**
Volume 1 - Number 06 - 3/23/93
I. Introduction
II. News from the wires
III. Questions 'n' Answers
IV. Op-Ed Section
V. Partial Bibliography for Further Reading
VI. Jargon Index
VII. How to Subscribe, Contribute and Get Back Issues
I. ***** INTRODUCTION *****
I would like to begin by thanking Dr. David Dorward for the paper he wrote
on Lyme testing for electronic publication, which we featured in LymeNet vol
#1 issue #05. Several physicians have already praised the article and
commented that it will help in interpreting the lab results. New subscribers
may obtain the article by requesting issue #05 (instructions below).
We begin this newsletter with something that caught me completely by
surprise: a flurry of legislative activity on LD issues. In the past 2
months more LD legislation has been proposed on the state and federal level
than in the past 10 years combined. In the "News from the Wires," you will
find summaries of all the bills pending before state legislatures and the
Congress. If you feel strongly about a certain bill, please write to your
representative and express your opinion.
Why did this happen? I'm not sure, but I'd be interested to hear your ideas.
In any case, this trend is very encouraging!
We also have several questions and answers in this issue. Finally, Dr. Lloyd
Miller provides us with some selected references on veterinary LD issues.
-Marc.
II. ***** NEWS FROM THE WIRES ******
New York State
==============
1993 NY A.B. 1212
DATE-INTRO: JANUARY 14, 1993
LAST-ACTION: JANUARY 14, 1993
SYNOPSIS: Includes within category of occupational disease Lyme Disease
(Lyme Borroliosis).
STATUS:
01/14/93 INTRODUCED. To ASSEMBLY Committee on LABOR.
SPONSOR: Brodsky et al
=====*=====
1993 NY A.B. 2510
DATE-INTRO: FEBRUARY 1, 1993
LAST-ACTION: FEBRUARY 1, 1993
SYNOPSIS: Requires every health and accident insurance policy, group or
blanket health insurance policy, and medical expense indemnity corporation,
hospital service corporation or health service corporation to provide
coverage for treatment of Lyme disease; requires workers' compensation
coverage for treatment of Lyme disease.
STATUS:
02/01/93 INTRODUCED. To ASSEMBLY Committee on INSURANCE.
SPONSOR: Warren
=====*=====
1993 NY A.B. 2545
DATE-INTRO: FEBRUARY 2, 1993
LAST-ACTION: FEBRUARY 2, 1993
SYNOPSIS: Provides for establishment of statewide toll-free telephone
hotline service for the purpose of responding to inquiries for information
and counseling referral relating to Lyme Disease; appropriates $100,000
therefor.
STATUS:
02/02/93 INTRODUCED. To ASSEMBLY Committee on HEALTH.
SPONSOR: Conte et al
=====*=====
1993 NY A.B. 2799
DATE-INTRO: FEBRUARY 4, 1993
LAST-ACTION: FEBRUARY 4, 1993
SYNOPSIS: Appropriates funds to reimburse county agricultural fairs and
county youth fairs which conduct Lyme disease awareness programs.
STATUS:
02/04/93 INTRODUCED. To ASSEMBLY Committee on AGRICULTURE.
SPONSOR: D'Andrea et al
=====*=====
1993 NY A.B. 2958
DATE-INTRO: FEBRUARY 8, 1993
LAST-ACTION: FEBRUARY 8, 1993
SYNOPSIS: Authorizes the Commissioner of Education, in cooperation with the
Department of Health, to create and maintain an instructional program for
students and teachers on the incidence, prevention and recognition of Lyme
disease.
STATUS:
02/08/93 INTRODUCED. To ASSEMBLY Committee on EDUCATION.
SPONSOR: Wertz et al
=====*=====
1993 NY A.B. 3642
DATE-INTRO: FEBRUARY 16, 1993
LAST-ACTION: FEBRUARY 16, 1993
SYNOPSIS: Requires the Department of Health through the Tick-Borne Disease
Institute to conduct a mass media public education and awareness campaign on
the cause, prevention, detection and treatment of Lyme disease and other
tick-borne diseases; specifies that such campaign shall be concentrated in
the counties of Westchester, Nassau and Suffolk during the months of April,
May, June and August.
STATUS:
02/16/93 INTRODUCED. To ASSEMBLY Committee on HEALTH.
SPONSOR: Wertz et al
=====*=====
1993 NY A.B. 3700
DATE-INTRO: FEBRUARY 16, 1993
LAST-ACTION: FEBRUARY 16, 1993
SYNOPSIS: Provides that the Department of Public Health shall provide
facilities and personnel for and shall conduct free {*filter*} tests for Lyme
Disease in the Counties of Westchester, Suffolk and Nassau to any person for
whom such a {*filter*} test has been recommended in writing by a physician and who
is not covered by any policy of insurance which will pay for such testing.
STATUS:
02/16/93 INTRODUCED. To ASSEMBLY Committee on HEALTH.
SPONSOR: Muscarella et al
=====*=====
1993 NY S.B. 634
DATE-INTRO: JANUARY 14, 1993
LAST-ACTION: JANUARY 14, 1993
SYNOPSIS: Includes within category of occupational disease Lyme Disease
(Lyme Borroliosis).
STATUS:
01/14/93 INTRODUCED. To ASSEMBLY Committee on LABOR.
SPONSOR: La Valle et al
=====*=====
1993 NY S.B. 2237
DATE-INTRO: FEBRUARY 22, 1993
LAST-ACTION: FEBRUARY 22, 1993
SYNOPSIS: Requires the Department of Health through the Tick Borne Disease
Institute to conduct a mass media Public Education and Awareness Campaign
on the cause, prevention, detection and treatment of Lyme Disease and other
tick-borne diseases; states such campaign shall be concentrated in the
counties of Westchester, Nassau and Suffolk during the months of April, May,
June and August.
STATUS:
02/22/93 INTRODUCED. To SENATE Committee on HEALTH.
SPONSOR: Hannon
=====*=====
MINNESOTA
=========
1993 MN H.B. 595
DATE-INTRO: FEBRUARY 25, 1993
LAST-ACTION: FEBRUARY 25, 1993
SYNOPSIS: Directs the Metropolitan Mosquito Control Commission and the
Commissioner of Health to provide an annual Lyme disease prevention education
program in public schools, and an information brochure for public
distribution; requires signs to be posted by the DNR at state parks;
requires funding from Mosquito Control Commission; requires statistical data
on all cases to be kept by the Department of Health, which will distribute
reporting forms to physicians.
STATUS:
02/25/93 INTRODUCED. To HOUSE Committee on HEALTH AND HUMAN SERVICES.
SPONSOR: Murphy et al
=====*=====
1993 MN S.B. 549
DATE-INTRO: FEBRUARY 25, 1993
LAST-ACTION: FEBRUARY 25, 1993
SYNOPSIS: Directs the Metropolitan Mosquito Control Commission and the
Commissioner of Health to provide an annual Lyme disease prevention
education program in public schools, and an information brochure for public
distribution; requires signs to be posted by the DNR at state parks;
requires funding from Mosquito Control Commission; requires statistical
data on all cases to be kept by the Department of Health, which will
distribute reporting forms to physicians.
STATUS:
02/25/93 INTRODUCED. To SENATE Committee on HEALTH CARE.
SPONSOR: Johnston et al
=====*=====
PENNSYLVANIA
============
1993 PA S.B. 464
DATE-INTRO: FEBRUARY 9, 1993
LAST-ACTION: FEBRUARY 9, 1993
SYNOPSIS: Provides for control and treatment of Lyme disease. Makes an
appropriation.
STATUS:
02/09/93 INTRODUCED. To SENATE Committee on PUBLIC HEALTH AND WELFARE.
SPONSOR: Greenleaf et al
====*=====
NEW JERSEY
==========
1993 NJ A.R. 119
DATE-INTRO: MARCH 1, 1993
LAST-ACTION: MARCH 1, 1993
SYNOPSIS: Designates May 1993 as "Lyme Disease Awareness Month".
STATUS:
03/01/93 INTRODUCED. To ASSEMBLY Committee on HEALTH AND HUMAN SERVICES.
SPONSOR: Farragher et al
=====*=====
OREGON
======
1993 OR H.B. 2555
DATE-INTRO: JANUARY 26, 1993
LAST-ACTION: JANUARY 26, 1993
SYNOPSIS: Requires reporting of Lyme disease to the Health Division.
STATUS:
01/26/93 INTRODUCED.
01/26/93 To HOUSE Committee on HUMAN DEVELOPMENT SERVICES.
SPONSOR: Local Sponsor
=====*=====
FEDERAL LEGISLATION
===================
1993 H.J. Res. 92 (House of Representatives)
DATE-INTRO: February 3, 1993
LAST-ACTION-DATE: March 4, 1993
SPONSOR: Representative George J. Hochbrueckner D-NY
TOTAL-COSPONSORS: 61 Cosponsors: 42 Democrats / 19 Republicans
SYNOPSIS: Joint resolution designating the weeks beginning June 6, 1993, and
June 5, 1994, as "Lyme Disease Awareness Week".
ACTIONS: Committee Referrals:
02/03/93 House Post Office and Civil Service Committee
Legislative Chronology:
1st Session Activity:
02/03/93 139 Cong Rec H 483 Referred to the House Post Office and Civil
Service Committee
02/23/93 139 Cong Rec H 795 Cosponsors added
03/04/93 139 Cong Rec H 1047 Cosponsors added
CO-SPONSORS:
Added 02/23/93:
Shays R-CT Morella R-MD Clement D-TN
Gallo R-NJ Saxton R-NJ Smith R-NJ
de Lugo D-VI Norton D-DC Quillen R-TN
LaFalce D-NY Walsh R-NY Rangel D-NY
Lowey D-NY Rose D-NC Roukema R-NJ
Schumer D-NY Kasich R-OH Pallone D-NJ
Horn R-CA Hyde R-IL Bevill D-AL
de la Garza D-TX Vento D-MN Pelosi D-CA
Gejdenson D-CT Andrews D-ME Clinger R-PA
Gilman R-NY Hughes D-NJ Pickett D-VA
Added 03/04/93:
King R-NY Frost D-TX McNulty D-NY
Andrews D-NJ Murtha D-PA Ravenel Jr. R-SC
Slattery D-KS McDermott D-WA McCloskey D-IN
Matsui D-CA Montgomery D-MS Doolittle R-CA
Dellums D-CA Manton D-NY Gonzalez D-TX
Faleomavaega D-AS DeLauro D-CT Parker D-MS
Coble R-NC Traficant, Jr. D-OH McCollum R-FL
Levy R-NY Unsoeld D-WA Waxman D-CA
Evans D-IL Scott D-VA Boucher D-VA
Spratt, Jr. D-SC Ackerman D-NY Jacobs, Jr. D-IN
Martinez D-CA
DATE OF VERSION: FEBRUARY 5, 1993 -- VERSION: 1
SPONSOR(S):
Mr. HOCHBRUECKNER introduced the following joint resolution; which was
referred to the Committee on Post Office and Civil Service
TEXT:
Whereas Lyme disease (borreliosis) is spread primarily by the bite of
four types of ticks infected with the bacteria Borrelia burgdorferi;
Whereas Lyme disease -carrying ticks can be found across the country - in
woods, mountains, beaches, even in our yards, and no effective tick
control measures currently exist;
Whereas infected ticks can be carried by animals such as cats, dogs,
horses, cows, goats, birds, and transferred to humans;
Whereas our pets and livestock can be infected with Lyme disease by
ticks;
Whereas Lyme disease was first discovered in Europe in 1883 and
scientists have recently proven its presence on Long Island as early as
the 1940's;
Whereas Lyme disease was first found in Wisconsin in 1969, and derives
its name from the diagnosis of a cluster of cases in the mid-1970's in
Lyme, Connecticut;
Whereas forty-nine States reported more than 40,000 cases of Lyme disease
from 1982 through 1991;
Whereas Lyme disease knows no season - the peak west coast and southern
season is November to June, the peak east coast and northern season is
April to October, and victims suffer all year round;
Whereas Lyme disease, easily treated soon after the bite with {*filter*}
antibiotics, can be difficult to treat (by painful intravenous
injections) if not discovered in time, and for some may be incurable;
Whereas Lyme disease is difficult to diagnose because there is no
reliable test that can directly detect when the infection is present;
Whereas the early symptoms of Lyme disease may include rashes, severe
headaches, fever, fatigue, and swollen glands;
Whereas if left untreated Lyme disease can affect every body system
causing severe damage to the heart, brain, eyes, joints, lungs, liver,
spleen, {*filter*} vessels, and kidneys;
Whereas the bacteria can cross the placenta and affect fetal development;
Whereas our children are the most vulnerable and most widely affected
group;
Whereas the best cure for Lyme disease is prevention;
Whereas prevention of Lyme disease depends upon public awareness; and
Whereas education is essential to making the general public, health care
professionals, employers, and insurers more knowledgeable about Lyme
disease and its debilitating side effects:
Now, therefore, be it
* Resolved by the Senate and House of Representatives of the United *
* States of America in Congress assembled, *
* That the weeks beginning June 6, 1993, and June 5, 1994, are *
* designated as "Lyme Disease Awareness Week", and the President is *
* authorized and requested to issue a proclamation calling upon the *
* people of the United States to observe such weeks with appropriate *
* programs, ceremonies, and activities.
=====*=====
1993 S.J. Res. 43 (Senate)
DATE-INTRO: February 4, 1993
LAST-ACTION-DATE: February 18, 1993
SPONSOR: Senator Joseph Lieberman D-CT
TOTAL-COSPONSORS: 56 Cosponsors: 35 Democrats / 21 Republicans
SYNOPSIS: A joint resolution designating the week beginning June 6, 1993, and
June 5, 1994, as "Lyme Disese Awareness Week."
ACTIONS: Committee Referrals:
02/04/93 Senate Judiciary Committee
Legislative Chronology:
1st Session Activity:
02/04/93 139 Cong Rec S 1385 Referred to the Senate Judiciary Committee
02/04/93 139 Cong Rec S 1491 Remarks by Sen. Lieberman, CT
02/18/93 139 Cong Rec S 1922 Cosponsors added
Original Cosponsors:
Dodd D-CT Moynihan D-NY D'Amato R-NY
Lautenberg D-NJ
Added 02/18/93:
Bradley D-NJ Reid D-NV Bumpers D-AR
Sarbanes D-MD Chafee R-RI Hollings D-SC
Kennedy D-MA Levin D-MI Warner R-VA
Johnston D-LA Akaka D-HI Breaux D-LA
Wellstone D-MN Cohen R-ME McCain R-AZ
Cochran R-MS DeConcini D-AZ Glenn D-OH
Pell D-RI Craig R-ID Murkowski R-AK
Stevens R-AK Durenberger R-MN Inouye D-HI
Metzenbaum D-OH Burns R-MT Nunn D-GA
Riegle D-MI Thurmond R-SC Coats R-IN
Graham D-FL Bond R-MO Danforth R-MO
Wofford D-PA Rockefeller D-WV Domenici R-NM
Kerry D-MA Braun D-IL Simon D-IL
Packwood R-OR Grassley R-IA Mikulski D-MD
Feingold D-WI Specter R-PA Sasser D-TN
Pressler R-SD Conrad D-ND Roth R-DE
Feinstein D-CA Daschle D-SD Kohl D-WI
Dorgan D-ND
DATE OF VERSION: FEBRUARY 8, 1993 -- VERSION: 1
SPONSOR(S):
Mr. LIEBERMAN (for himself, Mr. DODD, Mr. MOYNIHAN, Mr. D'AMATO, and Mr.
LAUTENBERG) introduced the following bill; which was read twice and
referred to the Committee on the Judiciary
TEXT:
[ Text same as in House version ]
III. ***** QUESTIONS 'N' ANSWERS *****
Subject: LymeNet Newsletter vol#1 #04
Quote:
>LYME COMMENT: [Exercise done under controlled conditions is recommended for
>patients with chronic Lyme disease. This article would indicate that the
>exercise may not have much effect on the pain symptoms. Maybe more important,
>it indicates that exercise was tolerated without exacerbating symptoms.
>Therefore, exercising and physical therapy to help maintain body condition in
>chronic Lyme patients would seem like a good idea. It would be interesting to
>know if Lyme patients are finding this to be the case.]
In my case, I was a runner and biker before I got Lyme Disease (LD) and
I continued to run and bike after (and during) LD symptoms. I've had
no recurrence of the LD symptoms. In fact, I feel healthier now
then before getting LD. (Please do not interpret this as a
recommendation to run out and get LD. ;-) )
Take care of yourself.
=====*=====
Subject: Veterinarians and Lyme vaccine
I must take exception to a comment in LymeNet -4 pertaining veterinarians and
the Lyme vaccine for dogs:[< ..... the vets push it, (the vaccine) because it
makes them lots of money, but all that says is that veterinarians are no more
ethical than a lot of physicians in trying to make a fast profit over the
suffering of dogs or people who have Lyme Disease.>]
In any profession there are bad apples but to paint us all with the same
brush is grossly inaccurate.
NOT ALL VETERINARIANS are pushing the vaccine. In fact a considerable
number are NOT administering it at the present time. Many veterinarians I
have contact with do in fact have the vaccine in their refrigerators but
have used very little of it, only administering it to patients at the owner's
request or to patients going into high risk areas. The figure the company
reports as doses sold does not necessarily equate with the number of doses
administered. Even if we estimate that 1.5 million dogs have been
vaccinated this is a very small proportion of the national dog population.
Controversies about how serious Lyme disease it is in animals, clinical
presentation, modes of transmission, laboratory diagnosis, and proper
treatment are all also present in the veterinary field. Vaccination
controversies continue regarding the need to vaccinate - especially in
non-endemic areas, safety (short and long term), efficacy, length of
protection, and the epidemiological implications of administering a vaccine
that renders the recipient serologically positive on all tests.
A second statement [<...as far as I know, there is NO evidence that it is at
all effective.>] made in the same issue also requires comment.
Scientific evidence of probable efficacy has been published [see reference
2]. Keep in mind that this information was developed by the manufacturer. To
date I am unaware of any published independent data to confirm or deny their
findings. I do know independent studies are in progress.
An independent *opinion* was expressed in reference 3. It states that there
are two ways to prevent Lyme disease in dogs. One is to prevent tick
engorgement. The other is vaccination. About vaccination it states that "The
Borrelia burgdorferi bacterin from Fort Dodge Laboratories is currently the
only licensed Lyme disease vaccine for dogs. More than two million doses have
been sold, and there appear to have been no immediate adverse reactions to
its use in dogs. Field observations would suggest that the vaccine may induce
protective immunity to acute Lyme disease in dogs. However, the vaccine does
not protect from actual infection. It is too early to know whether B.
burgdorferi persisting in dogs vaccinated after tick exposure might cause
later disease."
"Vaccination of dogs, therefore, can be recommended only in known endemic
areas and in dogs that are continually exposed to ticks."
Note the vaccine is a bacterin (i.e. killed organisms) and therefore can NOT
cause infection.
In my own practice (in a non-endemic area) we follow this recommendation.
We do not recommend vaccination of all dogs in our area. However, if a client
is concerned about his/her dog contracting the disease or is traveling to
highly endemic areas and requests vaccination we will vaccinate after
explaining what we currently know about safety and efficacy. It is unclear at
present how serious a disease this is in dogs or what the long term effects
of persistent infection may be. Therefore, if I were practicing in a highly
endemic area and the vaccine had a reasonable expectation of safely
preventing the disease I would recommend vaccination.
SUGGESTED READING:
1. Green RT: Questions "push" for vaccination against Borrelia burgdorferi.
Journal of the America Veterinary Medical Association 1992;201(10): 1491-93.
[letter]
2. Chu H, Chavez LG et al: Immunogenicity and efficacy study of a commercial
Borrelia burgdorferi bacterin. Journal of the America Veterinary Medical
Association 1992;201(3):403-18.
3. Lyme disease in Dogs. Institute News and Views 1992; (Spring-Summer).
[James A. Baker Institute for animal health Cornell University - College of
Veterinary Medicine]
=====*=====
Subject: Lyme Vaccine Available?
Hello,
I understand that a lyme vaccine exists for dogs,
and other 4-footed critters.
Is there a lyme vaccine available for humans? In
research stage? If yes, how effective is the vaccine?
Any other related information would be greatly
appreciated!
Thanks!
=====*=====
Subject: Which test is "LYME DISEASE AB SCREEN"?
Hi, folks,
I had a test for Lyme last August. On the bills I got, it said "LYME
DISEASE AB SCREEN". The charge was $34 (not including the {*filter*} drawing).
Which test was this? The result was negative. What is the probability
the result was false?
--
Thanks
IV. ***** OP-ED SECTION *****
This section is open to all subscribers who would like to express an opinion.
V. ***** PARTIAL BIBLIOGRAPHY FOR FURTHER READING *****
Subject: VETERINARY LYME DISEASE -- SELECTED REFERENCES
1. Appel MJG: Lyme disease in dogs and cats. The Compendium
1990;12(5):617-626.
2. Burgess EC: Borrelia Burgdorferi infection in Wisconsin horses and cows.
Annals of the New York Academy of Sciences 1988;539:235-242.
3. Burgess EC: Experimentally induced infection of cats with Borrelia
burgdorferi. American Journal of Veterinary Research 1992;53(9):1507-1511.
4. Cohen ND, Cohen Daniel: Borreliosis in horses: A comparative review. The
Compendium 1990;12(10):1449-1458.
5. Grauer GF, Burgess EC et al: Renal lesions associated with Borrelia
Burgdorferi infection in a dog. JAVMA 1988;193(2):237-239.
6. Greene RT: An update on the serodiagnosis of Canine Lyme Borreliosis. Jour
Vet Int Med 1990;4:167-171.
7. Fridriksdottir V, Overnes G, Stuen S: Suspected Lyme borreliosis in sheep.
Vet Rec 1992;130(15):323-4.
8. Fridriksdottir V, Nesse LL, Gudding R: Seroepidemiological studies of
Borrelia burgdorferi infection in sheep in Norway. J Clin Microbiol
1992;30(5):1271-7.
9. Levy SA: Lyme borreliosis in dogs. Canine Practice 1992;17(2):5-14.
10. Levy SA, Magnarelli LA: Relationship between development of antibodies to
Borrelia Burgdorferi in dogs and subsequent development of limb/joint
borreliosis. Journal of the American Veterinary Medical Association 1992;
200(3):344-347.
11. Lindenmayer J, Weber M et al: Comparison of indirect
immunofluorescent-antibody assay, enzyme-linked immunosorbent assay, and
western immunoblot for the diagnosis of Lyme disease in dogs. Journal of
Clinical Microbiology 1990;28(1):92-96.
12. Magnarelli LA et al: Clinical and serologic studies of canine
borreliosis. JAVMA November 1, 1987;191(9):1089-1093.
13. Magnarelli LA, Andersen JF et al: Persistence of antibodies to Borrelia
burgdorferi in dogs of New York and Connecticut. Journal of the America
Veterinary Medical Association 1990;196(7):1064-1068.
14. Magnarelli LA, Andersen JF et al: Tick parasitism and antibodies to
Borrelia burgdorferi in cats. Journal of the America Veterinary Medical
Association 1990;197(1):63-66.
15. Parker JL, White KK: Lyme borreliosis in cattle and horses: a review of
the literature. Cornell Vet 1992; 82(3):253-74.
16. Post JE, Shaw EE: Suspected borreliosis in cattle. Annals of the New York
Academy of Sciences 1988;539:488.
17 Shepard RM, Falkner FC: Pharmacokinetics of azithromycin in rats and dogs.
Journal Antimicrobial Chemotherapy 1990;25(Suppl A):49-60.
18. Wasmoen TL, Sebring RW, Blumer BM et al: Examination of Koch's postulates
for Borrelia burgdorferi as the causative agent of limb/joint dysfunction in
dogs with borreliosis. J Am Vet Med Assoc 1992;201(3):412-8.
19. Wells SJ, Trent AM et al: Association between clinical lameness and
Borrelia burgdorferi antibody in dairy cows. American Journal of Veterinary
Research 1993;54(3):398-405.
VI. ***** JARGON INDEX *****
Bb - Borrelia burgdorferi - The scientific name for the LD bacterium.
CDC - Centers for Disease Control - Federal agency in charge of tracking
diseases and programs to prevent them.
CNS - Central Nervous System.
ELISA - Enzyme-linked Immunosorbent Assays - Common antibody test
EM - Erythema Migrans - The name of the "bull's eye" rash that appears in
~60% of the patients early in the infection.
IFA - Indirect Fluorescent Antibody - Common antibody test.
LD - Common abbreviation for Lyme Disease.
NIH - National Institutes of Health - Federal agency that conducts medical
research and issues grants to research interests.
PCR - Polymerase Chain Reaction - A new test that detects the DNA sequence
of the microbe in question. Currently being tested for use in
detecting LD, TB, and AIDS.
Spirochete - The LD bacterium. It's given this name due to it's spiral
shape.
Western Blot - A more precise antibody test.
VII. ***** HOW TO SUBSCRIBE, CONTRIBUTE AND GET BACK ISSUES *****
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(215) 882-0138 Lehigh University
LymeNet Newsletter vol#1 #06