he is finally now starting to walk out of his wheelchair. I recently saw a young girl in a wheelchair that was dying from uncontrolled seizures. She was on high doses of morphine for pain, and we found that it was Lyme, Babesia, Bartonella and POTS that was causing her illness. She is now symptom free and off morphine. In her case, she managed to see improvement within the first month of treatment. There are solutions and answers, but you have to apply the 16-point MSIDS model to get to all of the underlying causes of the illness, and hang in there! I want to thank you for taking the time and interviewing me, because it is so important to give people hope, and discuss these important issues and solutions for all the Lyme patients that are suffering. dr. Richard Horowitz Written by Huib

Is there hope for Lyme patients? Interview with dr. Richard Horowitz

"Is there hope for Lyme patients?"

One of the top Infectious Diseases doctors answers to this urgent question for many.

This is the first publication of the 'Teike takes on Lyme' research project.

Can you please begin by introducing yourself?

My name is Dr. Richard Horowitz. I

am a board-certified internist. I have treated over 12.000 people with chronic Lyme disease in the United States, and I am the medical director of the Hudson Valley Healing Arts Center.

I opened our center approximately 20 years ago to meet the needs of all these chronically ill patients that had a difficult time getting access to care in the US.

I heard you were in Toronto, for what occasion where you there? I was teaching at a Lyme conference. I met with government officials and one of the members of parliament.

There was a gala for young children called 'Lyme Out Loud Canada.' It was for children who did not have access to care, who couldn't afford treatments and who are sick in Canada.

I also gave a talk to doctors the day afterwards. It was a four-hour lecture on the science of Lyme disease and tick-borne infections, and how we treat these multiple infections in the United States.

You have treated more than 12.000 patients, how are they now?

MSIDS model Fortunately, the vast majority of them are doing quite well.

Over the past 30 years I've developed a model that is a 16-point health care map that I call

MSIDS: Multiple Systemic Infectious Disease Syndrome.

What I found for those who are chronically ill who come to see me is that they don't just have Lyme disease.

They usually have co-infections like Babesiosis which is a malaria-like parasite, and many have Bartonella which is a form of cat scratch fever. We also find that people usually have other overlapping causes of inflammation apart from chronic infections.

For example, they may suffer from chronic insomnia, be eating the wrong diet, i.e., eating allergic foods which causes an inflammatory response, or they may be deficient in essential minerals like zinc, which can increase inflammatory molecules in the body.

These can result in chronic fatigue, headaches, joint and muscle pain, nerve pain, memory and concentration problems, and sleep disorders.

So, we have discovered that there are up to 16 factors keeping these people sick apart from Lyme disease.

Once we adequately treat all the forms of Lyme disease, as well as associated co-infections, food sensitivities, mineral deficiencies, sleep disorders, mitochondrial dysfunction, hormone dysregulation, POTS (Postural Orthostatic Tachycardia Syndrome)/with imbalances of the autonomic nervous system, and treat internal and external toxins and imbalances with the microbiome of the gut, the majority of our chronically ill patients improve.

PLEASE-study Unfortunately, many of the double-blind studies on Lyme disease that have been done in the United States and in Europe like the PLEASE study don't adequately address all the overlapping causes of illness that we see in our patients that I previously discussed, especially the co-infections.

They also did not integrate any of the new scientific research on Lyme “persister” cells in the body, or borrelia biofilms. We find that when we treat chronically ill patients with combination antibiotic regimens that include novel persister drugs like Dapsone, with biofilm busters, and simultaneously treat co-infections and abnormalities on the 16-point MSIDS map, these can make a big difference in getting people better.

Persister Protocols published two articles in the scientific literature last year about persister drugs for borrelia, which are essentially using old mycobacterium drugs like Dapsone and pyrazinamide for treating Lyme.

To answer how are they doing: many people who had failed prior treatments are now doing much better with these new protocols which target the different persister forms of Lyme disease and multiple co-infections.

We are very excited that we are finding new protocols to help patients who are chronically ill. What do you think is the importance of these persister-studies and are you able to help patients with these new insights? Research of Kim Lewis and Ying Zhang It is quite important.

There were several breakthroughs in the medical research during the past couple of years.

One came from dr. Kim Lewis at Northeastern University.

The other came from Dr Ying Zhang and his colleagues at John Hopkins University.

They are well respected PhD researchers, and they both found that there are persister cells that exist in Lyme disease, as there are in other chronic infections.

We used to think that it was just the cystic forms of borrelia that were responsible for persistent and relapsing infections.

Now we know that there are heterogeneous dormant persister cells that exist in biofilms, and borrelia can be in different stages of replication.

Results in the laboratory Dr. Lewis did research in his laboratory which showed that when he used ceftriaxone for Borrelia in culture it would kill off 99% of the bacteria, but once he stopped it the bacteria would grow back.

Dr. Zhang from John Hopkins also discovered that Borrelia persisted after standard antibiotics used for Lyme, like doxycycline and ceftriaxone, and that various antibiotic combinations had different effects against these persister cells.

How many people have been infected with Lyme disease?

I don't think we know how far this epidemic has really spread.

The CDC in the United States says that they have underestimated the numbers by 10-fold, so in 2013 the numbers went from 30.000 per year to over 300.000 per year.

It is now being estimated that it is about 400.000 cases per year in the United States.

We know from the WHO figures in Europe we are dealing with over a million cases in just Eastern Europe alone.

This was published a couple of years ago.

In 2015 there was a publication in Emerging Infectious Diseases that there was a 320% increase in the number of counties affected by Lyme disease in the US. Migratory birds are spreading the ticks from county to county.

This is also why the disease is spreading through Europe, and at this point it has also spread to China and many other countries worldwide.

CFS & Fibromyalgia Lyme mimics other diseases:

for example, 3.5% of the US population has Chronic Fatigue Syndrome (Myalgic Encephalomyelitis / S.E.I.D.), and 1.5% of the US population has Fibromyalgia.

That means that approximately 5% of the 350 million people in the United States have a chronic fatiguing, musculo-skeletal illness.

That translates into roughly 18 million people with Chronic Fatigue and Fibromyalgia, and we know that they are clinical diagnoses.

There are no blood tests for these conditions.

So, if you have fatigue, aches and pains, memory problems and you can't fall asleep and your doctor does an insensitive ELISA test (which misses about half of the cases of Lyme disease), you could be diagnosed with Chronic Fatigue Syndrome or Fibromyalgia.

Auto-immune Illnesses We also know that approximately 50 million people are diagnosed with auto-immune illnesses in the United States, and Lyme imitates rheumatoid arthritis, lupus and multiple sclerosis.

The vast majority of the people that I have seen with MS actually have Lyme disease.

We can get many of them off their MS drugs by treating Lyme and overlapping sources of inflammation on the 16-point MSIDS map.

Alzheimer’s

We are having a dementia epidemic in the United States and worldwide.

Every 67 seconds in the United States someone is diagnosed with Alzheimer’s disease.

We now know that Borrelia spirochetes are found in the brains of Alzheimer patients.

Many researchers from across the world have published this in the medical literature, including Dr Judith Miklossy from Switzerland and Dr Alan McDonald from the US.

Recently, researchers from Drexel University in Pennsylvania published that they are finding Lyme spirochetes in biofilms of the brains of people with Alzheimer's disease.

Lyme is “The Great Imitator” The reason we can’t estimate the true number of cases is because Lyme is imitating a broad range of other diseases, including Alzheimer's, autoimmune disease, as well as Chronic Fatigue Syndrome/S.E.I.D. (Systemic Exertional Intolerance Disease) and Fibromyalgia.

When you put the number of people affected by all those diseases together, we could be dealing with millions of cases of Lyme and associated tick-borne disease in the United States alone.

Of course, that is an estimate.

When the CDC estimated their numbers, they were using the two-tiered protocol of using an ELISA followed by an Western Blot, which will only pick up about 50% of the cases of Lyme disease.

You advocate personalized treatment and take into consideration multiple causes for one disease manifestation.

How is your approach different than the current medical paradigm and their approach of diseases such as Lyme?

ILADS and IDSA Guidelines

There are two sets of medical guidelines for treating Lyme disease. You have the IDSA, the Infectious Diseases Society of America, which in essence says Lyme is easy to diagnose and easy to treat. The IDSA guidelines, which are no longer on the US government's website (The National Guidelines Clearinghouse), were taken off because they are 10 years old, and not up to date with the new science that has emerged.

The ILADS guidelines however are still listed on the US government's website.

I was one of the founding members of ILADS, and was one of the authors of the first ILADS guidelines.

The recent ILADS guidelines were published by Dr Daniel Cameron, and met the Institute of Medicine’s highest standards for guideline development.

The Annals of Internal Medicine published an article several years ago which looked at the IDSA guidelines, and found that at least 50% of the recommendations were the authors opinions, and not based on strong levels of scientific evidence.

For example, the IDSA guidelines say that antibiotics don’t help those with chronic Lyme disease, but when you look at the three-double blind placebo controlled studies that where done by the NIH, in two out of the three studies the people got better.

In the Krups study which was published several years ago, their fatigue got better, and in Dr Brian Fallon's study, published in Neurology in 2008, the patient’s cognitive issues got better.

Their PET scans lit up on ceftriaxone, showing that the drug was having an effect.

The problem is that they didn't stay better because they stopped the treatment after several months, and Lyme can be a persistent infection when not caught early.

New Borrelia species One of the other problems that we are facing is that there are different emerging species of Borrelia.

There have been at least 15 new species of Borrelia reported in the medical literature in the last 20 years. That is almost 1 new species per year.

For example, Borrelia miyamotoi, which is a relapsing fever spirochete, is spreading in up to 15% of the ticks in the United States and in Europe, and tests for Lyme disease will not pick up that particular strain of Borrelia.

So, you could get an EM rash. You could have Bell’s Palsy.

You could have a meningitis and encephalitis and be quite ill and the doctor may suspect Lyme disease, but the testing comes back negative for Borrelia burgdorferi, the agent of Lyme disease, because it is due to a different borrelia species, and therefore the physician may choose not to treat. That would lead to long term medical problems and potential disability.

So, the guidelines are not taking into account all of these emerging species. We know that in Europe for example, Borrelia afzelii will cause an acrodermatitis chronicum atrophicans (ACA) rash. Borrelia garinii on the other hand, can cause neuroborreliosis.

Then you have other species in Europe like Borrelia Valaisiana as well as other borrelia species that also cause illness, and the standard testing will not pick them up.

Co-infections We need to look at emerging borrelia species as well as other associated tick-borne co-infections to help patients that are ill.

In the past two years, peer-reviewed medical articles have shown that over 80% of the time Babesia is transmitted at the same time as Lyme disease.

That is like getting malaria with Lyme. We found that these malarial-like parasites are important in keeping people ill, and they also can suppress the immune system.

That makes it more difficult to get rid of other parasitic infections when you have Babesia. Similarly, Bartonella will also suppress immunity (just like Lyme does).

We see a lot of people with Lyme disease who have Chronic Variable Immune Deficiency (CVID) where their immune systems are not functioning properly.

In these cases, you can give antibiotics for prolonged periods of time, but the immune deficiency interferes with treatment and clearing the bacteria from the body. Similarly, if you don't properly treat the co-infections, and other overlapping causes of illness/inflammation on the 16-point MSIDS map, such as internal and external toxins, detoxification problems, food allergies and sensitivities, mitochondrial dysfunction, hormonal dysregulation and sleep disorders, people will not completely get better. Health Care Costs Health care costs are rising globally, and that is why we need a paradigm shift in how we practice medicine.

Not just for Lyme, but for all chronic diseases. 86% of the health care costs, and 70% of the deaths in the United States are due to chronic disease, yet we don't even have a model for treating chronic disease? Every world government is trying to figure out how to lower healthcare costs and yet we are not looking at the underlying causes of what is causing chronic disease. The 16-point MSIDS model is a personalized, precision medical model that has helped thousands with chronic illness that have failed traditional approaches, and 19% of the people in the United States are disabled. I know in Europe you are struggling with the same problem. We need to look at other ways to treat these chronic diseases, and I believe that the MSIDS model is a good start. Lyme is not a new disease. How long has it been going on for, as what do you see is needed to make progress? Old bacteria Lyme has been around for a very long time. They found evidence for Borrelia spirochetes in Ötzi the Neanderthal man over 5000 years ago. They have found Babesia in fossilized specimens. These organisms have been around for millions of years. So, although these bacteria and parasites are not new, people have been increasingly moving into wooded areas, and imbalances in the ecosystems are leading to an increase in mice populations, contributing to an expansion of these tick-borne infections. We are seeing a rise in Ehrlichiosis, Anaplasmosis, Babesiosis, and more ticks are containing the Powassan virus, the Tickborne Encephalitis Virus, the Heartland virus, Bourbon virus, as well as rickettsial infections... many of these tick-borne infections are spreading. Some of these organisms have not only been around for a long period of time, but their numbers are also now increasing in the ticks, and we can get multiple infections with just one tick bite, leading to disabling symptoms. Environmental toxins I am also seeing a lot of environmental toxins like heavy metals and mold toxins getting into people. According to research by the CDC and Environmental Protection Agency (EPA), we are all exposed to hundreds of toxins every day, and these toxins can accumulate in the body because they are fat soluble and bind tightly to tissues. These toxins have recently been found to be linked to autoimmune reactions and multiple autoimmune diseases. Lyme disease can also trigger autoimmune reactions. Environmental toxins combined with some of these tick-borne infections are responsible for some of the chronic disease manifestations that we are now seeing in the 21st century. That is why we need to change how we approach healthcare, and shift the paradigm of how we practice medicine. We can’t just be looking for one cause for one illness. We need to look at multifactorial causes of illness, such as chronic infections, environmental toxins, and how the detoxification systems of the body are functioning. We should be especially careful because some of these infections, as well as environmental toxins, can be passed from a mother to a child. Studies from Harvard and UC California Davis are showing that these environmental toxins are now showing up in children diagnosed with Autism Spectrum Disorder (ASD). We know that doctors in Europe, who treat Lyme disease, are seeing some of these children with developmental delays and ASD, get better by treating infections and toxins. Modes of transmission We know that Lyme can be transmitted from a mother to her fetus, as can other tick-borne infections like Babesia, Bartonella and Rickettsial infections. Babesia, Anaplasma and Bartonella are also in the blood supply, and these, as well as relapsing fever borrelia can be transmitted by blood. We therefore have to be careful because there are multiple modes of transmission possible. I don't think most pregnant women are aware that they can have miscarriages and pass on these infections and toxins to their children. To protect our future generations, we need to pay attention to these potential infections and multiple environmental toxins that are now getting into the body, which can be transmitted from generation to generation. You have been collaborating with a team on a report for the World Health Organization (WHO). What is the significance of this report? Insurance coverage Insurance companies are oftentimes restricting access to proper care for those suffering with Lyme disease and associated co-infections. This is because they have adopted the IDSA guidelines, which unfortunately do not work in clinical practice for those suffering with chronic manifestations of Lyme disease. I have patients that have been to 10-20 doctors before seeing me, and are still ill, because those physicians were using IDSA guidelines which say that the blood testing is reliable, and that Lyme disease is easy to cure. Nothing could be farther from the truth. The standard two-tiered testing for Lyme disease is unreliable, and misses approximately half of those with the disease. If they do happen to be diagnosed, using one month of antibiotics will not help the majority of those with chronic Lyme/Post Treatment Lyme Disease Syndrome. We need to improve the guidelines and coding for those with chronic Lyme disease, to help prevent long term suffering and disability. WHO ICD coding We looked at the WHO guidelines and ICD 9 coding. We realized that there are no adequate codes for people who have chronic Lyme disease. There are many different manifestations for borreliosis, and many of the codes for these manifestations were not in the ICD9, ICD10 or ICD11 coding that is about to be released. We therefore created a document which expanded the coding for the clinical manifestations of Lyme, and organized a meeting in Geneva with the rapporteur from the WHO. Adhoc Committee Doctors, researchers and scientists from different countries across the world came together to review the scientific literature. We put together a document for the WHO, which expanded the coding for Lyme disease. The WHO is concerned with human rights and access to care, especially for those who are disadvantaged. Chronic Lyme patients are not having proper access to care because of inadequate diagnostic and therapeutic protocols for treating the disease. We hope this will help expand care, create better access to care, and help those who are suffering worldwide. For the people who are not getting better with the treatments available to them now, is there hope in the future? New solutions I have been working on solutions for Lyme disease now for 30 years. When I wrote my first book: “Why Can't I Get Better?” I would say that approximately 90-92% of the people got help using the 16-point MSIDS model that was described in my first book. In my new book “How Can I Get Better?” which was released in February of 2017, we included information on the new persister protocols that I published in the scientific literature last year. We are finding that among the 8-10% of people who were still ill using the MSIDS model described in my first book, approximately 2/3 of them are now getting better using the persister protocols that I have published in my second book: “How Can I Get Better?”. I do not have to put a PICC-line in or use IV ceftriaxone in many of these people because the dapsone protocol combined with doxycycline and rifampin is turning out to be an excellent protocol. It gets good penetration into the central nervous system. Many of my patient’s symptoms are getting better with this protocol, including resistant fatigue, joint/muscle and nerve pain, memory and concentration problems, as well as their sleep and mood disorders. There is hope There is hope for Lyme patients. They should never give up! We find that it sometimes however takes years to see improvement in the most difficult cases. I just had a young man who was in a wheelchair for 2,5 years unable to walk with Lyme and Parkinsonism’s, but he is finally now starting to walk out of his wheelchair. I recently saw a young girl in a wheelchair that was dying from uncontrolled seizures. She was on high doses of morphine for pain, and we found that it was Lyme, Babesia, Bartonella and POTS that was causing her illness. She is now symptom free and off morphine. In her case, she managed to see improvement within the first month of treatment. There are solutions and answers, but you have to apply the 16-point MSIDS model to get to all of the underlying causes of the illness, and hang in there! I want to thank you for taking the time and interviewing me, because it is so important to give people hope, and discuss these important issues and solutions for all the Lyme patients that are suffering. dr. Richard Horowitz Written by Huib"Is there hope for Lyme patients?" One of the top Infectious Diseases doctors answers to this urgent question for many. This is the first publication of the 'Teike takes on Lyme' research project. Can you please begin by introducing yourself? My name is Dr. Richard Horowitz. I am a board-certified internist. I have treated over 12.000 people with chronic Lyme disease in the United States, and I am the medical director of the Hudson Valley Healing Arts Center. I opened our center approximately 20 years ago to meet the needs of all these chronically ill patients that had a difficult time getting access to care in the US. I heard you were in Toronto, for what occasion where you there? I was teaching at a Lyme conference. I met with government officials and one of the members of parliament. There was a gala for young children called 'Lyme Out Loud Canada.' It was for children who did not have access to care, who couldn't afford treatments and who are sick in Canada. I also gave a talk to doctors the day afterwards. It was a four-hour lecture on the science of Lyme disease and tick-borne infections, and how we treat these multiple infections in the United States. You have treated more than 12.000 patients, how are they now? MSIDS model Fortunately, the vast majority of them are doing quite well. Over the past 30 years I've developed a model that is a 16-point health care map that I call MSIDS: Multiple Systemic Infectious Disease Syndrome. What I found for those who are chronically ill who come to see me is that they don't just have Lyme disease. They usually have co-infections like Babesiosis which is a malaria-like parasite, and many have Bartonella which is a form of cat scratch fever. We also find that people usually have other overlapping causes of inflammation apart from chronic infections. For example, they may suffer from chronic insomnia, be eating the wrong diet, i.e., eating allergic foods which causes an inflammatory response, or they may be deficient in essential minerals like zinc, which can increase inflammatory molecules in the body. These can result in chronic fatigue, headaches, joint and muscle pain, nerve pain, memory and concentration problems, and sleep disorders. So, we have discovered that there are up to 16 factors keeping these people sick apart from Lyme disease. Once we adequately treat all the forms of Lyme disease, as well as associated co-infections, food sensitivities, mineral deficiencies, sleep disorders, mitochondrial dysfunction, hormone dysregulation, POTS (Postural Orthostatic Tachycardia Syndrome)/with imbalances of the autonomic nervous system, and treat internal and external toxins and imbalances with the microbiome of the gut, the majority of our chronically ill patients improve. PLEASE-study Unfortunately, many of the double-blind studies on Lyme disease that have been done in the United States and in Europe like the PLEASE study don't adequately address all the overlapping causes of illness that we see in our patients that I previously discussed, especially the co-infections. They also did not integrate any of the new scientific research on Lyme “persister” cells in the body, or borrelia biofilms. We find that when we treat chronically ill patients with combination antibiotic regimens that include novel persister drugs like Dapsone, with biofilm busters, and simultaneously treat co-infections and abnormalities on the 16-point MSIDS map, these can make a big difference in getting people better. Persister Protocols I published two articles in the scientific literature last year about persister drugs for borrelia, which are essentially using old mycobacterium drugs like Dapsone and pyrazinamide for treating Lyme. To answer how are they doing: many people who had failed prior treatments are now doing much better with these new protocols which target the different persister forms of Lyme disease and multiple co-infections. We are very excited that we are finding new protocols to help patients who are chronically ill. What do you think is the importance of these persister-studies and are you able to help patients with these new insights? Research of Kim Lewis and Ying Zhang It is quite important. There were several breakthroughs in the medical research during the past couple of years. One came from dr. Kim Lewis at Northeastern University. The other came from Dr Ying Zhang and his colleagues at John Hopkins University. They are well respected PhD researchers, and they both found that there are persister cells that exist in Lyme disease, as there are in other chronic infections. We used to think that it was just the cystic forms of borrelia that were responsible for persistent and relapsing infections. Now we know that there are heterogeneous dormant persister cells that exist in biofilms, and borrelia can be in different stages of replication. Results in the laboratory Dr. Lewis did research in his laboratory which showed that when he used ceftriaxone for Borrelia in culture it would kill off 99% of the bacteria, but once he stopped it the bacteria would grow back. Dr. Zhang from John Hopkins also discovered that Borrelia persisted after standard antibiotics used for Lyme, like doxycycline and ceftriaxone, and that various antibiotic combinations had different effects against these persister cells. How many people have been infected with Lyme disease? I don't think we know how far this epidemic has really spread. The CDC in the United States says that they have underestimated the numbers by 10-fold, so in 2013 the numbers went from 30.000 per year to over 300.000 per year. It is now being estimated that it is about 400.000 cases per year in the United States. We know from the WHO figures in Europe we are dealing with over a million cases in just Eastern Europe alone. This was published a couple of years ago. In 2015 there was a publication in Emerging Infectious Diseases that there was a 320% increase in the number of counties affected by Lyme disease in the US. Migratory birds are spreading the ticks from county to county. This is also why the disease is spreading through Europe, and at this point it has also spread to China and many other countries worldwide. CFS & Fibromyalgia Lyme mimics other diseases: for example, 3.5% of the US population has Chronic Fatigue Syndrome (Myalgic Encephalomyelitis / S.E.I.D.), and 1.5% of the US population has Fibromyalgia. That means that approximately 5% of the 350 million people in the United States have a chronic fatiguing, musculo-skeletal illness. That translates into roughly 18 million people with Chronic Fatigue and Fibromyalgia, and we know that they are clinical diagnoses. There are no blood tests for these conditions. So, if you have fatigue, aches and pains, memory problems and you can't fall asleep and your doctor does an insensitive ELISA test (which misses about half of the cases of Lyme disease), you could be diagnosed with Chronic Fatigue Syndrome or Fibromyalgia. Auto-immune Illnesses We also know that approximately 50 million people are diagnosed with auto-immune illnesses in the United States, and Lyme imitates rheumatoid arthritis, lupus and multiple sclerosis. The vast majority of the people that I have seen with MS actually have Lyme disease. We can get many of them off their MS drugs by treating Lyme and overlapping sources of inflammation on the 16-point MSIDS map. Alzheimer’s We are having a dementia epidemic in the United States and worldwide. Every 67 seconds in the United States someone is diagnosed with Alzheimer’s disease. We now know that Borrelia spirochetes are found in the brains of Alzheimer patients. Many researchers from across the world have published this in the medical literature, including Dr Judith Miklossy from Switzerland and Dr Alan McDonald from the US. Recently, researchers from Drexel University in Pennsylvania published that they are finding Lyme spirochetes in biofilms of the brains of people with Alzheimer's disease. Lyme is “The Great Imitator” The reason we can’t estimate the true number of cases is because Lyme is imitating a broad range of other diseases, including Alzheimer's, autoimmune disease, as well as Chronic Fatigue Syndrome/S.E.I.D. (Systemic Exertional Intolerance Disease) and Fibromyalgia. When you put the number of people affected by all those diseases together, we could be dealing with millions of cases of Lyme and associated tick-borne disease in the United States alone. Of course, that is an estimate. When the CDC estimated their numbers, they were using the two-tiered protocol of using an ELISA followed by an Western Blot, which will only pick up about 50% of the cases of Lyme disease. You advocate personalized treatment and take into consideration multiple causes for one disease manifestation. How is your approach different than the current medical paradigm and their approach of diseases such as Lyme? ILADS and IDSA Guidelines There are two sets of medical guidelines for treating Lyme disease. You have the IDSA, the Infectious Diseases Society of America, which in essence says Lyme is easy to diagnose and easy to treat. The IDSA guidelines, which are no longer on the US government's website (The National Guidelines Clearinghouse), were taken off because they are 10 years old, and not up to date with the new science that has emerged. The ILADS guidelines however are still listed on the US government's website. I was one of the founding members of ILADS, and was one of the authors of the first ILADS guidelines. The recent ILADS guidelines were published by Dr Daniel Cameron, and met the Institute of Medicine’s highest standards for guideline development. The Annals of Internal Medicine published an article several years ago which looked at the IDSA guidelines, and found that at least 50% of the recommendations were the authors opinions, and not based on strong levels of scientific evidence. For example, the IDSA guidelines say that antibiotics don’t help those with chronic Lyme disease, but when you look at the three-double blind placebo controlled studies that where done by the NIH, in two out of the three studies the people got better. In the Krups study which was published several years ago, their fatigue got better, and in Dr Brian Fallon's study, published in Neurology in 2008, the patient’s cognitive issues got better. Their PET scans lit up on ceftriaxone, showing that the drug was having an effect. The problem is that they didn't stay better because they stopped the treatment after several months, and Lyme can be a persistent infection when not caught early. New Borrelia species One of the other problems that we are facing is that there are different emerging species of Borrelia. There have been at least 15 new species of Borrelia reported in the medical literature in the last 20 years. That is almost 1 new species per year. For example, Borrelia miyamotoi, which is a relapsing fever spirochete, is spreading in up to 15% of the ticks in the United States and in Europe, and tests for Lyme disease will not pick up that particular strain of Borrelia. So, you could get an EM rash. You could have Bell’s Palsy. You could have a meningitis and encephalitis and be quite ill and the doctor may suspect Lyme disease, but the testing comes back negative for Borrelia burgdorferi, the agent of Lyme disease, because it is due to a different borrelia species, and therefore the physician may choose not to treat. That would lead to long term medical problems and potential disability. So, the guidelines are not taking into account all of these emerging species. We know that in Europe for example, Borrelia afzelii will cause an acrodermatitis chronicum atrophicans (ACA) rash. Borrelia garinii on the other hand, can cause neuroborreliosis. Then you have other species in Europe like Borrelia Valaisiana as well as other borrelia species that also cause illness, and the standard testing will not pick them up. Co-infections We need to look at emerging borrelia species as well as other associated tick-borne co-infections to help patients that are ill. In the past two years, peer-reviewed medical articles have shown that over 80% of the time Babesia is transmitted at the same time as Lyme disease. That is like getting malaria with Lyme. We found that these malarial-like parasites are important in keeping people ill, and they also can suppress the immune system. That makes it more difficult to get rid of other parasitic infections when you have Babesia. Similarly, Bartonella will also suppress immunity (just like Lyme does). We see a lot of people with Lyme disease who have Chronic Variable Immune Deficiency (CVID) where their immune systems are not functioning properly. In these cases, you can give antibiotics for prolonged periods of time, but the immune deficiency interferes with treatment and clearing the bacteria from the body. Similarly, if you don't properly treat the co-infections, and other overlapping causes of illness/inflammation on the 16-point MSIDS map, such as internal and external toxins, detoxification problems, food allergies and sensitivities, mitochondrial dysfunction, hormonal dysregulation and sleep disorders, people will not completely get better. Health Care Costs Health care costs are rising globally, and that is why we need a paradigm shift in how we practice medicine. Not just for Lyme, but for all chronic diseases. 86% of the health care costs, and 70% of the deaths in the United States are due to chronic disease, yet we don't even have a model for treating chronic disease? Every world government is trying to figure out how to lower healthcare costs and yet we are not looking at the underlying causes of what is causing chronic disease. The 16-point MSIDS model is a personalized, precision medical model that has helped thousands with chronic illness that have failed traditional approaches, and 19% of the people in the United States are disabled. I know in Europe you are struggling with the same problem. We need to look at other ways to treat these chronic diseases, and I believe that the MSIDS model is a good start. Lyme is not a new disease. How long has it been going on for, as what do you see is needed to make progress? Old bacteria Lyme has been around for a very long time. They found evidence for Borrelia spirochetes in Ötzi the Neanderthal man over 5000 years ago. They have found Babesia in fossilized specimens. These organisms have been around for millions of years. So, although these bacteria and parasites are not new, people have been increasingly moving into wooded areas, and imbalances in the ecosystems are leading to an increase in mice populations, contributing to an expansion of these tick-borne infections. We are seeing a rise in Ehrlichiosis, Anaplasmosis, Babesiosis, and more ticks are containing the Powassan virus, the Tickborne Encephalitis Virus, the Heartland virus, Bourbon virus, as well as rickettsial infections... many of these tick-borne infections are spreading. Some of these organisms have not only been around for a long period of time, but their numbers are also now increasing in the ticks, and we can get multiple infections with just one tick bite, leading to disabling symptoms. Environmental toxins I am also seeing a lot of environmental toxins like heavy metals and mold toxins getting into people. According to research by the CDC and Environmental Protection Agency (EPA), we are all exposed to hundreds of toxins every day, and these toxins can accumulate in the body because they are fat soluble and bind tightly to tissues. These toxins have recently been found to be linked to autoimmune reactions and multiple autoimmune diseases. Lyme disease can also trigger autoimmune reactions. Environmental toxins combined with some of these tick-borne infections are responsible for some of the chronic disease manifestations that we are now seeing in the 21st century. That is why we need to change how we approach healthcare, and shift the paradigm of how we practice medicine. We can’t just be looking for one cause for one illness. We need to look at multifactorial causes of illness, such as chronic infections, environmental toxins, and how the detoxification systems of the body are functioning. We should be especially careful because some of these infections, as well as environmental toxins, can be passed from a mother to a child. Studies from Harvard and UC California Davis are showing that these environmental toxins are now showing up in children diagnosed with Autism Spectrum Disorder (ASD). We know that doctors in Europe, who treat Lyme disease, are seeing some of these children with developmental delays and ASD, get better by treating infections and toxins. Modes of transmission We know that Lyme can be transmitted from a mother to her fetus, as can other tick-borne infections like Babesia, Bartonella and Rickettsial infections. Babesia, Anaplasma and Bartonella are also in the blood supply, and these, as well as relapsing fever borrelia can be transmitted by blood. We therefore have to be careful because there are multiple modes of transmission possible. I don't think most pregnant women are aware that they can have miscarriages and pass on these infections and toxins to their children. To protect our future generations, we need to pay attention to these potential infections and multiple environmental toxins that are now getting into the body, which can be transmitted from generation to generation. You have been collaborating with a team on a report for the World Health Organization (WHO). What is the significance of this report? Insurance coverage Insurance companies are oftentimes restricting access to proper care for those suffering with Lyme disease and associated co-infections. This is because they have adopted the IDSA guidelines, which unfortunately do not work in clinical practice for those suffering with chronic manifestations of Lyme disease. I have patients that have been to 10-20 doctors before seeing me, and are still ill, because those physicians were using IDSA guidelines which say that the blood testing is reliable, and that Lyme disease is easy to cure. Nothing could be farther from the truth. The standard two-tiered testing for Lyme disease is unreliable, and misses approximately half of those with the disease. If they do happen to be diagnosed, using one month of antibiotics will not help the majority of those with chronic Lyme/Post Treatment Lyme Disease Syndrome. We need to improve the guidelines and coding for those with chronic Lyme disease, to help prevent long term suffering and disability. WHO ICD coding We looked at the WHO guidelines and ICD 9 coding. We realized that there are no adequate codes for people who have chronic Lyme disease. There are many different manifestations for borreliosis, and many of the codes for these manifestations were not in the ICD9, ICD10 or ICD11 coding that is about to be released. We therefore created a document which expanded the coding for the clinical manifestations of Lyme, and organized a meeting in Geneva with the rapporteur from the WHO. Adhoc Committee Doctors, researchers and scientists from different countries across the world came together to review the scientific literature. We put together a document for the WHO, which expanded the coding for Lyme disease. The WHO is concerned with human rights and access to care, especially for those who are disadvantaged. Chronic Lyme patients are not having proper access to care because of inadequate diagnostic and therapeutic protocols for treating the disease. We hope this will help expand care, create better access to care, and help those who are suffering worldwide. For the people who are not getting better with the treatments available to them now, is there hope in the future? New solutions I have been working on solutions for Lyme disease now for 30 years. When I wrote my first book: “Why Can't I Get Better?” I would say that approximately 90-92% of the people got help using the 16-point MSIDS model that was described in my first book. In my new book “How Can I Get Better?” which was released in February of 2017, we included information on the new persister protocols that I published in the scientific literature last year. We are finding that among the 8-10% of people who were still ill using the MSIDS model described in my first book, approximately 2/3 of them are now getting better using the persister protocols that I have published in my second book: “How Can I Get Better?”. I do not have to put a PICC-line in or use IV ceftriaxone in many of these people because the dapsone protocol combined with doxycycline and rifampin is turning out to be an excellent protocol. It gets good penetration into the central nervous system. Many of my patient’s symptoms are getting better with this protocol, including resistant fatigue, joint/muscle and nerve pain, memory and concentration problems, as well as their sleep and mood disorders. There is hope There is hope for Lyme patients. They should never give up! We find that it sometimes however takes years to see improvement in the most difficult cases. I just had a young man who was in a wheelchair for 2,5 years unable to walk with Lyme and Parkinsonism’s, but he is finally now starting to walk out of his wheelchair. I recently saw a young girl in a wheelchair that was dying from uncontrolled seizures. She was on high doses of morphine for pain, and we found that it was Lyme, Babesia, Bartonella and POTS that was causing her illness. She is now symptom free and off morphine. In her case, she managed to see improvement within the first month of treatment. There are solutions and answers, but you have to apply the 16-point MSIDS model to get to all of the underlying causes of the illness, and hang in there! I want to thank you for taking the time and interviewing me, because it is so important to give people hope, and discuss these important issues and solutions for all the Lyme patients that are suffering. dr. Richard Horowitz Written by Huib

Is there hope for Lyme patients? Interview with dr. Richard Horowitz  "Is there hope for Lyme patients?" One of the top Infectious Diseases doctors answers to this urgent question for many. This is the first publication of the 'Teike takes on Lyme' research project.   Can you please begin by introducing yourself?  My name is Dr. Richard Horowitz. I am a board-certified internist. I have treated over 12.000 people with chronic Lyme disease in the United States, and I am the medical director of the Hudson Valley Healing Arts Center.  I opened our center approximately 20 years ago to meet the needs of all these chronically ill patients that had a difficult time getting access to care in the US.  I heard you were in Toronto, for what occasion where you there?  I was teaching at a Lyme conference. I met with government officials and one of the members of parliament. There was a gala for young children called 'Lyme Out Loud Canada.' It was for children who did not have access to care, who couldn't afford treatments and who are sick in Canada. I also gave a talk to doctors the day afterwards. It was a four-hour lecture on the science of Lyme disease and tick-borne infections, and how we treat these multiple infections in the United States.   You have treated more than 12.000 patients, how are they now?  MSIDS model  Fortunately, the vast majority of them are doing quite well. Over the past 30 years I've developed a model that is a 16-point health care map that I call MSIDS: Multiple Systemic Infectious Disease Syndrome. What I found for those who are chronically ill who come to see me is that they don't just have Lyme disease. They usually have co-infections like Babesiosis which is a malaria-like parasite, and many have Bartonella which is a form of cat scratch fever. We also find that people usually have other overlapping causes of inflammation apart from chronic infections.  For example, they may suffer from chronic insomnia, be eating the wrong diet, i.e., eating allergic foods which causes an inflammatory response, or they may be deficient in essential minerals like zinc, which can increase inflammatory molecules in the body. These can result in chronic fatigue, headaches, joint and muscle pain, nerve pain, memory and concentration problems, and sleep disorders.  So, we have discovered that there are up to 16 factors keeping these people sick apart from Lyme disease. Once we adequately treat all the forms of Lyme disease, as well as associated co-infections, food sensitivities, mineral deficiencies, sleep disorders, mitochondrial dysfunction, hormone dysregulation, POTS (Postural Orthostatic Tachycardia Syndrome)/with imbalances of the autonomic nervous system, and treat internal and external toxins and imbalances with the microbiome of the gut, the majority of our chronically ill patients improve.   PLEASE-study  Unfortunately, many of the double-blind studies on Lyme disease that have been done in the United States and in Europe like the PLEASE study don't adequately address all the overlapping causes of illness that we see in our patients that I previously discussed, especially the co-infections. They also did not integrate any of the new scientific research on Lyme “persister” cells in the body, or borrelia biofilms.  We find that when we treat chronically ill patients with combination antibiotic regimens that include novel persister drugs like Dapsone, with biofilm busters, and simultaneously treat co-infections and abnormalities on the 16-point MSIDS map, these can make a big difference in getting people better.   Persister Protocols  I published two articles in the scientific literature last year about persister drugs for borrelia, which are essentially using old mycobacterium drugs like Dapsone and pyrazinamide for treating Lyme. To answer how are they doing: many people who had failed prior treatments are now doing much better with these new protocols which target the different persister forms of Lyme disease and multiple co-infections. We are very excited that we are finding new protocols to help patients who are chronically ill.   What do you think is the importance of these persister-studies and are you able to help patients with these new insights?  Research of Kim Lewis and Ying Zhang  It is quite important. There were several breakthroughs in the medical research during the past couple of years. One came from dr. Kim Lewis at Northeastern University. The other came from Dr Ying Zhang and his colleagues at John Hopkins University. They are well respected PhD researchers, and they both found that there are persister cells that exist in Lyme disease, as there are in other chronic infections. We used to think that it was just the cystic forms of borrelia that were responsible for persistent and relapsing infections. Now we know that there are heterogeneous dormant persister cells that exist in biofilms, and borrelia can be in different stages of replication.  Results in the laboratory  Dr. Lewis did research in his laboratory which showed that when he used ceftriaxone for Borrelia in culture it would kill off 99% of the bacteria, but once he stopped it the bacteria would grow back. Dr. Zhang from John Hopkins also discovered that Borrelia persisted after standard antibiotics used for Lyme, like doxycycline and ceftriaxone, and that various antibiotic combinations had different effects against these persister cells.  How many people have been infected with Lyme disease?   I don't think we know how far this epidemic has really spread. The CDC in the United States says that they have underestimated the numbers by 10-fold, so in 2013 the numbers went from 30.000 per year to over 300.000 per year. It is now being estimated that it is about 400.000 cases per year in the United States. We know from the WHO figures in Europe we are dealing with over a million cases in just Eastern Europe alone. This was published a couple of years ago.   In 2015 there was a publication in Emerging Infectious Diseases that there was a 320% increase in the number of counties affected by Lyme disease in the US. Migratory birds are spreading the ticks from county to county. This is also why the disease is spreading through Europe, and at this point it has also spread to China and many other countries worldwide.  CFS & Fibromyalgia  Lyme mimics other diseases: for example, 3.5% of the US population has Chronic Fatigue Syndrome (Myalgic Encephalomyelitis / S.E.I.D.), and 1.5% of the US population has Fibromyalgia. That means that approximately 5% of the 350 million people in the United States have a chronic fatiguing, musculo-skeletal illness. That translates into roughly 18 million people with Chronic Fatigue and Fibromyalgia, and we know that they are clinical diagnoses. There are no blood tests for these conditions.  So, if you have fatigue, aches and pains, memory problems and you can't fall asleep and your doctor does an insensitive ELISA test (which misses about half of the cases of Lyme disease), you could be diagnosed with Chronic Fatigue Syndrome or Fibromyalgia.   Auto-immune Illnesses  We also know that approximately 50 million people are diagnosed with auto-immune illnesses in the United States, and Lyme imitates rheumatoid arthritis, lupus and multiple sclerosis. The vast majority of the people that I have seen with MS actually have Lyme disease. We can get many of them off their MS drugs by treating Lyme and overlapping sources of inflammation on the 16-point MSIDS map.  Alzheimer’s  We are having a dementia epidemic in the United States and worldwide. Every 67 seconds in the United States someone is diagnosed with Alzheimer’s disease. We now know that Borrelia spirochetes are found in the brains of Alzheimer patients. Many researchers from across the world have published this in the medical literature, including Dr Judith Miklossy from Switzerland and Dr Alan McDonald from the US. Recently, researchers from Drexel University in Pennsylvania published that they are finding Lyme spirochetes in biofilms of the brains of people with Alzheimer's disease.  Lyme is “The Great Imitator”  The reason we can’t estimate the true number of cases is because Lyme is imitating a broad range of other diseases, including Alzheimer's, autoimmune disease, as well as Chronic Fatigue Syndrome/S.E.I.D. (Systemic Exertional Intolerance Disease) and Fibromyalgia. When you put the number of people affected by all those diseases together, we could be dealing with millions of cases of Lyme and associated tick-borne disease in the United States alone. Of course, that is an estimate. When the CDC estimated their numbers, they were using the two-tiered protocol of using an ELISA followed by an Western Blot, which will only pick up about 50% of the cases of Lyme disease.   You advocate personalized treatment and take into consideration multiple causes for one disease manifestation. How is your approach different than the current medical paradigm and their approach of diseases such as Lyme?  ILADS and IDSA Guidelines  There are two sets of medical guidelines for treating Lyme disease. You have the IDSA, the Infectious Diseases Society of America, which in essence says Lyme is easy to diagnose and easy to treat. The IDSA guidelines, which are no longer on the US government's website (The National Guidelines Clearinghouse), were taken off because they are 10 years old, and not up to date with the new science that has emerged. The ILADS guidelines however are still listed on the US government's website. I was one of the founding members of ILADS, and was one of the authors of the first ILADS guidelines. The recent ILADS guidelines were published by Dr Daniel Cameron, and met the Institute of Medicine’s highest standards for guideline development.  The Annals of Internal Medicine published an article several years ago which looked at the IDSA guidelines, and found that at least 50% of the recommendations were the authors opinions, and not based on strong levels of scientific evidence. For example, the IDSA guidelines say that antibiotics don’t help those with chronic Lyme disease, but when you look at the three-double blind placebo controlled studies that where done by the NIH, in two out of the three studies the people got better. In the Krups study which was published several years ago, their fatigue got better, and in Dr Brian Fallon's study, published in Neurology in 2008, the patient’s cognitive issues got better. Their PET scans lit up on ceftriaxone, showing that the drug was having an effect. The problem is that they didn't stay better because they stopped the treatment after several months, and Lyme can be a persistent infection when not caught early.   New Borrelia species  One of the other problems that we are facing is that there are different emerging species of Borrelia. There have been at least 15 new species of Borrelia reported in the medical literature in the last 20 years. That is almost 1 new species per year. For example, Borrelia miyamotoi, which is a relapsing fever spirochete, is spreading in up to 15% of the ticks in the United States and in Europe, and tests for Lyme disease will not pick up that particular strain of Borrelia. So, you could get an EM rash. You could have Bell’s Palsy. You could have a meningitis and encephalitis and be quite ill and the doctor may suspect Lyme disease, but the testing comes back negative for Borrelia burgdorferi, the agent of Lyme disease, because it is due to a different borrelia species, and therefore the physician may choose not to treat. That would lead to long term medical problems and potential disability.   So, the guidelines are not taking into account all of these emerging species. We know that in Europe for example, Borrelia afzelii will cause an acrodermatitis chronicum atrophicans (ACA) rash.   Borrelia garinii on the other hand, can cause neuroborreliosis. Then you have other species in Europe like Borrelia Valaisiana as well as other borrelia species that also cause illness, and the standard testing will not pick them up.   Co-infections  We need to look at emerging borrelia species as well as other associated tick-borne co-infections to help patients that are ill. In the past two years, peer-reviewed medical articles have shown that over 80% of the time Babesia is transmitted at the same time as Lyme disease. That is like getting malaria with Lyme. We found that these malarial-like parasites are important in keeping people ill, and they also can suppress the immune system. That makes it more difficult to get rid of other parasitic infections when you have Babesia. Similarly, Bartonella will also suppress immunity (just like Lyme does). We see a lot of people with Lyme disease who have Chronic Variable Immune Deficiency (CVID) where their immune systems are not functioning properly. In these cases, you can give antibiotics for prolonged periods of time, but the immune deficiency interferes with treatment and clearing the bacteria from the body. Similarly, if you don't properly treat the co-infections, and other overlapping causes of illness/inflammation on the 16-point MSIDS map, such as internal and external toxins, detoxification problems, food allergies and sensitivities, mitochondrial dysfunction, hormonal dysregulation and sleep disorders, people will not completely get better.    Health Care Costs  Health care costs are rising globally, and that is why we need a paradigm shift in how we practice medicine. Not just for Lyme, but for all chronic diseases. 86% of the health care costs, and 70% of the deaths in the United States are due to chronic disease, yet we don't even have a model for treating chronic disease? Every world government is trying to figure out how to lower healthcare costs and yet we are not looking at the underlying causes of what is causing chronic disease. The 16-point MSIDS model is a personalized, precision medical model that has helped thousands with chronic illness that have failed traditional approaches, and 19% of the people in the United States are disabled. I know in Europe you are struggling with the same problem. We need to look at other ways to treat these chronic diseases, and I believe that the MSIDS model is a good start.   Lyme is not a new disease. How long has it been going on for, as what do you see is needed to make progress?  Old bacteria  Lyme has been around for a very long time. They found evidence for Borrelia spirochetes in Ötzi the Neanderthal man over 5000 years ago. They have found Babesia in fossilized specimens. These organisms have been around for millions of years. So, although these bacteria and parasites are not new, people have been increasingly moving into wooded areas, and imbalances in the ecosystems are leading to an increase in mice populations, contributing to an expansion of these tick-borne infections.  We are seeing a rise in Ehrlichiosis, Anaplasmosis, Babesiosis, and more ticks are containing the Powassan virus, the Tickborne Encephalitis Virus, the Heartland virus, Bourbon virus, as well as rickettsial infections... many of these tick-borne infections are spreading. Some of these organisms have not only been around for a long period of time, but their numbers are also now increasing in the ticks, and we can get multiple infections with just one tick bite, leading to disabling symptoms.   Environmental toxins  I am also seeing a lot of environmental toxins like heavy metals and mold toxins getting into people. According to research by the CDC and Environmental Protection Agency (EPA), we are all exposed to hundreds of toxins every day, and these toxins can accumulate in the body because they are fat soluble and bind tightly to tissues. These toxins have recently been found to be linked to autoimmune reactions and multiple autoimmune diseases. Lyme disease can also trigger autoimmune reactions. Environmental toxins combined with some of these tick-borne infections are responsible for some of the chronic disease manifestations that we are now seeing in the 21st century.    That is why we need to change how we approach healthcare, and shift the paradigm of how we practice medicine. We can’t just be looking for one cause for one illness. We need to look at multifactorial causes of illness, such as chronic infections, environmental toxins, and how the detoxification systems of the body are functioning. We should be especially careful because some of these infections, as well as environmental toxins, can be passed from a mother to a child.   Studies from Harvard and UC California Davis are showing that these environmental toxins are now showing up in children diagnosed with Autism Spectrum Disorder (ASD). We know that doctors in Europe, who treat Lyme disease, are seeing some of these children with developmental delays and ASD, get better by treating infections and toxins.  Modes of transmission  We know that Lyme can be transmitted from a mother to her fetus, as can other tick-borne infections like Babesia, Bartonella and Rickettsial infections. Babesia, Anaplasma and Bartonella are also in the blood supply, and these, as well as relapsing fever borrelia can be transmitted by blood. We therefore have to be careful because there are multiple modes of transmission possible. I don't think most pregnant women are aware that they can have miscarriages and pass on these infections and toxins to their children. To protect our future generations, we need to pay attention to these potential infections and multiple environmental toxins that are now getting into the body, which can be transmitted from generation to generation.   You have been collaborating with a team on a report for the World Health Organization (WHO). What is the significance of this report?  Insurance coverage  Insurance companies are oftentimes restricting access to proper care for those suffering with Lyme disease and associated co-infections. This is because they have adopted the IDSA guidelines, which unfortunately do not work in clinical practice for those suffering with chronic manifestations of Lyme disease. I have patients that have been to 10-20 doctors before seeing me, and are still ill, because those physicians were using IDSA guidelines which say that the blood testing is reliable, and that Lyme disease is easy to cure.  Nothing could be farther from the truth. The standard two-tiered testing for Lyme disease is unreliable, and misses approximately half of those with the disease. If they do happen to be diagnosed, using one month of antibiotics will not help the majority of those with chronic Lyme/Post Treatment Lyme Disease Syndrome. We need to improve the guidelines and coding for those with chronic Lyme disease, to help prevent long term suffering and disability.   WHO ICD coding  We looked at the WHO guidelines and ICD 9 coding. We realized that there are no adequate codes for people who have chronic Lyme disease. There are many different manifestations for borreliosis, and many of the codes for these manifestations were not in the ICD9, ICD10 or ICD11 coding that is about to be released. We therefore created a document which expanded the coding for the clinical manifestations of Lyme, and organized a meeting in Geneva with the rapporteur from the WHO.   Adhoc Committee  Doctors, researchers and scientists from different countries across the world came together to review the scientific literature. We put together a document for the WHO, which expanded the coding for Lyme disease. The WHO is concerned with human rights and access to care, especially for those who are disadvantaged. Chronic Lyme patients are not having proper access to care because of inadequate diagnostic and therapeutic protocols for treating the disease. We hope this will help expand care, create better access to care, and help those who are suffering worldwide.   For the people who are not getting better with the treatments available to them now, is there hope in the future?  New solutions  I have been working on solutions for Lyme disease now for 30 years. When I wrote my first book: “Why Can't I Get Better?” I would say that approximately 90-92% of the people got help using the 16-point MSIDS model that was described in my first book. In my new book “How Can I Get Better?” which was released in February of 2017, we included information on the new persister protocols that I published in the scientific literature last year.  We are finding that among the 8-10% of people who were still ill using the MSIDS model described in my first book, approximately 2/3 of them are now getting better using the persister protocols that I have published in my second book: “How Can I Get Better?”. I do not have to put a PICC-line in or use IV ceftriaxone in many of these people because the dapsone protocol combined with doxycycline and rifampin is turning out to be an excellent protocol. It gets good penetration into the central nervous system. Many of my patient’s symptoms are getting better with this protocol, including resistant fatigue, joint/muscle and nerve pain, memory and concentration problems, as well as their sleep and mood disorders.   There is hope  There is hope for Lyme patients. They should never give up! We find that it sometimes however takes years to see improvement in the most difficult cases. I just had a young man who was in a wheelchair for 2,5 years unable to walk with Lyme and Parkinsonism’s, but he is finally now starting to walk out of his wheelchair.  I recently saw a young girl in a wheelchair that was dying from uncontrolled seizures. She was on high doses of morphine for pain, and we found that it was Lyme, Babesia, Bartonella and POTS that was causing her illness. She is now symptom free and off morphine. In her case, she managed to see improvement within the first month of treatment.  There are solutions and answers, but you have to apply the 16-point MSIDS model to get to all of the underlying causes of the illness, and hang in there!   I want to thank you for taking the time and interviewing me, because it is so important to give people hope, and discuss these important issues and solutions for all the Lyme patients that are suffering.  dr. Richard Horowitz      Written by	Huib
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