The borough of Stoke-upon-Trent, in the commencement of the reign of ... Queen Victoria, comprising its history, statistics, civil polity, & traffic ... also, the manorial history of Newcastle-under-Lyme, and incidental notices of other neighbouring place & objects;

Publication begun in numbers, 8 of which were issued by the author in collaboration with Simeon Shaw. The latter then retired (having contributed nothing after chapter X) and Ward completed the work as sole author.

An address upon the effects of ardent spirits. Delivered in the town-hall of Lyme, N.H. January 8, 1827. ...

Page 24 contains an advertisement for Henry's Commentary on the Bible.

An address upon the effects of ardent spirits, delivered in the town hall of Lyme, N.H. January 8, 1827.

Mode of access: Internet.

Address upon the effects of ardent spirits, delivered in the Town Hall of Lyme, N.H., January 9,1927.

Mode of access: Internet.

An address, upon the effects of ardent spirits. Delivered in the town hall of Lyme, N.H. January 8, 1827. ...

Mode of access: Internet.

The history and antiquities of the borough of Lyme Regis and Charmouth /

Includes index.

The Thomas Lee House, East Lyme, Connecticut; a history and description,

Mode of access: Internet.

Geographic Expansion of Lyme Disease in the Southeastern United States, 2000-2014.

Background.  The majority of Lyme disease cases in the United States are acquired on the east coast between northern Virginia and New England. In recent years the geographic extent of Lyme disease has been expanding, raising the prospect of Lyme disease becoming endemic in the southeast. Methods.  We collected confirmed and probable cases of Lyme disease from 2000 through 2014 from the Virginia Department of Health and North Carolina Department of Public Health and entered them in a geographic information system. We performed spatial and spatiotemporal cluster analyses to characterize Lyme disease expansion. Results.  There was a marked increase in Lyme disease cases in Virginia, particularly from 2007 onwards. Northern Virginia experienced intensification and geographic expansion of Lyme disease cases. The most notable area of expansion was to the southwest along the Appalachian Mountains with development of a new disease cluster in the southern Virginia mountain region. Conclusions.  The geographic distribution of Lyme disease cases significantly expanded in Virginia between 2000 and 2014, particularly southward in the Virginia mountain ranges. If these trends continue, North Carolina can expect autochthonous Lyme disease transmission in its mountain region in the coming years.

Identification and Characterization of Ixodes scapularis Antigens That Elicit Tick Immunity Using Yeast Surface Display

Repeated exposure of rabbits and other animals to ticks results in acquired resistance or immunity to subsequent tick bites and is partially elicited by antibodies directed against tick antigens. In this study we demonstrate the utility of a yeast surface display approach to identify tick salivary antigens that react with tick-immune serum. We constructed an Ixodes scapularis nymphal salivary gland yeast surface display library and screened the library with nymph-immune rabbit sera and identified five salivary antigens. Four of these proteins, designated P8, P19, P23 and P32, had a predicted signal sequence. We generated recombinant (r) P8, P19 and P23 in a Drosophila expression system for functional and immunization studies. rP8 showed anti-complement activity and rP23 demonstrated anti-coagulant activity. Ixodes scapularis feeding was significantly impaired when nymphs were fed on rabbits immunized with a cocktail of rP8, rP19 and rP23, a hall mark of tick-immunity. These studies also suggest that these antigens may serve as potential vaccine candidates to thwart tick feeding.

Bacterial triggers and autoimmune rheumatic diseases

Autoimmune rheumatic diseases are generally considered as a multifactorial aetiology, mainly genetic susceptibility combined with environmental triggers of which bacteria are considered one of the most prominent. Among the rheumatic diseases where bacterial agents are more clearly involved as triggers are: reactive arthritis (ReA), rheumatic fever (RF) and Lyme disease. The role of bacterial infections in inducing other seronegative spondyloarthritis and antiphospholipid antibody syndrome has been hypothesized but is still not proven. The classic form of ReA is associated with the presence of HLA-B27 and is triggered by the urethritis or enteritis causing pathogens Chlamydia trachomatis and the enterobacteria Salmonella, Shigella, and Yersinia, respectively. But several other pathogens such as Brucella, Leptospira, Mycobacteria, Neisseria, Staphylococcus and Streptococcus have also been reported to cause ReA. RF is due to an autoimmune reaction triggered by an untreated throat infection by Streptococcus pyogenes in susceptible individuals. Carditis is the most serious manifestation of RF and HLA-DR7 is predominantly observed in the development of valvular lesions. Lyme disease is a tick-transmitted disease caused by the spirochete Borrelia burgdorferi. Knowledge is limited about how this spirochete interacts with human tissues and cells. Some data report that Borrelia burgdorferi can manipulate resident cells towards a pro- but also anti-inflammatory reaction and persist over a long period of time inside the human body or even inside human cells.

A tick salivary protein targets cathepsin G and chymase and inhibits host inflammation and platelet aggregation

Platelet aggregation and acute inflammation are key processes in vertebrate defense to a skin injury. Recent studies uncovered the mediation of 2 serine proteases, cathepsin G and chymase, in both mechanisms. Working with a mouse model of acute inflammation, we revealed that an exogenous salivary protein of Ixodes ricinus, the vector of Lyme disease pathogens in Europe, extensively inhibits edema formation and influx of neutrophils in the inflamed tissue. We named this tick salivary gland secreted effector as I ricinus serpin-2 (IRS-2), and we show that it primarily inhibits cathepsin G and chymase, while in higher molar excess, it affects thrombin activity as well. The inhibitory specificity was explained using the crystal structure, determined at a resolution of 1.8 angstrom. Moreover, we disclosed the ability of IRS-2 to inhibit cathepsin G-induced and thrombin-induced platelet aggregation. For the first time, an ectoparasite protein is shown to exhibit such pharmacological effects and target specificity. The stringent specificity and biological activities of IRS-2 combined with the knowledge of its structure can be the basis for the development of future pharmaceutical applications. (Blood. 2011;117(2):736-744)

Occurrence of ticks (Acari: Ixodidae) in the municipality of Goiatins, Tocantins

Due to a suspected human case of Brazilian Lyme-like disease in the city of Goiatins, Tocantins State, an epidemiological survey was carried out in eight counties in this region during September 2007 and February 2008, where 1,890 ticks were collected from domestic animals and from the environment. A total of eight tick species were identified: Rhipicephalus sanguineus, Rhipicephalus (Boophilus) microplus, Dermacentor nitens, Amblyomma cajennense, Amblyomma oblongoguttatum, Amblyomma ovale, Amblyomma parvum and Amblyomma tigrinum. The last four species were described for the first time in this region. Although human parasitism by ticks is frequently described in Goiatins, no ticks collected from humans were analyzed. The Study of ixodids in this region contributes with the survey of Brazilian ticks, as well as the elucidation of the possible transmission of the agent that caused the Brazilian Lyme-like disease case in Goiatins.

Survey for Tick-Borne Zoonoses in the State of Espirito Santo, Southeastern Brazil

Blood samples collected from 201 humans, 92 dogs, and 27 horses in the state of Espirito Santo, Brazil, were tested by polymerase chain reaction, indirect immunofluorescence assays, and indirect enzyme-linked immunosorbent assay for tick-borne diseases (rickettsiosis, ehrlichiosis, anaplasmosis, borreliosis, babesiosis). Our results indicated that the surveyed counties are endemic for spotted fever group rickettsiosis because sera from 70 (34.8%) humans, 7 (7.6%) dogs, and 7 (25.9%) horses were reactive to at least one of the six Rickettsia species tested. Although there was evidence of ehrlichiosis (Ehrlichia canis) and babesiosis (Babesia cams vogeli, Theileria equi) in domestic animals, no human was positive for babesiosis and only four individuals were serologically positive for E. canis. Borrelia burgdorferi-serologic reactive sera were rare among humans and horses, but encompassed 51% of the canine samples, suggesting that dogs and their ticks can be part of the epidemiological cycle of the causative agent of the Brazilian zoonosis, named Baggio-Yoshinari Syndrome.

Aspectos da caracterização antigénica e molecular da Leptospirose em Áreas Endémicas

RESUMO A Leptospirose é uma zoonose re-emergente causada por espiroquetídeos patogénicos do género Leptospira. Em Portugal, é reconhecida, desde 1931, como uma importante doença infecciosa humana, cuja notificação é obrigatória desde 1986 para todos os serovares. Porém, devido ao acentuado polimorfismo clínico e à dificuldade de um diagnóstico laboratorial especializado, esta patologia nem sempre é confirmada. Com efeito, o isolamento do agente é difícil e o método convencional de diagnóstico, baseado no teste serológico de referência TAM (Teste de Aglutinação Microscópica), não é muito sensível na primeira semana da doença. Assim, foram três os principais objectivos desta dissertação: actualizar o padrão epidemiológico da Leptospirose, após uma extensa revisão bibliográfica da doença (Capítulos 1 e 2); esclarecer os aspectos imunológicos relacionados com os marcadores antigénicos que mais influenciam a regulação da resposta humoral na infecção humana, em particular, em área endémica (Capítulo 3); e, por último, promover a identificação molecular de alguns isolados de Leptospira, avaliar o respectivo poder patogénico no modelo murino e contribuir para o diagnóstico precoce da doença humana (Capítulo 4). O primeiro dos temas investigados, com base no estudo retrospectivo de uma larga série de 4.618 doentes sintomáticos analisados representa uma caracterização única da epidemiologia da Leptospirose, em particular, na Região Centro do País, e nas ilhas de São Miguel e Terceira (Açores), nos últimos 18 e 12 anos, respectivamente. Foram confirmados 1.024 (22%) casos, com uma distribuição média de 57 casos/ano, sendo a maior frequência no sexo masculino (67%). As áreas analisadas corresponderam à maioria das notificações em Portugal, com uma taxa de incidência média anual nas ilhas muito superior à registada no continente (11,1 vs 1,7/100.000 habitantes, respectivamente). Os adultos em idade activa (25-54 anos) foram os mais afectados, nos meses de Dezembro e Janeiro. A doença foi causada por serovares de nove serogrupos presuntivos de Leptospira interrogans sensu lato, com predomínio de Icterohaemorrhagiae, Pomona e Ballum, em cerca de 66% dos casos. A seropositividade da Leptospirose esteve associada às formas anictérica e ictérica da doença, sendo evidente uma elevada sub-notificação ( 20 casos/ano). Foram detectados e analisados os diversos factores de risco, verificando-se um risco elevado de transmissão em áreas geográficas onde a circulação dos agentes zoonóticos se processa em ciclos silváticos e/ou domésticos bem estabelecidos. Este estudo confirma que a incidência da Leptospirose em Portugal tem aumentado nos últimos anos, particularmente, nos Açores, onde a seropositividade elevada e a ocorrência de casos fatais confirmam esta patologia como um problema emergente de Saúde Pública. No âmbito do Capítulo 3, investigaram-se os aspectos imunológicos da Leptospirose humana na Aspectos da caracterização antigénica e molecular da Leptospirose em áreas endémicas Região Centro e nas ilhas de São Miguel e Terceira, caracterizando as proteínas e os lipopolissacáridos (LPS) envolvidos durante as fases aguda (estádio único) e tardia da doença (três estádios), através do follow-up serológico de 240 doentes com confirmação clínica e laboratorial de Leptospirose. Foram incluídos no estudo 463 soros, 320 (69%) dos quais, obtidos durante a fase de convalescença (até 6 anos após o início dos sintomas). Soros de dadores de sangue (n=200) e de doentes com outras patologias infecciosas (n=60) foram usados como controlos. As amostras foram testadas pela técnica de Western Blot com lisados de oito estirpes patogénicas pertencentes aos serogrupos mais prevalentes. O reconhecimento dos antigénios leptospíricos, nos quatro estádios evolutivos, resultou da detecção de reactividade específica anti-IgM e anti IgG, nos diferentes immunoblots. Detectaram-se cinco proteínas major (45, 35, 32, 25 e 22 kDa) comuns a todos os serovares. Os soros estudados com as estirpes dos serogrupos homólogos, previamente identificados pela TAM, reagiram contra as proteínas de 45, 32 e 22 kDa, conhecidas como LipL45, LipL32 e LpL21, respectivamente, sendo estes, os antigénios imunodominantes durante o período estudado, nas duas regiões geográficas. Os doentes açorianos mostraram, ainda, uma reactividade elevada contra os LPS, cujo significado é discutido face aos resultados negativos dos soros controlo para os marcadores referidos. Esta investigação indica, pela primeira vez, uma forte persistência da resposta humoral e o importante papel protector da LipL45, Lip32 e LipL21, anos após o início dos sintomas. Por último, procedeu-se à identificação de estirpes Portuguesas, isoladas de murinos e de um caso humano fatal (L. inadai), numa perspectiva polifásica de intervenção. Utilizaram-se três testes fenotípicos (testes de crescimento sob diferentes temperaturas e na presença de 8-azaguanina, a par de um teste de alteração morfológica induzida pela adição de NaCl 1M). Paralelamente, efectuaram-se ensaios de amplificação do gene rrs (16S ARNr) de Leptospira spp por PCR (Polymerase Chain Reaction), utilizando um par de primers “universais” (331 pb) e um segundo par, que apenas amplifica o gene secY (285 pb) de estirpes patogénicas, para definição da identidade dos isolados em estudo. Da integração dos resultados obtidos, confirmou-se que estes ocupam uma posição taxonómica “intermédia” entre as leptospiras saprófitas e as patogénicas. Desenvolveu-se, ainda, uma investigação (complementar) “in vivo” do carácter taxonómico “intermédio” do referido isolado humano, por cultura e amplificação do respectivo ADN de tecidos de hamsters inoculados para o efeito. Esta metodologia molecular foi posteriormente utilizada, com sucesso, no diagnóstico precoce de doentes com Leptospirose, sendo uma mais-valia na confirmação laboratorial de infecção por Leptospira, na ausência de anticorpos específicos na fase inicial da doença.

Borrelia burgdorferi antibodies in dogs from Cotia county, São Paulo State, Brazil

Dogs sera samples collected from Cotia County, São Paulo were tested using indirect immunoenzymatic test (ELISA) in order to study Lyme disease serology in dogs. ELISA method was standardized and G39/40 North American strain of Borrelia burgdorferi was used as antigen. Positive results were confirmed employing the Western blotting technique. Because of the possibility of cross-reactions, sera were also tested for different serological strains of Leptospira interrogans and L. biflexa using microscopic sera agglutination test. Twenty-three of 237 (9.7%) serum samples were positive in the ELISA; 20 of them (86.9%) were confirmed by the Western blotting, what suggests that Cotia may be a risk area for Lyme disease. Although 4 samples (1.7%) were positive for Lyme disease and leptospirosis, no correlation was found between the results (X² = 0.725; p = 0.394) what suggests absence of serological cross reactivity.