health care

In search of strategy to fight Lyme Disease

Posted 7/16/12

PROVIDENCE – At the behest of Sen. Jack Reed, local and national experts on Lyme Disease gathered on July 9 at the R.I. Department of Health to talk about efforts to improve prevention, diagnosis and treatment of the disease, which is the second-most reported disease in Rhode Island, according to health officials. (The event, ironically, was scheduled at the same time as the roundtable on breast cancer at Rhode Island Hospital, creating a situation of dueling Senators and dueling diseases.)

In 2010, there were 115 confirmed cases and 800 additional likely cases of Lyme Disease in Rhode Island; in 2011, there were 111 confirmed cases and 900 additional likely cases, according to Dr. Michael Fine, director of the R.I. Department of Health.

In 2012, there may be a surge in Lyme Disease in Rhode Island, according to Thomas N. Mather, professor of Public Health Entomology and director of the Tick Encounter Resource Center at the University of Rhode Island. He warned that numbers for the black-legged deer tick in Rhode Island, the carrier of Lyme Disease, are up 80 percent over 2011 levels and 142 percent above the previous 5-year average, meaning that the risk of contracting Lyme disease or other tick-borne diseases is especially high.

Lyme Disease is caused by a spirochete, borellia burgdorferi, and despite its growing prevalence, there are unresolved questions about diagnosis, preferred treatment and long-term disabilities associated with the untreated disease.

“We don’t have good diagnostic tests for Lyme Disease,” Fine told Providence Business News after the event. Most cases, he continued, are made as a result of clinical diagnoses, not blood tests.

Fine himself said he had had Lyme Disease three times, a result of his being outdoors and cutting 15 cords of wood a year. In 2006, he was attending the national American Public Health Association meeting in Philadelphia, when he realized he was stricken.

Fine’s advice on treatment: “If you don’t feel well, go to see your doctor. If you still don’t feel well, go to see your doctor again.”

Most doctors now recommend antibiotics after a tick bite and initial onset of Lyme Disease. There are ongoing debates about the effectiveness of long-term antibiotic treatments. New research conducted at Yale University suggests that a protein from the disease’s spirochete may remain and be the cause of many of the long-term problems associated with Lyme Disease, according to Dr. Charles Benjamin Beard, chief, Bacterial Diseases Branch, Division of Vector-Borne Diseases, at the Centers for Disease Control and Prevention. Beard also said that the spread of deer ticks into new habitats is being studied for its relationship to climate change.

Mathers recommended prevention and vigilance, wearing protective clothing in the woods, and conducting daily tick checks in the shower: “When you’re naked, it’s a great time to check for ticks.” Because ticks crawl up, and the deer tick nymph is about the size of a poppy seed, Mathers continued, it’s likely that “the tick may find the bottom of your testicles.”

Fine praised the Rhode Island Congressional delegation for its advocacy on behalf of public health issues. He also voiced sympathy for those who may be suffering from the long-term effects of Lyme Disease, and the need for more research. “In science and medicine, we know what we know, and we don’t know what we don’t know,” he said. “The public relies on us to be honest and accurate.”

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