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Are these the “Fat Cats” you were speaking of?


Resistance Royalty: Pelosi, Soros Headline Left’s Biggest Dark Money Conference


Anytime a major problem or issue arises in society think about who will gain or profit from it. Then remove yourself from the equation and take a step back to look at it from a third party perspective. See the so-called “problem”, look at who is reacting, why and in what way. Then look for who is offering up the solution.

When you do this from now on you’ll quickly see the real truth instead of the false truth they wanted you to see.  —The Hegelian Dialectic and its use in Controlling Modern Society, 2013


Private memo gives inside look at Democracy Alliance’s latest secret donor meeting

Queue – the Star Wars barroom…

CARLSBAD, Calif.—A secretive three-day conference where big money liberal donors are plotting the next steps of the “resistance” will be headlined by Friday speeches by billionaire George Soros and Democratic House Minority Leader Nancy Pelosi, according to internal documents obtained by the Washington Free Beacon.

The Democracy Alliance, a donor club of deep-pocketed liberal donors that each pledge to direct hundreds of thousands of dollars in funding to approved left-wing groups, descended on California’s posh La Costa Resort on Wednesday morning for its fall donor summit. The group continued its tradition of secrecy, promising all members and guests of the summit their participation would “remain confidential.”

The first page of the conference agenda, which was obtained by the Washington Free Beacon and can be viewed in its entirety below, lays out “participation guidelines,” explaining that the Democracy Alliance is a “safe place” for donors and activists to meet. Guests are instructed not to share members’ names with the press and not to post to any social media sites, to contact Democracy Alliance if “the media or a blogger” contacts them, and to “refrain from leaving sensitive materials out where others may find them.”

This latter directive was ignored.

The agenda for the meeting, titled “Beyond #Resistance: Reclaiming our Progressive Future,” lays out three full days of events culminating in a Friday night dinner headlined by Pelosi.

Democracy Alliance Fall Investment Conference Agenda by Washington Free Beacon on Scribd. (These documents show how Soros will be meeting with House Minority Leader Nancy Pelosi and scores of rich liberals to plot the future of the opposition To President Donald Trump.)

A few hours earlier guests can attend “A Talk with George Soros,” who will be introduced with a “special videotaped message” by Democratic senator Kamala Harris (Calif.).

All of the events are scheduled to take place at the La Costa Resort, which features 17 tennis courts of both clay and hard surfaces including one with 1,000 seats for spectators, 36 holes of golf on the Legends Course and the Champions Course, an array of pools including three hot tubs that overlook said golf courses, a spa building, and the Deepak Chopra Center, where guests can do yoga or receive mind-body medical consultations.

Pelosi and Harris are not the only two politicians to have a presence at the swanky conference—Pennsylvania governor Tom Wolf (D.) held a Thursday event on his reelection efforts, Sen. Amy Klobuchar (D., Minn.) will speak on Friday about “Russian interference in the 2016 election,” and Rep. Ben Ray Lujan (D., Minn.), who chairs the DCCC, will attend a “festive brunch” on Saturday morning. Also making a “special appearance” on Friday will be Virginia’s governor-elect Ralph Northam.

The agenda also lists “special guests” at the conference, some more famous than others. Attendees showcased in the agenda range from failed California politician Sandra Fluke to liberal CNN contributor Van Jones to Center for American Progress CEO Neera Tanden.

Jones was headlining a Thursday dinner on “going outside the bubble” and learning from Trump voters.

Not all events and prominent guests are listed in the conference agenda.

Not listed, for example, was a Thursday night happy hour hosted by Planned Parenthood president Cecile Richards, who was spotted in attendance.

Also not listed as a special guest at the conference was David Brock, who checked in early Wednesday afternoon and has made himself highly visible at La Costa—slowly strolling around the sprawling property and staying up at the hotel bar till past midnight.

Brock is not a “partner” of Democracy Alliance—in fact, he has worked to create his own liberal donor network—but groups he controls, such as Media Matters for America, are among the many groups Democracy Alliance directs funding to.

Not listed in the agenda or spotted at the resort has been billionaire Tom Steyer, one of Democracy Alliance’s most prominent members in the past. Pelosi publicly reprimanded Steyer earlier this month for running a $10 million ad calling for President Trump’s impeachment.

Also not listed in the Democracy Alliance program was a meeting held by Patriotic Millionaires, who gave a Thursday morning briefing on the “tax fight” and “what is at stake.” The briefing was delivered by Larry Mishel of Americans for Tax Fairness, Thea Lee of Economic Policy Institute, and Jacob Leibenluft, a member of the Obama administration’s National Economic Council who is now with the Centeron Budget and Policy Priorities.

Not all meetings at the conference are open to all guests. Some meetings are “by invitation only,” “for prospective partners only,” or for “partners only.”

Right before Pelosi’s speech, for example, will be a “Partners only” forum dedicated to “committing resources.” The Democracy Alliance has never made its commitment decisions available to the public.

Democracy Alliance president Gara LaMarche wrote in a letter to attendees included in the agenda that President Trump’s November victory was “the most cataclysmic election of modern history.”

[Byline Brent Scher and Joe Schoffstall]

17 November 2017
The Washington Free Beacon (edited)

Elsewhere: Senate Tax Hearing Gets Heated When Dem Accuses Orrin Hatch of Working ‘For the Rich’

Fact is… Seven of the ten richest members of Congress are Democrats while only three are Republicans, according to a recently published analysis done by the Center for Responsive Politics.

Meanwhile ….

Nancy Pelosi of California, the Democratic leader, once again makes reference to “Fat Cats” … She said most Americans would get a “raw deal” under the GOP bill. “This tax scam won’t create jobs. It won’t raise wages. . . . It will only fill the coffers of donors and the fat cats,”  and  “With straight faces and with the speed of light — I have to give them credit — they raced this thing through in the dark of night. They’re trying to sell a bill of goods to the middle class that this is in their interest, that this is a middle income tax cut,” she said, adding that “Republicans are raising taxes on 36 million middle-class families.” 

Perhaps they had to pass it to see what’s in it… Transference much?

Flashback: Pelosi’s District Fat Cats Gobble Up Obamacare Waivers

Recall, Chief Justice John Roberts’s original 2012 defense of Obamacare was based on his understanding of the individual mandate as a “tax.” Thus, SCOTUS Justice’s Obamacare Decision Vindicates Inclusion Of The Individual Mandate In Tax Reform Bill.  Sounds like a job for a “Master Legislator” or something.

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Imaginings


“In a society dominated by the production and consumption of images, no part of life can long  remain immune from the invasion of spectacle.”  –Christopher Lasch

The minds of the potentially free individual has been infiltrated. Image generatiing devices are commonplace and now flood the mind with psychic levels of consumerism and propaganda of every form, flavor and genre. It has after all, become the primary means of marketing everything, including self-destruction and moral decadence, as if there can be any difference between the two.

Mass media invades the psychic privacy of each individual and exacerbates the decay of the culture and society in which it exists. It propagates its toxic influences and is able to convince many, that the poison it produces is indeed progress. But progress to whom, exactly?

By the time totalitarian control has taken over, and the promised utopia has turned into dystopia for the collective denizens; they will have discovered it too late, as any freedom that once existed has been dissolved, and any thought of such freedom is looked upon with hatred and punished accordingly.

Freedom and independence make real progress, they can be liken to fire as illustrated in the story below. Those who have this fire, want to selfishly keep it and guard it from others as a means to generate fear, enslave and to control them.  But there is always a thread of hope.

The following tale is a cultural legend that teaches us humankind benefits if it can maintain its balance between the past and future, and the physical and spiritual, all we need do is listen, pay attention and imagine the proper way to utilize our skills.

This Native American story illustrates that there is more than one way to weave illusions and turn them into something beneficial. Most mythologies share this common bond with the human spirit. Native American folklore is not so different and calls us, if we will listen, to make use of our individual creativity and weave our dreams of freedom and independence into our own destiny.

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Grandmother Spider Steals the Fire – A Mississippi Choctaw Legend

The Choctaw People say that when the People first came up out of the ground, People were encased in cocoons, their eyes closed, their limbs folded tightly to their bodies. And this was true of all People, the Bird People, the Animal People, the Insect People, and the Human People. The Great Spirit took pity on them and sent down someone to unfold their limbs, dry them off, and open their eyes. But the opened eyes saw nothing, because the world was dark, no sun, no moon, not even any stars. All the People moved around by touch, and if they found something that didn’t eat them first, they ate it raw, for they had no fire to cook it.

All the People met in a great powwow, with the Animal and Bird People taking the lead, and the Human People hanging back. The Animal and Bird People decided that lief was not good, but cold and miserable. A solution must be found! Someone spoke from the dark,

‘I have heard that the people in the East have fire.’ This caused a stir of wonder, ‘What could fire be?’ There was a general discussion, and it was decided that if, as rumor had it, fire was warm and gave light, they should have it too. Another voice said, ‘But the people of the East are too greedy to share with us.’ So it was decided that the Bird and Animal People should steal what they needed, the fire!

But, who should have the honor? Grandmother Spider volunteered, ‘I can do it! Let me try!’ But at the same time, Opossum began to speak. ‘I, Opossum, am a great chief of the animals. I will go to the East and since I am a great hunter, I will take the fire and hide it in the bushy hair on my tail.’ It was well know that Opossum had the furriest tail of all the animals, so he was selected.

When Opossum came to the East, he soon found the beautiful, red fire, jealously guarded by the people of the East. But Opossum got closer and closer until he picked up a small piece of burning wood, and stuck it in the hair of his tail, which promptly began to smoke, then flame. The people of the East said, ‘Look, that Opossum has stolen our fire!’ They took it and put it back where it came from and drove Opossum away. Poor Opossum! Every bit of hair had burned from his tail, and to this day, opossums have no hair at all on their tails.

Once again, the powwow had to find a volunteer chief. Grandmother Spider again said, ‘Let em go! I can do it!’ But this time a bird was elected, Buzzard. Buzzard was very proud. ‘I can succeed where Opossum has failed. I will fly to the East on my great wings, then hide the stolen fire in the beautiful long feathers on my head.’ The birds and animals still did not understand the nature of fire. So Buzzard flew to the East on his powerful wings, swooped past those defending the fire, picked up a small piece of burning ember, and hid it in his head feathers. Buzzard’s head began to smoke and flame even faster! The people of the East said, ‘Look! Buzzard has stolen the fire!’ And they took it and put it back where it came from.

Poor Buzzard! His head was now bare of feathers, red and blistered looking. And to this day, buzzards have naked heads that are bright red and blistered.

The powwow now sent Crow to look the situation over, for Crow was very clever. Crow at that time was pure white, and had the sweetest singing voice of all the birds. But he took so long standing over the fire, trying to find the perfect piece to steal that his white feathers were smoked black. And he breathed so much smoke that when he tried to sing, out came a harsh, ‘Caw! Caw!’

The Council said, ‘Opossum has failed. Buzzard and Crow have failed. Who shall we send?’

Tiny Grandmother Spider shouted with all her might, ‘LET ME TRY IT PLEASE!’ Though the council members thought Grandmother Spider had little chance of success, it was agreed that she should have her turn. Grandmother Spider looked then like she looks now, she had a small torso suspended by two sets of legs that turned the other way. She walked on all of her wonderful legs toward a stream where she had found clay. With those legs, she made a tiny clay container and a lid that fit perfectly with a tiny notch for air in the corner of the lid. Then she put the container on her back, spun a web all the way to the East, and walked tiptoe until she came to the fire. She was so small, the people from the East took no notice. She took a tiny piece of fire, put it in the container, and covered it with the lid. Then she walked back on tiptoe along the web until she came to the People. Since they couldn’t see any fire, they said, ‘Grandmother Spider has failed.’

‘Oh no,’ she said, ‘I have the fire!’ She lifted the pot from her back, and the lid from the pot, and the fire flamed up into its friend, the air. All the Birds and Animal People began to decide who would get this wonderful warmth. Bear said, ‘I’ll take it!’ but then he burned his paws on it and decided fire was not for animals, for look what happened to Opossum!

The Birds wanted no part of it, as Buzzard and Crow were still nursing their wounds. The insects thought it was pretty, but they, too, stayed far away from the fire.

Then a small voice said, ‘We will take it, if Grandmother Spider will help.’ The timid humans, whom none of the animals or birds thought much of, were volunteering!

So Grandmother Spider taught the Human People how to feed the fire sticks and wood to keep it from dying, how to keep the fire safe in a circle of stone so it couldn’t escape and hurt them or their homes. While she was at it, she taught the humans about pottery made of clay and fire, and about weaving and spinning, at which Grandmother Spider was an expert.

The Choctaw remember. They made a beautiful design to decorate their homes, a picture of Grandmother Spider, two sets of legs up, two down, with a fire symbol on her back. This is so their children never forget to honor Grandmother Spider, Fire bringer!

Author unknown.

Yeah – Breakout the dusty music…


Let it sneak out of my headphones as it groves across the room. — Shhh… listen.



Standard YouTube License, Rare Earth – affiliated with Motown’s Rare Earth record label. All Rights Reserved

What a ‘Real’ Church Massacre looks like…


Collective phenomena are less sensitive to correction than individual phenomena. Because it is widely shared by identification, collective delusion is less amendable to correction than individual self-deceit.

Never Forget: The US Gov’t Carried Out the Largest Church Massacre—24 Years Ago, In Texas


Think about it.

Bill Clinton & Janet Reno Murdered 82 At Waco, Texas: Bill Clinton Personally Orchestrated the 1993 Waco, Texas Genocide : Guilty Of Sedition And Inciting Oklahoma City Bombing!

A government that jails and murders ranchers and law abiding citizens as terrorists for burning some grassland, or practicing their non-state sanctioned religion, while graciously allowing urban thugs“space to destroy,” and intimidate, will not hesitate to fabricate reasons to take the guns that people use as protection against such acts. Neither can such a government that uses the IRS to punish its political opponents be trusted with defending the second amendment, or any other constitutional freedom, for that matter. 


waco-696x366

The mainstream media has completely forgotten about the deadliest church massacre in history, the one the US government carried out in Waco, Texas.

On Sunday, a horrifying tragedy unfolded as a mass shooting terrorist walked into a Texas church and began slaughtering innocent women, men, and children. The massacre left 26 people dead, according to police, including an unborn child who died inside his pregnant mother.

On Wednesday, the names of the deceased were released along with the heartbreaking photos of the children, two of which were only 5 and 7-years-old. The tragedy is being dubbed the deadliest mass shooting in Texas history.

Sadly, there have been many deadly massacres which have taken place inside places of worship. From the 16th Street Baptist Church bombing to the Charleston Church shooting to Sutherland Springs, over the years, psychotic terrorists have gone into churches and indiscriminately taken innocent lives.

Now, some of those in the mainstream media are calling Sutherland Springs the deadly massacre in a church in US history. However, the actual largest church massacre in history had a far greater death toll.

The US government carried out the deadliest church massacre in history and it led to the deaths of 82 men, women, and children. It all came to a violent end 24 years ago in Texas.

Our source material comes from the FBI’s own vault, which contains two files on the case against Vernon Howell, also known as David Koresh. Koresh was the leader of the “Branch Davidians Seventh Day Adventists.” According to the FBI case file, Koresh was believed to have been holding people against their will at his compound in Waco, Texas, potentially guilty of “involuntary servitude and slavery” charges.

In 1992, Child Protective Services (CPS) was called in to investigate the accusations. After a thorough investigation, CPS concluded no one was being held at the compound against their will, nor any child abuse, and the federal prosecutor, who reviewed the report, saw no reason to prosecute Koresh. On October 16th, 1992, the FBI closed the case against Koresh and the allegations he was abusing children and holding his followers against their will.

Still, however, the FBI proceeded with investigating other allegations the Branch Davidians had converted semi-automatic AR-15 (assault) rifles into fully automatic ones, a violation of federal law. Also alleged was that the group was planning a mass suicide. The FBI concluded, “no information has been developed to verify the accuracy of the allegations.” Still, the FBI put local law enforcement on notice.

Despite having no concrete evidence Koresh, who some have said was delusional, had violated anyone’s civil rights, or abused any children, the investigation into the weapons violations continued. The Bureau of Alcohol, Tobacco, Firearms and Explosives pursued the allegations the group was stockpiling weapons and explosives. According to the ATF,  the bureau found:

136 FIREARMS, INCLUDING ASSAULT RIFLES AND HANDGUNS

700+ MAGAZINES FOR THOSE FIREARMS

200,000+ ROUNDS OF VARIOUS AMMUNITION

110 UPPER AND LOWER RECEIVERS FOR AR15/M16 RIFLES

GRENADE-LAUNCHER ATTACHMENTS FOR AR15/M16 RIFLES

400+ EMPTY M31 RIFLE GRENADES, ALONG WITH BLACK POWDER AND OTHER

EXPLOSIVE CHEMICALS

Wishing to further investigate the compound’s armory, the ATF secured a search warrant and attempted to raid the compound on February 28th, 1993. The Davidians, possibly feeling they must protect their home, property, and persons from the intruders, opened fire on the federal agents, an action which led to the deaths of several ATF agents and compound members.

FOUR ATF AGENTS (SA TODD MCKEEHAN, SA CONWAY LEBLEU, SA ROBERT WILLIAMS AND SA STEVEN WILLIS) WERE KILLED; 20 ATF AGENTS WOUNDED FROM GUNSHOTS OR SHRAPNEL AND 8 SUFFERED OTHER INJURIES. SIX DAVIDIANS WERE ALSO REPORTEDLY KILLED AND FOUR WOUNDED FROM GUNSHOTS, ALTHOUGH THIS COULD NOT BE FORENSICALLY PROVEN BECAUSE OF THE LATER DESTRUCTION (BY FIRE) OF THE COMPOUND.

The raid initiated a 51-day standoff with the ATF as well as the FBI. Koresh released 24 members from the compound, who were mostly children, and continued the stand-off with authorities which was broadcast daily across the country until day 51 arrived.

On that day, the government brought in heavy equipment and penetrated the compound with a tank-like machine which pumped the compound full of CS Gas. What happened next, in the minds of many who saw it, can only be likened to a horror film.

The compound became ablaze with a roaring fire. The all-consuming inferno killed 76 people who were huddled inside. Later, it was determined many of those who’d perished were also shot by firearms. Researchers, who later investigated the incident, concluded federal agents were observed shooting from the compound’s grounds into the building already set ablaze by fire.

While the official government narrative is those individuals committed suicide, the researchers were able to demonstrate they were likely killed by automatic weapons fired by federal agents, possibly killed as they were attempting to flee their burning compound.

To this day, the ATF maintains the fire was, “set by cult members, as law enforcement attempted to force them out by introducing tear gas into the building.” And for years, following the fiery destruction of the compound, the FBI maintained the same story line. \

However, in 1999, then-Attorney General Janet Reno made the following admission, “I am very, very troubled by the information I received this week suggesting that pyrotechnic devices may have been used in the early morning hours on April the 19th, 1993, at Waco. At this time, all available indications are that the devices were not directed at the main wooden compound, were discharged several hours before the fire started, and were not the cause of the fire. Nonetheless, it is absolutely critical that we do everything humanly possible to learn all the facts as accurately as possible and make them available to the public and Congress.”

Those facts, according to some of the survivors of the fire, who were inside at the time the fire broke out, are undeniable. They are convinced the government used incendiary devices to set ablaze the tear gas which had been pumped into the building. And they’re not alone.

According to CBS News, “Independent filmmaker Michael McNulty came upon some evidence that appeared damaging to the government. He found a shell casing from a certain type of tear gas round that could start a fire – a device the Justice Department had denied using for more than six years – publicly and to Congress.”

That shell casing led to Reno’s acknowledgment, but the government still has not taken full responsibility, as Reno denied the devices were used to penetrate the building. Questions still remain as to why they would be used at all.

Even though it was later determined Koresh had, indeed, molested children, and was by all intents and purposes a pedophile of the worst kind, the fact remains. The government used gas and allegedly fired on its own people which either directly or indirectly led to the deaths of 76 people — inside a church. Sadly, there was no outcry and this incident serves as a brutal reminder of what can happen when the US government makes up its mind to take out those they disagree with.

[Byline Matt Agorist]

thefreethoughtproject.com

Delivered by The Daily Sheeple (edited)
09 November 2017

Rewarding Bad Behavior – It’s what they do…


The Bergdahl Progressives

Photos surfaced on Twitter of Sgt. Bowe Bergdahl smiling and embracing a Taliban leader, adding to the suspicion of treason.

Sgt. Bowe Bergdahl smiling and embracing a Taliban leader, captured here obviously “misbehaving before the enemy.”

FARMINGTON, ME — I’m minding my own business in a bookstore near the University of Maine’s campus here when I hear two women talking.

One of them is trashing Donald Trump as the other sagely nods. Then they start gushing about Barack Obama’s “greatness” and what “a fine president” he was.

Tempted almost beyond endurance to say something, I buried my head in the Brad Thor thriller that I had been thumbing through. Nothing I would have said could have changed their minds. Nothing. We live in two different universes.

While driving back, a number of snappy one-liners came to mind. But none would have done any good. Progressivism and its cousin, atheism, often are practiced with unacknowledged religious fervor. One-liners cannot penetrate devotees’ armor any more than opposite sentiments should undermine the faith of a devout Christian, Jew or Muslim.

I thought later about the women’s admiration of Obama while reading about Army deserter Bowe Bergdahl’s light, dishonorable discharge without incarceration for leaving his post in 2009 and causing severe injuries and possibly related deaths of several fellow soldiers in Afghanistan. Sgt. Bergdahl’s return was procured by President Obama in 2014 in exchange for five Taliban commanders who have gone back to plotting the destruction of the United States and our allies.

Here’s a snapshot, courtesy of columnist Don Feder, into Bowe Bergdahl’s view of the nation that sacrificed so much to secure his return:

“In an e-mail to his parents before he took French leave in 2009, Bergdahl said he was ‘ashamed to be an American’ (twice), that ‘the title of US soldier is just the lie of fools,’ that ‘the US Army is the biggest joke the world has to laugh at… It is the army of liars, backstabbers and bullies, and ‘the horror that is America is disgusting.’”

It’s a good bet that Bergdahl would take a knee at an NFL game during the national anthem if he were a player.

Keep in mind that Mr. Obama honored Bergdahl’s parents at the White House Rose Garden. National Security Advisor Susan Rice hailed the deserter as having served “with honor and distinction.”

At the sentencing, the court heard from Shannon Allen, wife of National Guard Master Sergeant Mark Allen, who was shot in the head while searching for Bergdahl. Sgt. Allen, who is unable to speak, will spend the rest of his life in a wheelchair, unable to lift his arms to hug his 9-year-old daughter.

“He’s not able to reach out for her or talk to her,” Mrs. Allen said. “He’s never had the chance to really play with her or help coach her sports or ask about her day…. He lost me as a wife, essentially, because instead of being his wife I am his caregiver. I mean, we can’t even hold hands anymore.”

In a 2014 Facebook post next to a photo of wheelchair-bound Allen in his dress blues, alongside their young daughter, she wrote, “Meet my husband, injuries directly brought to you by the actions of this traitor.

“He can’t give an account of what went down, because he can no longer speak. Now, which guy is a ‘hero’ again?!?’’

Barack Obama did a lot of other un-American things during his eight-year reign, including his bowing to foreign rulers, his infamous apology tour of the Middle East, and his cash payment of $1.7 billion to Iran. But, the Bergdahl deal is right up there.

Instead of being proud of America, Obama’s Bergdahl progressives believe that the land of the free and home of the brave needs to be taken down a peg. How dare we enjoy an “exceptional” amount of success when the rest of the world lags behind? So what if our country began with the unique view that our rights come from the God of the Bible, not government, and that this led to unprecedented liberty and prosperity?

The proffered solution of the Bergdahl progressives to any and all inequality is to make America more like the rest of the world, not less.

It means blurring the line between honor and dishonor. And confusing traitors with victims or heroes.

And it means elevating the most un-American president in history to a higher place than the 43 presidents before him.

[Byline Robert Knight]

14 November 2017
Townhall

*********

Related

Father Of Soldier Who Obama Released, Declares Muslim Victory Call, And Obama Smiles

Meet the Six who died looking for Bergdahl-the deserter

Bergdahl faces little-known, rarely used misbehavior charge

In Summary

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Biological Health Hazard – (Zoonotic Disease Outbreak) Anaplasmosis, Lyme disease, Babesiosis: Maine, USA


ANAPLASMOSIS, LYME DISEASE, BABESIOSIS – USA: (MAINE) INCREASED CASES
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Published Date: 2017-11-14 13:50:35
Subject: PRO/AH/EDR> Anaplasmosis, Lyme disease, babesiosis – USA: (ME) increased cases
Archive Number: 20171114.5443131

File:National-atlas-maine.png

State of Maine: This map was obtained from an edition of the National Atlas of the United States. Like almost all works of the U.S. federal government, works from the National Atlas are in the public domain in the United States. Online access: NationalAtlas.gov | 1970 print edition: Library of Congress, Perry-Castañeda Library

Date: Mon 13 Nov 2017 4:00 AM EST
Source: Portland Press Herald [edited]

Reported cases of a tick-borne disease are swelling in Maine this year [2017], but it’s not Lyme disease. Cases of anaplasmosis, an illness with flu-like symptoms that are similar to Lyme but typically more severe, have jumped from 52 a year in Maine 5 years ago to 433 this year, through [24 Oct 2017], according to the Maine Center for Disease Control and Prevention. Of this year’s 433 cases, 113 were hospitalized, according to Maine CDC statistics.

The deer tick, the same tick that’s a carrier for the bacteria that cause Lyme disease, is also a carrier for anaplasmosis.

Lyme — of which there have been more than 1000 cases per year in Maine since 2011 — has established a long-term presence in the state, but anaplasmosis has remained under the radar.

Anaplasmosis cases are also rising in other New England states: Massachusetts had 828 cases in 2016 compared to about 200 in 2012, while New Hampshire, Vermont, and Rhode Island are also reporting increases. Lyme cases remain strong in Maine, but the 1039 cases through September [2017] are below 5-year averages. Another tick-borne disease, babesiosis, is also increasing, but still at much lower rates than Lyme or anaplasmosis, with 93 cases through September [2017].

Anaplasmosis symptoms are flu-like and can include fever, chills, fatigue, and joint pain. About 25-30 percent of all anaplasmosis cases result in hospitalizations, compared to about 5 percent of Lyme cases.

Mainers are more at risk of anaplasmosis, experts say, for a number of reasons. Part of the issue is greater awareness and more testing by people who fall ill. But also, more deer ticks are infected with anaplasmosis and passing the bacteria on to humans, said Chuck Lubelczyk, a field biologist with the Maine Medical Center Research Institute in Scarborough. “It certainly is spreading,” Lubelczyk said.

Several years ago, in southern Maine, 5 percent or fewer of ticks that were tested had anaplasmosis, he said. Now, it’s doubled, and about 10 percent of the ticks are infected with anaplasmosis. In the midcoast and points north, it was extremely rare for a deer tick to have anaplasmosis bacteria. A few percent of the tested ticks along the midcoast now have it, about the same rates as southern Maine 5 to 7 years ago, Lubelczyk said.

In comparison, more than 50 percent of deer ticks — sometimes more than 65 percent — carry Lyme disease in Maine.

Lubelczyk said ticks seem to be out earlier and longer than previously, emerging earlier in the spring and lingering into the fall, and he sees more nymph-stage ticks, which are small and difficult to detect. “We may be having 2 different tick populations, one that arrives earlier and another that arrives later. It’s not clear yet,” he said.

Sara Robinson, a Maine CDC epidemiologist, said anaplasmosis is more difficult to detect than Lyme, as anaplasmosis does not have the “bull’s-eye” rash that appears in some infected with Lyme, signaling that they have the disease. Robinson said the best way to tell is if you’re feeling like you have the flu outside of flu season, which is typically October to May. “If you feel like you’re getting the flu in the summer, call your doctor,” Robinson said.

“Anaplasmosis is becoming more frequent in Maine and particularly emergency room and urgent care sites need to be aware that a ‘summer flu’ in an endemic area is anaplasmosis until proven otherwise,” [Dr Heidi Heap-Chester, who cared for a patient who tested positive for “multiple tick-borne diseases”] said. Anaplasmosis responds well to antibiotic treatment if caught early, but it’s difficult to catch early.

Prevention is also key. Wear long clothing and repellents when in tick habitat, such as the woods, and when picking up dead wood or leaves. Check often for ticks, which are difficult to see. Lubelczyk said one of the more common ways to pick up a tick is from your pet. The tick that’s on your pet can drop off after feeding and crawl on you.

People who do find a tick on them should remove it immediately and have it tested. In most cases, ticks need to be attached to a human for 36 hours before diseases can be transmitted.

[Byline: Joe Lawlor]

Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

Related:  Maine reports more than 400 anaplasmosis cases through September

[_Anaplasma phagocytophilum_, the causative agent of anaplasmosis (also known as human granulocytic anaplasmosis or HGA), _Borrelia burgdorferi_, the causative agent of Lyme disease, and _Babesia microti_, the causative agent of babesiosis, are transmitted to humans in wooded areas of the northeastern United States by the same tick (_Ixodes scapularis_). Typically, the nymph stage of the tick, which is about the size of a poppy seed, transmits these diseases. For a picture of the nymph, see http://www.cdc.gov/parasites/babesiosis/. Patients may be concurrently co-infected by these pathogens.

An increased incidence of anaplasmosis can be due to a true increase in the number of cases as the primary vector and the reservoir hosts spread geographically into previously uninvolved regions, but also better recognition and reporting of these diseases may contribute to the increases in the number of reported cases.

Some individuals infected with _A. phagocytophilum_ do not become ill or experience only very mild symptoms and do not seek medical treatment. The symptoms tend to be most severe in aged or immunosuppressed people. In infected persons who are symptomatic with anaplasmosis, illness onset occurs 5-21 days after a bite from an infected tick. Initial presentation typically includes sudden onset of fever, headache, malaise, and myalgia, often accompanied by thrombocytopenia, leukopenia, and elevated liver transaminases. Approximately 5 to 7 percent of patients require intensive care, and the disease can be fatal. Severe infections can include prolonged fever, shock, confusion, seizures, pneumonitis, renal failure, hemorrhages, and death.

The presence of hemolytic anemia suggests babesiosis. Some patients also have splenomegaly, hepatomegaly, or jaundice. Severe cases can be associated with marked thrombocytopenia, disseminated intravascular coagulation, hemodynamic instability, acute respiratory distress, myocardial infarction, renal failure, hepatic compromise, altered mental status, and death.

Their diagnoses are based on specific antibody tests, detection of specific nucleic acid (DNA) by polymerase chain reaction (PCR), and microscopy of thick and thin blood films. In babesiosis, manual (non-automated) review of Wright-stained peripheral blood smears or buffy-coat preparations can demonstrate intraerythrocytic ring forms. Sometimes it can be difficult to distinguish between _Babesia_ and _Plasmodium_ (especially _P. falciparum_) parasites. Cytoplasmic inclusions consisting of vacuolar microcolonies of _A. phagocytophilum_ within neutrophils can be found in 20 to 80 percent of patients with anaplasmosis, unlike the rarity of visualizing organisms within circulating mononuclear cells in patients with human monocytotropic ehrlichiosis (Weinberg G: Laboratory diagnosis of ehrlichiosis and babesiosis. Pediat Infect Dis J 2001; 20(4): 435-7).

Because _A. phagocytophilum_ and _B. microti_ are found in the blood stream, infected blood can serve as a vehicle for person-to-person transmission (Centers for Disease Control and Prevention. _Anaplasma phagocytophilum_ transmitted through blood transfusion — Minnesota, 2007. MMWR 2008; 57(42): 1145-8. [date cited] Available from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5742a1.htm).

Treatment with doxycycline 100 mg twice daily orally or intravenously for 10 days for all symptomatic patients suspected of having anaplasmosis is recommended for a minimal total course of 10 days. This treatment regimen should be adequate therapy for patients with anaplasmosis alone and for patients who are co-infected with Lyme disease, but is not effective therapy for patients who are co-infected with _B. microti_.

Most asymptomatic persons with babesiosis do not require treatment. For ill patients, babesiosis is treated for at least 7-10 days with a combination of either: atovaquone plus azithromycin, or clindamycin plus quinine (this combination is the standard of care for severely ill patients).

The northeastern US state of Maine can be located on the HealthMap/ProMED-mail interactive map at http://healthmap.org/promed/p/222. A map of Maine counties can be found at http://geology.com/county-map/maine-county-map.gif. – Mod.ML]

See Also

2016
—-
Lyme disease – USA: (upper Midwest region) new Borrelia species 20160222.4040006
Lyme disease, anaplasmosis – USA: (ME) incr. cases 20161214.4697848
Anaplasmosis, babesiosis, Lyme disease – USA: (ME) increased incidence 20160825.4442433

2014
—-
Anaplasmosis – USA (02): (ME) increased incidence, update 20141013.2857236
Anaplasmosis – USA: (ME) increased incidence 20140805.2661101

2012
—-
Anaplasmosis – USA (02): (ME) background 20120813.1241732
Anaplasmosis – USA: (ME) increased incidence 20120811.1239966
Babesiosis, anaplasmosis – USA: (MA) 20120709.1195265

2011
—-
Babesiosis – USA (02): nationwide survey, background 20111219.3634
Babesiosis – USA: nationwide survey 20111218.3624

2009
—-
Babesiosis, blood transfusion – USA: (NYC) risk advisory 20090225.0777
………………………………………….sb/ml/mj/mpp

Source:
A ProMED-mail post
ProMED-mail is a program of the International Society for Infectious Diseases


 Related

Human infection with a novel tick-borne Anaplasma species in China: a surveillance study   Volume 15, No. 6, p663–670, June 2015 – The Lancet Infectious Diseases

Chinese researchers have identified a new strain of tickborne Anaplasma species that infects humans and goats in China, according to a report yesterday in The Lancet Infectious Diseases.

The team collected blood samples from patients who had a history of tick bite in the preceding 2 months at a hospital in Heilongjiang province from May 1 to Jun 10, 2014. They found that 28 of 477 patients (6%) were infected with a novel strain of Anaplasma that differed from the A phagocytophilum and A ovis species known to infect people.

Because the parasite also infects goats, the investigators dubbed it Anaplasma capra.

All 28 patients developed non-specific febrile manifestations, including fever in 23, headache in 14, malaise in 13, dizziness in 9, myalgia in 4, and chills in 4. Ten had rash or eschar, 8 had lymphadenopathy, 8 had gastrointestinal symptoms, and 3 had stiff neck. Five patients were hospitalized because of severe disease. —CIDRAP – Center for Infectious Disease Research and Policy


Pritt BS, Mead PS, Hoang Johnson DK, et al: Identification of a novel pathogenic _Borrelia_ species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study. Lancet Infect Dis. 2016. 2016; published online; abstract available at http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00464-8/abstract.

Lyme borreliosis is the most common tick-borne disease in the northern hemisphere. It is a multisystem disease caused by _Borrelia burgdorferi_ sensu lato genospecies and characterised by tissue localisation and low spirochaetaemia. In this study, we aimed to describe a novel _Borrelia_ species causing Lyme borreliosis in the USA.

_Borrelia burgdorferi_ sensu lato (that is, in the broad sense) is a group of genetically and phenotypically divergent spirochetal bacterial species, not all of which are known to cause human disease (http://cmr.asm.org/content/12/4/633.long). Human infection, called Lyme borreliosis, due to _B. burgdorferi_ sensu lato may involve multiple organs or tissues, resulting in skin, cardiac, neurological, and musculoskeletal disorders. Different _B. burgdorferi_ sensu lato species have been associated with distinct clinical manifestations. Multiple erythema migrans (EM) and Lyme arthritis are more common in the United States than in Europe, whereas neuroborreliosis [or Lyme affecting the nervous system], borrelial lymphocytoma [bluish-red nodular swelling], and acrodermatitis chronica atrophicans [condition affecting distal parts of the limbs; the most common manifestation of the late stage of Lyme disease] have more frequently occurred in European patients. In addition, _Borrelia_ species are differentially distributed worldwide. In Europe, most commonly _B. burgdorferi_ sensu stricto, _B. garinii_, and _B. afzelii_ cause Lyme borreliosis in humans; whereas, in the North America, only _B. burgdorferi_ sensu stricto was known to cause Lyme borreliosis.

The news report above describes the finding of a new _B. burgdorferi_ sensu lato genospecies (candidatus _B. mayonii_) in 6 (5 blood, 1 synovial fluid) of 100 545 clinical specimens that were submitted by physicians for routine PCR from 1 Jan 2003 to 30 Sep 2014 in the upper Midwestern USA. This organism was also detected in _Ixodes scapularis_ ticks collected at probable patient exposure sites, but was not detected in clinical specimens before 2012.

Genetic differences between species within the _B. burgdorferi_ sensu lato complex may result in problems with the serodiagnosis of Lyme borreliosis, especially in regards to immunoblot assays, although it may be less important for enzyme-linked immunosorbent assays (ELISAs) (http://jid.oxfordjournals.org/content/169/2/313.abstract?ijkey=575b92fb19da9611b73c374a6947577b14843bee&keytype2=tf_ipsecsha). However, ELISAs using the C6 peptide are reported to overcome these problems (http://cid.oxfordjournals.org/content/57/3/333.long). We are not told if there are similar problems with the serodiagnosis of Lyme borreliosis due to candidatus _B. mayonii_.

[This causative agent of Lyme borreliosis appears to be quite rare and limited at this time to the upper Midwestern USA]

See Medscape, Reuters report


Anaplasmosis 

Background

Anaplasmosis is a tickborne disease caused by the bacterium Anaplasma phagocytophilum and the novel (Anaplasma capra). Anaplasmosis was previously known as human granulocytic ehrlichiosis (HGE) and has more recently been called human granulocytic anaplasmosis (HGA). In the U.S., Anaplasmosis is transmitted to humans by tick bites primarily from the black-legged tick (Ixodes scapularis). Of the four distinct phases in the tick life-cycle (egg, larvae, nymph, adult), nymphal and adult ticks are most frequently associated with transmission of anaplasmosis to humans.

Clinical Description

The first symptoms of anaplasmosis typically begin within 1-2 weeks after the bite of an infected tick. A tick bite is usually painless, and some patients who develop anaplasmosis do not remember being bitten. The following is a list of symptoms commonly seen with this disease. However, it is important to note that few people with the disease will develop all symptoms, and the number and combination of symptoms varies greatly from person to person.

  1. Fever
  2. Headache
  3. Muscle pain
  4. Malaise
  5. Chills
  6. Nausea / Abdominal pain
  7. Cough
  8. Confusion
  9. Rash (rare with anaplasmosis)

Anaplasmosis can be a serious illness that can be fatal if not treated correctly, even in previously healthy people. Severe clinical presentations may include difficulty breathing, hemorrhage, renal failure or neurological problems. The estimated case fatality rate (i.e., the proportion of persons who die as a result of their infection) is less than 1%. Patients who are treated early may recover quickly on outpatient medication, while those who experience a more severe course may require intravenous antibiotics, prolonged hospitalization or intensive care.

Rash is rarely reported in patients with anaplasmosis and the presence of a rash may signify that the patient has a co-infection with the pathogen that causes Lyme disease or another tickborne disease, such as Rocky Mountain Spotted Fever.

The severity of anaplasmosis may depend in part on the immune status of the patient. Persons with compromised immunity caused by immunosuppressive therapies (e.g., corticosteroids, cancer chemotherapy, or long-term immunosuppressive therapy following organ transplant), HIV infection, or splenectomy appear to develop more severe disease, and case-fatality rates for these individuals are characteristically higher than case-fatality rates reported for the general population.

Because A. phagocytophilum infects the white blood cells and circulates in the blood stream, this pathogen may pose a risk to be transmitted through blood transfusions. A. phagocytophilum has been shown to survive for more than a week in refrigerated blood. Several cases of anaplasmosis have been reported associated with the transfusion of packed red blood cells donated from asymptomatic or acutely infected donors. Patients who develop anaplasmosis within a month of receiving a blood transfusion or solid organ transplant should be reported to state health officials for prompt investigation. Use of leukoreduced blood products may theoretically decrease the risk of transfusion-associated transmission of these pathogens. However, the filtration process does not remove all leukocytes or bacteria not associated with leukocytes from leukoreduced blood. Therefore, while this process may reduce the risk of transmission, it does not eliminate it completely.

There are several aspects of anaplasmosis that make it challenging for healthcare providers to diagnose and treat. The symptoms vary from patient to patient and can be difficult to distinguish from other diseases. Treatment is more likely to be effective if started early in the course of disease. Diagnostic tests based on the detection of antibodies will frequently appear negative in the first 7-10 days of illness. For this reason, healthcare providers must use their judgment to treat patients based on clinical suspicion alone. Healthcare providers may find important information in the patient’s history and physical examination that may aid clinical diagnosis. Information such as recent tick bites, exposure to areas where ticks are likely to be found, or history of recent travel to areas where anaplasmosis is endemic can be helpful in making the diagnosis.

The healthcare provider should also look at routine blood tests, such as a complete blood cell count or a chemistry panel. Clues such as a low platelet count (thrombocytopenia), low white blood cell count (leukopenia), or elevated liver enzyme levels are helpful predictors of anaplasmosis, but may not be present in all patients. After a suspect diagnosis is made on clinical suspicion and treatment has begun, specialized laboratory testing should be used to confirm the diagnosis of anaplasmosis.

More Information:

Centers for Disease Control and Prevention
National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
Division of Vector-Borne Diseases (DVBD)

Follow the Nanotechnology – Digital Medicines: Hacking Privacy, and Tuning-up the Reality Distortion Field


FDA approves first-of-its-kind antipsychotic that tracks whether patients are taking it

Digital Medicines

The Food and Drug Administration has approved an antipsychotic drug that carries a digital sensor to track whether patients are taking it, according to an agency announcement published Monday.

The new drug, Abilify MyCite, is used to treat schizophrenia and manic episodes associated with bipolar disorder. After a patient has swallowed it and once the medication reaches the stomach, a sensor sends a message to a wearable patch, which then transfers information onto a mobile app.

Patients then use the app to track whether they have taken their medication and they can give caregivers or doctors access to that information through an online site.

The drug was made in collaboration with Otsuka pharmaceutical and Proteus Digital Health, which designed the sensor. It’s the first of its kind to have such a tracking system.

“Being able to track ingestion of medications prescribed for mental illness may be useful for some patients,” Dr. Mitchell Mathis, director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research, said in a statement. “The FDA supports the development and use of new technology in prescription drugs and is committed to working with companies to understand how technology might benefit patients and prescribers.”

The labeling for the drug notes that it isn’t clear, however, whether patients were more likely to take the drug because of the app.

Abilify on its own has been approved since 2002 and is now off patent. Its combination with the sensor retains a black box warning, which the FDA places on medications when serious side effects can occur.

In the case of Abilify, the label notifies patients and doctors that older patients who have psychosis as a result dementia would be at an increased risk of death if they were to take the medication. In children and teens, as well as in young people who take antidepressants, Abilify MyCite can have an increased risk in suicidal thoughts and behavior. FDA published another warning in 2016 showing that in rare cases some patients began having compulsive urges to gamble, binge eat, shop and have sex.

More common side effects for Abilify include nausea, vomiting, anxiety, insomnia and restlessness. Additionally, the patch that tracks the sensor can cause skin irritation.

The FDA previously rejected the drug about 1.5 years ago, saying it needed more information about whether human error could create any risks.

[Byline Kimberly Leonard]

13 November 2017
Washington Examiner (edited)

Product Recall pending.


Otsuka And Proteus® Announce The First U.S. FDA Approval of A Digital Medicine System: ABILIFY MYCITE® (aripiprazole tablets with sensor)

Otsuka’s approach for this first-of-its-kind treatment is novel for a pharmaceutical company.  ABILIFY MYCITE, (aripiprazole tablets with sensor) the first FDA-approved digital medicine system, is comprised of an Otsuka aripiprazole tablet embedded at the point of manufacture with an IEM sensor. This IEM sensor is the size of a grain of sand, and is made up of ingredients found in food. The IEM sensor activates when in contact with stomach fluid and communicates to a wearable sensor, called the MYCITE Patch. The IEM sensor is then digested and eliminated from the body.  This initial limited roll out will be a crucial step in determining Otsuka’s broader go-to-market plan. Visit www.ABILIFYMYCITE.com for more information and media resources.

Proteus Digital Health is enabling a new category of therapy: Digital Medicines. These offerings include widely used drugs, formulated so they communicate when they have been swallowed; a wearable patch that detects medicines and captures physiologic response; mobile applications to support patient self-care and physician decision-making; and data analytics to serve the needs of health system managers. The company has more than 440 issued patents that protect this enabling technology, and regulatory clearances in the U.S., European Union and China. Proteus Digital Health is privately held by investors that include Carlyle, Essex Woodlands, Kaiser Permanente®, Medtronic®, Novartis®, Otsuka®, Oracle®, and ON Semiconductor®. Further information is available at: www.proteus.com.

(Press Release Excerpt)

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