Transcript No Slide Title

Tick-Borne
Diseases and
Associated
Diseases
Jack Dunham, DVM
Kathy White, BA Ed.; MSW
Representing the Lyme Association of
Greater Kansas City, Inc.
A non-profit, all-volunteer organization
P.O. Box 25853, Overland Park, KS 66225
Phone: (913) 438-5963 (GET-LYME)
Email: Lymefight @aol.com
Website: www. lymefight.info
Our Mission
1)To provide services to people who have Lyme
disease.
2)To cooperate with the medical community.
3)To promote public awareness and prevention
education.
Presentation Purpose
To increase awareness of...

tick-borne diseases in Kansas

associated diseases
To present information about...


symptoms
tests and treatments being used by Lyme
disease doctors who are members of ILADS
(International Lyme and Associated Diseases Society)
This presentation is for information only and should not be used as diagnostic or treatment advice.
Jack Dunham's Story

Tick bite in 2006

In Bonner Springs in Wyandotte County, KS

Developed Lyme rash and symptoms

Began treatment but didn't get well

Later was diagnosed with WA-1 babesia

Still have symptoms

Still on treatment
2007 Kansas Research Study
A researcher from Kansas State U. collected ticks and mice
from four counties in NE Kansas in 2007.
Results from a farm:

10 Acres in Western Wyandotte County

Lyme and WA-1 Babesia were found in

All of the mice

Most of the ticks (all Lone Star ticks)
It is not widely known that Lone Star ticks
are carrying these diseases.
2007 - Research on a
Jefferson County, KS Farm
Lyme found in:

Some of the ticks collected.

All four family members who live there have been
infected with Lyme disease and have been treated.
This research has not been published.
We do not have information concerning the testing done in
the other two counties.
Kathy White's Story

Tick bite in April, 1998

In Wyandotte County, KS

Bull's-eye rash and illness

Developed Lyme, babesia, and what was probably a
spotted fever group rickettsial disease

Treatment began 4 ½ weeks after tick bite.

Three weeks of 200 mg. of doxycycline per day was not
enough. The disease became much worse when
treatment stopped.
Handouts
Green folder containing:

Handbook

ILADS "Basic Information"

Brochure
References
(Primary sources of information for this presentation):
(1) Dr. Joseph Burrascano's "Diagnostic Hints and
Treatment Guidelines" (www. ilads.org)
(1)The CDC (www. cdc.gov)
(1)ILADS "Basic Information" (www. ilads.org)
ILADS (International Lyme and Associated Diseases
Society) is an organization of doctors who are interested
in treating tick-borne diseases. They offer a physician
training program and have an annual scientific
conference.
Ticks

Are arachnids, related to spiders, mites, and chiggers.

Have 8 legs, except the larvae have 6.

Feed on the blood of animals and humans.

Adult female drops off and lays several thousand eggs.

Larvae hatch in late spring or summer.

Nymphs emerge in spring.

Adults are active year-round, even in winter.

Some adults are active even when it's below freezing.
Tick-Borne Diseases
General Information

Ticks carry many diseases, some fatal.

Ticks commonly transmit 3 or more diseases at once.

It can take years to diagnose them all.

There are no reliable tests for many tick-borne diseases.

There are no tests for some strains of some of these diseases.

About half of patients are unaware of having had a tick bite.

The tick can be too tiny to be noticed.



Diagnosis may need to be clinical, based on symptoms and history
of tick exposure during the past month.
Symptoms resemble many other diseases.
If a patient is still ill after being treated for a tick-borne disease,
consider co-infections.
Types of Ticks
Argasidae (soft ticks)
 Live in animal nests
 Feed many times during their lives
 Feed for a few minutes during the night
and then drop off
 Example: relapsing fever tick
Ixodidae (hard ticks):
 Feed 3 times during their lives
 Once as larvae, once as nymphs, once as adults
 Remain attached for several days and then drop
off
 Genera: Ixodes, Amblyomma, Dermacentor,
Rhipicephalus
Types of Ticks
1. Ixodes (black-legged ticks)
ex.: Ixodes scapularis
(deer tick)
Western
Black- Legged
Tick
Deer Tick
2. Amblyomma
ex.: Amblyomma
americanum (lone star tick)
Amblyomma maculatum
(Gulf Coast tick)
Types of Ticks
3. Dermacentor
ex: Dermacentor variabilis
(American dog tick)
Female
Dermacentor andersoni
(wood tick)
Male
4. Rhipicephalus – ex.:
Rhipicephalus sanguineus
(brown dog tick)
Ticks Change Size And
Color As They Feed
Female, Deer Tick
Female, Lone Star Tick
Female, Lone Star Tick
Tick Anatomy
Female American dog tick
(ventral view)
Tick Drawings from CDC
Left to Right:
Adult Female, Adult Male, Nymph, Larva
Black-Legged Tick, Deer Tick
(Ixodes Scapularis)
American Dog Tick, Wood Tick
(Dermacentor)
Lone Star Tick
(Amblyomma americanum)
Lone Star Tick
American Dog Tick
Gulf Coast Tick
Rocky Mountain Wood Tick
Brown Dog Tick
Black-Legged Ticks
Reported Cases in Dogs in Kansas
www. dogsandticks.com
Lyme Disease
Anaplasma
Erlichia
Kansas Counties Endemic for Lyme
The CDC definition of a Lyme disease endemic county: Two or more
confirmed cases contracted in the county and reported since 1986.
The following counties are endemic:
Johnson
Sedgwick
Wyandotte
Butler
Shawnee
Leavenworth
Riley
Atchison
Douglas
Jefferson
Many other counties may be endemic.
The EM (erythema migrans) rash is reportable in endemic counties as
a confirmed case if the patient is known to have been in a wooded,
brushy, or grassy area in the county during the past 30 days. A
positive test is not required to report these cases.
The EM rash must be at least 5 centimeters (about 3") in diameter to
be reportable. It can just be a red spot. Central clearing or rings are
not required for reporting purposes.
Herxheimer Reaction
Dr. Adolph Jarisch and Dr. Karl Herxheimer first discovered
this reaction in syphilis patients.
A Jarisch-Herxheimer reaction is...

Common when Lyme patients begin antibiotics.

Often called a "Herx."

A temporary worsening of symptoms.

Caused by toxins released by dying bacteria.

Can last several days or longer.
Herxheimer Reaction
Symptoms can include:

Severe headache
Increased pain

Profound fatigue
Heart problems

Insomnia

Depression
Exacerbation of
previous symptoms

Suicidal thoughts
New symptoms
Herxheimer Reaction
Severity and duration depend on how long a person has
had untreated Lyme and the quantity of bacteria.
Detoxifying the body helps to reduce the severity
and duration of this reaction.
If symptoms are severe or life-threatening, doctors
often temporarily stop treatment and resume it later,
often starting with a lower dose and gradually
increasing it.
Supplements and vitamins can boost the immune
system and also cause a Herx.
Tick-Borne Diseases in Kansas
 Lyme
Disease
 STARI
Other Rickettsial
diseases (Spotted fever
group Rickettsia, SFGR)
 Babesia
Mycoplasma
 Ehrlichiosis
Bartonella
 Anaplasma
Tularemia
 Rocky
Q Fever
Mountain
Spotted Fever
Tick Paralysis
Babesia
Babesia is caused by a protozoan, closely related
to the protozoan that causes malaria.
Symptoms
At onset of Lyme (8 days or more after tick bite):
High fever and chills in some patients
Later:
 Severe fatigue
 Global headaches, like a hat is
too tight
 Body aches, muscle pain
 Fevers of up to 104 degrees
 Chills, sweats, especially night
sweats
 Eye pain
 Breathing problems,
"air hunger"
 Occasional dry cough
 Poor balance
 Encephalopathy
 Hemolytic anemia
 Hypercoagulation
Babesia Facts
 Babesia & malaria are both caused by protozoans that
reproduce inside red blood cells and destroy them.
 A very common co-infection with Lyme. Many members
of our Lyme Association have babesia.
 Nationally reportable as of January, 2011.
 Reporting criteria can be found at www.cdc.gov.
 Found in Cattle in Miami County forty years ago.
 Not known to affect humans in this area of the country
until recently.
Babesia Blood Smear
A blood smear can show
protozoans in red blood
cells. However, a person
may be ill with only a few
red blood cells infected,
and there may be none
visible in the sample being
viewed.
A negative test does not
rule out babesia.
Babesia and Lyme
 A combination of babesia and Lyme makes both diseases
much worse.
 Both diseases suppress the immune system and make it
more difficult to recover.
 Babesia enables the Lyme bacteria to survive Lyme
treatment.
 Lyme disease spirochetes cycle and cause a Herx every 4
to 6 weeks.
 Babesia cycles every 4 to 6 days.
Babesia Blood Transfusion Risk
 Many people infected are healthy and don't know they carry
babesia.
 Babesia is unknowingly being transmitted through blood
transfusions.
 At least 9 people in the U.S. have died after receiving babesiainfected blood.
 There are no tests to screen donated blood for babesia.
 CDC recommends babesia patients not donate blood.
 Wise for people who get a lot of tick bites to refrain from
donating blood.
 Lyme disease can also survive in stored blood, as can agents
of some other tick-borne diseases.
Babesia Testing
Quest Diagnostics, LabCorp, and Igenex (www. igenex.com,
1-800-832-3200) have tests for Babesia microti and
Babesia duncani (WA-1).
There are no specific tests for Babesia MO-1 (Missouri
strain) or the other strains. There are at least 13 strains of
babesia carried by ticks.
Quest Diagnostics has an ECP (Eosinophil Cationic Protein)
test. It can indicate a protozoan infection without
identifying the species – useful for species for which we
don't have tests.
Babesia Treatment
(According to Dr. J. Burrascano's Guidelines, pp. 23-24)
Mepron (atovaquone) or Malarone (atovaquone +
proguanil)
+
Azithromycin (Zithromax) or Clarithromycin (Biaxin)
or Telithromycin (Ketek)
+
Artemisia (a non-prescription herb)
(It increases the effectiveness of the medications.)
Babesia Treatment
(According to Dr. J. Burrascano's Guidelines, pp. 23-24)
 Research is showing atovaquone does not get absorbed
well unless taken with food containing fat.
 Treatment for acute illness should be 3 weeks, and at
least 4 months for chronic cases. Relapses occur.
Re-treatment may be needed.
 Dr. Burrascano no longer recommends the clindamycin
and quinine protocol. Almost half of patients had to
abandon treatment because of side effects, and there was
a failure rate of almost 50%. Some doctors find it helpful.
 Can cause a terrible Herx when beginning treatment,
which can cause profound fatigue, headache, profuse
sweating, and other symptoms that last a few days or
longer.
Tick-Borne Bartonella
 A very common co-infection with Lyme disease.
 Ticks carry Bartonella henselae (cat scratch disease).
 Ticks also carry other bartonella strains.
 There are no tests for most strains of bartonella.
 Consider bartonella if a person remains ill after Lyme
disease treatment.
Symptoms of Bartonella
 Swollen lymph nodes, can be the size of golf balls
 Fever
 Headache
 Fatigue
 Poor appetite
 Abdominal pain
 Endocarditis
 Uveitis, retinitis, other eye problems
 Red papular rashes
 Parallel lines resembling stretch marks
 Insomnia
 Seizures, in some patients
Bartonella Symptom Pictures
Swollen Lymp Node
Bartonella Symptom Pictures
Bartonella Treatment
(Burrascano, pp. 24-25)
For Bartonella henselae:
–
erythromycin or doxcycline
For other strains:
–
levofloxacin for adults over age 18
–
various other drugs
For children:
–
azithromycin
Mycoplasma
 Common co-infection with Lyme disease
 Bacterial infection
 Treated with certain antibiotics that are effective for cell-wall
deficient bacteria
 Several species found in ticks, most commonly mycoplasma
fermentans.
 Difficult to diagnose.
 Mycoplasma fermentans can disrupt the immune system.
Mycoplasma
Multitude of symptoms that can resemble other diseases.
Found in patients with:
Lyme disease
Chronic fatigue syndrome
Rheumatoid arthritis
ALS
Crohn's disease
Other inflammatory bowel diseases
Gulf War syndrome
Fibromyalgia
MS
Chronic asthma
Autism
Very common co-infection with Lyme disease, but many
doctors are not looking for it.
MDL Laboratories has a PCR test for mycoplasma (1-877-2690090, www. mdlab.com).
Some Diseases Caused by
Rickettsia Bacteria
(Source: www. cdc.gov)
Ehrlichiosis
(HME, human monocytic ehrlichiosis)
Anaplasmosis
(HGA, human granulocytic anaplasmosis, formerly called HGE)
Rocky Mountain spotted fever
(RMSF)
Spotted fever group rickettsias
(SFGR) (R. parkeri, R. amblyommii, etc.)
These diseases share
similar symptoms
 Fever
 Confusion
 Chills
 Abdominal
 Severe headache
 Nausea
 Muscle aches or pain
 Vomiting
(sometimes)
 Malaise
 Diarrhea
(sometimes)
pain
Additional Symptoms
Maculopapular and/or petechial rash (rare in anaplasmosis and
ehrlichiosis)
Black, crusty eschar at site of tick bite is typical of RSFG but rare
in Rocky Mountain spotted fever
Rash: Doesn't appear until a person has been ill with one of
these diseases for several days. Many patients don't get a
rash.
The RMSF rash typically begins at the wrists and ankles and
moves up the limbs. May also occur on the palms of the hands
and soles of the feet. A petechial rash can occur later, and the
toes may turn black.
There is some evidence that spotted fever group rickettsias may
usually cause a milder illness than RMSF.
Rocky Mountain Spotted Fever
Picture
Diagnosis Issues
 May not get diagnosed until the rash appears.
 Specific tests can be ordered, but treatment must not
wait until test results come back.
 Antibody tests for anaplasma are likely to be negative
during the first week or two of infection.
 These diseases can be transmitted along with Lyme or
other tick-borne diseases.
 Symptoms from co-infections complicate diagnosis.
Meningitis
 Can be caused by ehrlichiosis, anaplasmosis, and Rocky
Mountain spotted fever.
 If a person is hospitalized with meningitis, try to determine
whether there has been recent tick exposure.
 Don't assume it is viral.
 If it is one of these diseases, doxycyline may save a life.
 Checking the blood for low platelets, low leukocyte count, and
elevated liver enzymes may be helpful.
Early Diagnosis of Rickettsial Diseases
 Ask patient if he/she was exposed to ticks during the two
weeks prior to illness.
 Patient may not have noticed a tick bite.
 A CBC panel and liver enzyme test can indicate the possibility
of a rickettsial disease.
 These diseases cause leukopenia (low white blood cell count),
thrombocytopenia (low platelet count), and elevated liver
enzymes.
Treatment of Rickettsial Diseases
 Treatment is most successful if begun promptly (before
the 5th day of illness).
 Don't wait for test results.
 Tests are usually negative early in the illness.
 Begin treatment as soon as a rickettsial disease is
suspected.
 These diseases can be fatal if treatment is delayed.
Medication Recommendations
(Source: www. cdc.gov)
Doxycycline: Ehrlichiosis, Anaplasmosis, RMSF, and SFGR




For adults and children of all ages
Other drugs don't work as well, not even other tetracyclines.
Sulfa drugs make these diseases worse.
Children under 8 can take up to 5 two-week courses at CDC
recommended dose without harming their permanent teeth.
For pregnant women and people with a life-threatening allergy to doxycycline:
 Chloramphenicol is effective for RMSF.
 Causes grey baby syndrome, which can be fatal for baby.
 Not effective for anaplasma or ehrlichia.


Rifampin works for anaplasma and ehrlichia.
Not effective for RMSF.
Treatment Duration for
These Diseases:
(www. cdc.gov)
The CDC says to treat for at least 3 days after the fever subsides
and the patient is better.
Treatment should last for 7-14 days.
For Ehrlichiosis and Anaplasmosis, Dr. Burrascano Suggests:
(Burrascano, p. 25)
Doxycycline, 200 mg. daily for adults, for 2-4 weeks
Higher doses, parenteral therapy, and longer duration may be
needed, based on severity and duration of illness, immune
suppression, and advanced age.
If treatment fails, consider adding rifampin, 600 mg. daily.
Tick Paralysis
 A rare allergic reaction to a tick bite
 Caused by a neurotoxin in saliva of a female tick
 Begins with weakness in legs
 Paralysis begins in the lower legs and moves up the body
 Lungs become paralyzed
 Can be fatal unless the tick is found and removed in time
 Once the tick is removed, the patient recovers
 The tick is often on the head, usually at the back, at the
hairline
 The tick can be on the neck, back or other location
Lyme Disease Definition
The CDC (Centers for Disease Control) definition:
Lyme disease is caused by Borrelia burgdorferi (Bb)
bacteria and is transmitted by the bite of an infected
black-legged tick.
Black-legged ticks are also known as “deer ticks” and
“Ixodes pacificus ticks.” Bb bacteria are called
“spirochetes” because of their spiral shape.
Problems with the CDC definition:
It excludes most cases in the central states.
 Some people in this area get Lyme disease from deer ticks.
 Most in Missouri and Kansas get infected by lone star ticks.
Researchers have found Bb bacteria in
 Lone star ticks, wood ticks, American dog ticks, and brown dog
ticks.
 People have tested positive after bites by all these ticks.
 Bb bacteria have also been found in Gulf Coast Ticks.
It does not include the variations of borrelia bacteria.
Problems with the CDC definition:
Variant strains often don’t get diagnosed and treated.
 The CDC calls the disease "Lyme-like" or STARI when
caused by a lone star tick, although the rash, symptoms,
severity, and treatment are the same as for Lyme disease.
 This causes many doctors to ignore the illness and not treat it.
 This often causes the disease to become chronic and
debilitating, sometimes leading to death.
 Prompt treatment of Lyme disease and STARI with 4 to 6
weeks of antibiotics can often prevent it from becoming
chronic.
Lyme Disease General Information








One of the fastest growing infectious diseases in the US.
It is increasing much faster than HIV or AIDS.
It has infected more Americans than HIV.
The number of cases is increasing as the number of deer and
ticks increases.
Lyme disease is world-wide.
It has been reported in all 50 states and has been found on
every continent except Antarctica.
Ticks carrying Lyme disease have been found on migrating
birds on sub-antarctic islands.
Infected ticks on migrating birds continue to take the disease
to new areas.
Lyme Disease General Information

Some people die from Lyme disease, usually after years of illness.

We know of 14 people who have died in Kansas since 1991 because
of Lyme disease.

They include an unborn baby and a girl aged 17. Only one was over
age 62.

Many others die undiagnosed.

Lyme disease is causing disability in many more people than West
Nile Virus.

Government funding for West Nile Virus and AIDS is much higher
than funding for Lyme disease.
Disparity in Funding:
Lyme versus West Nile Virus
From California Lyme Disease Association 2004
Reported Cases of Lyme Disease vs West Nile Virus 2004
25000
20000
19804
15000
10000
5000
2539
0
# Lyme Cases
# WNV Cases
Disparity in Funding:
Lyme versus West Nile Virus
Federal Funding for Vector Borne Diseases 2004
$90,000,000
$80,000,000
$70,000,000
$60,000,000
CDC $$
NIH $$
$50,000,000
$40,000,000
$30,000,000
$20,000,000
$10,000,000
$0
Lyme Disease
West Nile Virus
History of Lyme Disease
1883 – the ACA (acrodermatitis chronica atrophicans) Lyme
disease skin condition was described in Germany.
1894 – A researcher stored mice in a Massachusetts
museum. About 100 years later, Bb bacteria were found
on the mouse pelts.
1960's – Polly Murray in Old Lyme, Connecticut began
documenting symptoms in her family of what later
became known as Lyme disease.
History of Lyme Disease
1967 – A doctor in Germany reported that, although most
Lyme disease is caused by ticks, about 10% of patients
were getting the disease from horseflies.
1975 – Polly Murray and another mother contacted Yale to
report an unusual illness that was affecting their families
and neighbors in and near Lyme and Old Lyme,
Connecticut. A Yale doctor investigated. This led to the
discovery of Lyme disease.
1981 – While doing research on ticks, Willy Burgdorfer
discovered the Borrelia burgdorferi bacteria that causes
Lyme disease.
Early Lyme Disease Symptoms
People may get an illness with some of these symptoms
1 to 32 days after a tick bite. These early symptoms
resemble the flu. Some people don’t get these early
symptoms.
A red spot. It may grow, may clear in the center, and may
or may not develop rings like a bull’s-eye. Many people
don’t get a red spot or rash. The red spot is called an
erythema migrans (EM) rash.
Lyme Disease Rashes
Lyme Disease Rashes
Lyme Disease Rashes
Lyme Disease Rashes
Lyme Disease Rashes
Lyme Disease Rashes
Early Lyme Disease Symptoms

EM rash, other rashes
Swollen glands

Chills, with or without
fever; sweating
Stomach and digestive
problems

Fatigue, sleepiness
Joint pains

Sore or aching muscles
Severe headache

Sore throat, cough
Eyes hurt in sunlight

Runny nose, sinus
infection
Stiff neck
Meningitis
Late Lyme Disease Symptoms
The early symptoms may last about a week and then go away. If
not diagnosed and treated promptly with at least 6 weeks of
antibiotics, the following symptoms may develop weeks,
months, or years later:

Arthritis, or joint pains that move from joint to joint, with or without
swelling

Muscle pains that move around

Headache that may last for days or years

Chronic nausea, vomiting that lasts for months or years

Diarrhea, constipation

Skin rashes; spots that resemble bruises but may clear in center

Irregular heartbeat and other heart problems
Late Lyme Disease Symptoms

Blurry vision, other vision problems, red eye(s)

Ringing in ears; hearing loss

Numbness, tingling, or burning sensations

Paralysis; tremors; dizziness; seizures

Post sleep paralysis: temporary paralysis of arms or body after
awakening

Problems with thinking, concentration, and memory; confusion;
brain fog; sleep problems

Mood swings, depression, psychiatric illnesses
Lyme Disease and Syphilis
Lyme disease is caused by a bacterium called a spirochete,
closely related to the spirochete that causes syphilis.
Both diseases:

are treated with antibiotics.
 have similar symptoms.
 Have an early stage and a late stage.
 can cause arthritis, movement disorders, psychiatric illness,
heart problems, and blindness.
 Are called "the great imitator" because they imitate many other
diseases.
 Cause a Jarisch-Herxheimer reaction when treatment begins.
 Can cause miscarriages, stillbirths, and children born with the
illness.
Lyme Disease Can Cause











Fibromyalgia
Chronic Fatigue Syndrome
Lupus
Multiple Sclerosis
ALS (Lou Gehrig's Disease)
Rheumatoid Arthritis
Parkinson’s
Guillain-Barre Syndrome
Bell's Palsy
Sjogren’s Syndrome
Hypercoagulation
Thyroid Disorders, too high or low
Alzheimer’s
Attention Deficit Disorder
Autism, Asperger's Syndrome
Autism Spectrum Disorders
Tourette's Syndrome
Depression
Bipolar Disorder
Obssesive-Compulsive Disorder
Other psychiatric disorders
Other diseases
When these are caused by Lyme disease, patients often improve
with antibiotic treatment. Many improve dramatically, but it can
take a year of treatment or more. The patients may never be totally
well. Patients may relapse if treatment is stopped.
Lyme Disease and Autism


When autism is caused by Lyme disease, antibiotics may
cause a sudden change in behavior.
It may become bizarre at first, as the bacteria die off.

A few days later, behavior may be normal, but autisic
behavior may return after the antibiotic treatment ends.

Whenever there is an unusual response to antibiotics, the
possibility of Lyme disease should be considered.
Thinking Problems
Associated with Lyme

Concentration

Memory

Thinking

Making decisions
Mood and Psychiatric Symptoms
Associated with Lyme
Lyme disease can cause:

Personality changes

Depression

Mood swings

Insomnia

Violent outbursts


Visual and/or auditory
hallucinations
Obsessive-compulsive
disorder

Bipolar disorder

Panic attacks


Sudden suicidal impulses
A wide variety of psychiatric
disorders
When these conditions are caused by Lyme disease,
antibiotic treatment often helps tremendously.
Lyme Disease Diagnosis
Diagnosing Lyme disease can be extremely difficult,
because:

The early stage symptoms resemble the flu.

The late stage resembles many other diseases.

Many people never saw the tick and didn't know they had a
tick bite.

Many people with Lyme disease have negative test results.

Many doctors are unaware of the Lyme disease epidemic here
and don't consider the diagnosis.

Many doctors are unaware that a person with a negative test
can still have Lyme disease.
Testing for Tick-Borne Diseases
Blood must be fresh for the most accurate results.

When blood is being sent out-of-state, it should be drawn Mon.,
Tues., or Wednesday, and sent overnight by Federal Express.

Lyme Disease Tests

The CDC says Lyme disease is a clinical diagnosis, but
testing can be used to confirm a diagnosis.

The CDC doesn't recommend testing in the early stage,
because treatment needs to begin immediately, and it can take
4-6 weeks for antibodies to develop.
Antibody Tests

The ELISA and Western blot are antibody tests.
Many Lyme patients never develop a detectable level of
antibodies.


The ELISA is a titer test used as a screening test.

It misses at least 35% of culture proven cases.
A
screening test should be able to detect at least 95% of
cases.

Most Lyme disease specialists don't use the ELISA.
Western Blot Test
The Western blot (WB) also
misses many cases.
About 36% of culture-proven Lyme
cases remain WB negative
throughout the illness.
IGeneX Labs
795 San Antonio Rd.
Palo Alto, California 94303
Phone 800-832-3200
www. igenex.com
IGeneX has the best Western blot
(WB) test for Lyme. It detects 952439 Kuser Rd.
97% of cases, with fewer than 4%
Hamilton, New Jersey 08690
Phone 877-269-0090
false positives. They don’t work
www. mdlab.com
with insurance companies, but
many people get some out-ofMDL has a Western blot test which network coverage. Their WB costs
is somewhat better than local
about $200 for both IgM and IgG,
labs but misses many cases.
or $100 for either one.
MDL works with insurance
companies.
Medical Diagnostic Labs (MDL)
Interpreting the Western Blot

The CDC has very strict reporting criteria for the Lyme
disease Western blot.

Many patients don't get enough positive bands to meet the
criteria.

The CDC says not to use the reporting criteria for
diagnosis.

Dr. Burrascano says the following are specific for Lyme
disease: Bands 18, 23-25, 31, 34, 37, 39, 83, and 93.

No other disease is known to cause these to be positive.
CD-57 Test

The CD-57 NK test can be used to diagnose Lyme and monitor
treatment progress.

Lyme patients typically have an absolute CD-57 NK count below 60.
(Normal is over 200.)

Dr. Burrascano says that, if treatment ends before the score is above
200, a relapse will probably occur.


The lab may not report the absolute count.
To determine the absolute count, multiply the percent of CD-57 NK
lymphocytes by the absolute total lymphocyte count.
LabCorp's CD-57 test is called the HNK1 (CD-57) Panel, code #
505026. It's done at their lab in Burlington, NC.
Quest Diagnostics has a CD-57 test in San Juan Capistrano, CA,
phone 1-800-642-4657.
Culture

Culture tests fail to detect many cases of Lyme disease.

The Lyme disease bacterium, Borrelia burdorferi Bb), has
a 4-week growth cycle. This slow growth rate makes it
extremely difficult to grow in culture.

Also, the Bb bacteria don't thrive well outside the body,
so they may die in a lab before growing.
LUAT Test
LUAT Test – IGeneX has a Lyme Urine Antigen Test
(LUAT).


It measures pieces of dead Lyme bacteria in the urine.
It is most likely to be positive a few days after treatment
begins, after the bacteria start to die. For best results, the
sample should be collected as soon as the patient wakes
up in the morning.

PCR-DNA Test





This test is more sensitive than antibody tests.
Spiro Stat Technologies does PCR and DNA testing for Lyme and
other spirochetal diseases.
They also have tests for some other tick-borne diseases.
Tests include: Borrelia burgdorferi, Borrelia lonestari, some other
species of borrelia, Babesia microti, Bartonella henselae, ehrlichia,
anaplasma, 9 species of rickettsia, tularemia, and other diseases.
Their panel of tests costs $500 (or more).

They do not currently have tests for Babesia duncani (WA-1) or
other strains of babesia or bartonella.

Spiro Stat Technologies, Lubbock, TX Phone 877-767-7476
www. spirostattech.com.
Reasons for False Negative
Lyme Antibody Tests
The ELISA and Western blot tests are blood (serum) tests used
to detect antibodies. A false negative test gives negative
results even though the patient really has Lyme disease.
This can occur because:

The testing is done too soon after the tick bite. It often takes 46 weeks for a detectable level of antibodies to develop.

The patient has a poorly functioning immune system that is not
producing enough antibodies to be detected.

The patient is or has recently been on steroids or anti-cancer
drugs which suppress the immune system.

The patient is or has recently been on antibiotics, which can
reduce the production of antibodies.
Reasons for False Negative
Lyme Antibody Tests

The antibodies may be bound to the bacteria, with not
enough free-floating to be detected. (Some of the sickest
patients test negative, because their antibodies are busy
fighting numerous bacteria.)

The bacteria have changed their antigenic make-up, evading
recognition by the immune system.

The patient has a variant strain of the disease that the test fails
to detect.

The lab has such a high cut-off point that a positive test is
determined to be equivocal or negative.

The patient has positive bands, but the test is interpreted
based on strict reporting criteria and not on criteria for
diagnosis.
Why Don’t Most Cases of Lyme
Disease Get Reported?
Support groups have helped thousands of people with Lyme and
Lyme-like illnesses in central, southern, and western states. Only a
very few of these cases were reported.
1. Many doctors, unaware that it is in all 50 states, don't suspect it.
2. Diagnosis is difficult:
a. Symptoms resemble other diseases.
b.Tests are not very sensitive.
c. Many, perhaps most, cases don't get diagnosed.
3. Most diagnosed cases don't meet reporting criteria. The CDC
revised their reporting criteria in 1996, 2008, and 2011 so that fewer
cases could be reported.
4. Most cases that do meet reporting criteria don't get reported. The
CDC estimates that only about 10% of cases that meet reporting
criteria are actually getting reported.
Why don't cases that meet
reporting criteria get reported?
 The reporting criteria are complicated.
 Doctors may be confused by the criteria, too busy to fill out the forms, and
tired of having their reports rejected.
 Many Lyme patients see doctors in other states.
 The doctor may not have the reporting form for the state where the patient
lives nor the time to obtain it.
 The Lyme Association of Greater Kansas City has helped about 2,000
people who have Lyme disease. Almost none of these cases was reported.
 Many doctors think Lyme disease is rare and don’t diagnose it.
 Undiagnosed cases aren't reported.
 A low number of reports makes doctors continue to think it’s rare.
 This is a vicious circle.
Lyme Disease Treatment
www.cdc.gov; Burrascano

Treatment is most successful if begun promptly.

Do not wait for test results, which are usually negative early in the
illness.

Lyme disease is a bacterial infection treated with antibiotics.

Doxycycline is the usual treatment for adults.

Children are often given amoxicillin.

If children have a high fever, there could be a coinfection with
ehrlichiosis or spotted fever, in which case doxycycline is given.

Lyme disease specialists recommend at least 4 to 6 weeks of
treatment.
Lyme Disease Treatment

Dr. Burrascano recommends treatment for at least 4 weeks after all
symptoms are gone, to prevent a relapse.

If the disease is not treated promptly and adequately in the early
stage, the disease can become chronic.

Chronic Lyme disease may require years of antibiotics, changing to
different antibiotics from time to time.

People who have neurological symptoms or who don't respond to
oral treatment may benefit from months or even a year or more of IV
treatment.

A healthy diet and vitamins & supplements are helpful.
Lyme Disease Transmission








Not transmitted via casual contact.
Usually transmitted by a tick bite.
Can be transmitted through bites by fleas, horseflies, deerflies, and
occasionally mosquitoes.
Can pass through the placenta to an unborn baby if a pregnant
mother has Lyme disease.
Has been found in breast milk, tears, sweat, semen, vaginal fluid,
and stored blood.
Possibly sexually transmitted; research is needed.
Can survive in stored blood. We don't yet know whether it is being
transmitted via blood transfusion.
People with Lyme disease should not donate blood or organs.
Lyme Disease Transmission
Lyme disease Borrelia burgdorferi (Bb) bacteria have been
found in:
blacklegged ticks
brown dog ticks
fleas
lone star ticks
horse flies
mites
American dog ticks
deer flies
mosquitoes
wood ticks
A study found that a mosquito did transmit Lyme disease
bacteria to a hamster. Some people have been diagnosed
with Lyme disease after a mosquito bite.
References to some of the research studies are at the end
of this presentation.
Please Consider the Possibility of
Lyme Disease even if:
The patient lives in a less endemic part of the state
The patient was bitten by the “wrong” kind of tick
The patient was bitten by an insect instead of a tick
The patient did not get a rash
The red spot or rash was too small for reporting criteria
The test was negative
Diseases Associated
with Tick-Borne Diseases
Re-Activated Dormant
Herpes Viruses:

HHV-6A

HHV-6B

Epstein Barr virus

Varicella-Zoster (chickenpox)

Cytomegalovirus (CMV)

Other herpes viruses
Morgellons
Possibly, XMRV Virus
Tularemia
(rabbit fever)
Transmitted by a tick bite or by handling rabbits
Usually treated with doxycycline
The CDC also recommends Streptomycin, Gentamycin,
Doxycycline, Ciprofloxacin
Symptoms
 A red, open sore that last a
long time, at the bite site
 Chills
 Headache
 Swollen lymph nodes near the
bite site, often in the armpit or  Fatigue
groin
 Pneumonia, sometimes
 Fever, up to 104 degrees
Tularemia Symptom Picture
A Tularemia lesion on the dorsal skin of right hand. Tularemia is caused by the
bacterium, Francisella tularensis. Symptoms vary depending on how the person
was exposed to the disease, and as is shown here, can include skin ulcers.
Colorado Tick Fever
Cause: a virus
Transmission: a tick, usually a wood tick (D. andersoni)
Where: Mostly in the mountains of Colorado and Idaho, at
elevations above 4,000 feet. (The disease is mentioned in this
presentation because many Kansans travel to Colorado.)
Symptom onset: 4 or 5 days after tick bite
Symptoms: Fever, chills, malaise, severe headache, pain
behind eyes, muscle pain, abdominal pain, nausea, vomiting,
sometimes flat or pimply rash.
Colorado Tick Fever
.
Progression: Fever goes away after about 3 days but returns 13 days later and lasts a few more days.
Treatment: pain relievers. Children should not be given aspirin
because of risk for Reye's Syndrome.
Blood transfusion risk: A few people have contracted the
disease from blood transfusions. The virus can remain in the
blood for up to 4 weeks, so patients should be advised not to
donate blood during that time.
Tick-Borne Relapsing Fever
Cause: Several species of borrelia spirochetes
Transmitted by: Soft ticks (Lice also transmit relapsing fever)
 The disease can cross the placenta if a woman is infected
during pregnancy.
Where: Western states; southwest Kansas; caves in Texas;
rustic mountain cabins in Colorado that have rodent nests.
Soft ticks live in: caves, rodent burrows, and nests of rodents,
birds, and bats.
 Unlike hard ticks, they feed on a host for about an hour during
the night and then drop off. They can transmit relapsing fever
within a few minutes after biting. They take many blood meals
during their lives.
Tick-Borne Relapsing Fever
Symptoms: high fever, chills, excessive sweating, rapid
heartbeat, rapid breathing, headache, muscle pain, weakness,
dry cough, nausea, vomiting, petechial or maculopapular rash
Symptom Onset: 3-18 days after tick bite
Progression: Initial illness lasts about 3-6 days and ends with a
crisis that can cause fatal shock. A relapse occurs about 7-10
days later. Future relapses are milder. There are usually 3-10
relapses.
Treatment: (according to emedicine.medscape.com)
Tetraycycline, Doxycycline, Erythromycin (for children and
pregnant women), Chloramphenicol (for adults allergic to
tetracyclines)
Tick-Borne Relapsing Fever
Fatality rate: less than 1% in treated patients.
Herxheimer reaction: Many patients, when starting treatment,
have a Herx reaction which can be fatal, with high fever,
excessive sweating, tachycardia, rapid breathing, and
hypotension. Researchers reported that intravenous
meptazinol reduces this reaction in louse-borne relapsing
fever.
(The Lancet, Apr. 16, 1983. 1(8329) 835-9, "Meptazinol Diminishes the
Jarisch-Herxheimer Reaction of Relapsing Fever: by Baya Teklu, et. al.)
Q Fever
Cause: Coxiella burnetii bacteria
Contracted on farms and ranches that have infected cattle,
sheep, or goats
Usually contracted from contact with:
Placenta or birth fluids while assisting in the birth of the young
from infected animals
Also contracted by:
Inhaling dust contaminated with feces, the placenta, or amniotic
fluid of infected animals
Drinking unpasturized milk from infected animals
Contact with urine of infected animals
A bite from an infected tick
Q Fever
 Most infected animals show no symptoms
 The disease may be discovered by an outbreak of animal
stillbirths on the ranch or farm
Symptoms of Q Fever in humans:
 High fever,
104 or 105 degrees
 Severe headache
 Malaise
 Myalgia
 Chills, sweats
 Dry cough
 Nausea, vomiting
 Abdominal pain
 Chest pain
Q Fever Can Cause






Pneumonia
Meningitis
Encephalitis
Endocarditis
Myocarditis
Pericarditis
 Aortic aneuryism
 Hepatitis
 Cirrhosis
Q Fever Treatment
(www.cdc.gov)
Most successful if begun promptly. Don't wait for test results, which
are usually negative early in the illness.
Acute Stage: Treat 2 to 3 weeks with
Doxycycline
Chronic Illness: Treat 18 months with
Doxycycline, 100 mg. 2 times a day plus
Hydroxychloroquine, 200 mg. 3 times a day
Children:
Doxycycline if severely ill
Co-trimoxazole for mild illness in children under age 8
Pregnancy: Treat for duration of pregnancy
Co-trimoxazole, 1 time per day
XMRV (HGRV) Virus –
Linked with Chronic Fatigue Syndrome or Lyme Disease?
A study published in 2006 reported a link between the XMRV
virus and prostate cancer.
("Identification of a novel Gammaretrovirus in prostate tumors of patients homozygous for
R462Q RNASEL variant." PloS Pathog 2006 Mar;2(3):e25. Epub 2006 Mar 31. A. Urisman, et
al., Dept. of Biochemistry and Biophysics, University of California San Francisco.)
A study published in 2009 reported a link between XMRV
and chronic fatigue syndrome (CFS).
("Retrovirus Might be Culprit in Chronic Fatigue Syndrome." Science News vol. 176, no. 10,
p.13. Judy Mikovits, PhD, et al., Whittemore Peterson Institute, Reno, NV.)
XMRV was found in 67% of 101 patients with chronic fatigue syndrome
(CFS).
XMRV was found in only 8 of 218 (3.7%) healthy controls. Additional tests
found XMRV in almost 98% of about 300 CFS patients.
Other studies have failed to find a link between XMRV and prostate
cancer or CFS, so findings of both studies are being disputed.
Retroviruses

XMRV (xenotropic murine leukemia virus-related virus) is a
retrovirus, similar to the HIV retrovirus that causes AIDS.

Retroviruses remain in the host for life.

Retroviruses suppress the immune system and activate other
dormant viruses.

Many CFS patients have chronic viruses, and some have
chronic Lyme disease.

XMRV is also called HGRV virus, for Human Gamma Retro
Virus, since it infects humans.

Some CFS patients with XMRV/HGRV are being treated with
anti-retroviral drugs used for HIV.
XMRV Transmission

According to the Mikovitz study, XMRV is much more prevalent
than HIV.

Therefore, it must have additional ways to be transmitted.

Some doctors suspect ticks and/or fleas may transmit it.

XMRV is closely related to a retrovirus that infects mice.

Ticks and fleas pass diseases from mice to people.
Risk for Blood Supply?

The Mikovitz study found XMRV in almost 4% of healthy
people in the control group.

This means 10 million healthy people in the U.S. may
unknowingly carry the disease.

It could pose a risk for people receiving blood transfusions.

There is currently no screening test for XMRV.

It is not yet known whether XMRV is being transmitted through
blood transfusions.
Research on Blood
Aug., 2010 – Scientists from the NIH, FDA, and Harvard Medical
School released a study of XMRV in blood.








Blood from 37 CFS patients had been stored since about 1995.
Mouse leukemia retroviruses related to XMRV were in stored blood of 32 of
37 CFS patients, 86.5%.
The viruses were detected in only 3 of 44 healthy blood donors, 6.8%.
Fresh blood was drawn from 8 of the CFS patients whose stored blood had
been tested.
The viruses were found in 7 of them, indicating that the patients are still
infected.
As a result of this study, the Red Cross stopped accepting blood donations
from CFS patients.
VIP Diagnostics in Reno has culture and PCR tests for XMRV (HGRV).
See www. vipdx.com for more information.
They recently stopped the testing.
A Family Story of XMRV

Test Results

Treatment
Morgellons Disease

Causes painful open sores that last for months or don't heal.

Causes black granules and white clear, red, blue, black, or green
fibers to emerge from the skin.

Fibers can be removed from sores or intact skin with tweezers.

Fibers don't match any known fibers.

Calcium and other minerals have been found in some fibers.

Many fibers are hard and feel like splinters.

Causes stinging and crawling sensations under the skin and intense
itching.

These symptoms interfere with sleep.
Morgellons Fibers
Long fiber emerging from woman's arm.
Notice the two bumps, it's obviously not a hair.
Morgellons Fibers
Two white fibers emerging from thumb
knuckle.
Fibers emerging from under and around
thumb nail.
Morgellons Sores
Morgellons Sores & Black Specks
Black specks emerging from skin
under eye.
Morgellons Infected Dog
Morgellons Disease

Reported in all 50 states and in Canada, Europe and world-wide.

Appears to be an emerging disease; incidence is on the increase.

Almost all Morgellons patients have Lyme disease or another tickborne disease.

Most people with Lyme do NOT have Morgellons.

Some Lyme specialists are treating Morgellons.

Lyme support groups can help people find a Lyme specialist.

It is unknown whether Morgellons may be transmitted by ticks.

Another possibility is contact with soil.

Many Morgellons patients develop the disease after contact with
soil, as in gardening.
Morgellons Disease

Antibotics helps many patients.

Many also need antiparasitic and/or antifungal drugs.

Some have improved by taking NutraSilver colloidal silver internally.
(See stories at www.nutrasilver.com)


When starting treatment, patients typically have a temporary
worsening of symptoms (a Herx reaction), with a mass exodus of
fibers.
May be somewhat contagious.

Many patients have family and close friends with the
disease.

Some patients have dogs or cats with it.

However, many families just have one person infected.
Morgellons Disease

The CDC is investigating the cause.

Some possible causes include an unknown fungus, nematodes,
other parasites, and/or Agrobacterium.

Agrobacterium is a plant bacterium found in the soil.

It has been genetically modified. It gets into the cells of
plants and changes their genetic structure.

Agrobacterium has been found in the skin of Morgellons
patients but not in controls.

Agrobacterium creates cellulose, a plant material which
appears to be in some of the fibers.
Morgellons Disease

People can have the fibers without the sores. Some people have
sores without fibers.

If they have fibers, they have Morgellons, because that is the
definition. It's a fiber disease.

There are no tests for Morgellons.

The disease is diagnosed based on patient history and visible fibers.

A doctor who does not see any protruding fibers
can look for fibers under the skin with an
EyeClops BioniCam microscope.
Morgellons Patients Are Ill







In addition to fibers and sores, they have insomnia, fatigue, memory
problems, mood swings, and depression which leads some to
suicide.
Some have joint pain, vision problems, muscle weakness, and other
symptoms.
Most (about 95%, according to Ginger Savely) also have Lyme
disease. Determing to what extent Lyme is causing or exacerbating
some of these symptoms can be difficult.
Some have a thick, black, oily substance that oozes out of their
pores.
Some lose their hair in clumps, and their teeth may turn black,
starting at the gum line, and then fall out.
Osteoporosis may develop in the bones.
It is unknown whether the calcium in the fibers is coming from the
bones and teeth.
Finding Morgellons Fibers

Dr. Ginger Savely, DNP advises doctors to buy an EyeClops
BioniCam magnifier to examine the skin of Morgellons patients.

Other microscopes are too powerful. She says magnification of 30
to 100 is best for viewing Morgellons fibers under the skin, with 60
giving the best view.

The BioniCam is sold as a child's toy and is available at
Amazon.com and sometimes at Toys R Us.

The price is usually slightly over $100.

It has a light, and illumination is important for seeing fibers under
sores and intact skin.

Digital photographs can be taken with this microscope.
Dr. Ginger Savely, DNP, is a nurse practitioner with a doctorate
degree in Nursing Practice (not an M.D.) She has treated over
500 Morgellons patients, perhaps more than anyone else in the world.
To Use the BioniCam

First wipe the skin with an alcohol wipe or dampened non-linty
eyeglasses paper, to remove any environmental fibers that may be
on the skin.

Rubbing intact skin with the paper may bring the fibers closer to the
surface for easier viewing.

The fibers that show up are usually blue or red but can be other
colors.

You usually have to place the magnifier on several areas of skin
before finding fibers, so this is not a quick examination.
Morgellons is on the Increase
If you have never seen a person with it, you
may someday.
You may notice a person whose face or body
is covered with open sores.
For more information:
See www. Morgellons.org and www. thecehf.org.
Do an internet search of "Morgellons" and "Agrobacterium."
Buy DVD's of Morgellons conferences at www. thecehf.org.
For consultation on treatment,
contact Ginger Savely through www. gingersavely.com.
Tick Habits




Ticks crawl upward, against gravity.
They are attracted to carbon dioxide from people and animals.
Adult ticks like to feed and mate on deer.
Ticks have to stay cool and moist.
l







Where are ticks?
Mostly in woodsy areas, where deer roam.
Hiding in damp piles of leaves, tall grass, and bushes.
Sometimes in short grass, on well-watered shady lawns.
Sitting at the tips of blades of grass with their legs
outstretched, ready to grab onto a passing host.
Waiting in low brush or on shrubs along trails.
In the bushes on golf courses.
Sometimes they drop from trees.
Tick Bite Prevention

Wear long pants, a long-sleeved shirt, shoes that cover
the feet, and a hat.

Wear light-colored clothes to see ticks better.

Tuck your shirt in, and tuck the cuffs of pants into your
socks.

Seal your socks to your pant legs with duct tape to
prevent ticks from reaching skin.

Use duct tape or wide masking tape, sticky side out,
around clothes below knees, to catch ticks crawling up.

Use repellent on clothes and exposed skin; wash it off
when you come inside.
Tick Bite Prevention

Hike in the center of trails; try not to brush against plants
along trails.

Wear a roll of wide masking tape or duct tape around your
arm to keep it handy, in case you get attacked by
hundreds of tiny ticks at once.

Don’t stand still long on trails. Lone star ticks can crawl
quickly to get on you.



Stay out of tall grass and piles of leaves.
If a golf ball gets into the bushes, don’t go in to get it. Use
another ball. Don’t risk getting a tick on you.
Check yourself often for ticks when outside.
Repellents

The CDC recommends spraying permethrin
(permanone) on clothing the day before an outing.
Permethrin is an insecticide and must not be used on
skin. It is the most effective product. Ticks drop off and die
without biting.

The CDC recommends products containing DEET on
skin, such as OFF and Cutter's. DEET is toxic and should
be washed off when coming indoors. DEET doesn’t repel
ticks but can make it difficult for them to find you.

Picaridin, which is in Cutter's Advanced, is less toxic than
DEET and is used world-wide to prevent mosquito bites.
It provides some protection against ticks.
Repellents

People have reported that repellents containing cactus
juice are more effective than DEET.

Lemon oil eucalyptus is an all-natural repellent that is
somewhat effective for ticks. There is concern that it may
not be safe for children.

Bounce fabric softener sheets placed in socks can help
keep insects away. They haven’t been studied for ticks.

Bathing in Irish Spring soap or rubbing a dry bar of it on
the cuffs of socks and pants can repel insects. It may or
may not help repel ticks.
Check Yourself Thoroughly

When you come inside, bathe as soon as possible.

Using lots of soap may help remove any unattached ticks.

Check yourself all over for ticks.

Check cozy places, where skin meets skin and clothing
fits tightly.

Check the waist, belly button, behind knees, private parts,
armpits, neck, in and behind ears, and under the hair.

Use a mirror for your back.

Look and feel for ticks. They can be as tiny as the dot of
an "i" and may feel like a tiny scab.
Check Yourself Thoroughly

If covered with ticks, take clothes off in a dry bathtub and
place them immediately in the washing machine or dryer,
or place them in a trash bag and spray permethrin
insecticide into the bag. Close the bag tightly until ready
to launder clothes.

Dry clothes an extra hour on high heat after the clothes
have dried. Ticks die if thoroughly dried out. They
survive the washing machine.

Check your pets for ticks before they come indoors.

Discuss ways to protect pets and farm animals with your
veterinarian.
Remove Ticks Properly
If ticks are found and removed right away, they may not
have time to give you Lyme disease. It often takes several
hours for a tick to give you the germs.
The old ways to remove an attached tick aren’t safe now
that many ticks carry Lyme disease in their guts.
DON’T USE

A hot match, petroleum jelly, liquid soap, alcohol, nail
polish, nail polish remover, or other chemicals. (These
may make the tick vomit germs into you.)

Your fingers, or regular tweezers. (These may squeeze
the tick's gut and squirt germs into you.)
Remove Ticks Properly
DO USE:

Fine-pointed tweezers. This works for adult ticks, if you
grasp the tick at the mouth, where the tick is attached to your
skin; it’s not safe for the tiny young ticks, because the gut
might get squeezed and squirt germs into you.

A credit card or something else you can slide under the tick.
Slide something under the tick and press upward at the mouth
until the tick pulls itself out.

A tick remover that slides under the tick. The Lyme Assoc.
sells a tool that slides under the tick for $4.
After removing a tick, disinfect the bite site, removal tool,
and your hands.
How to Use Tick Remover
• Slide V-shaped slit of tool
under tick.
• Tilt tool up at 45 degree
angle, to position tick in
smallest part of the V.
• Lift tick up slowly.
Please visit our exhibit table to:

Receive a free tick remover

See our display with additional pictures of
rashes and ticks

Pick up a copy of Dr. Burrascano's "Diagnostic
Hints and Treatment Guidelines" (or see it at
www. ilads.org)

Pick up some brochures for your office

Talk with us
Lyme Disease Neurological Symptoms
Lyme disease can cause physical, cognitive, and psychiatric
symptoms.
Symptoms may come and go from week to week, day to
day, or even during the day.
They can vary in intensity throughout the day.
A person can suddenly get a terrible pain in the knee. It may
be fine in a few minutes, and then the elbow may
suddenly hurt intensely.
Lyme Disease Neurological Symptoms
A headache may last for years but may vary in intensity
throughout the day.
The ability to concentrate and to comprehend oral and
written speech may vary throughout the day.
Blurry vision may come and go from day to day.
Lyme can affect the brain, heart, vision, and hearing.
People can suddenly not recognize familiar places.
Speaking and Conversation Problems
Associated with Lyme
Conversation problems can come and go throughout the
day.
It can be difficult to:

Think of the right words to say.

Put words in the right order in sentences.

Hold a thought long enough to finish a sentence.
Episodes of stuttering and jumbled speech can occur.
Lyme Disease Transmission Studies
Lyme disease Bb bacteria have been found in Texas in:
Lone Star ticks (Amblyomma americanum)
Gulf Coast ticks (Amblyomma maculatum)
Deer ticks (Ixodes scapularis)
Cat fleas (Ctenocephalides felis)
"Isolation of Borrelia burgdorferi from arthropods collected
in Texas," by G.J. Teltow, P.V. Fournier, and Julie A. Rawlings;
Microbiological Services Division, Bureau of Laboratories,
Texas Dept. of Health, Austin. Am. J Trop Med Hyg, May 1991.
"The etiologic agent of lyme disease in deer
flies, horse flies, and mosquitoes." By
Magnarelli LA, Anderson JF, Barbour AG. J
Infect Dis 1986; 154:355-8.
Bb Bacteria were found in deer ticks, American dog
ticks, 3 species of mosquitoes, 4 species of deer flies,
and 3 species of horse flies in Connecticut.
After infected mosquitoes fed on 12 uninfected
hamsters, one hamster developed antibodies to Bb,
proving that mosquitoes in the U.S. can transmit
Lyme disease.
Bb Found in 30 Species of Arthropods
Bb bacteria were found in 30 species of
arthropods (arachnids and insects), including
13 species of mites, 15 species of flies, and
two species of fleas.
"Incidence of the spirochete Borrelia burgdorferi
in arthropods (Arthropoda) and antibodies in
vertebrates (Vertebrata)." By P.Pokorny. [Article
in Czech.]
Cesk Epidemiol Mikrobiol Imunol, Jan. 1989;
38(10:52-60)