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Cape Cod Times

Lyme disease threat growing

[email protected]
October 11, 2009

For years, Bay State residents have viewed Lyme disease as the scourge of the Cape and Islands.

But with cases in the Berkshires and Worcester area creeping toward local levels, the tick-borne illness is now a statewide phenomenon.

Lyme cases
Areas of the highest incidence of Lyme disease include Cape Cod and southeastern Massachusetts, the islands of Nantucket and Martha's Vineyard, areas north of Boston, towns along the upper Middlesex and Worcester county borders, along the Quabbin Reservoir watershed and in southern Berkshire County.

Barnstable County - Confirmed cases: 233; Incidence rate (per 100,000): 105

Dukes County - Confirmed cases: 51; Incidence rate (per 100,000): 340

Nantucket County - Confirmed cases: 63;Incidence rate (per 100,000): 662

Source: Massachusetts Department of Public Health, 2007.
And while that's bad news for most, advocates for people with Lyme disease say the illness may now be getting the serious attention it deserves.

Legislation calling for more aggressive treatment and for the creation of a special Lyme disease commission have languished in committee but are now the subject of renewed interest on Beacon Hill.

Representatives from across the state attended a recent hearing before the Committee on Public Health, said Brenda Boleyn, chairwoman of the Cape and Islands Lyme Disease Task Force.

"Lyme disease has always been associated with coastal areas," Boleyn said. But she said that is no longer the case.

Out in western Massachusetts, Berkshire County had 94 cases of Lyme in 2007, the last year for which the state has statistics. The overall incidence rate per 100,000 people was 70 -- just eight points lower than the Barnstable County rate in 2006.

In the middle of the state, Worcester County reported 381 cases of Lyme disease, which had an incidence rate of 51 -- more than double what that county experienced in 2004.

Barnstable, Dukes and Nantucket counties still have the most concentrated levels of Lyme in the state, with 2007 incidence rates of 105, 340 and 662 per 100,000 people, for a total of 347 cases that met the Centers for Disease Control surveillance guidelines.

"This is a tremendous problem in Massachusetts," said Dr. Alfred DeMaria, epidemiologist with the state Department of Public Health. "A lot of it has to do with ecological changes in the environment." Those changes have drawn deer and the deer ticks that feed on them into residential areas.

traveling for treatment
One bill before a state legislative panel would create a special commission to study Lyme disease. Another would protect doctors who treat Lyme by prescribing antibiotics beyond the single 28-day course recommended by the CDC.

Legislation allowing more aggressive treatment would provide immediate benefits for patients, said Boleyn, whose task force has been working on similar legislation since 2005. She said a bill filed in 2006 by former state Rep. Shirley Gomes, a Republican from Harwich, didn't make it out of legislative session.

Many Massachusetts residents have to travel to Connecticut and New York to get help for entrenched Lyme disease that can cause neurological impairments and wreck the quality of their lives, Boleyn said.

"It really would be very helpful to everyone if the doctors are protected and the patients are covered well," said Sally Andersen of Orleans, who has been treated for Lyme. She said doctors "should have a free hand and not be intimidated by insurance companies."

But Dr. Alan Sugar, medical director of infectious disease clinical services at Cape Cod Healthcare, fears that the legislation would set a "dangerous precedent."

Practicing medicine on the basis of testimonials and personal experiences instead of scientific evidence will cause U.S. medical practice standards to regress, he said.

Sugar said he's not aware that long-term antibiotic treatment works, but he has seen two patients who were "almost killed" by long-term, indwelling I.V. catheters.

Carol Bellis of Sandwich said intravenous treatment of Lyme turned her life around after she fell ill in 2004. Getting a nine-month prescription for antibiotic treatment required an appointment with a doctor in New York City, but she says it was worth it.

The treatment took care of the muscle weakness, fatigue, tingling, twitching and joint pain that followed her Lyme infection, Bellis said.

Now she thinks nothing of hopping on her bicycle for a 25-mile ride, she said. "I lead a normal life without being exhausted. I feel it's a crime not to administer it."

The controversy over best treatment protocols is sure to heat up as cases of Lyme proliferate.

Statewide, cases of Lyme disease grew 35.4 percent from 2006 to 2007. Early reports show the number of Lyme cases in Massachusetts will top 4,000 in 2008, meaning the number of people sickened by the bacteria carried by the deer tick has more than doubled since 2002, when the DPH reported 1,930 cases.

Advocates for people with Lyme disease say these numbers are only the tip of the iceberg, since many sick patients do not meet the CDC surveillance criteria for public health reports.

To be included in the DPH reports, a person must have a classic "bull's eye" rash or have a positive Lyme test and clinical symptoms.

Some people argue that the surveillance criteria are too strict, including only rashes of a certain size. They say Lyme tests are notoriously tricky, and public health officials should rely on doctors' diagnoses to determine who has Lyme.

Raymond Pena of Brewster, a retired librarian active with the Brewster Lyme Disease Support Group, said the Brewster town health department determined that local doctors had diagnosed 77 cases of Lyme in 2007, but only 25 were reported to the DPH.

He's afraid that the state will use the more restrictive surveillance data to deny the severity and prevalence of the disease on the Cape and Islands.

"It's very easy for the state to say it's not that serious. It's serious," he said.

funding cut
Already, state funding for education and research on Lyme disease has dried up, but officials say that is due to the state budget crisis, not any intention to downplay Lyme disease.

DeMaria said state officials have been warning the public Lyme is a serious problem for years. He said surveillance criteria are by definition different from diagnostic criteria and shouldn't affect how doctors diagnose Lyme in their offices.

The epidemiologist praised Cape and Islands efforts to educate the public about the tick-borne illness, but the director of the Barnstable County Cooperative Extension Service said prevention efforts are limping along now that state money has been cut.

Last year, the state's allotment of $75,000 for the Cape and Islands was reduced to $25,000. This year, Lyme funding was cut entirely.

"When we run out of educational materials, we won't have any money to print" more, Bill Clark said.

Last spring, the county extension service dropped its school-based tick awareness program because it doesn't have money to pay nurses to run it, and it's not planning to hold any more education awareness seminars for doctors and other health professionals.

Clark said he doesn't know whether the county will be able to continue with a deer-baiting program that has shown promising results in stopping tick activity in selected areas of the Cape and Islands.

The county will soon run out of corn to attract deer to feeding stations where their heads are coated with tick-killing pesticide, he said.

Clark said county entomologist David Simser is applying for grant money to continue the project.

Pena said there already seems to be a decline in signs warning people about deer ticks in Cape Cod parks.

That upsets him.

"To let people get sick and continue to be sick doing zero about it is ridiculous," he said. "It's unethical."

Andersen said Lyme awareness needs to spread beyond coastal New England. "It's a national problem," she said.

Posts: 571 | From Massachusetts | Registered: Oct 2008  |  IP: Logged | Report this post to a Moderator
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That's really sad about the funding cuts!! NO LYME AWARENESS in the schools!??

Dr Sugar can go jump in the lake! [cussing]

Opinions, not medical advice!

Posts: 95440 | From Texas | Registered: Feb 2001  |  IP: Logged | Report this post to a Moderator

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Thanks for the info.
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edited; went to site and found this ...

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22dreams, thx for posting, and i feel so bad for all mass. members on this hog wash piece of garbage.

tutu summoned it up for me as well, and NO more printing of lyme brochures! [toilet] [tsk]

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