Today the big conference in Germany got started. Dr. Bransfield and I were to speak there, but in the end were not able to go. Instead, we had a professional video made of our speeches (Thanks to Pat Smith and many others) which is being presented. We then went on individual phone links for the question and answer session. The translator read several questions to me, then gave my reply in real time to the audience.

Prior to the conference, I worked with Dr. Meer, who is there in person, presenting on co-infections. I had her begin her talk with a debunking of the Klempner article. She basically took bullet points out of the ILADS response to Klempner. I thought that by starting with this, she will be on the offensive and cut short criticism of our presentations before they had a chance to use his paper.

As it turned out, her presentation went AFTER mine, so I was given a question about that paper, which I was able to defer to Dr. Meer.

After the phone link, I wrote up the questions, and my answers (tough! I had no time at all to compose my responses, so they are off the cuff).

I typed up the Q&A and attached it, in case any of you are interested.

This Saturday, the big England conference will be held, and exactly the same format will be used- Our videos will be shown, we will have a live phone link for Q&A, and dr. Meer will be there in person.

I'll give an update on that conference then.

Many thanks to all who have helped us with this- from the authors of the Klempner rebuttal, to Dr. Bransfield, Pat Smith, and all the others who are such good people. You are all great!

Joe B.....................!

Questions from the German Congress

German experts state that not all cases of Borreliosis need to be treated, and mild Borreliosis will go away on its own over years even if not treated
  1. I disagree
  2. many examples of spirochetal infections, such as Syphilis, that can persist and recur later and make the patient ill
  3. symptoms may decrease over time but never fully go away
  4. many studies on the long term outcome of Lyme in untreated patients have shown late illness, occurring as long as 14 years later.
German experts recommend a 14 day course of therapy for EM with a simple oral antibiotic, such as doxycycline. If the illness is not clear, they will treat with 14 days of IV therapy. If still not clear, then no further treatment.
  1. Borrelia are disseminated early. Studies have shown that Borrelia can be in the central nervous system even before the EM appears. Therefore, one must treat all cases of Lyme, even early ones, aggressively with regard to both dose and duration of antibiotics.
  2. Lyme is a Borreliosis- in the family of relapsing fevers. The cycle of Borrelia is four weeks. This means that in any one month the Borrelia are susceptible to killing only once. If treatment is not for four weeks, then some Borrelia will not be killed.
  3. My study with IV therapy in Lyme patients- compared outcome based on blood cultures of patients after treatment, with duration of therapy. None of the patients treated for 2, 3, of four weeks were cured, and only some of those treated for 6 weeks were.
  4. Treatment duration is a statistical issue- shorter durations increase the likelihood of persistent illness, whereas longer treatment durations increases the chance for cure.
  5. All Lyme patients are different, and the amount of spirochetes they have is different. It is inappropriate and illogical to treat all Lyme patients with the same regimen. I never recommend any arbitrary endpoint of therapy. I recommend treatment be continued until several weeks after the patients symptoms are gone.
The Klempner article states that persistent symptoms after antibiotics are not from persistent infection, and that long term antibiotics are not helpful
Deferred to Dr. Meer, who will address this in her talk.


What is my opinion on co-infections, and reactivation of other infections such as herpes virus and Mycoplasmas?

  1. Studies have shown that ticks can contain Borrelia, Bartonella, Babesia, Rickettsia, Ehrlichia, and viruses, as one would expect from an insect that lives for 2 years in the dirt and drinks the blood of many wild animals.
  2. When someone is co-infected, there is immune suppression, resulting is increased severity of illness, one that is more difficult to treat, and one that needs longer term treatment.
  3. The majority of my Chronic patients are co-infected
  4. žTreatment resistantÓ Lyme in which a patient is still ill after antibiotic treatment for Lyme may represent a co-infection, because not all treatments for Lyme will be adequate for some of the co-infections.
  5. I recommend that in all Lyme patients who seem to be more ill, you test for all co-infections and treat them all.
  6. The patients must be followed clinically, because there is no test for cure.
  7. Because of the immune suppression, there can be reactivation of latent infections, such as Herpes. So these other infections need to be identified and treated if found.

The video tape (2 hrs) is of professional quality and will be available for general circulation through the LDA. It contains lectures by Dr Burrascano and myself with a brief interview of two patients. Pat Smith will be adding a section to the tape.

version: 19.6.2003
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