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» LymeNet Flash » Questions and Discussion » General Support » TV show "House" has episode on tick disease

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Author Topic: TV show "House" has episode on tick disease
DR. Wiseass
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TV show, "House" FINALLY does an episode on a tick-borne illness - however insufficient it was!

In essence, the tick was still attached to the pubic area of the patient and was causing increasing paralysis. After the tick was removed and she was put on some med (can't remember) -- she was gonna be good as new!

Oh PLU-EASE!!!

Here's a link to the show's board where you can post a review about the episode "Safe" (if you saw it) - and notice they also have a forum to discuss the episode.

http://www.tv.com/house/show/22374/reviews.html&flag=3

Perhaps this is an opportunity to gently educate the public (& the writers - assuming they read the episode reviews) that tick borne diseases aren't always easy to treat.

I'm having a hard time with my computer AND my brain tonite so I'll have to wait on mine...just thought I'd throw the suggestion out there!

Hugs & [kiss]

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DR. Wiseass
NOT a real doc - just a real wise  -
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painted turtle
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Yes I saw that!!

I was surprised. It's great it got out there on a popular tv show.

BUT...once the tick was removed, she got sent home the next day...going to be fine.

So, while it brought awareness to the extreme dangers of the tick...it did not at all assess the reality of treatment, or what a tick can do to a person long term.

Kudos to them for getting it out there! That is a great start.

Hopefully more and more awarenesses of the reality of the situation will come out.

I've been waiting for them to bring up lyme disease since most episodes show the symptoms!!!

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www.lymefire.blogspot.com

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Melanie Reber
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I have seen Lyme mentioned as a differential on this show several times...
but it is always dismissed due to the lack of a rash.

Even though it was highly dramatized, it was helpful to emphasize the emergency nature of this often overlooked Co-infection.

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treepatrol
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Tick Paralysis -- Washington, 1995
Tick paralysis (tick toxicosis) -- one of the eight most common tickborne diseases in the United States (1) -- is an acute, ascending, flaccid motor paralysis that can be confused with Guillain-Barre syndrome, botulism, and myasthenia gravis. This report summarizes the results of the investigation of a case of tick paralysis in Washington.


On April 10, 1995, a 2-year-old girl who resided in Asotin County, Washington, was taken to the emergency department of a regional hospital because of a 2-day history of unsteady gait, difficulty standing, and reluctance to walk. Other than a recent history of cough, she had been healthy and had not been injured.


On physical examination, she was afebrile, alert, and active but could stand only briefly before requiring assistance. Cranial nerve function was intact. However, she exhibited marked extremity and mild truncal ataxia, and deep tendon reflexes were absent. She was admitted with a tentative diagnosis of either Guillain-Barre syndrome or postinfectious polyradiculopathy.


Within several hours of hospitalization, she had onset of drooling and tachypnea. A nurse incidentally detected an engorged tick on the girl's hairline by an ear and removed the tick. Within 7 hours after tick removal, tachypnea subsided and reflexes were present but diminished. The patient recovered fully and was discharged on April 11. The tick species was not identified.


Reported by: E Haas, D Anderson, R Neu, Asotin County Health Dept, Clarkston, Washington. N Berkheiser, MD, Saint Joseph Regional Medical Center, Lewiston, Idaho. J Grendon, DVM, P Shoemaker, J Kobayashi, MD, P Stehr-Green, DrPH, State Epidemiologist, Washington State Dept of Health. Div of Field Epidemiology, Epidemiology Program Office, CDC.


Editorial Note
Editorial Note: Tick paralysis occurs worldwide and is caused by the introduction of a neurotoxin elaborated into humans during attachment of and feeding by the female of several tick species. In North America, tick paralysis occurs most commonly in the Rocky Mountain and northwestern regions of the United States and in western Canada.


Most cases have been reported among girls aged less than 10 years during April-June, when nymphs and mature wood ticks are most prevalent (2). Although tick paralysis is a reportable disease in Washington, surveillance is passive, and only 10 cases were reported during 1987-1995.


In the United States, this disease is associated with Dermacentor andersoni (Rocky Mountain wood tick), D. variabilis (American dog tick), Amblyomma americanum (Lone Star tick), A. maculatum, Ixodes scapularis (black-legged tick), and I. pacificus (western black-legged tick) (3,4).


Onset of symptoms usually occurs after a tick has fed for several days. The pathogenesis of tick paralysis has not been fully elucidated, and pathologic and clinical effects vary depending on the tick species (4).


However, motor neurons probably are affected by the toxin, which diminishes release of acetylcholine (5). In addition, experimental studies indicate that the toxin may produce a substantial decrease in maximal motor-nerve conduction velocities while simultaneously increasing the stimulating current potential necessary to elicit a response (5).




If unrecognized, tick paralysis can progress to respiratory failure and may be fatal in approximately 10% of cases (6). Prompt removal of the feeding tick usually is followed by complete recovery.


Ticks can be attached to the scalp or neck and concealed by hair and can be removed using forceps or tweezers to grasp the tick as closely as possible to the point of attachment (7).


Removal requires the application of even pressure to avoid breaking off the body and leaving the mouth parts imbedded in the host. Gloves should be worn if a tick must be removed by hand; hands should be promptly washed with soap and hot water after removal of a tick.


The risk for tick paralysis may be greatest for children in rural areas, especially in the Northwest, during the spring and may be reduced by the use of repellants on skin and permethrin-containing acaricides on clothing. Paralysis can be prevented by careful examination of potentially exposed persons for ticks and prompt removal of ticks.


Health-care providers should consider tick paralysis in persons who reside or have recently visited tick-endemic areas during the spring or early summer and who present with symmetrical paralysis.


References

Spach DH, Liles WC, Campbell GL, Quick RE, Anderson DE, Fritsche TR. Tick-borne diseases in the United States. N Engl J Med 1993;329:936-47.

CDC. Tick paralysis -- Wisconsin. MMWR 1981;30:217-8.

CDC. Tick paralysis -- Georgia. MMWR 1977;26:311.

Gothe R, Kunze K, Hoogstraal H. The mechanisms of pathogenicity in the tick paralyses. J Med Entomol 1979;16:357-69.

Kocan AA. Tick paralysis. J Am Vet Med Assoc 1988;192:1498-500.

Schmitt N, Bowmer EJ, Gregson JD. Tick paralysis in British Columbia. Can Med Assoc J 1969;100:417-21.

Needham GR. Evaluation of five popular methods for tick removal. Pediatrics 1985;75:997-1002.

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Do unto others as you would have them do unto you.
Remember Iam not a Doctor Just someone struggling like you with Tick Borne Diseases.

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kelmo
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Later that night, after House, there was a Seinfeld rerun where Elaine can't have a baby shower in her friend's apartment because she has Lyme Disease and Epstein Barre. Two mentions in one night!

Yes, the House episode was simplistic. I guess that's all they can do in a short time. I wonder what REAL doctors think of it. Can you imagine a doctor ever spending that much time worrying about what's making you sick?

Kelly

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jennygump31
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I saw both of those as well and it was so very good to see that thing maybe starting to come out as actual issues. Some day they will know its not all in our heads.
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Ann-OH
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Thanks for the good info, Tree!
It really is true that once the tick causing tick-paralysis is removed, recovery is almost immediate. Weird!

Ann - OH

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pab
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House is my favorite TV show.

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Peggy

~ ~ Hope is a powerful medicine. ~ ~

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Aniek
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Of course, if the writers are really smart, they will bring back the same patient next season after having been diagnosed with fibromyalgia or maybe even MS, because she suddenly went into a seizure like state where she couldn't control her limbs because her muscles began moving uncontrollably.

Dr. House could go through all the long list of causes of myoclonus, and how it isn't common with fibro or MS, and is it a seperate disorder or...wait, Lyme can sometimes cause myoclonus and this patient was in here last year with a tick!

The difficulty will then be that she isn't miraculously cured...but she is just starting her antibiotic treatment.

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"When there is pain, there are no words." - Toni Morrison

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Jellybelly
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Oh, I am glad some of you saw it. I can't believe I missed it, it is one of my favorite shows. My chiro told me about it. I always thought that some day they would do a show on Lyme/Tick borne disease. It had been mentioned several times before. Hopefully I will see the rerun.

I think it would be great if they brought her back next season with full blown Lyme.

Thanks Annie for letting me know this was here. I forget this General board is here, no wonder no one had posted about it on the MEDICAL board [bonk]

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