Our neighbor to the east, Pennsylvania, has ranked third in the country
in CDC accepted, reported cases of Lyme disease for the past several years,
with 2781 cases in 1999. We are thankful to Larry Linford, Damminix Project
Chair of the Lyme & Associated Diseases Of The Brandywine Valley,
Unionville, PA. for the following article. Mention of brand names does not
constitute endorsement by LADBV [or the Bull's-Eye]. For information about
Damminix that kills deer ticks in your yard, contact: E-mail:
[email protected]
Anywhere you see deer you are at risk. The deer bring the ticks to your
yard; birds and other animals help transport the ticks. But the principal
culprits in spreading the disease are mice. A deer tick infected with the Lyme
bacteria and seeking a blood meal, will bite a mouse and transmit the bacteria
to the mouse. Then other deer ticks sucking on the mouse will become infected
thereby spreading the disease.
Mice have been found in homes with many deer ticks attached to them! The
spring and summer months are the "Pryme Tyme for Lyme," however you can be
bitten any month of the year when the weather is mild. The ticks are active
when the temperature gets to about 40 degrees.
Pets are particularly vulnerable and frequently will bring deer ticks into
your house. Inspect them closely before they come in. See your veterinarian
for protective chemicals such as Frontline that will kill deer ticks.
Use Damminix tubes to kill the deer ticks. Damminix consists of
biodegradable cardboard tubes with cotton balls inside that are treated with a
chemical called Permethrin.
Mice will take the cotton back to their nest and the Permethrin will kill
the deer ticks but not affect the mice. It is highly targeted and much safer
than trying to broadly spray your yard with a pesticide. Tests on Long Island,
NY, where Lyme Disease is even more rampant than Southeastern Pennsylvania,
have shown that Damminix will reduce the number of infected deer ticks by more
than 90%.
When it is hot, consider buying a white "bucket style" hat made of terry
cloth sold by The Vermont Country Store (1-802-362-8440). Wetting the hat
before going outside can help keep you cool especially since you're wearing
long pants and long sleeves. It works.
Cornell University Pesticide Management Education Program Web page reports
there is a controversy about the safety of DEET when applied to the skin.
Concentrations of 50-75% DEET applied to the skin of soldiers caused reactions
such as skin irritation, large painful blisters & permanent scarring.
Similar reactions were found among workers in the Everglades.
Dr. David Wade, toxicologist for the Michigan Department of Agriculture
recommends users limit their use of products containing DEET, especially on
children, due to possible health dangers. He states exposure to high levels of
DEET may cause such health problems as headaches, restlessness, crying spells,
and convulsions. In other studies, children had serious reactions including
slurred speech, confusion and seizures.
This raises serious questions about the safety of products containing DEET
when applied to the skin. DEET can damage some plastics & synthetic
fibers. Morflex, the largest producer of the DEET chemical, cautions that DEET
should only be used on natural fibers. It makes one wonder, if DEET is strong
enough to dissolve some plastics and synthetic fibers, do you want to put it
on your skin?
Permethrin is a better alternative since it is labeled for application only
to clothing and it is far more effective since it will kill deer ticks as well
as repel them. Remember, there is no repellent that will provide 100%
protection over a long period of time.
If you do find a deer tick attached to you, remove it carefully. Use fine
pointed tweezers and grasp the tick as close to the skin as possible and pull
gently straight out. Do not put petroleum jelly on the tick. Save the tick in
a plastic bag with a moistened cotton ball for identification and testing.
If you do find a deer tick attached to you, see your doctor promptly. Early
diagnosis and antibiotic treatment is essential to recovery. Unfortunately,
the common laboratory test used (ELISA also called the Lyme Titer) results in
many false negatives. There are other tests but most doctors are reluctant to
use them at first. The diagnosis for Lyme Disease is a clinical one and the
tests are for confirmation.
After returning inside, wash and dry your clothes immediately. Do not even
let them lay on the floor since a deer tick might be attached and get loose in
your house.
Have a great DEER TICK-FREE year outdoors! Enjoy the outdoors but be wise
and protect yourself.
The GCLDSG has bumper stickers available at meetings or by sending $2.00 to
GCLDSG, 7644 Main St. Cleveland, OH 44138. - Be sure to include your full
mailing address.
By Larry Linford
Lyme Disease is a bacterial
infection caused by being bitten by a tiny deer tick. If not properly
diagnosed and treated early, it can become crippling and debilitating.
According to the Chester County (PA) Health Department, Lyme Disease is the #1
reportable disease in the County. All the suburban counties around
Philadelphia are considered some of the highest risk areas in the country.
Anyone who works or
plays outdoors is at risk. Deer ticks like cool, moist environments like tall
grassy areas around the edge of yards, along roads, garden areas, shrubs and
in wooded areas. Outdoor workers, gardeners, campers, hikers, people who hunt
or fish, golfers who stray into the rough, people who live in the city but go
for a picnic to a park are all at risk; the list is endless. You can be at
risk right in your own back yard! You can be at risk when mowing the lawn or
picking up leaves in the fall. Children are especially vulnerable since they
tend to run and play without caution.
Keep your lawn mowed and cut
down brushy areas. Remove enough trees so the lawn gets sunshine to create a
less inviting environment for deer ticks. Remove brush and leaves around your
house and the edge of the yard. Trim bushes away from your house. When working
in your yard, avoid touching the ground with your bare hands. Avoid touching
plants and bushes as much as possible.
Avoid tick-infested areas where
possible. Avoid sitting directly on the ground; use a blanket or other ground
cover. When at a picnic, try to avoid touching the ground. When walking near
bushes or trees, avoid touching them. Walk in the center of trails. Avoid
sitting on stone walls or woodpiles; these are places deer ticks like.
Wear light-colored long pants and long
sleeves and white socks when outside. Tuck your shirt into your pants and tuck
your pants into your socks. This will help prevent a tick from crawling under
your clothing and getting to your skin. Wear light-colored gloves. The light
color makes it easier to see a tick on your clothing or gloves. Check yourself
frequently for deer ticks when you are working outside. Wear a hat to protect
your head from deer ticks as well as the sun.
Spray your boots,
socks, pants, sleeves, gloves and hat with Permethrin spray. Do not apply it
to your skin and apply it outdoors. The Permethrin spray has the same active
ingredient as the Damminix mentioned above only in a lower percentage. It not
only repels deer ticks, but it will kill them. It is relatively long lasting.
It is available under several brand names including: Duranon, Permanone,
Sawyer, etc. It can be found in the camping section of stores. Follow all
label directions carefully.
Permethrin is a synthetic
chemical developed to simulate the natural chemical pyrethrum that protects
plants from insect attack. Permethrin is not a natural product. It is
different from a normal insect repellent in that it will kill insects and deer
ticks as well as repel them. Also, the labels state that one treatment lasts
two weeks. It was developed in the 1970s by the Department of Agriculture and
has been used successfully since then.
A product intended to be applied to
the skin is Avon's Skin-So-Soft Mosquito, Flea and Deer Tick Repellent. It is
a different formulation from the regular Skin-So-Soft products and not as
greasy feeling. The label indicates it contains 0.05% Oil of Citronella and a
PABA-free sunscreen (either SPF 15 or 30). It comes in an Herbal Fresh scent
or Original, which has little scent. There is a special version for children.
It is available from any AVON representative. Call 1-800-FOR-AVON to get your
local representative.
There are many insect repellents on the market
that contain a chemical called DEET (N, N-diethyl-meta-toluamide). They are
widely available including some popular brand names as OFF!, Deep Woods OFF!,
Cutters, Ben's, etc. Many of them are intended to be applied to the skin and
say so on the label. They are available in a wide range of concentrations. The
general theory is that, the higher the concentration, the better the
protection and the longer it will last. Products that contain DEET will only
repel deer ticks; they will not kill them.
After returning inside do a
careful tick check. Deer ticks are very tiny and may be hard to see; the ticks
you are used to seeing are most likely not deer ticks. If possible, have
someone else inspect you especially in the areas where it is difficult for you
to see. Be sure to check your hairline.
LYME DISEASE
A
National Health Crisis
BY ED
SILVERMAN
STAR-LEDGER STAFF [New Jersey]
From:
www.nj.com/business/ledger - 12-19-00
After more than a year of controversy, the Food and Drug Administration will hold a special meeting next month to review the safety of the Lyme disease vaccine, which some doctors and consumers believe causes a severe arthritic side effect.
The Jan. 31 session will be the first such hearing since Lymerix was approved two years ago by regulators amid a growing clamor for a treatment for Lyme disease, which claims up to 16,000 new victims each year nationwide.
The meeting also comes after FDA investigators recently expanded their routine review of Lymerix side effect reports to include any side effect that simply mentions arthritis or similar maladies.
An FDA spokeswoman declined to comment on the specifics of the meeting or any possible outcomes, while a spokeswoman for SmithKline Beecham, the British drug maker that is about to merge with Glaxo Wellcome plc, maintained Lymerix is safe.
"We're not seeing any unexpected adverse events coming through," said Carmel Hogan, the SmithKline spokeswoman. "But we see this very much as an opportunity to put our data out in the public domain."
The controversy hinges on theories that a protein contained in the vaccine may produce an untreatable form of severe arthritis in people with a particular gene, known as HLA-DR4. About 30 percent of the population is believed to have this gene.
So far, more than 440,000 people have been vaccinated with Lymerix. Several dozen people since have claimed they developed severe arthritis-like symptoms and, subsequently, some tested positive for the HLA-DR4 gene.
Through July, the FDA tabulated 774 adverse events, including 77 reports that specifically mentioned some form of arthritis. For its part, SmithKline, which is seeking regulatory approval to market a children's version, is conducting a follow-up safety study.
"But here you have healthy, young people getting the vaccine and then getting sick," said Charlene DeMarco, a physician and an emerging-diseases specialist in Egg Harbor. "It's impossible that the vaccine didn't have anything to do with those reactions."
DeMarco and others want a moratorium, especially since Lymerix packaging information doesn't mention hypothetical genetic links - information that was given patients in clinical trials run by Yale University just weeks before the FDA approved the vaccine.
"This meeting is a case of better late that never," said Stephen Sheller, a Philadelphia attorney who has filed numerous lawsuits on behalf people who claim they were harmed by Lymerix. "But people need to know about adverse events not mentioned on the label."
In a recent interview, Susan Ellenberg, director of biostatistics and
epidemiology at the FDA, said: "We're not seeing a red flag . . . So far,
there's nothing that tells us we have evidence these (side effect) cases are
caused by the vaccine."
Contact: Leslie Lang [email protected]
University of North Carolina
School of Medicine
Chapel Hill�New research on the tick-borne bacteria responsible for Lyme disease likely will make scientists think differently about how to develop a more effective vaccine.
The findings clearly demonstrate that as a tick feeds on its host, molecular changes occur on the outer surface of the Lyme bacteria Borrelia burgdorferi that are more complex than previously known. During the tick's blood meal, its saliva transmits the bacteria to the host.
In terms of Lyme disease immunization, this is important because any truly effective vaccine must prime the immune system to mount an antibody attack against foreign antigens-the invader's outer surface proteins.
"Previous research showed there were certain surface proteins that were expressed in the tick gut and others that were expressed in the host, and that a switch occurred en route from the tick to the host. This paper shows us that things are a lot more complicated," said Aravinda M. de Silva, PhD, assistant professor of microbiology and immunology at the University of North Carolina at Chapel Hill School of Medicine.
The new findings are reported in the January 16 issue of the Proceedings of the National Academy of Sciences. Along with de Silva, co-authors are Jun Ohnishi, PhD, UNC postdoctoral researcher in microbiology and immunology and Joseph Piesman, PhD, division of vector-borne diseases at the Centers for Disease Control and Prevention.
In their study, the researchers focused on two (OspA and OspC ) of the more than 150 membrane proteins known to be associated with B. burgdorferi.
"We wanted to see how these two proteins changed as the bacteria moved from the tick gut to the host," de Silva said. "And to our surprise, what we observed was not simply a matter of one protein being expressed in the gut and another being expressed in the host, as had been previously thought. During transmission, what the tick actually spits into the host is a bacteria population that is highly variable, compared to the fairly homogeneous population found in the tick before the blood meal."
In other words, given two surface proteins there are four possible combinations. Some bacteria could express only OspA, some only OspC, some might express both, some neither.
"And in fact during the tick feeding process we found all four of these different combinations," da Silva said. Moreover, when the study team looked at another Borrelia surface gene called vlsE, they found a large number of variations generated during tick feeding, compared to only one or two when the tick was not feeding.
"We are excited by the findings because this once again supports the concept that arthropod vectors are not just flying or crawling syringes that go around inoculating bacteria. There's a developing biology going on inside this vector. The bacteria population essentially adapts during the transmission process to maximize the chance of infecting the host," de Silva said According to de Silva, individuals in the bacterial population expressing lots of different sets of surface proteins makes it easier to evade the host's immune response.
"If all the bacteria entering the host have the same set of molecules on the surface, then it's easier to for the immune system to control the infection and it's easier to develop vaccines against it," de Silva explained. "But that fact that the tick introduces so many different flavors probably explains an observation we made several years ago: Lyme spirochetes delivered by ticks are better at evading the host's immune response than cultured spirochetes injected into animals.
The process of bacterial diversity occurs during the blood meal, de Silva pointed out. "So, early on, before the blood meal, the population in the tick gut is still very uniform. Lyme disease ticks feed for 3 to 5 days, and over this period the bacterial population inside the tick as well as the bacteria moving from the tick to host become more diverse with respect to the proteins on their surface."
In their report, the researchers point to two possible approaches to developing Lyme disease vaccine candidates. One would be to focus on antigens produced within the tick at early stages of feeding (before the population diversifies) that may lead to transmission-blocking immunity. The other would be a vaccine based on those surface proteins that are indispensable and common to all the bacteria entering the host.
A Lyme vaccine based on OspA, which was recently approved for human use, is an example of the former. When a tick feeds on a OspA-vaccinated individual or animal, antibodies that have developed in response to the vaccine enter the tick gut and kill the bacteria inside the gut before the population has a chance to diversify. This prevents the transmission process from taking place, de Silva explained.
De Silva pointed out that it was luck, "pure chance," that the current Lyme OspA vaccine happened to work in the tick the way it did. "If people had known that the OspA was mainly produced within the unfed nymphal tick, they probably wouldn't have tried to develop this vaccine." In clinical trials, one year after receiving three doses of the OspA vaccine, 75-80% of people exposed to infected ticks were protected from infection. However, research indications are that protection may not be long-term.
"Understanding more about the biology of transmission may lead to better
vaccines that complement or replace OspA vaccine," de Silva said.
OKLAHOMA CITY, Dec. 29 - Oklahoma scientists soon will have more money to look for cures for deadly food-borne infections, Lyme disease and the anthrax virus.
Two Oklahoma medical research centers will receive $21 million in biomedical research grants from the National Institutes of Health, officials said Thursday.
The Oklahoma Medical Research Foundation and the University of Oklahoma Health Sciences Center have planned four research projects. The foundation will receive $11.5 million and the health sciences center will receive $9.1 million.
The two institutions will use the funds to create the Centers for Biomedical Research Excellence.
Projects approved include a study of the intricate interactions between ticks that carry Lyme disease and the disease itself. Infected ticks transmit the deadly disease to humans when they burrow under skin.
There is no cure.
Also, scientists will look for cures for food-borne infections such as E. Coli. Humans can contract E. Coli from uncooked hamburger and even vegetables, said Dr. Frank Waxman, director of the Experimental Program to Stimulate Competitive Research.
Waxman said the goal of the centers will be to understand the mechanisms of
diseases, which will lead to vaccines and cures.
"That's the way science
works,'' he said. "You have to study so you can understand.''
Waxman held a news conference Thursday at the state Capitol to announce the funding.
The National Center for Research Resources administers the grant to promote biomedical research in states that historically have not received the grants.
Oklahoma was one of three states that received funding for both proposals it submitted. It also received more funding than any other state.
Scientists from Oklahoma State University, the University of Tulsa, the University of Oklahoma and the University of Oklahoma Health Science Center in Tulsa will participate in the research projects.
Young scientists will be allowed to work on the projects through a
mentoring program, Waxman said.
April 21- 23, 2001- Farmington, Connecticut
Organizing Committee
Edward M. Bosler, PhD SUNY at Stony Brook
School of Medicine
Willy Burgdorfer, PhD, MD National Institutes of Health
Sam Donta, MD Boston University School of Medicine
Brian Fallon, MD
Columbia Univ. College of Physicians & Surgeons
James Miller, PhD UCLA
School of Medicine
Charles Pavia, PhD NY Medical College School of
Medicine, NYCOM Microbiology and Immunodiagnostic Laboratory of NYIT
Ronald Schell, PhD Univ. of Wisconsin School of Medicine
Target Audience
This conference is designed for clinical
professionals (including but not limited to Primary Care Physicians, Nurse
Practitioners, Physician Assistants, Public Health Officers, Researchers and
Veterinarians) and other health professionals (medical directors, risk
managers) who wish to enhance their knowledge of Lyme disease and other
tick-borne disorders.
Program Details:
Place: Hartford Marriott, Farmington, CT
800-228-9290 860-678-1000 $89 single/double. Reserve your room now as the
hotel may sellout! Rate applies 4/20 - 4/24.
Public Forum: Sunday April 22 5:30 pm - 6:30pm. No charge.
Fee:
includes scientific sessions, book of proceedings, 2 lunches, 4 breaks, 2
dinner-receptions (4/21 6:30pm -10:30pm; 4/22 7pm -11pm). Written notice of
cancellation must be received by March 15 for a refund. There is no audio nor
video taping allowed of this program.
__ $275 by March 12
__ $300
March 13 - April 16
__ $350 April 17 to on-site
__ $180 Poster
Presenters - Call us or see web for forms. Deadline 4/10. Grad. Students -
Full-time w/University validation letter
__ $80 Reception Only
__ $20
CME Certificate
To register, or for further information, contact the LDF at:
Lyme
Disease Foundation, 1 Financial Plaza, Hartford, CT 06103
860-525-2000 Fax
860-525-8425
Hotline 800-886-LYME [email protected] www.Lyme.org
[Though the seminar will have taken place by the time you read this, it shows a very important approach to treatment of cognitive problems caused by Lyme disease. Laura Sibert is the daughter of Dr. and Mrs. Ralph Sibert of the Cleveland area.]
Leo J. Shea III, Ph.D., is Neuropsychologist and Clinical Assistant
Professor of Rehabilitation Medicine and at the Rusk Institute of
Rehabilitation Medicine, New York University School of Medicine. He will be
the featured speaker at a seminar entitled: "Lyme Disease: Neuropsychological
Deficits and Promising New Techniques in Cognitive Remediation."
The
seminar will be held on Saturday, January 27, 2001 from 1:00 to 3:00 PM at the
Middlebrook School Cafeteria on School Rd. in Wilton [CT]. The event is free
and open to the public. It is co-sponsored by The Wilton Task Force on Lyme
Disease, the Wilton Public Schools Department of Special Services and SPEDNET.
Dr.Shea will explain the newest techniques in cognitive remediation and
their role in improving daily functioning in Lyme disease patients. He will
illustrate his work with case studies. Dr. Shea will comment on his findings
in adults and teenagers.
Laura Sibert, a Lyme disease patient who has extensive experience with cognitive remediation techniques, will explain how they have made a difference in her life.
Why Cognitive Remediation in Lyme Disease?
Studies have shown that
patients with brain injury have greater rates of functional recovery when they
receive systematic multimodal therapy. A major part of such a system is the
application of cognitive remediation to diagnosed cognitive deficits.
The overall goal of cognitive remediation is the amelioration of acquired
cognitive deficits through:
� an informational and educational process
which commences with early diagnosis, followed by discrete and highly specific
neuropsychological testing
� a detailed explanation of the nature and
functional impact of the neurocognitive/behavioral deficits, focused on
increasing patient learning, mastering and habituating of specific
compensatory strategies to improve daily functioning
� increasing patient
acceptance of the changes occasioned by the illness and the valuing of
"present self"
Initial case studies with Lyme disease patients indicate that, as with
other acquired brain injured patients, systematic application of the cognitive
remediation process holds promise for increased daily functioning.
GREENWICH -The Greenwich Lyme Disease Task Force is fighting the illness with science, pledging to help raise money for a proposed $3 million research center at Columbia University.
Funding research related to the diagnosis and the chronic effects of Lyme disease has been a long-term task force goal, according to Co-President Debbie Siciliano.
"To have the vast resources of Columbia University behind this project is amazing," Siciliano said. "This is a project worth investing in."
Since the summer, the group has raised $250,000 for the project, and hopes to raise another $1 million at its annual "Time for Lyme" benefit this spring, Siciliano said.
Dr. Brian Fallon, a neuropsychiatrist from Columbia University, said the center would emphasize research on the effects of chronic Lyme disease and finding a reliable test for detecting the illness.
Fallon spoke to task force members yesterday at Siciliano's Greenwich home.
The center would integrate the work of scientists nationwide who are
investigating small pieces of the Lyme puzzle, he said.
"It's extremely
important to focus all the efforts," Fallon said.
Fallon is studying persistent Lyme encephalopathy, a condition of long-term Lyme disease sufferers who have memory, attention and thinking problems.
The study is funded by a $4.7 million grant Fallon received from the National Institutes of Health.
Fallon emphasized the need for an effective Lyme test. Current tests are only effective shortly after infection and don't account for many patients suffering from chronic Lyme-related illnesses, he said.
"We need a test which will be able to diagnose the disease with certainty,"
Fallon said. "There's not enough work being done on it."
Fallon said
untreated Lyme disease can cripple the nervous and cardiovascular systems.
Victims have a wide range of symptoms from verbal difficulties to light
sensitivity.
"One of the baffling things about this disease is that its clinical manifestations are so varied," Fallon said. "We need to start looking at why."
Health authorities believe for every confirmed case of Lyme disease there are many unconfirmed ones. In Connecticut in 1999, only 3,213 of the 9,209 instances of Lyme disease reported by physicians to the state were confirmed as actual cases.
When her son became gravely ill this summer, Debra Lynn Porter, a member of the group from Westchester County, N.Y., questioned why the doctors barely considered Lyme disease.
After her son later developed meningitis, Lyme disease was finally diagnosed and doctors prescribed a special regimen of Lyme-fighting antibiotics.
"The tests they have now are inaccurate," Porter said. "I kept asking the doctors, 'Could this be Lyme?' Nobody thought it could be."
Efforts to fight Lyme have been hampered by the lack of a reliable test, said Wendy Blumenthal, director of community health planning and promotion for the Greenwich Department of Health. She advises the local task force.
"People suffering from long-term Lyme disease have a need for a clearer method of diagnosis," Blumenthal said. "Early diagnosis and treatment are important, too, before the disease becomes a multisystem disorder."
Siciliano said future government funding to fight Lyme depends on scientifically sound research and hard evidence of the prevalence of the disease.
The task force and an affiliate in New Jersey, the Lyme Disease Association, are planning to support a bill that would appropriate $125 million in federal funding for Lyme research and education.
"The center will open a door that has been closed," Siciliano said. "This
type of work feeds on itself and grows."
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