Sorry - could not get the maps to appear here, but you may be able to access them by emailing the author - I really do not know if the woud be possible.
Date: 10/09/06 12:59:49
To: S L
Subject: *A Geostatistical Analysis of Possible Spriochetal Involvement in MS & related diseases
A Geostatistical Analysis of Possible Spirochetal Involvement in Multiple Sclerosis and Other Related Diseases
� Megan M. Blewett 2006
[email protected]
Abstract
Zoonotic diseases, especially those with insect or arthropod vectors, are recognized public health problems. This class of diseases includes West Nile Virus, Human Granulocytic Ehrlichiosis (HGE), Babesiosis, Rocky Mountain Spotted Fever, and Lyme Disease. This study examines whether Multiple Sclerosis (MS), which is the most common primary neurological disorder of young adults, also belongs in this category. Visual and geostatistical analyses of MS and Lyme reveal striking similarities between the two diseases. Maps displaying each disorder�s geographic distribution by county reveal this overlap visually. In addition, the statistical correlation between MS and Lyme deaths (specifically all arthropod-borne disease deaths) is significant at the state-level and highly significant at the county-level. MS incidence is known to vary with latitude; the study�s statistical analysis reveals that Lyme Disease follows the same trend. Discussion of possible biological explanations of these geographical and statistical trends is included in this article. Significant correlations also exist with other diseases: on the state level, the correlation between MS and breast cancer is 0.330, and between MS and ALS (Motor Neuron Disease used in this study), the value is 0.618. The control, external accident/injury, did not yield significant correlations. Producing the maps and data required contacting all of the state epidemiologists in the nation for Lyme incidence data. Compiling the data has resulted in one of the most comprehensive Lyme databases available to researchers. The results of the visual, geostatistical, and biochemical analyses suggest common spirochetal involvement in MS and related diseases.
A Geostatistical Analysis of Possible Spirochetal Involvement in Multiple Sclerosis and Other Related Diseases
Introduction
Zoonotic diseases, especially those with insect or arthropod vectors, are well-recognized public health concerns. Such diseases include West Nile Virus, Human Granulocytic Ehrlichiosis (HGE), Babesiosis, Rocky Mountain Spotted Fever, and Lyme Disease. Multiple Sclerosis (MS) is the �most common primary neurological disorder of young adults� (Warren, 2001, page 1). The National Multiple Sclerosis Society estimates that 400,000 people in the United States have MS (National Multiple Sclerosis Society, 2005). The National Institute for Neurological Disorders and Stroke (NINDS) reports that the cause of MS is �linked to an unknown environmental trigger, perhaps a virus (NINDS, 2006a). Although a viral cause of MS is the prevailing view, some researchers believe MS is a zoonotic disease caused by a spirochete and spread by an arthropod vector. This study examines the spirochete hypothesis.
Spirochetal involvement in MS was a hypothesis gaining ground in Europe in the 1930s (Murray, 2005). Unfortunately, most of the research in support of this hypothesis, as well as the researchers themselves, was lost during World War II. A surviving researcher, Gabriel Steiner, published work after World War II that identified a spirochete, Spirochaeta Myelophthora, as the causal agent of MS with an unknown vector (Steiner, 1952; Steiner, 1954). Some of those who worked with Steiner in the United States as well as other researchers hypothesize that MS and Lyme might be either: 1) the same disease; or 2) different diseases caused by two different spirochetes carried by the same arthropod vector (Mattman, 2001; Rubel, 2003; Fritzsche, 2005).
Figure 1. Normalized Count of MS Deaths by County (1998 Deaths Divided by 1990 Census Population)
Figure 2. Normalized Count of Other Specified Arthropod-Borne Diseases (OSABD) Deaths by County (1998 Deaths Divided by 1990 Census Population)
Geostatistical and biochemical analyses reveal many similarities between MS and Lyme. Each is influenced by geography, and MS and Lyme overlap in this geographic distribution. The author began to examine the relationship between MS and Lyme after being struck by the similarity of the distribution apparent in generated distribution maps of both diseases. See Figure 1 and Figure 2. There are also biochemical similarities. NINDS (2006a) defines MS as �An unpredictable disease of the central nervous system � in which the body, through its immune system, launches a defensive attack against its own tissues � the nerve-insulating myelin.� NINDS (2006b) also recognizes the neurological complications of Lyme, which usually occur in the second stage, and include �numbness, pain, weakness, Bell's palsy � visual disturbances, and meningitis symptoms � decreased concentration, irritability, memory and sleep disorders, and nerve damage in the arms and legs.�
Each of the disorders is characterized by damage to the blood-brain barrier (BBB) endothelium and subsequent increased barrier permeability (Pardridge, 1998). Degradation of the barrier in Lyme patients involves bacterial breakdown of the collagen in the BBB basement membrane. The method of degradation in MS is not known (Russell, 1997), though thickness of the collagen layer could be a factor for prevalence among certain ethnic groups. For example, African-Americans have high levels of collagen and low rates of MS. Both diseases also involve demyelination triggered by what can resemble an autoimmune attack against the myelin sheath. Among MS patients, the mysterious increase in lymphocyte movement across the BBB could be in response to a bacterial invader. Lastly, MS and Lyme disease share an inflammatory response, most likely the work of proinflammatory chemokines and cytokines(Rothwell, 2002). The epidemiological and biochemical similarities suggest, but do not confirm a common bacterial basis for MS and Lyme.
The possibility of a common bacterial basis for both MS and Lyme is examined in this study using geostatistical analysis. Such analysis combines descriptive and inferential statistical techniques with data visualization (cartographics). The results have proven useful in understanding the etiology of many diseases including cholera, plague, malaria, smallpox, AIDS, and Lyme (Ormsby, 2001, Cliff, 2004; Koch, 2005
. The hypothesis to be tested is that MS and Lyme Disease are triggered or influenced by a similar zoonotic spirochetal agent and spread by a tick-like vector. If a common etiology exists, then a geostatistical relationship between Lyme and MS should be observed at either the state-level or the county-level or both. The analysis can be improved by using a control variable (disease) and at least one other condition in which the causal agent or geographic distribution might be similar to that of MS.
The control variable in this study is accident/injury because this condition should be unrelated to a bacterial distribution. The two diseases with a suggested bacterial cause or geographic similarity to MS are Breast Cancer (Cantwell, 1998) and Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig�s Disease) (Agency for Toxic Substances and Disease Registry, 2003).
THERE IS A LOT MORE - TABLES AND TEXT. WHAT I HAVE POSTED BELOW ARE THE REFERENCES LISTED:
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