The New York Times
New York NYJuly 18, 2004

WESTCHESTER

Forget About the Deer

By DANIEL CAMERON

Mount Kisco -- The Town of Greenburgh is so fed up with its abundance of deer that it has formed a committee to survey residents on their choice of shooting
or poisoning them, or trapping and shipping them somewhere else.

This is all
well and good if you're trying to save shrubs and reduce motor vehicle
accidents, two of the reasons cited for eliminating deer, but it won't help with
another goal: lowering cases of Lyme disease, which have more than doubled nationwide during the 15 years that I have been treating the disease.

Instead of blaming deer, we need to look at our own activities. Perhaps the most effective way to fight Lyme is to eliminate not deer, but a beloved fixture of
suburban yards: the birdfeeder.

The problem starts with a bug that should never have been called a deer tick.

Its proper name is the black-legged tick. Deer aren't even carriers of Lyme disease; the main carrier is the white-footed mouse, while birds and rabbits
also carry the disease.

It's true that deer provide a blood meal to ticks that have been infected by white-footed mice and other carriers, but so do dogs,
raccoons and striped skunks.

The disease moves into suburban backyards in part because the infected ticks are
attracted to birdfeeders, as are Lyme-carrying birds and small mammals. People
who acquire the disease in their backyards aren't getting it just (or even mostly) from ticks on deer - all 27 species of birds in one Connecticut study carried the ticks that cause Lyme.

Instead of fixating on the deer population, we should be looking at alternatives
for combating Lyme and reducing our chances of developing this chronic disease.

Getting rid of birdfeeders would help. DEET insect repellent, when used on clothes and shoes, can ward off 90 percent of the ticks. The American Academy of Pediatrics advises that DEET is safe for children if used sparingly and not
applied to "a child's face, hands, or skin that is irritated or abraded."

Spraying yards with the pesticides carbaryl and granular deltamethrin once or
twice a year would eliminate up to 90 percent of the nymphal ticks. Pesticides
should be used sparingly to protect other insects. And removing brush and leaf
litter or creating a buffer zone of wood chips or gravel between forest and lawn or recreational areas can reduce the number of ticks by 50 percent to 90 percent.

Another focus of our attention should be how to treat this serious disease. I
have witnessed the ravages of Lyme on countless occasions. I see patients who
have been sick with Lyme disease for more than two years because a doctor would
not treat them unless they had a positive laboratory test. I also have patients
who have been sick for more than six months because they were never told that
fatigue, poor memory, irritability and sleeplessness could be symptoms of neurologic Lyme disease. I have treated teenagers who were too sick to attend school and had to be tutored at home to finish their education.

A National Institutes of Health trial found 107 chronic Lyme disease patients
who were sick for more than four years. Quality of life was worse for them than
for patients with diabetes and recent heart attacks.
Yet as debilitating and fast-spreading as the disease is, doctors differ over
how to diagnose and treat it. The Infectious Disease Society of America, for
instance, recommends a one-time short-term treatment of 10 to 30 days.

In contrast, the International Lyme and Associated Diseases Society guidelines
on the prevention and management of chronic Lyme disease, of which I am the
chief author, recommend more aggressive treatment for people at risk. Since the
disease is chronic in up to half of patients treated for Lyme, these guidelines
call for treatment of symptoms even when blood tests are negative for Lyme, and
the early and prolonged use of antibiotics, including repeated courses should
the disease recur. We still need lots of testing and research to find the best
way to treat Lyme.

For those who are frustrated with Lyme disease, forget about the deer. Killing
them won't do the trick.
Instead, lobby your local leaders for more financing on
Lyme disease research and look in your own backyard.

Daniel Cameron is a doctor in private practice.
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Letters to the Editor:
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And here is an Op Ed piece by one of our LLMD's taking about how serious chronic lyme is (need to read to the latter partof the article to get to that part.