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Experience From - Karl King , John Vonhof , Pat Wellington Scott Parker , Earl Blewett ,


Karl King

Wisconsin has plenty of ticks in the Summer, so I always inspect for them, especially if I've been out trout fishing all day.

They usually walk around looking for a warm spot to dig in. That may take 2-24 hours. For that reason, it is good to shower soon after coming back from an outing in the woods.

The transmission of the disease organisms does not take place at the initial bite, but during the feeding by the tick. Squeezing the tick to get it out is a bad idea because that my force the organisms into the wound. Try to get the head of the tick with tweezers, not squeezing the body.

Once the tick is out, apply Bactine to reduce infection chances.

Watch the area closely for a week. If you see a red rash or circle around the bite area, see a doctor promptly. Some people get flu-like symptoms.

The sooner treatment begins the more likely that the disease will be beaten. If left untreated, the result can be arthritis and/or heart disease that is very debilitating. Obviously, if you have any doubt, see a doctor.


John Vonhof

Karl King wrote:

The transmission of the disease organisms does not take place at the initial bite, but during the feeding by the tick. Squeezing the tick to get it out is a bad idea because that my force the organisms into the wound. Try to get the head of the tick with tweezers, not squeezing the body.

I found a new tick removal tool that works great. Backpacker magazine, in the May, 97 issue had a very informative article about ticks. They evaluated several tick removal tools and the one that won out was the: Pro-Tick Remedy (1-800-PIX-TICK) PO Box 573, Stony Point, NY 10980.

The cost is about 3.50. The tool is a small 2 1/4 by 1/2 inch stainless steel tool which is slightly "V" shaped with a long "V" cut into one end. You simply slide the tool under the tick so its body is caught in the narrowing V, and lift up. No squeezing and so no chance of pushing bad stuff from the tick into your skin. An instruction booklet is included.

I called and ordered five for myself and friends. I like the tool so much that I included a brochure in the post race packets of my Ohlone Wilderness 50K Trail Run. A simply design yet better than all the tweezers we typically use.


Pat Wellington

Subject: Lyme Disease Vaccine

The recently FDA-approved Lyme Disease vaccine is more complicated than just one shot!

The April issue of the UC Berkeley Wellness Letter contains the following article on the Lyme disease vaccine and how it works:

At Last, a Lyme Disease Vaccine

A three-part shot known as LYMErix was recently approved by the FDA as the first vaccine against Lyme disease. You need two shots a month apart, and then a third one a year later. It may be hard to remember to get the third shot, but it significantly boosts immunity. Its only common side effect appears to be a little redness and soreness at the injection site. The three shots have been shown to prevent Lyme disease in anywhere from 68 to 92% of people (without the third shot, this drops to about 50%).

Like most vaccines, this one produces antibodies in the blood that "recognize" and kill an invading microorganism--in this case the bacterium that causes Lyme disease. The microorganism is carried by a deer tick and can be introduced into the body via a tick bite. (In the Northeast, the tick usually lives on mammals, especially deer, and on birds. In the Far West, it lives mainly on lizards and wood rats, as well as other mammals.) If you've been vaccinated, your antibody-laden blood enters the tick and kills the bacteria before they have a chance to migrate into you. This is the elegant result of genetic engineering at the expense of the bacteria. Vaccination costs $50 to $100 for the three shots.

Who needs to be vaccinated?

Anybody aged 15 and over who lives where Lyme disease is common, particularly those who hike or spend time outdoors in wooded areas, should consider it. Risk of infection is highest in the Northease (Massachusetts, Rhode Island, Connecticut and New York), as well as New Jersey, Maryland, Pennsylvania, Delaware, Wisconsin, Minnesota, and Michigan, and a few counties of Northern California. Lyme disease is rare or nonexistent in the Rocky Mountain states, Hawaii, and Alaska.

Those who've already had Lyme disease should consider vaccination. This is because Lyme disease, unlike such infections as chicken pox, does not confer lasting immunity. You can get it twice. But you should NOT be vaccinated if you still have any acute or chronic symptoms of the disease.

What are the drawbacks?

Last words: According to an FDA spokesperson, "It's important for people to realize that protection will never be 100%." Still, the new vaccine is an encouraging advance, provided people continue to take precautions. If you're planning to be vaccinated, act now. You'll get some protection even from the first two shots.


Scott Parker

Summer is coming and there has been some discussion concerning lyme disease in the past, including the new vaccine (LYMErix- SmithKline Beecham). LYMErix will be heavily promoted in markets where Lyme disease is endemic, and some of you may have considered taking this vaccine. As an infectious disease specialist I will take the liberty of offering the following:

After the vaccine was proven effective in a large clinical trial (>10,000 participants), it received FDA approval. There are concerns that chronic Lyme disease arthritis may be due to the body's immune reaction to a protein (OspA) on the surface of the Lyme disease bacteria (Borrelia burgdorfi) (see E. Akin et al, Infect. Immun. vol. 67; p. 173 and Science vol. 281; p. 703). OspA is the immunogen in the vaccine, and thus may cause chronic debilitating arthritis in some individuals with chronic use over several years. Original studies on LYMErix have not been associated with excessive side effects or adverse events, but the study participants were followed for a relatively brief period (3 vaccinations over 12 months with 20 months of follow-up) of time, and were not vaccinated repeatedly over several years (which is likely necessary for long term protection). The Medical Letter (a respected and conservative journal that reviews treatment regimens for physicians) concluded that "Lyme disease vaccine is effective and has been well tolerated, but its long term safety is worrisome and antibiotics are generally effective in treating early disease and preventing complications. How long vaccination remains protective is unknown; antibody levels suggest that frequent boosters may be necessary. Use of this vaccine should be sharply limited'. (emphasis added - Medical Letter 3/26/99 vol. 41 p. 29-30).

If you live in an area endemic with Lyme disease (New England - D.C. and points north, Wisc. Mich. and Calif.) you may consider taking the vaccine for protection, but should be aware of the potential risks. Other effective measures for prevention include "tick checks" after spending time on the trails, and antibiotic therapy for the characteristic rash (round or oval red rash, possibly with clearing in the center) at the site of tick bite.


Earl Blewett

There's a very good article in the June 4th Morbidity and Mortality Weekly Report on Lyme disease vaccines and on the disease itself. It's a government publication and can be accessed for free.

This link is the article

http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4807a1.htm

This link is a Lyme disease risk map.

http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4807a2.htm

Best wishes from Oklahoma where we have Lyme disease but Rocky Mountain Spotted Fever is more of a risk.