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Page 1: James L. Schaller, MD, Naples Floridapersonalconsult.com/free/Checklists2012.pdf · In 2011 a new human Bartonella species was added to the over thirty-five Bartonella species currently
Page 2: James L. Schaller, MD, Naples Floridapersonalconsult.com/free/Checklists2012.pdf · In 2011 a new human Bartonella species was added to the over thirty-five Bartonella species currently
Page 3: James L. Schaller, MD, Naples Floridapersonalconsult.com/free/Checklists2012.pdf · In 2011 a new human Bartonella species was added to the over thirty-five Bartonella species currently
Page 4: James L. Schaller, MD, Naples Floridapersonalconsult.com/free/Checklists2012.pdf · In 2011 a new human Bartonella species was added to the over thirty-five Bartonella species currently

i

ChecklistsforBartonella,BabesiaandLymeDisease

2012Edition

J.L.Schaller,M.D.,M.A.R.andK.Mountjoy,M.S.

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INTERNATIONALACADEMICINFECTIONRESEARCHPRESSBankTowers•NewGateCenter(305)Highway41[TamiamiTrailNorth]

Naples,FL34103

Copyright©2012byJamesSchaller,MD,MARAllrightsreserved.

CoverDesign:NickBotnerResearch:RandallBlackwell,LindsayGibson,KimberlyMountjoy

LibraryofCongressCatalogingDataSchaller,J.L;Mountjoy,K.

ChecklistsforBartonella,BabesiaandLymeDiseasebyJ.L.SchallerandK.Mountjoy

ISBN978-0-9840889-5-9

1.Tickinfections2.Fleainfections3.Diagnosis

Note on Citation Style

Thestyleofthesereferencesvaries.Makingthemuniformwouldnotaddto the ability to locate a citation.Mostwere left as theyappearedwhenuncoveredfromawiderangeoflocations.

ManufacturedintheUnitedStatesofAmericaFirstEdition

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To those working to restore real and concrete liberty to the United StatesSpecifically, as the world’s top jailer, with 25% of the world’s

inmates in the USA, we are not the freedom nation, we are the PRISON NATION.

May God, conscience or peers, help sheriffs, police, child protectionworkers, judges and attorney generals to have real integrity,

balance and a heart of service.

In America the abuse of power in law enforcement and child services is now routine, and character, humility, kindness and wisdom

need to be restored.

If you are working to restore the rights of the poor, weak and falsely accused—this text and my affection are dedicated to you.

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Contents

BARTONELLAIntroduction...........................................................................1.Checklists...............................................................................3

Psychiatric.and.Neurological........................................3Dermatology.or.Skin......................................................5Eye.....................................................................................6Heart.................................................................................7General.Medical..............................................................7Possible.Laboratory.Findings........................................9Environment..................................................................10

Bibliography........................................................................13

BABESIAIntroduction.........................................................................65Checklists.............................................................................67

Psychiatric.and.Neurological......................................67Heart.and.Circulatory.System.....................................67Major.Organs.................................................................68General.Medical............................................................69Lab.Results.....................................................................71Reactions.or.Changes.in.Body.....................................73Environment..................................................................74

A.Word.on.Manual.Blood.Examinations........................76Bibliography........................................................................79

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LYME.DISEASEIntroduction.......................................................................105Checklists...........................................................................107

Laboratory.Testing—Indirect.and.Direct.................107Body.Examination.Results.........................................109

Sample.Neurological.Exam.................................. 110Patients’.Reported.Physical.History......................... 111

Psychiatric.and.Neurological............................... 111Major.Organs......................................................... 113Skin.......................................................................... 114Musculoskeletal..................................................... 114General.Medical..................................................... 115Environment........................................................... 117

Final.Words........................................................................ 119Bibliography......................................................................121

Dr..Schaller’s.Sample.Publications.................................159Disclaimer.and.Safety.Issues..........................................167Contacting.Dr..Schaller....................................................169

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The Bartonella ChecklistIncreasing Suspicion of an Emerging Stealth Infection

James L. Schaller, M.D., M.A.R.

Introduction

In2011anewhumanBartonellaspecieswasaddedtotheoverthirty-fiveBartonellaspeciescurrentlypublicallypublishedinGeneticDatabanks. Itwasdiscoveredandhighlightedby the talentedveterinarianresearcherEdwardBreitschwerdt.HehassaidthingsmoreclearlythantheideasIwasponderingin2005,whiledoingmostoftheresearchformyBartonellabook.Hesaidsimply,butwithdevastatingandhighlyusefulclarity, thatBartonella testing is terrible, the treatments are poor, it is typically found on the outside of red blood cells, and thecurrentresearchonBartonellaispathetic—onestudyatNIH.Ifthiswasnotenough,hesaidin2011, “Bartonella is carried by more vectors than any infection on the earth.” So it is hardly a backdoor “co-infection.”PerhapsLymeisthe“co-infection.”

Recently, the German researchers Kaiser and Riess summarizedBartonella research in this manner: after 2 decades of Bartonellaresearch,knowledgeontransmissionandpathologyofthesebacteriaisstilllimited.Bartonellaspecieshaveemergedtobeimportantpathogensinhumanandveterinarymedicine.

Whycreateachecklistwhenaphysiciancanjustorderanantibodytest?First,Ihavefoundattimes,Bartonellacanturnoffitsownantibodies,andthosecausedbyothertickandflea-borneinfectionsinhumans.Inastudyofsixty-oneBartonellainfecteddogs,PerezandMaggireportedrecently thatmostBartonella infected dogsdid not have detectable Bartonella antibodies.

ThecriterialistedbelowmayhavecausesunrelatedtoBartonella.Forexample,eachyearmorestudiesshowthepresenceofpolyinfections,andthisraisestheproblemofwhichinfectioniscausingwhatsymptom,sign or lab test change. For example,most tick infections can cause

1

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headacheorfatigue.Knowingwhichinfectionisthecausedoesbecomeclearifyouaredoingveryadvancedtreatmentsthataredesignedtokillonlyoneinfection.Thelimitationofthesepolyinfectionstudiesisthattypicallythetestingdetectionrateforeachtickorflea-borneinfectionisnotover95%forallpossiblespeciesandstrainspossiblyinfectinghumans.

However, since Bartonella can disable and kill healthy people, thechecklist below is set to catch virtually every infected patient.Thisis neither right nor wrong. Philosophy, sociology, presuppositions,medicalfashionandpsychologyusuallyallplayaroleinsettingcutoffsforadiagnosis.Allscienceisguidedbypresuppositions,andthatiswhyevenmathresearchisguidedbyawiderangeofvariables.In medicine, psychology, philosophical assumptions and sociology control all of medicinebutareunappreciatedduetoalackoftraining.See Kuhn’s The Structure of Scientific Revolutions exceptionally summarized at the following link: http://des.emory.edu/mfp/Kuhn.html

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ChecklistsforBartonella,BabesiaandLymeDisease 3

THE BARTONELLA CHECKLIST

James Schaller, M.D., M.A.R.

(Please Check Any Symptoms That Apply)

PSYCHIATRIC AND NEUROLOGICAL

£Currentanxietythatwasnotpresentatageten

£Currentdepressionnotpresentatagesixteen

£Knee-jerkemotionalresponsesworsethanpastdecadesandworsening

£Brainfog

£Depression

£Depressionthatisnotfullycontrolledonroutine anti-depressant doses,orhighdoseantidepressantsarerequiredtocontrolmood[Improvement of moodorbeing“lessdepressed”isnotsuccessfuldepressiontreatment.]

£Anxietyispoorlycontrolledwithaveragedosing

£Depressionispoorlycontrolledbyreasonabletreatmenttrials.

£Suicidalfeelingsorroutinethoughtsofdeath

£Crying

£Obsessivethoughtsorfearinexcessofevent

£Obsessivethoughtsthatintrudeintothemindwhichareinexcessofnormal

£Adecreaseinpleasure

£Rageworsewithtime

£Irritabilityworsewithtime

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£Impatienceisgreaterwhencomparedtotenyearsago[inachild--anyirritabilityinexcessofwhatiscommonformostchildrenwithanidenticalage].

£Cursingorhostilespeechthatisworseovertime

£Increasedaddictionsthatareveryresistanttotypicalrecoveryranges

£Increasedimpulsivityincontrasttopastyearsorpastdecades

£Severeneurologicaldisorderswithoutaclearcause

£Severepsychiatrictroublesthatdonotseemtofitwiththediagnosticcriteriaorthereistroublecontrollingsymptomswithtreatment

£Newphysical,emotionalorverbalabuseinthehomewhichwasnotpresentinthepast

£Panicattacksthatwerenotpresentattenyearsofage

£Anxietymedicationhastobeincreasedtovery high levelstocontinuepastbenefit

£Diagnosedashavingbipolardisorder,butdonotfitthecriteriawell

£Anypsychiatricdisorderthatalsoshowsmedical pathology in laboratory tests

£Restlessness

£Combativebehavior

£Aparent,grandparent,childorsiblingwithsuicideattempts

£Aparent,grandparent,childorsiblingwhohasstartedphysicalorextremeverbalfights

£Intermittentconfusion

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ChecklistsforBartonella,BabesiaandLymeDisease 5

£Seizures

£BrainlesionsseenonabrainscansuchasanMRIorCTofthehead

£Shorttermmemorydeficits

£Difficultyinlearningnewinformation

DERMATOLOGY OR SKIN

£Persistentrashesthatlastover3weeks

£Nodulesundertheskin

£Hyper-pigmentationordarkareasofskinwhichwerenotpresentatbirth

£Hypo-pigmentationorobviouslightareasofskin

£Unexplainedhairloss

£Spontaneousbreaksorholesintheskinassmallasamillimeter

£Skinulcerations

£Stretchmarksineccentriclocations,e.g.,arms,uppersideunderarmpit,aroundarmpitorontheback

£Stretchmarksfilledwithred,pink,purpleordarkbluecolorwhicharenotcausedbypregnancyorweightloss[remember,manywithmanypregnanciesorweightlossdonothave20stretchmarks]

£Anyskinmarkingsorgrowthsgreaterthanmostpeople

£Bloodvesselsorcoloronskingreaterthanmostpeople

£Redpapulesofanysize

£Skintagsincludingonesremovedbyadermatologistorshavedoff

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£Unusualbloodvesselsofanykindincludinginsideorganssuchasbladderorintestinalwalls

£Anyskinfindinginexcessof95%ofmosthumans

£Skinfindingsshowingincreasedbloodvesselsofanysize

£Skinfindingsshowingincreasedtissueformationthatisincreasedovertheflatnessofsurfaceskin[ThismaybeduetoBartonella,untreatedLymedisease,orbothinfectionsandsystemicinflammation]

£Skinshowingbloodvesselsthataretoolargeortoomanyforthe location of the blood vessels,e.g.,surfacethighandcalfskinwithverythicksurfacebloodvesselsorlegs,upperarmsorshouldershaveexplosionsofmanyfinebloodvessels

£Burningskinsensations[thismayhavemanycauses].

£Itchingwithoutaclearcauseandwhichishardtocontrolandremove

£Skinerosionwithoutaclearcausesuchasafire,fallorchemicalburn

£Minorcutsorscratcheswhichhealslowly

£Veryslowhealingafterasurgery

£“Granulomas”orballsoftissue

£Formicationorfeelingsofbeingbittenbybugsorbugsensationsonskinwithnobugsontheskin

EYE

£Retinainfection

£Retinainfarctordeadtissueinthebackoftheeye

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ChecklistsforBartonella,BabesiaandLymeDisease 7

£Neuroretinitisorinflammationoftheretinaandopticnerveinthebackoftheeye

£Uveitisorinflammationofthemiddlelayeroftheeyeortheinterioreye

£Papilledemaorswellingoftheopticnerveasitentersthebackoftheeyeduetoraisedintracranialpressure

£Stellatemaculopathy

£Acuteblurredvision

£Suddenand/orsignificantchangeinvision

HEART

£Endocarditisorinflammationoftheheart

£Heartvalvepathology

£Enlargementoftheheart

£Anyamountofdeadcardiactissue

£Arrhythmiasoftheheart

£Palpitationsunrelatedtopanicattacks

GENERAL MEDICAL

£Sleepmedicationstake90-120minutetotakeeffectinsteadof30minutes

£Insomnia[Ifprofoundfatigueispresent,thismightnotapply]

£Atemperatureunder98.3inasickperson.Atemperatureunder99.0ifLymediseaseorBabesiaisalsopresent

£Anuncomfortableinfectioninthebodywithnodiscerniblecause

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8 BartonellaChecklist•SchallerandMountjoy

£Gastroesophagealrefluxdisease(GERD)

£Diarrhea

£Colitisoraninflammationofthecolon

£Liverenlargementwithnoclearcause

£Bloodvesselproliferationorincreasednumbersinanyinternalorgans

£Lesionsorwoundswithnoclearcause

£Asorethroatwithnootherclearreason

£Apersistentsorethroatinhumidityinexcessof45%[lowhumiditydriesoutthroattissue]

£Gingivitisorbleedingduringflossing

£Unusualdiscomfortonthesolesofthefeetespeciallyinthemorning

£Puffytissueoninsoleoranypartofankles

£Ankle“edema”orexpandedtissuethatdoesnotpitwhenpressed[becauseitisexpandedtissueandnotmerelyfluid]

£Bonepain

£Inflammationoftheouterbonesurfaceorosteomyelitis

£Jointpain[thiscanbealsoduetoLymediseaseandmanyothermedicalproblems]

£Musclepain[thiscanbealsoduetoLymediseaseandmanyothermedicalproblems]

£Medicalproblemsdescribedas“idiopathic”(ofunknownorunclearcause)

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ChecklistsforBartonella,BabesiaandLymeDisease 9

£Presenceoftwotickorfleainfectionswithtwopositivetickorflea-borneviruses,bacteriaorprotozoa.

Aspreviouslymentioned,Bartonellahasmorethan30publishedspeciesin public genetic databases and has more vectors than possibly anyinfectionintheworld.Therefore,thepresenceofotherinfectionssuchastick-borneviruses,bacteriaorprotozoa,shouldraisesuspicion.SomeoftheseincludeBabesia,STARI(Masterson’sDisease),Neoehrlichia,Anaplasma, Lyme disease,Mycoplasmas,Q Fever, RockyMountainspotted fever (Rickettsia), tick-borne relapsing fever, Tularemia(bacteria),Ehrlichia,ProtozoaFL1953,andvirusessuchasCMV,HHV-6,CoxsackieBTypes1,2,3,4,5,6,ParvoB-19orPowassan.

POSSIBLE LABORATORY FINDINGS

£IL-6isverylow.

£IL-1Bisverylow.

£TNF-alphaisinlower10%ofnormalrange.

£VEGFisabovethenormalrange[however,ifBabesiaispresentorbeingtreatedtheVEGFwillfallintonormalorabnormallowlevels].

£X-rayofthebonemayshowareasofboneloss.

£BiopsiesoflymphnodesarenegativeforMycoplasmaandnoclearevidenceofotherinfectionsorillnessesarefound

£Biopsiesoflymphnodesappearingsimilartosarcoidosis

£Tissuebiopsieswhichareabnormalbutwithnoclearcauseoftissueproblems

£AswabofafreshscratchorbiteskinlesionispositiveforBartonella.

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ENVIRONMENT

£Exposuretocatsanddogsinexcessofveryincidentalrarecontact

£Exposure to cats and dogsthathavebeenstraysorgooutside[reviewsofhundredsofprofessionaljournalarticlesmakethisariskinanunknownpercentage]

£Ticksorfleasarefoundonanypetyoucontact

£Thepatient’smotherissuspectedofhavingBartonellabasedonnewerdirectandindirect testing.

£Asibling, father, spouse or childwithanytickorflea-borneinfectionwhosharedwiththepatientaresidenceorvacationlocationwithproximitytobrush

£Outdoorexposuretooutdoorenvironmentssuchasbrush,wildgrasses,wildstreamsorwoodswhichhappenedwithouttheuseofDEETonskinandPermethrinonallclothing(It only takes one exposure to get a bite.Ifyouusedprotection“mostofthetime,”youwerestillexposed.)

£Exposuretolice

£Fleabitesorfleaexposure

£Exposuretopetsthatareexposedtoticksorfleas

£Ascratchfromacat

£Abitefromacatordog

£Exposuretobitingflies

£Hunting,livingorvacationingneardeerorsmallmammals

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ChecklistsforBartonella,BabesiaandLymeDisease 11

£Clearexposuretoanytypeoftick.[Bartonellaiscarriedbyahugenumberofcarriers,butfornow,thepercentthatcarryBartonellaisnotknown.Further,thecapacitytodetectallnewspeciesinthevectorsorinhumansinfecteddoesnotexistorisnotroutinelyavailableindirecttestingofallhumaninfectiousBartonellaorganismsinbothlargeorspecialtylabs].

£Ticksfoundonyourclothing

£Ticksfoundonyourskin

£Ticksfoundinyourhomeorcar,vacationspotorrecreationarea

IfonereadsthemajorityofBartonella journalarticles, itseemsclearBartonellaharmsthebodyinhundredsofways.Butforourpurposesindiagnosis, theabovecriteriashouldbeenoughtopreventamisseddiagnosis. More criteria exist. Certainty claims or criticism aboutBartonellapositionswithoutreadingatleastof1,000articlesisconfusing.HowisthispossiblewithnewBartonellafindingsandunderstandingseachmonth?Therearealsonewspecieswhosegeneticsequencesshowtheiruniquenessalmosteverymonthinpublicdatabases.Inthisspirit,thisscaleismeantmerelytoincreasesuspicionofBartonella,whichisasuperstealthinfectionthattakesperhapsfiftydaystogrowoutonsomebacteriagrowthplates,andfloatsinthebloodasitlowersfevers.Italsoclearlysuppressessomekeyimmunesystemfightingchemicals.Cureclaimsmadewithouttheuseofindirecttesting,markedlydocumentedinsuperiorjournals,shouldbeexaminedfurthertoproveeffectiveness.

Dr. Schaller is the author of 30 books and 27 top journal articles.His publications address issues in at least twelve fields of medicine.He has the most recent textbook on Bartonella. He has published on Bartonella under the supervision of the former editor of the Journal of the American Medical Association (JAMA), and his entries on multiple tick and flea borne infections, including Bartonella [along with Babesia and Lyme disease] were published in a respected infection textbook endorsed by the NIH Director of Infectious Disease.He has seven texts on tick and flea-borne infections based on his markedly unique full-time research and study practice, which is not limited to either finite traditional or integrative progressive

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12 BartonellaChecklist•SchallerandMountjoy

medicine. Dr. Schaller has read on these emerging problems for many years.

Copyright © 2011 JAMES SCHALLER, M.D., M.A.R. version 19.

This form cannot be altered if it is printed or posted in any manner without written permission. Posting a negative evaluation is forbidden. Printing to assist in diagnostic reflections is encouraged, as long as no line is redacted or altered including these final paragraphs. Dr. Schaller does not claim this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional. All translations are permitted.

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ChecklistsforBartonella,BabesiaandLymeDisease 13

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AbererE.Lymeborreliosis--anupdate.JDtschDermatolGes.2007May;5(5):406-14.[ArticleinEnglish,German].JDtschDermatolGes.2007May;5(5):406-14.PMID:17451386

AbuzeidWM,RuckensteinMJ.Spirochetesinotology:arewetestingfortherightpathogens?OtolaryngolHeadNeckSurg.2008Jan;138(1):107-9.PMID:18165003

AccorintiM.Ocularbartonellosis.IntJMedSci.2009;6(3):131-2.Epub2009Mar19.PMID:19319232

AdamskaM.[Bartonellaspp.asazoonoticpathogenstransmittingbyblood-feedingarthropods].[ArticleinPolish].WiadParazytol.2010;56(1):1-9.PMID:20450002

Aguero-RosenfeldME,WangG,SchwartzI,WormserGP.Diagnosisoflymeborreliosis.ClinMicrobiolRev.2005Jul;18(3):484-509.PMID:16020686

Al-AttarN,RuimyR,BaronF,HvassU.Bartonellaendocarditiscomplicatingcongenitalheartdisease.BMJCaseRep.2009;2009.pii:bcr06.2008.0092.Epub2009Mar17.PMID:21686936

AlvesAS,MilhanoN,Santos-SilvaM,SantosAS,VilhenaM,deSousaR.EvidenceofBartonellaspp.,Rickettsiaspp.andAnaplasmaphagocytophilumindomestic,shelterandstraycatbloodandfleas,Portugal.ClinMicrobiolInfect.2009Dec;15Suppl2:1-3.Epub2009Mar26.PMID:19416279

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14 BartonellaChecklistBibliography•SchallerandMountjoy

AngCW,NotermansDW,HommesM,Simoons-SmitAM,HerremansT.Largedifferencesbetweenteststrategiesforthedetectionofanti-BorreliaantibodiesarerevealedbycomparingeightELISAsandfiveimmunoblots.EurJClinMicrobiolInfectDis.2011Aug;30(8):1027-32.Epub2011Jan27.PMID:21271270

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AngelakisE,LepidiH,CanelA,RispalP,PerraudeauF,BarreI,RolainJM,RaoultD.HumancaseofBartonellaalsaticalymphadenitis.EmergInfectDis.2008Dec;14(12):1951-3.PMID:19046532

AngelakisE,PulciniC,WatonJ,ImbertP,SocolovschiC,EdouardS,DellamonicaP,RaoultD.ScalpescharandnecklymphadenopathycausedbyBartonellahenselaeafterTickBite.ClinInfectDis.2010Feb15;50(4):549-51.PMID:20070235

AngelakisE,RouxV,RaoultD,RolainJM.Real-timePCRstrategyanddetectionofbacterialagentsoflymphadenitis.EurJClinMicrobiolInfectDis.2009Nov;28(11):1363-8.Epub2009Aug14.PMID:19685089

Arav-BogerR,CrawfordT,SteereAC,HalseyNA.CerebellarataxiaasthepresentingmanifestationofLymedisease.PediatrInfectDisJ.2002Apr;21(4):353-6.PMID:12075773

ArvandM,RaoultD,FeilEJ.Multi-locussequencetypingofageographicallyandtemporallydiversesampleofthehighlyclonalhumanpathogenBartonellaquintana.PLoSOne.2010Mar19;5(3):e9765.PMID:20333257

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ChecklistsforBartonella,BabesiaandLymeDisease 15

AtamanyukI,RajaSG,KostolnyM.Bartonellahenselaeendocarditisofpercutaneouslyimplantedpulmonaryvalve:acasereport.JHeartValveDis.2011Jan;20(1):94-7.PMID:21396492

BaconRM,BiggerstaffBJ,SchrieferME,GilmoreRDJr,PhilippMT,SteereAC,WormserGP,MarquesAR,JohnsonBJ.SerodiagnosisofLymediseasebykineticenzyme-linkedimmunosorbentassayusingrecombinantVlsE1orpeptideantigensofBorreliaburgdorfericomparedwith2-tieredtestingusingwhole-celllysates.JInfectDis.2003Apr15;187(8):1187-99.Epub2003Apr2.PMID:12695997

BakkenJS,DumlerJS.Clinicaldiagnosisandtreatmentofhumangranulocytotropicanaplasmosis.AnnNYAcadSci.2006Oct;1078:236-47.PMID:17114714

BallR,ShadomySV,MeyerA,HuberBT,LeffellMS,ZacharyA,BelottoM,HiltonE,Bryant-GenevierM,SchrieferME,MillerFW,BraunMM.HLAtypeandimmuneresponsetoBorreliaburgdorferioutersurfaceproteinainpeopleinwhomarthritisdevelopedafterLymediseasevaccination.ArthritisRheum.2009Apr;60(4):1179-86.PMID:19333928

BarbierF,FournierPE,DaugeMC,GallienS,RaoultD,AndremontA,RuimyR.BartonellaquintanacoinfectioninStaphylococcusaureusendocarditis:usefulnessofscreeninginhigh-riskpatients?ClinInfectDis.2009May1;48(9):1332-3.PMID:19344260

BatyG,LanotteP,HocquelouxL,PrazuckT,BretL,RomanoM,MereghettiL.[PCRrDNA16Susedfortheetiologicaldiagnosisofbloodculturenegativeendocarditis].[ArticleinFrench].MedMalInfect.2010Jun;40(6):358-62.Epub2009Sep30.PMID:19796889

BaylissDB,SteinerJM,SucholdolskiJS,RadeckiSV,BrewerMM,MorrisAK,LappinMR.SerumfelinepancreaticlipaseimmunoreactivityconcentrationandseroprevalencesofantibodiesagainstToxoplasmagondiiandBartonellaspeciesinclient-ownedcats.JFelineMedSurg.2009Aug;11(8):663-7.Epub2009Jun26.PMID:19560385

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16 BartonellaChecklistBibliography•SchallerandMountjoy

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ZhongJ,SkouloubrisS,DaiQ,MyllykallioH,BarbourAG.Functionandevolutionofplasmid-bornegenesforpyrimidinebiosynthesisinBorreliaspp.JBacteriol.2006Feb;188(3):909-18.PMID:16428394

ZobbaR,ChessaG,MastrandreaS,PinnaParpagliaML,PattaC,MasalaG.SerologicalandmoleculardetectionofBartonellaspp.inhumans,catsanddogsfromnorthernSardinia,Italy.ClinMicrobiolInfect.2009Dec;15Suppl2:134-5.Epub2009May18.PMID:19456814

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64 BartonellaChecklistBibliography•SchallerandMountjoy

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ChecklistsforBartonella,BabesiaandLymeDisease 65

The Babesia ChecklistImproving Detection of A Common,

Emerging Stealth Infection

James L. Schaller, M.D., M.A.R.

Introduction

Below are examples of signs, symptoms and indirect ways to helpincrease the diagnosis of Babesia.An examination of public geneticdatabasesshowsthatwelloverthirty-fivespeciesexist,manyofwhichhavevariants.

Please note that an unknownpercentage of people infectedwith thissinglecelledparasitehavenosymptoms,atleastformanyyears.

ThischecklistisnotmeanttobeusedasadefinitivetooltodiagnoseBabesia.Itismyexpertopinionthatnodefinitive100%oreven98%accuratetoolexists.

Mygoalismerelytodecreaseillnessinthosepeoplewhoarepositivebutdonotshowupaspositiveonabasicdirecttest(falsenegative).

Indeed,itisnotuncommonforapatientwithBabesiatopresentwithanegativetestresultovertentimes,regardlessofthelaboratory,andthentoshowupwithapositiveonDNAtestingwhenexposedtotwoorthreetreatmentsagainstprotozoaforthreedays,ortohavenewconversionfrom negative to positive antibody testing six weeks after a similarprovocationtrial.

I do not oppose or endorse such approaches, but feel it necessary tomentionthatthesameoutcomehasoccurredwith“Malaria-prevention”treatment.Additionally, there have been instances in which the useofherbs,suchasartesunate,forcancerprevention,hasresultedinanunintendedoutcome: theconversionofaBabesiaantibody titer fromnegativetopositive.

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Having authored four books on the topic of Babesia, I have createdthisscalebasedonyearsoffull-timereadingandapassiontoadvancedetection. Thischecklist ismeant toprevent falsenegatives: somepatients who appear to be negative may not actually be negative. Ihavedonethisbecausemyyearsoffull-timereadingandresearchhaveshownmethatmissingthisparasitefor5,10,30or50yearsisfarmoredangerousthancarefultreatment.Treatmentsideeffectsarelowifthetreatmentisstartedat20% of the suggested dose.

I would appeal to you that one cannot be considered an expert intreatingthispotentiallyfatalinfectionbymerelyreadingafewarticlesorguidelines.Norisexpertiseacquiredbydiagnosingandtreatingthehighlyobvious,immenselyill,sickest1%ofpatientsasthe“norm”inBabesiadiagnosis.Expertiseshouldrequireat least areviewof1500articlesover fiveyears.The fact thatparasite textbooksusuallyoffermerely1-2pagesaboutthisinfectionshowsthatitisnotmasteredorunderstoodevenbythoseinterestedinparasites.

ThecureofBabesiadoesnot fitaset formula,butnooneshouldbehopeless about reaching a full recovery. I have currently started anew, research-based, creative thinking textbook on optimal Babesia treatmentsforpublicationin2012.Itwilldiscussfamiliartreatmentsandofferideastomaximizetheseoptions,butIwillalsoadddiscussionsonneweroptionsforpatientsandclinicianswhoarenotsatisfiedwiththecurrentoptions.

Insummary,howcananycertainmedicalorscientificBabesiapositionexist, when new species, sub-species or variants that infect humansareroutinelyemerging,andforwhichthereisnotevenadirecttest—regardlessofsensitivity?

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ChecklistsforBartonella,BabesiaandLymeDisease 67

THE BABESIA CHECKLIST

James Schaller, M.D., M.A.R.

(Please Check Any Symptoms That Apply)

PSYCHIATRIC AND NEUROLOGICAL

£Family,friendsorothersreportyoulooktiredorfoggy

£Slowedthinking

£Psychiatriclabel(s)giventoachildorrelativeforalltheirtroubleswhenclearmedicalproblemsexistasshownbyabnormallaboratoryresults(Iamnottalkingaboutbasicorganfailurelabs,buttheuseofwide testing which includes inflammation and anti-inflammation chemicals, hormones, nutrient levels, and other immune system chemicals)

£Enlargedlymphnodes(butalsoinLyme,Bartonella,otherinfections,highinflammation,tumorsandotherdiseases)

£Braintroublessuchastroublekeepingupwithpastroutinelifedemands,latenessduetotroublewithmotivationandorganization,andtroublewithconcentration[Anyofthesewouldbeapositive]

£Memorytroubles[thisisnotspecifictooneinfectionoronediseaseprocess.Forexample,exposuretoindoormold’sbiologicalchemicalscandecreasememorywithinanhourdependingonthespeciesmix.]

£Profoundpsychiatricillnesses[thisisnotlimitedtoasingleinfection.]

HEART & CIRCULATORY SYSTEM

£Asuddenlossofbloodpressure

£Transfusionsusingbloodthatisnotyourown

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£Anemiaevenifanon-infectiouscausehasbeenproposed

£Anemiawithoutaclearexplanation

£Severechestwallpains

£A“heartattack”beforetheageof55(whenyouhavethreeriskfactors)

£A“heartattack”orinfarctoftheheartbeforetheageof60yearsold,withonlyoneriskfactor.[Beingmaleisconsideredariskfactorformany.Menexperienceheartdamagesoonerthanwomen.Otherriskfactorsincludetobaccouseorexposure,suchassecondhandsmokeathome,diabetes,highbloodpressure,highlevelofstickycholesterolsuchasLipoprotein(a)orhightriglyceridelevels,familyhistoryofheartattacks,limitedphysicalactivity,Obesity(mightbedefinedaswearingpantsover39inchesifyouareamanandover34inchesifyouawomanorabodyfatorbodymassindexof30orhigher),excessangerorroutinepoorhandlingofstress,andabuseofstimulantdrugssuchascocaineoramphetamines.Iwouldaddahomocysteinelaboratorylevelover10,majordepression,novitaminK2supplementation,afreedihydrotestosteroneinthe10thpercentileorlower,fragmentedorpoorsleep[whichincreasesinflammation],ahighC4aRIA,aMMPIinexcessof300andalowVIPbloodlevel.

MAJOR ORGANS

£Ayellowhueoneyes,handsandskin(jaundice)withnootherclearcause

£Anenlargedliver(whichsitsunderyourrightribcage)

£Anenlargedspleen(underyourleftribcage).This is falsely believed to be a common human sign; actually it is very rare.

£Arupturedspleen[rarebutitgetsfastmedicalattentionandthereforeisover-representedinmedicalarticles]

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£Darkurine[thisisrarerthansomearticlesintimate]

£Aninabilitytourinate

£Shortnessofbreath[noclearasthma,pneumonia,COPDorothercommoncause]

£Pulmonaryedemawhichisahighamountoffluidintheairsacsofthelungs,whichleadstoshortnessofbreath

£Astrokeofanysizeorinanyorgan(thewordstrokemeanstissueisunabletogetoxygen).Thestrokeorinfarctcanbeinthebrain,retina,kidney,heartandmanyothertissues.

£AnMRI,CTorotherimagingstudythatshowsdeadtissueinanyorganwithnoknowncause

GENERAL MEDICAL

£Headacheswithnoclearcause

£Headacheswhicharehardtocontroland/orsevere

£Headacheslastingoverthreeyearsandwhichincreaseinpaindespitetreatments

£Weightgaininclearexcessofdietandexercise

£Weightlosswithreasonableeatingandaverageexercise

£Excessfatinlowerbellyareathatisinexcessoflifestyleandactivity

£Anorexiaoradecreaseinappetite

£Anydecreaseinappetite

£Apoorappetite

£Fatigueinexcessofthatexperiencedbymostpeopleinthesameagerange

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£Fatiguethatproducesneedforsleepinexcessof8½hoursdaily

£Fatiguewithongoinginsomnia[considerthepossibilityofbothBartonellaandBabesiainthiscase]

£Daytimesleepurgencydespitenighttimesleep

£Nightsweats

£Excessiveperspirationduringnormaldailyactivity

£Hotflashesinanormaltemperatureroom

£Intermittentfever

£Chills

£Anyfeverinexcessofthreedays

£Spikeofafeverover100.5afterapossibletickbite

£Listlessness

£Swellinginlimbsandotherpartsofbody

£Wavesofgeneralizeditching[thissignofinfectionandinflammationisnotlimitedjusttoBabesia.]

£Lumpsorothertypesoftissuecollectionwithnoclearcause[Othertickandflea-borneinfectionscanalsocausethesegrowths.]

£Wastingmuscles

£Thegeneralwastingawayofbodytissuethatisvisible

£Profoundbonelossinmarkedexcessofthatexpected at given age

£Excessbreasttissueinamanorboy

£Randomstabbingpains

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£Nauseaorvomiting

£Anyenhancedsense:sensitivitytolight,touch,smells,tasteorsound

£Asenseofimbalance

£Oneormoremedicalproblemswithunclearcause(s),withchangingorcontradictorydiagnoses,orwhichareeventuallycalled“idiopathic”

£Twotickorfleainfectionswithtwopositivetickorflea-borneviruses,bacteriaorprotozoa.Thepresenceofotherinfectionssuchastick-bornevirusesorbacteriaraisessuspicionofaBabesiainfection.

£Thepresenceofoneormoremysteryillnessesafteranevaluationbythreequalityphysicians

LAB RESULTS

£EosinophilCationicProtein(ECP)levelisintop15%ofnormal.Thisisalteredinperhaps15-20%ofBabesiapatients.

£TheECPlevelisabovenormal.(Otherthingscanincreasethislab,butitisanerrorthataBabesiainfectionisnotontheselists).

£TheECPlevelincreases30%ormoreinresponsetoaprotozoakillingmedicationinserialtesting.(Thistestisabout40-60%sensitiveandmanypatientshavenochangeinthislabevenwitheffectivetreatment).

£TheECPlevelisbelowdetectablelevels.

£AbsoluteEosinophilsintheloworhighrange[thisisnotdefinitiveinanymanner,butisausefultool.]

£ApercentageofEosinophilsinlowrangeorhighnormalrange

£VeryhighEosinophils[rarewithBabesia,butotherfindingssuggestotherpossiblecauses]

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£AnormalorlowVEGFlabresultinthepresenceofBartonella

£ATNF-alphainexcessof1.0inthepresenceofBartonella

£ACD57orCD57/8levelthatdropsrightafterthestartofaBabesiatreatment,orwhichfallssteadilywithongoingBabesiatreatment

£Hemolyticanemiawithlabtestshowingpositivebloodproductsinyoururine[thisisnotaroutinefinding.]

£YourclinicianunderstandstheuseofindirecttestingandfeelsyourlabpatternissuggestiveofthepresenceofBabesia.ThisinvolvesmorethananECPspike.

£SincedirecttestingforBabesiabyanylabmissesmanyhumanspeciesandisofvariablereliability,andthecommonpresenceofBartonellasuppressessomeantibodytests,apositiveor“indeterminate”islikelyapositive.Haveyouhadan“indeterminate”or“borderline”Babesiaresult?

£Bilirubinabnormality[elevatedinperhaps5%ofpatients]

£Ironabnormalitiesinexcessofnormal[highorlowlevels.Thefindingofgeneticdiseasethatincreasesironpathologydoesnotnecessarilyruleoutthisfinding.TheironpathologycanbegeneticoracquiredillnessplusBabesia[SeemyHEScancercurepaperinMedscapeinwhichthecancer-likeeosinophilswereprimedbyBabesia].

£AfterBabesiatreatmentwithclearprotozoakillingagentsusedalsotokillmalaria,IL-6movesfromverylowtoanincreasedlevel.

£AfterBabesiatreatmentwithclearprotozoakillingagentsusedalsotokillmalaria,IL-1Bmovesfromverylowtoanincreasedlevel.

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£Babesiacreatesandprovokeschangesinthehumanbodychemistry.TestsarebeingdesignedtoidentifychemicalsonlymadebyBabesia.AsampleisBabesiamicrotisecretedantigen1(BmSA1).

£AnypositiveEpstein-Barrvirusoverthenormallowlevel.Youmayhaveaninfection,infections,orinflammation.ItisnotmerelyfoundinBabesia.[Thisisnotaroutinecauseoffatigue].

£Autoimmunitytestingispositive.Thisisastrongerpositiveiftherearetwoautoimmuneresults.Forexample,apatienthasapositiveANAandhasantibodiesagainsttheirthyroidsystem.

£Positivelaborskintestingplacingpatient’sfoodsensitivityintop5%ofpopulation

£Elevatedmonocytes

£Elevatedneutrophilswithnoclearinfectionsource

£ElevatedC-reactiveprotein

£ElevatedD-dimer

£AnabnormallyhighALTwhichisaliverenzymeincreasedbylivertrauma,toxinsorinfectionssuchasBabesia[ararefinding].

£Lymphocytopenia—lowlymphocyteswhichareatypeofinfection-fightingwhitebloodcell

£Thrombocytopenia—plateletnumberunder50,000

£AhighlactatedehydrogenaseorLDH.Thisenzymemeasurestissuedamageparticularlyfoundintheheart,liver,kidney,skeletalmuscle,brain,bloodcellsandlungs.

REACTION OR CHANGES IN BODY

£ReacttoanyderivativeofArtemisia(SweetWormwood).*Note:thereactiondoesnotneedtolastmorethanadayandanyimmediatestomachachesorloosestoolsdonotapply.

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£Reacttoamalariadrug.Forexample,ativoquone(Mepron),proguanilaloneorwithativoquone(Malarone),artesunate,day1-3ofartemesinin,anewhighdoseofartemesininDay1-2,artemeter,Alinia,clindamycin,quinineorazithromycinat2,000mg/dayorallyoratanydoseIVforfivestraightdays.(ItrequiresprofoundwisdomforacliniciantodistinguishbetweenasideeffectandareactioncausedbyaneffectiveBabesiatreatment.Forexample,insomniacausedbythesyntheticdrugLariumismeaningless,sinceLariumhasthisasasideeffectinuninfectedpatients.Butfatigue,insomniaorsevereheadacheresultingfromateaspoonofativoquone(Mepron)ondayoneareverysuspicioussymptomsforaknownprotozoanlikeBabesiaorMalariaorothersimilarinfectionsthatarenewlyidentifiedgenetically).

£MoodchangeswithanyherbordrugthatkillsprotozoalikeBabesia,withtheexceptionofLarium

£Muscleachesorjointaches/pain,especiallyworseafteruseofaprotozoakillingmedicinesuchasproquanil,Alinia,ativoquone,clindamycin,oroneofmanynewemergingprogressivenaturalmedicineorsyntheticmalariadrugtreatments

£Insomniaaftertakingamalariakillingherbordrug

£Anxietyand/ordepressionaftertakingamalariakillingherbordrug

£Rageortemporarypersonalityregressionrightafteruseofamalariakillingherbormedication,e.g.,ativoquone,Malarone,proguanil,artesunate,day1-3ofartemesinin,artemeter,Alinia,clindamycinorazithromycinat2,000mg/dayorallyoratanydoseIVforfivestraightdays.

ENVIRONMENT

£Pets,farmanimalsorlocalrelativeswithANYclinical symptomsofatick-bornevirus,bacteriaorprotozoainfectionwithoutacleardiagnosis

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£Thepatient’smotherissuspectedofhavingorhasbeendiagnosedwithBabesia,STARI(Masterson’sDisease),Neoehrlichia,Anaplasma,Lymedisease,Mycoplasmas,QFever,RockyMountainspottedfever(Rickettsia),tick-bornerelapsingfever,Tularemia(bacteria),Ehrlichia,ProtozoaFL1953,orvirusessuchasCMV,HHV-6,CoxsackieBTypes1,2,3,4,5,6,ParvoB-19orPowassan.

£A sibling, father, spouse or childwithanytickborneinfectionwhosharedaresidenceorvacationwithproximitytobrush(woodedarea)

£Exposuretooutdoorenvironmentswithbrush,wildgrasses,wildstreams,golfcoursesorwoodsin excess of ten minutes in any location lived in or visited

£Pet(s) or family animalsofanytype,e.g.,horses,havehadoutdoorexposurestoareaswithbrush,wildgrasses,wildstreamsorwoods.Ifthepetswereanimalssuchasdogs,whichcanbegivenanti-tickandfleatreatments,weretheseanimalsalwayson schedulewiththesetreatments?

£Clearexposuretoticksinyourcurrentorpasthomes

£Clearexposuretoticksduringvacationsorothertravels

£Haveyoueverhadanytypeoftickbite?

£Haveyoueverfoundatickonyourclothing?

£Haveyoueverfoundatickonyourbody?

£Haveyoubeenwithothersatalocationinwhichtheyhadticksontheirclothingorskin?

£Sexualcontactisadebatedformofcommunicationofsometickandfleaborneinfections.Ihavenoposition.Isolationinabodyfluiddoesnotmeanthatisaroutetospreadtheinfection.Ifyouandyourhealerfeelthisisapossiblerouteofinfection,hasthepatienthadintimatecontactwiththesharingofbodyfluidswithaninfectedperson?

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£Youliveinastatethathasreportsofanytick-borneinfectioninover40people.[Currently,thiswouldusuallybeLymediseaseonly].

£Youlivenexttoastatethathasreportsofanytick-borneinfectioninover60people.[Currently,thiswouldusuallybeLymediseaseonly].

£Manysmallmammalslivenearyourhome,exerciselocation,vacationlocationsorwork.

A WORD ON MANUAL BLOOD EXAMINATIONS

NobloodsmearwillbepositiveforBabesiaunlessyouhaveaprofoundnumberof infectedredbloodcells. This isveryrare. Therefore,no blood smear should be considered negative unless it has been examined for at least thirty minutes. While a 2-3minute examof largewhite blood cellsmaybe fully sufficient to identify cancersand other diseases, a search for over eighty Babesia red blood cellpresentationsunder1000x,as found inmybook,Hematology Forms of Babesia,requiresatleastthirtyminutes.Unfortunately,inpatientspositiveforBabesia,routinemanualredbloodsmearexamswithaclearrequesttolookforBabesiaunderamicroscopeat1,000xmagnificationhavemissedtheBabesiaatleast98%ofthetime.Inpapersreportingclearly visualizedBabesia in blood smears the patients tend to haveimmenseinfection,i.e.,over3%ofredbloodcellsareinfected.

However,ifoneprivatelycontractswithamicrobiologist,pathologistor can get a lab director to allow their staff to spend the extra time,thepositiveresultsonthebloodsmearincreasewithclearlypositivelyinfectedpatients. Iknowmostlaboratoriesareveryoverworked,butthenotion that ablood slide isgoing to showanobvious tetrador aclassicXpatternisanerror.Usingslidesfromrespectednationalorstatesources,Ifoundonlybyverycarefulexam,overfiftypresentationsofBabesiathatareusuallymissed.Indeed,inmytextbookonBabesiaimagesmostoftheshapeshadneverbeenpublished.Nooneinhistoryhadevertakenthetimetolookcarefullyat200slidesandrecordeach

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uniqueshape.Itisfairlystunningtowritethisandconfirmsthatmanytickandfleainfectionsareclearlyemergingandnotyetmastered.

Pleaseappreciatethatstainshelpdefinewhetherasubstanceiswhatitappearstobe. Forexample,someinthealternativemedicineschoolfeelthatCandidaisabadpresenceintheintestinesandfeelitoftengetsintothebloodthroughdefectsintheintestinalwall.WhileCandidaisnotagoodpresencefortheintestine,IhavefoundthatsomebloodsampleswithitemsthatlooksignificantlylikepartsofCandidadonotstainforcelluloseandothercomponentsofyeasts.Mypointisthatinthelasttenyears,indiscussionsorstudy,excellentpathologistsandmicrobiologistshaveshownmetheclearreasonhumanityhasdevelopedhighlysophisticatedstainingtechniques--theycanbediagnosticandverycosteffective.AndsomemedicalscientistsareaddingnewtechnologytoBabesiaidentification(discussedinmyBabesia 2009 Update andmyHematology of Babesiatext).

Babesiaisanemerginginfection. AnycertaintyclaimsorcriticismaboutBabesiapositionswithoutextensiveresearchandover200hoursof reading ispremature. Again,newBabesia speciesareemergingeveryone to fourmonths. Indeed,evenanewprotozoanhasbeenfound that looks likeBabesia under a highpoweredmicroscope, butwhenitisgeneticallysequenceditisnotBabesiaorimmaturemalaria,whichcanlooksimilar. ItisanewinfectionandispresentlycalledFL1953andwasgeneticallysequencedbyDr.EllisandDr.Fry.ItlookslikeBabesia,butisnotBabesiagenetically.

Therefore,sincehumanBabesiaisanewemergingillness,thisscaleismeantmerelytoincreaseawarenessofBabesia,aninfectionthatcankillpatientsofanyage.WritingsinthepastfifteenyearshaveeitherseenBabesiaasamere“co-infection”orafootnoteofaspirocheteinfection[i.e.,Lyme].Anythingthatcanhideforacoupleofdecades,andthenpossiblykillyouwithaclot inyourheart,brainor lungsorbyothermeans,isnotacasualinfection.

Babesia cure claims should bemadewith the use of indirect testingbirthedfromextractsofsuperiorjournalsreadaminimumoffiveyears.Currently,thesemanywell-establishedindirectlabtestpatternsarenot

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78 BabesiaChecklist•SchallerandMountjoy

usedorunderstoodby immenselybusyand smart cliniciansworkingfull-time.Whilethisisfullyunderstandable,Ihopeitmaychangeinthecomingdecade.

Dr. Schaller is the author of 30 books and 27 top journal articles. His publications address issues in at least twelve fields of medicine.

He has published the most recent four textbooks on Babesia.

He has published on Babesia as a cancer primer under the supervision of the former editor of the Journal of the American Medical Association (JAMA), and his entries on multiple tick and flea-borne infections, including Babesia [along with Bartonella and Lyme disease], were published in a respected infection textbook endorsed by the NIH Director of Infectious Disease.

Dr. Schaller has produced seven texts on tick and flea-borne infections based on his markedly unique full-time reading and study practice, which is not limited to either finite traditional or integrative progressive medicine. With a physician’s medical license, he has been able to sort through many truth claims by ordering lab testing. He does not casually follow the dozens of yearly truth claims, without indirect testing laboratory proof. He has read full-time on these emerging problems for many years. He is rated a TOP and BEST physician (in the top 5 percent of doctors) by both physician peers and patients.

Copyright © 2011 JAMES SCHALLER, M.D., M.A.R. version 49.

This form may not be altered if it is printed or posted, in any manner, without written permission. Posting a critical or negative evaluation is forbidden. Printing to assist in diagnostic reflections is encouraged, as long as no line is redacted or altered, including these final paragraphs. Dr. Schaller does not claim that this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional.

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ChecklistsforBartonella,BabesiaandLymeDisease 79

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AbouLailaM,SivakumarT,YokoyamaN,IgarashiI.InhibitoryeffectofterpenenerolidolonthegrowthofBabesiaparasites.ParasitolInt.2010Jun;59(2):278-82.Epub2010Feb21.PMID:20178862

AderinboyeO,SyedSS.Congenitalbabesiosisinafour-week-oldfemaleinfant.PediatrInfectDisJ.2010Feb;29(2):188.PMID:20118748

AlekseevAN.[Thepossibilityofthedetectionofonemoretick-borneinfection--babesiosis--ontheterritoryofRussia].[ArticleinRussian].ZhMikrobiolEpidemiolImmunobiol.2003May-Jun;(3):39-43.PMID:12886630

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AlkhalilA,HillDA,DesaiSA.Babesiaandplasmodiaincreasehosterythrocytepermeabilitythroughdistinctmechanisms.CellMicrobiol.2007Apr;9(4):851-60.Epub2006Nov3.PMID:17087736

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ArmstrongPM,BrunetLR,SpielmanA,TelfordSR3rd.RiskofLymedisease:perceptionsofresidentsofaLoneStartick-infestedcommunity.BullWorldHealthOrgan.2001;79(10):916-25.PMID:11693973

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ArnezM,Luznik-BufonT,Avsic-ZupancT,Ruzic-SabljicE,PetrovecM,Lotric-FurlanS,StrleF.CausesoffebrileillnessesafteratickbiteinSlovenianchildren.PediatrInfectDisJ.2003Dec;22(12):1078-83.PMID:14688569

AsadS,SweeneyJ,MermelLA.Transfusion-transmittedbabesiosisinRhodeIsland.Transfusion.2009Dec;49(12):2564-73.Epub2009Sep16.PMID:19761547

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ZhaoY,LoveKR,HallSW,BeardellFV.Afatalcaseoftransfusion-transmittedbabesiosisintheStateofDelaware.Transfusion.2009Dec;49(12):2583-7.Epub2009Nov9.PMID:19906041

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104 BabesiaChecklistBibliography•SchallerandMountjoy

ZivkovicZ,TorinaA,MitraR,AlongiA,ScimecaS,KocanKM,GalindoRC,AlmazánC,BlouinEF,VillarM,NijhofAM,ManiR,LaBarberaG,CaracappaS,JongejanF,delaFuenteJ.Subolesinexpressioninresponsetopathogeninfectioninticks.BMCImmunol.2010Feb19;11:7.PMID:20170494

ZobbaR,ParpagliaML,SpezziguA,PittauM,AlbertiA.FirstmolecularidentificationandphylogenyofaBabesiasp.fromasymptomaticsow(SusscrofaLinnaeus1758).JClinMicrobiol.2011Jun;49(6):2321-4.Epub2011Apr13.PMID:21490184

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ChecklistsforBartonella,BabesiaandLymeDisease 105

LYME DISEASE SYMPTOM CHECKLISTJames Schaller, M.D., M.A.R.

INTRODUCTION

The followingchecklist isnotmeant tobecompleteorauthoritative.InformationaboutLymediseaseisconstantlyemergingandchanging.Therefore any checklist is intended for use as a starting point. Intraditional medicine, a physician performs a complete history andphysical.Labsandstudiesassistinclarifyingthedifferentialdiagnosis.InLymedisease,muchdebateexistsaboutlaboratorykits,thealterationof kits to have fewer possible bands, and which labs are optimallysensitiveandspecific. Thischecklistisnotintendedtoaddressthatissueortreatment.

Over200animalscarrytheIxodestick,whichisthemostcommonlyknown insect spreadingLyme disease. With somany vectors, theunderlyingassumptionbehindthischecklististhatLymeisnotrareinNorthAmerica,Europe,SouthAmerica,Russia,AfricaorAsia.

WeknowLymediseaseishighlyunder-reported.Onestudyshowedonly1in40familydoctorsreportedit.

Immediatelyuponbiting,theticktransmitsapainkiller,anti-histamineandananti-coagulant.Basedonanimalstudies,itisalsopossiblethebulls-eyerashislesscommonthanassumed,inpartbecauseinjectionsof spirochete relatedmaterial in laboratoryanimalsonlyshowa rashwiththesecondinjection.Withthisbackground,Iwouldappeal,thatifayoungormiddleagedadultexperiencesabite,andhasprofoundsymptoms,isitpossiblethiswasasmallnumberofinfectiousparticlesignitingalargernumberfrom2,5or20yearsearlier?Iamnotaskingforananswer,justforthepossibilitytobeconsidered.

Thischecklistisofferedwiththesincerewishthatotherswillimproveonit.Itisthisauthor’spersonalbeliefthattickandflea-borneinfectionmedicine is as specializedasHIVandHepatitismedical science andtreatment.

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106 LymeDiseaseChecklist•SchallerandMountjoy

Someofthechecklistmaterialsmightbenewtoyou,whichunderscoresthe need for another scale to add to the ones currently in existence.This list isbasedonamassive reviewof thousandsofpapersoveradecadeof full-timereading,2012sciencerevelations,and/ormassivechart reviews. SincemodernLymediseaseseemstofocuson tick-bornediseaseandotherlaboratorytesting,wewillstartwithlabtestingconsiderations. Ifalabtesthasavalueorapercentage,thenumberschosen are intended to avoid missing those positive patients whootherwisewouldbeoverlooked.Theconcernisaboutphysiciansandotherhealthcareworkersnottreatinganinfectedpatient,whoovertimecanexperiencedisabilityorevendeathatafrequencythatisimpossibletodetermine.

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ChecklistsforBartonella,BabesiaandLymeDisease 107

THE LYME DISEASE CHECKLIST

James Schaller, M.D., M.A.R.

(Please Check Any Symptoms That Apply)

LABORATORY TESTING — INDIRECT AND DIRECT

£VitaminDlevelisinthelowest20%.Ifyousupplement,itshouldbeintop50%.

£CD57orCD58isinthelowest20thpercentile.

£Freetestosteroneisin10thpercentileorbelow.

£In5%ofpatientsthetestosteroneorfreetestosteroneisoverthenormalrange.

£DHEAisinlower20%.Orrarelyisitfullyoverthetoplevel.

£Freedihydrotestosteroneisinthelowest20thpercentileorwelloverthenormalrange.

£EpsteinBarrVirusisabnormalinanymeasure.[Thisvirusisbelievedtobepositiveovernormalpositivelevelsinthepresenceofinfectionsorhighinflammation.]

£OntheWesternBlot,IgGorIgManyspecies specificbandatanybloodlevel,e.g.,18,21,23,30,31,34,37,39,83,93.

£AfreeT3levelunder2.8[thenormalbottomrangein1990was2.6;theinfluxoflargenumbersofelderlypatientsresetthehealthy“normal”range].

£PositiveforvirusessuchasCMV,HHV-6,CoxsackieBTypes1,2,3,4,5,6,ParvoB-19orPowassanvirus

£PositiveforMycoplasma,e.g.mycoplasmapneumonia

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£ThepatientispositiveforinfectionsotherthanroutineLyme,[thatisBorrelia burgdorferi sensu stricto,BorreliaafzeliiandBorreliagarinii].Someoftheotherinfectionsalsocarriedbyinfectiousticks,fleasorothervectorsincludeBabesia(duncani,microtiorother),Anaplasma(HGA),Ehrlichia(variousspecies/strains),Neoehrlichia,RockyMountainorotherSpottedFevers,Brucellosis,Q-fever,STARI(Master’sDisease),Malaria,andBartonella[e.g.,B.henselae,B.quintana,B.elizabethaeandB.melophagi].Oncetestsarecommerciallyavailablefortestingallformsofprotozoaaffectinghumans,includingFL1953,allBartonellaspecies,andBorreliamiyamotoiandotherLymespecies,reportingshouldincrease.

£IL-Bisinlowest10thpercentile.

£IL-6isinlowest10thpercentile.

£TNF-alphaisunder2,orinlowest20thpercentile.

£AWBCcountwas,oris,under4.5.

£EosinophillevelintheCBCmanualexamiseitherat0-1or6-7.

£TotalmanualEosinophillevelis140orless.

£X-rayorotherstudyshowscartilagedefectsinexcessofinjuryoragemedian.

£Ifafullauto-immunitypanelisrunwithatleasteightdifferenttests,twoarepositive;forexample,youhaveapositiveanti-gliadinandapositivethyroidperoxidase.

£Positiveornearpositive(borderline)ELISA,PCR,orapositivetissuebiopsy;oratickfromyourbodyispositiveforLymeorothertickinfection

£Labtestsshowhighinflammation,e.g.,ahighC4a,elevatedcholesterolandC-peptide.TheseareneverspecificjustforLyme.

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£LabtestsshowaMSHlevelunder30[thereferencerangeof0-40isduetotheincreaseofverysickpatientstested,and40-85isabetterreferencerangewhichwasusedbeforethefloodofthesickresettherangeofnormal].MSHisananti-inflammatoryhormone.

£VIPisunder20.Thisisananti-inflammationchemical.

BODY EXAMINATION RESULTS

£Weightlossorgaininexcessof20poundsin12weeks

£Aroundorovalrashwithadarkcenterwasorispresentinaloose“bulls-eyepattern”orothersizeandshaperashesthathavenoothercauseafterexposuretoticksandvectors

£Healingisslowafterscratchesorsurgery.Forexample,afteracatscratch,fleabiteortickbitethemarkisstillvisiblelater.

£Skinonarms,handsorfeethasatexturelikericepaper.

£Clearreactionandeffectisseenwithantibiotictreatment.Specifically,amarkedimprovementorworseningofaseriousmedicalproblemorfunctionisobservedwithaspirochetekillingtreatment,e.g.,doxycycline,tetracycline,minocycline,anypenicillinsuchasamoxicillin,azithromycin,clarithromycinorcefuroxime.

£Presenceofskintags,redpapulesofanysize,excessbloodvesselscomparedtopeers,andstretchmarkswithcolororinsignificantexcessofpeers.

£Molesandraisedorhardplaquesinexcessofthefewonnormalskin

£Areasofskinwithulcerationssuchasthoseseeninsyphilis,butatanylocationonthebody

£Areasofclearhypo-pigmentationandhyper-pigmentation

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£PositiveACA(Acrodermatitischronicaatrophicans)whichisasignoflongtermuntreatedLymedisease.SomereportACAbeginsasareddish-bluepatchofdiscoloredskin,oftenofthehandsorfeet.Itmayincludethebackinsomepatients.Thelesionslowlyatrophiesovermonthstoyears,withmanydevelopingskinthatisthin,dry,hairless,wrinkledandabnormallycolored.Thecoloroftheextremitiessuchashandsandfeetcanbered,darkred,brown,darkblueorpurple.

Sample Neurological Exam

£Patient’sshort-termmemoryispoor.Forexample,ifaskedtorecallthesenumbers—23,5,76,43and68—thepatientcannotrecallthem.

£Patientcannotreversefournumbers,soifgiven—18,96,23and79—thepatientcannotdoit.

£Ifaskedtosubtract17from120,(collegegraduate),itcannotbedoneinatimelymanner.Ifahighschoolgraduate,subtract7from100andcontinuetosubtractby7fourtimesin20seconds.

£Lightheadednessuponstandingquicklyinexcessofpeers,andwithnoclearcause

£Dizzinessunrelatedtoposition

£DizzinessmadeworsebyLymekillingantibiotics

£Troubledoinganinestepheel to toe straight line walk testwithfingersslightlyinpockets[Thepatientshouldnotswayorneedtheirhandspulledouttopreventafall].Inpatientswithpastexperienceinskating,skiing,danceorballetthisshouldbevery easyandisrarelyachallengetosuchpeople.Ifitisnoteasy,itissuspiciousmedically,butnotonlyforLymedisease.

£Troubleperformingaoneleglift,inwhichonelegislifted15inchesoffthegroundinfrontofyou,asyoucount,e.g.,“oneMississippi,twoMississippi,etc.”

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£Positivenystagmus[youreyejerkswhenyoulookrightorleft]

PATIENT’S REPORTED PHYSICAL HISTORY

Psychiatric & Neurological

£Mildtosevereneurologicaldisordersorpsychiatricdisorders

£Averyprofoundneurologicaldiseasewhichdoesnotclearlyfitthelabs,studiesandcourseoftheillness

£Amoderateorseveremedical,psychiatricorneurologicalillness.[Manyseveredisorderscanbeassociatedwithspirochetessuchasthosecausingsyphilis,andsomeproposethatLymeisalsorelatedtoawell-knownseriousbraindisease.]

£Severemedical,psychiatricorneurologyillnesswithuncommonfeatures,suchasParkinson’sdisease,appearingatayoungage

£Facialparalysis(Bell’spalsy)

£Personalityhaschangednegativelyandsignificantlyfornoclearreason.

£Psychosisatanyage,butespeciallyafter40yearsofagewhenusuallyitwouldhavealreadymanifesteditself

£Severeanxiety

£Maniaorprofoundrage

£Depressionwithminimalgeneticrisk

£Depressionoranxietythatdidnotexistwhenyouwerelessthan25yearsofage

£Irritability

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£Anyoneofthefollowing:paranoia,dementia,schizophrenia,bipolardisorder,panicattacks,majordepression,anorexianervosaorobsessive-compulsivedisorder

£AdultonsetADHD/ADD[PrimarypsychiatricbiologicalADDorADHDispresentat7yearsofage.Adultonsetisasignofamedicalcondition.]

£Increasedverbalorphysicalfightingwithothers

£Functioningatworkorinparentingisatleast20%reduced

£Patienceandrelationalskillsaredecreasedby20%ormore

£Amildtoprofounddecreaseofinsight,i.e.,aninfectedpatientdoesnotseetheirdecreasedfunction,failedtreatmentorpersonalitychange

£Aneweccentricrigiditytohearingnewmedicalorotherimportantinformation

£Difficultythinkingorconcentrating

£Poormemoryandreducedabilitytoconcentrate

£Increasinglydifficulttorecallnamesofpeopleorthings

£Difficultyspeakingorreading

£Difficultyfindingthewordstoexpresswhatyouwanttosay

£Inabilitytolearnnewinformationaswellasinthepast[receptivelearning]

£Repeatingstoriesorforgettinginformationtoldtocloserelations,suchasaspouse,roommate,sibling,bestfriendorparent

£Confusionwithoutaclearreason

£Anaddictionthatresultsinrelapseinspiteofsincere,reasonableandseriouseffortstostop

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£Fatigueinexcessofnormal,orfatiguethatisgettingworse

£Troublesleepingincludingmildtosevereinsomniaanddisruptedsleep

£Sleepinexcessof9hoursadayornight,orsleepinginexcessof9hourseverydayifallowed

£Troublefallingasleep

£Troublestayingasleep[Takinga5minutebathroombreakdoesnotcount]

Major Organs

£GastritisorstomachsensitivitynotcausedbyH.Pylori

£Intestinaltroublesthatareunabletobefullymanagedand/orwhichhavenocleardiagnosis

£Nauseawithoutaclearreason

£Earproblemssuchaspainorincreasedear“pressure”

£Any troublewiththesenses(vision,sound,touch,tasteorsmell).Theuseofcorrectivelensesorcontactsdoesnotcount,unlesstheprescriptionischangedmorethanexpected.

£Buzzingorringinginears

£Doublevision,floaters,dryeyes,orothervisiontrouble

£Conjunctivitis(pinkeye)oroccasionaldamagetodeeptissueintheeyes

£Bladderdysfunctionofanykind

£Treatmentresistantinterstitialcystitis

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£Bloodclotsfastwhenyougetacut,oryouhaveadiagnosedproblemwithclotting.Thismayalsobeseeninblooddrawswhereblooddrawneedleclotswhenbloodisbeingremoved.Ifonabloodthinner,bloodthinnesslevelgoesupanddowntoomuch.

£Cardiacimpairment

£Chestpainwithalllabsandstudiesinnormalrange

£Occasionalrapidheartbeats(palpitations)

£Heartblock/heartmurmur

£Heartvalveprolapse

£Shortnessofbreathwithnoclearcauseonpulmonaryfunctiontests,examination,labtesting,X-rays,MRI’s,etc.

£Airhungerorfeelingsofshortnessofbreath

Skin

£Numbness,tingling,burning,orshocksensationsinanareaofskin

£Oneormoretroublesomeskinsensationsthatmoveovermonthsoryearsanddonotalwaysstayinonelocation

£Rashorrasheswithoutasimpleandobviouscause

£Rashesthatpersistdespitetreatment

£Eccentricitchingwithnoclearcause

£Hairlosswithnoclearcause

Musculoskeletal

£Musclepainorcramps

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£Musclespasms

£Musclewastingwithoutaclearcause

£Troublewithyourjawmuscle(s)orjointinsomnia(TMJ)

£Jointdefectsinonejointwithnoclearcauseif20oryounger

£Jointdefectsintwojointsormoreif35oryounger

£Jointdefectsinthreeormorelocationsifyoungerthan55withnocleartrauma

£Swellingorpain(inflammation)inthejoints[Mostpatientsneverhavejointdisease.]

£Jointpainthatshiftslocation

£Neckstiffness

£Chronicarthritiswithorwithoutepisodesofswelling,redness,andfluidbuildup

General Medical

£Gainingorlosingweightinamannerclearlyinconsistentwithdietandexercise

£Newormorefoodallergiesthantenyearsago

£Feelworseaftereatingbreads,pastaorsweets

£Nolongertolerateorenjoyalcohol

£Anti-histaminesarebothersome,moresothaninthepast.

£Reactiontomedicationsisexcessive(youarevery“sensitive”tomedications)

£Yourresponsetoantibioticsissignificantlypositiveandyoufeelmorefunctional,or you have the opposite reactionandfeelworse,feelingill,fatiguedoragitated.

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£Chronicpaininexcessofwhatseemsreasonable

£Nervepainwithoutaclearcause

£Sensitivitytolights,sounds,touch,smellorunusualtastes

£Sensitivitytocleaningchemicals,fragrancesandperfumes

£Headachesthatdonotrespondfullytotreatment,orwhicharegettingworse

£Newallergiesorincreasedallergiesoverthoseofyourpeers

£Anyautoimmunity--Lymeandothertickinfections,overmanyyears,increaseinflammationanddecreaseanti-inflammationchemicals.Webelievethisleadstoincreasedfoodsensitivities,increasedautoimmunityandaheightenedsensitivitytovariouschemicalsandmedications.

£Daytimesweats

£Nighttimesweats

£Chills

£Flu-likesymptoms

£Abnormalmenstrualcycle

£Decreasedorincreasedlibido

£Increasedmotionsickness

£Fainting

£Aspinningsensationorvertigo

£Illnessesthatcomeandgoanddecreasefunctioningwithnocertaincause

£Seriousillnessesthatunderminefunctionwithnoclearcause,andwhichaffectmorethanonebodyorgan

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£Anabnormallabresult,physicalexamfindingorillnessthatisgivenmanydiagnosesorhasnoclearcause

ENVIRONMENT

£Someoneinyourneighborhoodwithin400yardsinanydirectionofyourdwellinghasbeendiagnosedwithatickborneinfection[Thisincludesvacationlocations].

£Youhavesomeonelivingwithyouwithanytypeoftick-borneinfection—thisassumestheywerenotmerelytestedforoneinfection.[ItisnotproventhatthesmallLyme-carryingticksonlycarryLyme,anditispossiblesomecarryotherinfectionswithoutcarryingLymeatall.

£Youhaveremovedanyticksfrom your bodyinyourlifetimeatanylocation.

£Youhaveremovedticksfrom your clothinginyourlifetimeatanylocation.

£Afteratickorbugbite,youhadafeverforatleast48hours.

£Afteratickorbugbite,youwereill.

£Grewuporplayedinareaswithmanysmallwildmammals

£Whenyouareinaroomthathasvisiblemoldorsmellslikemoldandyoustarttofeelill,youdonotreturntoyourbaselinehealthin24hours.

£Anydiscomfortwithin two minutesofbeinginamustyormoldylocation.Thismaybeasignofchronicuntreatedinfection,becauseamere30inhalationsofmolddebriscausessystemiceffectsinyourbody

£Pets or farm animalspositivewithANYtickbornevirus,bacteriaorprotozoa,orclinicalsymptomswithoutacleardiagnosisorcause

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118 LymeDiseaseChecklist•SchallerandMountjoy

£Thepatient’smotherissuspectedofhavingorhasbeendiagnosedwithBabesia,Ehrlichia,RockyMountainSpottedFever,Anaplasma,Lyme,Bartonellaorothertickbornediseasebasedonnewerdirectandindirecttesting,orclinicalsignsandsymptoms.

£A sibling, father, spouse or childwithanytickborneinfection

£Casual or work-related exposure to outdoor environmentswithbrush,wildgrasses,wildstreamsorwoods(Examples-golfcourses,parks,gardens,riverbanks,swamps,etc.)

£Pets,e.g.,horses,dogsorcats,havehadoutdoor exposurestoareassuchasbrush,wildgrasses,wildstreamsorwoods.

£Youplayedingrassinthepast.

£Youhavebeenbittenbyfleas.

£Youhavebeenscratchedbyacatordog.

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ChecklistsforBartonella,BabesiaandLymeDisease 119

FINAL WORDS

SomeoftheabovelistedsignsandsymptomsfitotherinfectionsthatmaybemorecommonthanLymedisease.Unfortunately,theresearchandexperienceindicatingdiverseinfectionscarriedbytheIxodesandotherticksisignoredsoasmallnumberofsymptomsandsignswereaddedtothischecklist..Further,“testing”usuallyinvolvesonetestforamono-infection--BorreliaorLyme. TicksandothervectorsshouldneverbeassumedtocarryonlyLymedisease.

PleasenotethatwhenwearetalkingabouttheIxodestickwearenotreferringtothisasa“deertick”sinceithasover200vectors(Ostfeld).Many of the tick reduction options presently suggested are not successful in accomplishing their goals.Reducingdeerpopulations,oncethoughttoreducetickpopulationsandincidenceofLymedisease,maysimplyincreaseticknumbersinmammalsandothercarriersthatliveclosertohumans.

All healers have their familiarway of thinking, testing and treating.Kuhnhasshownweareallbiasedandstruggle tobeobjective…andfail.Certaintyissimplyimpossibleinmedicalscience.Further,tickandfleainfectionshavealmostinfinitepathologicaleffectsbecausethehumanbodyandtheseclustersofinfectionsaresocomplex. Ihavenotsuggestedagridorasetnumberofsymptoms,becauseonewouldnotfitthislist.Simply,thegoalofthischecklististohaveyouthinkbroadly.

You cannot use this checklist to diagnose Lyme disease or to rule it out.

ALymechecklistisverymedicallyimportant,sinceitisstillanemergingillnessandcansometimesdisableorincreasemortalityriskinpatientsofanyageifnotdiagnosedandtreatedearlyintheinfection.

Writings in the past fifteen years have either viewed Babesia andBartonella as mere “co-infections,” or a footnote of a spirocheteinfection[i.e.,Lyme].Either infectioncanhidefordecades,andthen

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120 LymeDiseaseChecklist•SchallerandMountjoy

possiblydisableorkillapersonbycausingaclot,heartarrhythmiaorbyothermeans.

The detection of Lyme from stained tissue samples or blood is verydifficult. Currently, the well-established indirect lab test patternspresentedarenotusedorunderstoodbyallhealthcareprofessionals.Whilethisisfullyunderstandable,Ihopeitmaychangeinthecomingdecade.Tickinfectionshavesystemic impactsonthebody,andarenotlimitedtoeffectsreportedinjournalarticles,afewbooksoranynationalorinternationalguidelines.

Dr. Schaller has published the four most recent textbooks on Babesia and the only recent textbook in any language on Bartonella.His most recent book on Lyme, Babesia and Bartonella includes a“researchersonly”listofover2,600referencesconsideredtobea start forbasiceducationintickinfectionmedicine.

HepublishedarticlesonbothBabesiaasacancerprimerandBartonellaasaprofoundpsychiatricdiseaseunderthesupervisionof theformereditor of the Journal of the American Medical Association (JAMA). He also published entries onmultiple tick and flea-borne infections,includingBabesia,BartonellaandLymedisease,inarespectedinfectiontextbookendorsedbytheNIHDirectorofInfectiousDisease.

Dr. Schaller is the author of seven texts on tick and flea-borne infections. He is rated a BEST physician, an honor that is awarded to only 1 in 20 physicians by physician peers. He is also rated a TOP physician by patients, again ranking in the top 5 percent of physicians.

Copyright © 2011 JAMES SCHALLER, M.D., M.A.R. version 25.

This form may not be altered if it is printed or posted, in any manner, without written permission. It can be printed for free to assist in diagnostic reflections, as long as no line is redacted or altered, including the introduction or final paragraphs. Dr. Schaller does not claim that this is a flawless or final form, and defers all diagnostic decisions to your licensed health professional.

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ChecklistsforBartonella,BabesiaandLymeDisease 121

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AbererE.[NeuroborreliosisorBorreliahysteria.Thiscasebecomesanightmare!].[ArticleinGerman].MMWFortschrMed.2006Nov9;148(45):8.PMID:17615738

Aboul-EneinF,KristoferitschW.Normalpressurehydrocephalusorneuroborreliosis?WienMedWochenschr.2009;159(1-2):58-61.PMID:19225737

AlaediniA,LatovN.AntibodiesagainstOspAepitopesofBorreliaburgdorfericross-reactwithneuraltissue.JNeuroimmunol.2005Feb;159(1-2):192-5.Epub2004Nov26.PMID:15652419

AngelakisE,BilleterSA,BreitschwerdtEB,ChomelBB,RaoultD.Potentialfortick-bornebartonellosis.EmergInfectDis.2010Mar;16(3):385-91.

AuwaerterPG.Point:antibiotictherapyisnottheanswerforpatientswithpersistingsymptomsattributabletolymedisease.ClinInfectDis.2007Jul15;45(2):143-8.Epub2007Jun5.PMID:17578771

BanarerM,CostK,RychwalskiP,BryantKA.Chroniclymphocyticmeningitisinanadolescent.JPediatr.2005Nov;147(5):686-90.PMID:16291364

BanethG,BreitschwerdtEB,HegartyBC,PappalardoB,RyanJ.Asurveyoftick-bornebacteriaandprotozoainnaturallyexposeddogsfromIsrael.VetParasitol.1998Jan31;74(2-4):133-42.

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BariePS.Warning!DangerWillRobinson!LymediseaseclinicalpracticeguidelinesoftheInfectiousDiseasesSocietyofAmerica,activistpatients,antitrustlaw,andprosecutorialzeal.SurgInfect(Larchmt).2007Apr;8(2):147-50.PMID:17437359

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PrzytułaL,Gińdzieńska-SieśkiewiczE,SierakowskiS.[DiagnosisandtreatmentofLymearthritis].[ArticleinPolish].PrzeglEpidemiol.2006;60Suppl1:125-30.PMID:16909789

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PuéchalX.[NonantibiotictreatmentsofLymeborreliosis].[ArticleinFrench].MedMalInfect.2007Jul-Aug;37(7-8):473-8.Epub2007Mar21.PMID:17376627

PuiusYA,KalishRA.Lymearthritis:pathogenesis,clinicalpresentation,andmanagement.InfectDisClinNorthAm.2008Jun;22(2):289-300,vi-vii.PMID:18452802

ReikLJr.LymeDiseaseandtheNervousSystem.NewYork:ThiemeMedicalPublishers.1991,pp57-61.

ReikLJr.NeurologicaspectsofNorthAmericanLymedisease.InLymeDisease,ed.PatriciaK.Coyle,M.D.St.Louis:Mosby-YearBookInc.1993,pp.101-112.

RenaudI,CachinC,GersterJC.GoodoutcomesofLymearthritisin24patientsinanendemicareaofSwitzerland.JointBoneSpine.2004Jan;71(1):39-43.PMID:14769519

ReshetovaGG,ZaripovaTN,TitskaiaEV,MoskvinVS,UdintsevSN.[PhysicalfactorsinrehabilitationtreatmentofpatientswithIxodestick-borneborreliosiswithprimarylesionsofthejoints].[ArticleinRussian].VoprKurortolFizioterLechFizKult.2004Nov-Dec;(6):10-3.PMID:15717529

RocheLanquetotMO,AderF,DurandMC,CarlierR,DefferriereH,DinhA,HerrmannJL,GuillemotD,PerroneC,SalomonJ.[Resultsofaprospectivestandardizedstudyof30patientswithchronicneurologicalandcognitivedisordersaftertickbites].[ArticleinFrench].MedMalInfect.2008Oct;38(10):543-8.PMID:18722064

RolainJM,BrouquiP,KoehlerJE,MaguinaC,DolanMJ,RaoultD.RecommendationsfortreatmentofhumaninfectionscausedbyBartonellaspecies.AntimicrobAgentsChemother.2004Jun;48(6):1921-33.PMID:15155180

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RoratM,KucharE,SzenbornL,MałyszczakK.[Growingboreliosisanxietyanditsreasons].[ArticleinPolish].PsychiatrPol2010Nov-Dec;44(6):895-904.PMID:21449171

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SavelyV.Lymedisease:adiagnosticdilemma.NursePract.2010Jul;35(7):44-50.PMID:20555245

SchallerJ.TheDiagnosis,TreatmentandPreventionofBartonella:AtypicalBartonellaTreatmentFailuresand40HypotheticalPhysicalExamFindings–FullColorEdition.VolumeI-II.Tampa,FL:HopeAcademicPress.2008.

SchallerJ.Babesia.inEncyclopediaofPlagues,PestilenceandPandemics.Ed.J.Bryre.Westport,CT:GreenwoodPress;2008.

SchallerJ.Bartonella.inEncyclopediaofPlagues,PestilenceandPandemics.Ed.J.Bryre,Westport,CT:GreenwoodPress;2008

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ChecklistsforBartonella,BabesiaandLymeDisease 149

SchallerJ.LymeDisease.inEncyclopediaofPlagues,PestilenceandPandemics.Ed.J.Bryre.Westport,CT:GreenwoodPress;2008

SchallerJ.Babesia2009SupplementandUpdate.Tampa,FL:HopeAcademicPress.2009.

SchallerJL.Artemisin,Artesunate,ArtemisinicAcidandOtherDerivativesofArtemisiaUsedforMalaria,BabesiaandCancer.Tampa,FL:HopeAcademicPress.2006.

SchallerJL.TheHealthCareProfessional’sGuidetotheTreatmentandDiagnosisofHumanBabesiosis,AnExtensiveReviewofNewHumanSpeciesandAdvancedTreatments.Tampa,FL:HopeAcademicPress.2006.

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SteereAC,MalawistaSE,BartenhagenNH,SpielerPN,NewmanJH,RahnDW,HutchinsonGJ,GreenJ,SnydmanDR,TaylorE.TheclinicalspectrumandtreatmentofLymedisease.YaleJBiolMed.1984Jul-Aug;57(4):453-61.

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StrickerRB.Counterpoint:long-termantibiotictherapyimprovespersistentsymptomsassociatedwithlymedisease.ClinInfectDis.2007Jul15;45(2):149-57.Epub2007Jun5.PMID:17578772

StrickerRB,JohnsonL.Lymedisease:aturningpoint.ExpertRevAntiInfectTher.2007Oct;5(5):759-62.PMID:17914908

StrickerRB,JohnsonL.ChronicLymediseaseandthe‘AxisofEvil’.FutureMicrobiol.2008Dec;3(6):621-4.PMID:19072179

StrickerRB,JohnsonL.Genderbiasinchroniclymedisease.JWomensHealth(Larchmt).2009Oct;18(10):1717-8;authorreply1719-20.PMID:19857097

StrickerRB,JohnsonL.Lymediseasediagnosisandtreatment:lessonsfromtheAIDSepidemic.MinervaMed.2010Dec;101(6):419-25.PMID:21196901

StrickerRB,JohnsonL.Lymedisease:thenextdecade.InfectDrugResist.2011;4:1-9.Epub2011Jan7.PMID:21694904

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StrickerRB,LautinA,BurrascanoJJ.Lymedisease:point/counterpoint.ExpertRevAntiInfectTher.2005Apr;3(2):155-65.PMID:15918774

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TreibJ,WoessnerR,DoblerG,FernandezA,HozlerG,SchimrigkK.Clinicalvalueofspecificintrathecalproductionofantibodies.Actavirol1997Feb;41(1):27-30.

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Vel’ginSO,ProtasII,PonomarevVV,DrakinaSA,ShcherbaVV.[Clinicalpolymorphismofneuroborreliosisatalatestageofthedisease].[ArticleinRussian].ZhNevrolPsikhiatrImSSKorsakova.2006;106(3):48-51.PMID:16608111

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WeissmannG.“ChronicLyme”andothermedicallyunexplainedsyndromes.FASEBJ.2007Feb;21(2):299-301.PMID:17267382

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WidheM,JareforsS,EkerfeltC,VrethemM,BergstromS,ForsbergP,ErnerudhJ.Borrelia-specificinterferon-gammaandinterleukin-4secretionincerebrospinalfluidandbloodduringLymeborreliosisinhumans:associationwithclinicaloutcome.JInfectDis.2004May15;189(10):1881-91.Epub2004Apr26.PMID:15122525

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ChecklistsforBartonella,BabesiaandLymeDisease 157

ZajkowskaJM,SwierzbińskaR,PancewiczSA,KondrusikM,Hermanowska-SzpakowiczT.[ConcentrationofsolubleCD4,CD8,CD25receptorsaswellIFN-gammaandIL-4releasedbylymphocyteofchronicLymepatientsculturedwith3genotypesofBorreliaburgdorferi].[ArticleinPolish].PolMerkurLekarski.2004May;16(95):447-50.PMID:15518424

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ZeaiterZ,LiangZ,RaoultD.GeneticclassificationanddifferentiationofBartonellaspeciesbasedoncomparisonofpartialftsZgenesequences.JClinMicrobiol.2002Oct;40(10):3641-7.PMID:12354859

Zu-RheinGM,LoSC,HuletteCM,PowersJM.Anovelcerebralmicroangiopathywithendothelialcellatypiaandmultifocalwhitematterlesions:adirectmycoplasmalinfection?JNeuropatholExpNeurol.2007Dec;66(12):1100-17.PMID:18090919

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158 SchallerandMountjoy

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Dr. Schaller has been published in:

Journal of the American Medical Association

Journal of Clinical Neuroscience

Medscape (Academic Journal of WebMD)

Journal of the American Society of Child and Adolescent Psychiatry

American Journal of Psychiatry

European Journal of Child and Adolescent Psychiatry

Compounding Pharmaceuticals: Triad

Fleming Revell Press (Four Languages)

Internal Medicine News

Family Practice News

Spire Mass Market Books

Internet Journal of Family Medicine

Greenwood Press

Child and Adolescent Psychiatry Drug Alerts

Hope Academic Press

Clinical Psychiatry News

Psychiatric Drug Alerts

Townsend Journal

OB/GYN News

AMA News

Currents

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160 SchallerandMountjoy

A Sample of Other Books by Dr. Schaller

Thislargetextbookisclearandeasytoread.Itisreallythreebooks.Whilesomepointsarepartiallyoutdatedsince2006,muchwouldbeconsiderednewtomostreaders.

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ChecklistsforBartonella,BabesiaandLymeDisease 161

TheOnlyHematologyBookExclusivelyDedicatedtoBabesia.

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162 SchallerandMountjoy

TheMostUp-To-DateAcademicandPatient-CenteredBookonPracticalArtemisiaBabesiaIssues.

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ChecklistsforBartonella,BabesiaandLymeDisease 163

Bartonella diagnosis is very complex. This current text creativelyused a new set of tools based on solid research of blood vessel andskinaugmentationchemicalscreatedbyBartonella.ItliterallycreatesafullBartonellaphysicalexam.Thisbookhelpswithlimitedbasiclabtesting,andpreventstheuseofroutinelyrelapsingorpoortreatmentspromotedinbothtraditionalandintegrativemedicine.Nootherbookonthistopicisbasedonoverathousandtopresearcharticles,andnoonehadpublishedanythingremotelyclose to replacing thiswork inoverfiveyears.

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164 SchallerandMountjoy

Dr.SchallerisaCertifiedMoldInvestigatorandaCertifiedMoldRemediator.HereisAnotherPractical

andReadableMoldMycotoxinBook.

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ChecklistsforBartonella,BabesiaandLymeDisease 165

TheOnlyCurrent,PracticalandAdvancedClinicalBookonthisRevolutionaryTreatmentfor

OpioidAddictionandModestPain.

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166 SchallerandMountjoy

Themanymissedmedicalandneurologicalcausesofpoorfocusandbadbehaviorscannolongerbeignored.Thisuniquetextadvancesmedicineandshowshowmuchinyouthpsychiatryhasmedicalrootsthatareignoredorunknowneveninsolidchildandadolescentpsychiatrypractices.

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Disclaimer

Dr.Schallerisnotaspecialistininfectiousdiseasemedicine.Heisalsonot a pathologist.Both of these specialties have over 2,000 diseasestotreatandstudy.Dr.Schallerisonlyinterestedinfourinfectionsandhas readandpublishedononly these four.Themedical ideas,healththoughts,healthcomments,productsandanyclaimsmadeaboutspecificillnesses,diseases,andcausesofhealthproblemsinthisbookarepurelyspeculative,hypothetical,andarenotmeanttobeauthoritativeinanysetting.NocommentorimagehasbeenevaluatedbytheFDA,CDC,NIH,IDSAortheAMA.NeverassumeanyUnitedStatesmedicalbody,society,orthemajorityofAmericanphysiciansendorseanycommentinthisbook.Nocommentinthisbookisapprovedbyanygovernmentagency,medical body ormedical society.Nothing in this book is tobe used to diagnose, treat, cure or prevent disease. The informationprovidedinthisbookisforeducationalpurposesonly.Itisnotintendedas a substitute for the advice from your physician or other healthcareprofessionals.Thisbook isnot intended toreplaceoradjustanyinformationcontainedon,orin,anyproductlabelorpackaging.

Nopatientshouldusetheinformationinthisbookforthediagnosisortreatmentofanyhealthproblem,orforprescriptionofanymedicationorothertreatment.Youshouldconsultwithahealthcareprofessionalbeforedecidingonanydiagnosis,orinitiatinganytreatmentplanofanykind.Dr.Schallerdoesnotclaimtobeanexpertinanyillness,diseaseor treatment. In this book, he ismerely sharing one of his interests.Pleasedonot startanydiet,exerciseor supplementationprogram,ortakeanytypeofnutrient,herb,ormedication,withoutclearconsultationwithyourlicensedhealthcareprovider.

Babesia or Bartonella diagnosis or treatment comments and reportsof possiblepositiveor negative treatmentoutcomes arehypothetical.Notreatmentshouldberejectedorembracedbyanyone,basedonthepreliminaryresearchandstudyinthisbook.

In this book, Dr. Schaller makes no authoritative or proven claimaboutanydiagnosis, lab testingor treatment.Dr.Schalleronlyoffershypothetical ideas. Dr. Schallermakes no authoritative claims aboutmedications,nutrients,herbsorvarioustypesofalternativemedicine.

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168 SchallerandMountjoy

Theideas in thisbookwillneed tobesubmitted toyour localexpertinallopathic,osteopathicorprogressivemedicine,ortootherlicensedhealthcarepractitioners.Thisbookisnotmeanttobeaninformalorformalguidelinebookthatpresumestocontrol800,000physicians,orthe300millionpatientstheyserve.Youareaskedtoletthewisdomofyourhealthcarepractitioners,andyourownstudy,beastartingpointtoguidetreatmenttailoredspecificallytoyourbody.Again,Dr.Schallermakesnoclaimtobeanexpertinanyaspectofmedicine.Hemakesnoclaimtoknowmorethanotherphysicians.

Additionally,Dr. Schallermakes no claim that any statement in thisbookiscorrect.

Sincethisappearstobethefirstbookexclusivelydedicatedtoadvancedmoderncutting-edgetickandfleainfectionexpandeddiagnosiscriteria,it isverylikelytocontainerrorsThisiscommonwithbooksthatarethefirstonsuchsensitivetopics.Everyreasonableefforthasbeenmadenot to try tooverstate findings.Further, it is important to realize thatanysinglelabfindingortreatmentoutcomecanhavemultiplecauses,and not all of thesemay be known to this author, or to other healthpractitioners. Therefore, all health care practitioners should look forotherconfirmationsoutsidethisbookbeforebeginningonanytreatmentplan,ifpossible.

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ChecklistsforBartonella,BabesiaandLymeDisease 169

Contacting Dr. Schaller

Should you wish to talk to Dr. Schaller he offers individualized edu-cation consults, which can be arranged by calling 239-263-0133. Please leave all your phone numbers, a working email and a fax number. These consults are typically in 15 minute units and can last as long as you wish. All that is required is the completion of a short informed consent form.

If you would like a full diagnostic consult or to see Dr. Schaller as a patient, know he treats patients from all over the USA and from outside the country. He meets with you first and then does follow-up care with you by phone. He does require you to have a family doc-tor, internist or pediatrician, since he is only a consultant.

If you would like to fly in to see Dr. Schaller, his staff are very familiar with all the closest airports, and we have special hotel dis-counts.

I wish you the very best health!

Warm Regards,Rona C. MBAOffice Manager

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