Lyme Handbook

Excerpted from the Bangor Daily News ( Posted: 05/30/2012)

The tiny deer ticks marching northward through Maine may be hard to spot, but the diseases they carry are hard to miss.

Maine is recording increasing numbers of illnesses transmitted by the bite of the eight-legged deer tick, including two lesser-known germs following in Lyme disease’s footsteps. Cases of anaplasmosis, which affects white blood cells, have spiked from nine in 2007 to 26 in 2011, according to state epidemiologist Dr. Stephen Sears. Already in 2012, 15 cases have been reported.

“Although those numbers are very small compared to Lyme, the fact that it’s increasing, and it seems to be increasing pretty significantly each year, suggests to me that we really all need to become aware of all these diseases,” Sears said.

Also on health officials’ radar is babesiosis, a less common but potentially serious tick-borne disease in which microscopic parasites infect red blood cells. It can especially sicken those with weak immune systems and people who have had their spleen removed.

Both anaplasmosis and babesiosis cause fever, headache, and muscle aches, though some people infected with babesiosis experience no symptoms.

“If [people] get fevers and chills in the summer and they don’t have a rash, that could be Lyme disease without a rash, it could be anaplasma, it could be something else,” Sears said. “If they had tick exposure, that’s especially important.”

The deer tick can transmit Lyme, anaplasmosis and babesiosis. With one bite, a tick could infect its host with all three diseases.

The dog tick, meanwhile, which is larger with characteristic white markings, can carry Lyme but doesn’t transmit it.

Numbers wise, anaplasmosis and babesiosis still pale in comparison to Lyme disease. The most conspicuous of the tick-borne diseases, Lyme sickened about 1,000 Mainers in 2011 and more than 180 so far this year.

But the two emerging diseases are shadowing Lyme’s progression from southern to northern New England.

“Anaplasmosis and babesiosis are emerging in southern Maine the way we saw Lyme disease emerge several decades ago,” said Susan Elias, a clinical research associate at Maine Medical Center’s Vector-borne Disease Laboratory in South Portland. “We’re now seeing those two diseases moving inland and up the coast in the same pattern as Lyme.”

For more: http://bangordailynews.com/2012/05/30/health/lyme-disease-and-other-tick-related-illnesses-on-the-rise-in-maine/?ref=latest

Posted in babesiosis, Lyme
Tags: Anaplasmosis, Babesia, Lyme, Lyme Disease, Maine, ticks

Excerpted from Forbes  ( Posted: 05/22/2012)

We’ve run many stories at Forbes parsing the reasons for JPMorgan’s multibillion-dollar trading loss this month. As the days tick past, analysts and journalists continue to struggle to comprehend and explain the complex hedging strategy that did so much damage at the venerable bank.

But on Sunday, The New York Times had a front-page piece that brought the huge loss down to a level anyone could understand. A central reason a bank known for its mastery of risk management could make such a huge mistake: One of its top executives, chief investment officer Ina Drew, 55, succumbed to the most human of problems: She got sick, apparently with Lyme Disease and, starting in 2010, missed out on chunks of time in the office, where she had been managing clashing personalities and internal rivalries and making sure that no one took on too much risk.

Read more: http://www.forbes.com/sites/susanadams/2012/05/22/jpmorgans-6-billion-case-of-lyme-disease/

Posted in Lyme
Tags: Lyme, Lyme Disease

Excerpted from PoughkeepsieJournal.com  ( Posted: 05/18/2012)

Health professionals are looking into a rare case of a little girl who was paralyzed after being bitten by an American dog tick.

The 2-year-old was unable to eat or drink — immobilized by a potentially fatal illness — when she was brought to Albany Medical Center this month. Jenna Tomlins woke up May 4 feeling tired and lethargic.

“She couldn’t stand up, she couldn’t really move,” said her mother, Rachel Tomlins, 25, of Hopewell Junction. “I just thought maybe she was tired. She was up late the night before.”

Her mother recalled the girl having trouble drinking.

“That’s when I called the pediatrician,” she said.

The doctor suggested the girl, who had no rash or fever, get some fresh air. When she appeared weaker, she was brought to a local emergency care center.

“The doctor was completely baffled, so we took her to Vassar,” Tomlins said. “She had X-rays, CAT scans, urine analysis, blood tests and a spinal tap. They thought maybe she had botulism.”

But the tests came back negative. By then, the child’s tongue had swelled.

For more:  http://www.poughkeepsiejournal.com/article/20120518/NEWS01/305180030/-Tick-paralysis-strikes-girl-2?gcheck=1&nclick_check=1

Posted in Lyme
Tags: Dog Tick, Lyme, New York, ticks

Excerpted from ABC News  ( Posted: 05/16/2012)

Patients prescribed the antibiotic azithromycin are more likely to die than those prescribed a different antibiotic, according to a study published in the New England Journal of Medicine on Wednesday. These results were especially pronounced for those who died from heart attacks, strokes, sudden cardiac death and other cardiovascular causes.

Last year, doctors wrote 55.3 million prescriptions for Azithromycin, commonly known by the trade name Z-Pak,  according to IMS Health. Like the popular antibiotic amoxicillin, azithromycin is commonly prescribed to help fight off bacterial infections. But while they are often prescribed for similar conditions, the two drugs work differently from each other.

Wayne Ray, professor of preventive medicine at Vanderbilt University, in Nashville, Tenn., and lead author of the study, says he thinks many doctors prescribe azithromycin instead of amoxicillin because of its easier regimen; patients on azithromycin take fewer pills over fewer days, which means they are more likely to finish their entire course of medicine. Finishing the entire course not only leads to more effective treatment, but it also lessens the risk of the patient developing a drug-resistant bug.

But, Ray says of azithromycin, “the risk of death may outweigh convenience and compliance, at least for high-risk patients.”

For more: http://abcnews.go.com/blogs/health/2012/05/16/z-pak-antibiotic-raises-death-risk-for-some-says-study/

Posted in Uncategorized
Tags: Antibiotics, Doctors, Zithromax

Excerpted from ReadingEagle.com  ( Posted: 05/15/2012)

The federal Centers for Disease Control has clinical criteria for Lyme disease that are narrowly defined in order to ensure accuracy when tracking the disease.

These criteria are mainly useful for the early stages of Lyme when patients present with more obvious symptoms, such as a rash in the shape of a bull’s-eye and arthritis-like problems.

The CDC criteria are not very helpful for clinicians attempting to detect late-stage neurologic Lyme.

For example, the most common manifestation of late neurologic Lyme is cognitive dysfunction, often referred to as encephalopathy.

A patient who presents with new onset encephalopathy and a positive blood test for Lyme would not be considered by the CDC to be a case of Lyme disease.

Although the CDC recognizes that Lyme encephalopathy exists, encephalopathy is not part of the “surveillance case definition.”

Hence, physicians who rely on the narrow surveillance case criteria of the CDC for clinical diagnosis will fail to diagnose some patients who have Lyme disease.

In these cases, the patient’s treatment will either not occur or be delayed.

Such delay in treatment could result in an acute, treatable illness becoming a chronic, less-treatable one.

More: http://readingeagle.com/article.aspx?id=386212

Posted in CDC, Lyme
Tags: CDC, Lyme, Lyme Disease, ticks

Excerpted from Boston.com  ( Posted: 05/10/2012)

In the summer of 1997, while working at a camp in Maine after my freshman year of college, I found a blotchy red rash on my right arm. The camp nurse shrugged. “Maybe it’s from your sleeping bag. Let’s give it a few days and see what happens.”

A few days later I collapsed in the dining hall. When I came to, the camp nurse told me I’d had a low blood sugar reaction, something that had never happened to me before. She didn’t think to connect the incident with my mysterious rash, which by then had faded. She didn’t think to test me for Lyme disease, known for its tell-tale rashes. She didn’t think to test me for babesia, ehrlichia or bartonella, tick-borne parasites that consume oxygen in the red blood cells, which can first manifest as hypoglycemia. She didn’t think to do any of these tests, because she didn’t know the serious health threat that ticks pose in wooded areas.

I don’t blame the camp nurse for my misdiagnosis, but I do blame the lack of awareness surrounding tick-borne illness that led to her ignorance. It took eight years for a doctor to connect the dots of my burgeoning constellation of symptoms. By then the bacteria had spread to every system of my body, crossed the blood-brain barrier and invaded my central nervous system, and was replicating at a rate that evaded the strongest antibiotic treatment.

I was left bedridden, hooked up to an IV, for two years. The co-infections of babesia, ehrlichia and bartonella caused nightsweats, fevers, and neurological symptoms that demanded intense anti-malarial treatment.

This is the fate that awaits anyone who does not receive a proper diagnosis of tick-borne illness right away.

Our best defense against this health threat is Lyme literacy, not just amongst the general population but amongst doctors, too.

Read more: http://www.boston.com/Boston/dailydose/2012/05/misdiagnosed-lyme-disease-one-reader-horrific-experience/ULt7ITNpRotIyRlfGCMYQO/story.html

Posted in babesiosis, Lyme
Tags: Babesia, Bartonella, Ehrlichiosis, Lyme, Lyme Disease, Massachusetts