Thanks for everyones help doing the research for this project. You pitched in when I needed you and helped "keep me straight"... heheheheYou are the best! We ended up with about 94 pages with all the references and documentation. It looks real nice.
I am posting the questions and answers below... Keep in mind it is specific for a certain state... so your answers may not match the ones shown here if applying it to your area.
Again.. thanks everyone for all the help you provided. We are going to make a difference! Someone is paying attention! 
TICK BORNE ILLNESS QUESTIONNAIRE
QUESTIONS AND ANSWERS
1. Is Lyme Disease caused by a virus, bacteria, or a parasite?
Lyme Disease is caused by a spirochetal bacteria.
2. Who is the doctor that identified the spirochete that causes Lyme Disease?
Dr. Willie Burgdorfer identified the spirochete responsible for Lyme Disease
(Borrelia burgdorferi) in the early 1980?s.
3. How long after a person is in contact with an infected source will Lyme Disease symptoms appear?
Lyme Disease symptoms may appear days, to weeks, to months, to years after the initial infection.
4. How many species of ticks carry the Lyme Disease spirochetes? List three species of
ticks found in Maryland. Approximately how many species of fleas, mites, mosquitoes,
or flies how been found to carry the Lyme Disease spirochete?
At least nine species of ticks, six species of mosquitoes, 13 species of mites, 15 species
of flies, two species of fleas, and numerous wild and domestic mammals including
rabbits, rodents, and birds have been found to carry the spirochete that causes Lyme
Disease.
5. Does a ?bulls-eye? rash go away without treatment?
A Lyme rash (ECM) will often disappear on its own without treatment, but it may
linger for quite some time. It may reappear later as a single rash, or emerge later
as multiple rashes, or it may appear in a different location on the body.
6. Does a Lyme rash occur at the site of the bite or elsewhere?
The ECM rash may appear at the site of the tick bite or elsewhere on the body. Not
everyone will get a rash and some will have multiple rashes.
7. If prescribing doxycycline for a tick bite, what precautions should be advised while
taking the medication?
Patients should be advised that taking doxycycline may cause sun sensitivity.
Doxycycline should not be taken with milk or other dairy products since these
products may inhibit absorption of the antibiotic. Doxycycline is not recommended
for children since it may cause discoloration of their teeth. Doxycycline may also
promote yeast and fungal overgrowths which should be addressed. Nausea,
vomiting, and diarrhea are some of the possible side effects of Doxycycline. Birth
control pills may not be as effective while taking Doxycycline and additional
precautions to prevent pregnancy may be necessary. Doxycyline should not be taken
with antacids or supplements that contain calcium, iron, magnesium, or sodium
bicarbonate. Doxycycline use may cause liver problems or bruising. People taking
Doxycycline should be advised that severe allergic reactions may occur and if there
are any problems while taking Doxycycline, they should be reported to the doctor.
8. List five tick borne diseases in Maryland that can be passed to humans by a tick.
Lyme Borelliosis, Babesia Microti, Bartonella Henslea, Bartonella Quintana, Rocky
Mountain Spotted Fever, Brucellosis, Ehrlichia HGE, Ehrlichia HME, Southern
Tick-Associated Rash Illness (STARI), Tularemia (rabbit fever)- and possibly
Leptospirosis are some of the tick borne illnesses that may be passed to animals or
humans in Maryland.
9. If a patient has previously had Lyme Disease and is bitten by another infected tick, are they immune to Lyme Disease?
No, they are not immune. Multiple bites may expose people to a number of other
tick borne diseases in addition to new strains of Lyme Disease.
10. Is a lumbar puncture required to confirm neuro-Lyme? Why?
No. Lyme Disease, as stated by the CDC, is a ?clinical diagnosis?. Research
indicates that less than 20 percent of those with Lyme Disease have shown a positive
reading in the spinal fluid.
11. List five of the most common diseases that are often mistaken for Lyme Disease.
There are many different diseases or conditions that are found in patients with
Lyme Disease. All too often Borellia organisms are not being considered as the
cause for patients complaints, signs, and symptoms. For example, an
Ophthalmologist may diagnose any of the following conditions: conjunctivitis, ocular
myalgias, keratitis, episcleritis, optic neuritis, pars planitis, uveitis, iritis, transient
or permanent blindness, iritis, photophobia, temporal arteritis, vitritis, Horner's
syndrome, ocular myasthenia gravis, or Argyll-Robertson pupil. All of the
conditions listed have been documented in Lyme Disease patients and many of these
diseases or conditions improve with proper antibiotic therapy. Urologists, for
example, may not realize that recurring bladder infections or swollen testicles are
being caused by spirochetal organisms. Infectious Disease specialists often dismiss
patients concerned about Lyme Disease because many are under the assumption that
Lyme Disease is very ?rare?, and/or they are not familiar with the various signs and
symptoms of Lyme Disease.
Lyme Disease is often misdiagnosed as:
Chronic Fatigue Syndrome, Multiple Sclerosis, Alzheimer's, Parkinson's Disease,
Lupus, Lou Gehrigs (ALS) Disease, Guillian-Barre Syndrome, Polymyositis,
Hepatitis, Cardiac Disorders, Fibromyalgia, TMJ, Ringworm, Tullio Phenomenon,
Encephalitis, ADD, ADHD, Meningitis, Depression, Panic Disorders, Bell?s Palsy,
Candidiasis, Chronic Mononucleosis, Hypoglycemia, Scleroderma, Epstein Barr
Virus, Heart Disorders, Autoimmune Diseases, Bannwarth?s Syndrome, Cancers,
Kidney Disease, Raynauds Syndrome, Stress-related Illness, Sleep Disorders,
Thyroid problems, Vasculitis, Anorexia, Agoraphobia, Cerebrovascular Disorders,
Arthritis, Connective Tissue Diseases, Hearing Disorders, Crohn?s Disease, Purpura,
Pseudotumor, Sjogrens Syndrome, Stroke, and Respiratory Insufficiency.
12. If a person has an EM rash and a negative ELISA test, should they be treated? How?
Yes. An ECM rash is diagnostic for Lyme Disease. Current guidelines approved by
ILADS (International Lyme and Associated Diseases Society) recommends oral
therapy for at least 6 weeks for both adults and children when a rash is present.
Lyme patients who are pregnant have special guidelines to help protect themselves
and their unborn child. According to the CDC, Lyme Disease is a ?clinical
diagnosis? and negative tests are not to be used to rule out the disease.
13. List the studies you have read by the any of the worlds leading Lyme Disease experts.
Where can a patient go to be enrolled in a current Lyme study?
There are over 15,000 published medical studies, abstracts, videos, and general
brochures concerning Lyme and other tick borne illnesses. Physicians may request
assistance and information from ILADS, the International Lyme and Associated
Diseases Society. There are a number of ongoing Lyme Disease studies, such as the
four year study being conducted Dr. B. Fallon, which is being funded by the NIH.
The results of the chronic Lyme Disease study by Dr. Samuel Donta were recently
released.
14. How many different strains of the spirochetes that cause Lyme Disease have been
identified to date in the United States and world wide?
Eight different species and over three hundred strains of spirochetes that cause
Lyme Disease symptoms have been identified world wide. To date, more than 100
different strains have been identified in the United States.
15. What is STARI?
STARI is a strain of spirochete that was ?discovered? in the southeastern sections of
the United States within the past few years. It causes Lyme-like symptoms but is not
normally detected by the current standard Lyme tests. STARI (Southern
Tick-Associated Rash Illness)
16. What is WA-1?
WA-1 is a newly identified strain of Babesiosis which has been found in a number of
people who are also infected with Lyme Disease. There have been new tests
developed to identify this specific strain in humans but the tests are not performed at
all labs. To test for this strain of Babesiosis, physicians should have blood sent to specialty labs, such as Igenex Lab in CA.
17. Approximately how many Lyme Disease patients are co-infected with Babesiosis in
Maryland? What is the most effective treatment for Babesiosis?
Estimates from labs, support group leaders, and doctors offices indicate that
approximately 25-50 percent of patients with Lyme Disease in Maryland are also are
co-infected with Babesiosis. Unfortunately, many patients are never tested so the
numbers may be even higher.
A combination of Atovaquone (Mepron-750 mg. 2x daily) and Azithromyacin
(Zithromax- 250 mg day) is considered to be the best treatment for Babesiosis. Some
patients who were untreated for long periods may need exteneded treatment or may
need to be retreated if symptoms return. This treatment protocol is less toxic than
the quinine sulfate and clindamycin combination that was once used and there are
fewer side effects reported.
18. What percentage of people with Lyme Disease remember having a rash or remember
being bitten by a tick?
Various studies show that anywhere from 20-80 percent of seropositive Lyme
Disease patients with active symptoms do not recall a rash. Less than 50 percent of
Lyme Disease patients remember being bitten by a tick.
19. After a person is bitten by a tick, how soon is it before the spirochete can be found in the spinal fluid?
Reports indicate spirochetes can disseminate quickly throughout the system (in as
little as 6 hours in some cases). In addition, spirochetes are able to change forms and
remain undetected in the spinal fluid. The old ?wait and see? if symptoms appear
before treating theory allows the organism to go unchecked, causing multiple
problems and decreasing the patients chance for a full recovery.
20. What signs and symptoms would lead a doctor to suspect a Babesia infection in a
patient? How many strains of Babesiosis have been identified and how many are
commonly tested for in commercial labs?
The following signs/symptoms may be present in those infected with Babesiosis:
Fatigue * Arthralgias* Myalgia* Drenching sweats* Headaches* Emotional
lability* Depression* Dark urine* Splenomegaly* Dizziness* Nausea and
vomiting* Cough* Dyspnea* Fever* Chills* Hepatosplenomegaly* Jaundice*
Malaise* Shortness of breath* Bleeding tendencies, bruising* Thrombocytopenia*
Hemoglobinuria* Hyperesthesia* Pulmonary edema* Encephalopathy* Low to
normal range leukocyte counts* Possible elevated levels of dehydrogenase,
bilirubin, transaminase* Anorexia*
Approximately 25%- 66% of Babesia patients are known to be co-infected with
Lyme disease. These symptoms may continue for long periods of time, decrease,
then return. A low Babesiosis titer (IgG) often indicates a chronic infection. An
acute or current infection may show a higher reading on the IgM test initially.
There are over 100 species of Babesia in the United States but only ONE or TWO
species are currently checked by commercial labs.
21. Describe the rash seen in patients with Lyme Disease and two of the most common
variations of that rash.
There is no ?typical rash? that all patients get when infected with Lyme Disease.
Many people do not remember a rash or even a tick bite. If a rash does appear, it
may be anywhere from a light pink color to blazing red, to blue, to purple depending
on the skin color, the type of rash, and possible co-infections. The ECM rash can be
as small as a quarter, be present in several locations, or be large enough to cover the
entire back of an adult. The rash may be mistaken for an insect bite reaction or even
ringworm. It may be hot, it may flake or swell. It may be well formed and
expanding or have uneven or raised edges. It may disappear and return later and it
may be slightly itchy in some individuals.
Borrelial lymphocytoma may appear on the earlobe, the scrotum, or on the nipple of
the breast. It may be bright red to a bluish color and may disappear and return
later.
The ACA rash (acrodermatitis chronica atrophicans) may have the appearance of a
scleroderma rash and is often noticed on the feet and ankles and/or the hands. It
may appear elsewhere on the body and may affect organs.
22. Describe the rash seen in patients with Babesiosis.
Many patients infected with the Babesia organism do not present with a rash,
however, they may appear jaundiced and some may have a petechial rash.
23. Describe the rash seen in patients with Bartonella.
The rash/lesion that is typically associated with Bartonella may not be present in
patients or may not be noticed. If there is a rash/lesion, it may appear to be a small
reddish brown lesion (often mistaken for an insect bite). It may heal without
intervention. The patient exposed to Bartonella may have urticaria, vesiculopapular
lesions, or erythema nodosums. Many Bartonella patients have swollen and/or
tender lymph nodes which may become infected.
24. How do you test for and treat (which drugs) the ?cyst? form or ?L? form of the Lyme
Disease?
Specific tests have been developed to identify some of the various forms of
spirochetes using dark field microscopes. Flagyl, which has been shown to burst the
cell walls of the cyst form, is currently being prescribed to patients. Normally it is
prescribed along with other antibiotics, since Flagyl alone is not effective on the
intact spirochetes.
25. What has the CDC determined to be the proper testing procedure for confirming that
a patient does or does not have Lyme Disease?
TRICK question- The CDC states emphatically that Lyme tests are NOT to be used
to exclude a diagnosis of Lyme Disease. A negative test is NOT to be considered
absolute by any means... nor is it to be used to indicate a cure. As the CDC states,
Lyme Disease is a ?clinical diagnosis?. No test has been developed that can confirm
a patient is ?cured? of Lyme Disease.
26. What is the two tier testing procedure set up by the CDC for testing patients
suspected of having Lyme Disease and what are the most common problems with this
procedure?
Doctors have been instructed (CDC guidelines) to obtain an ELISA (titer) first,
which, under the best circumstances, only identifies 40-50 percent of those who
actually have Lyme Disease. An ELISA should NOT be used as a screening test due
to the unreliable results. The guidelines state, if the ELISA is positive, physicians
are to perform a Western Blot test which, under the best circumstances, only
identifies 70-80 percent of those who have been exposed. Most labs do not report
specific bands on the Western Blot tests, hindering the experienced physician and
the diagnosis even further. This procedure allows many cases of Lyme Disease to be
missed, therefore, patients are not being identified or properly treated.
The CDC guidelines also state which specific bands on a Western Blot are to be used
to consider a test positive. When the list was developed, certain bands specific for
Lyme Disease, were not included. When these bands are positive, it confirms
exposure, but it is mistakenly reported to the doctor and patient as a ?negative test?.
Many ?borderline tests? are reported to patients, by the physician, as being negative
and many positive tests are reported to be ?false-positive? because physicians are
not familiar with reading test results, nor with the multiple symptoms that can occur
in a person with Lyme Disease, and the connection between the two is missed. Many
patients who have chronic Lyme Disease will have low titers or seronegative results.
27. Which bands normally show up first on a Western Blot test? Which bands are
specific for Lyme Disease? Which bands normally appear after the patient has had
Lyme for at least one year?
The first Western Blot band to show positive is normally the 41KD band followed
intermittently by the 23KD band. Bands 18KD, 23-25KD, 31KD, 34KD, 37KD,
39KD, 83KD and 93KD are specific for indicating Bb exposure. The problem is they
may not show up early in the infectious stages or may not appear for a year or more,
or they may not show up at all. The ILADS 2002 Guidelines state that the presence
of the 41KD band along with one of the specific bands listed above indicates a person
has been exposed to Lyme Disease.
28. List 6 reasons why a Lyme test may not be accurate.
1. Antibiotic use prior to testing
2. Patient has been on steroids or cancer drugs
3. Antibodies are bound by bacteria
4. Immunosupression
5. The bacteria has shifted forms
6. Lab standards for cut off are too high
7. The test was performed too early or before antibodies had a chance to form
8. Bands checked are for reporting purposes, not for clinical diagnosis
9. Poor lab used that does not specialize in tick borne illnesses
10. Contamination of specimen
11. Various strains are not identified using standard tests
29. Can bismuth be used for Lyme patients?
Studies have shown that bismuth will penetrate Borellia cyst walls. Intestinal
problems are especially common in children with Lyme Disease and bismuth
compounds may eventually prove to be effective in treating the cyst form of the
bacteria in the intestines.
30. What are the symptoms of Bartonella, what is the standard treatment for Bartonella,
and how long should a person be treated?
Common symptoms of Bartonella include fatigue, swollen lymph nodes,
encephalopathy, headaches, cognitive dysfunction, rash/lesions, vision problems,
numbness, and tingling. Reports indicate Doxycycline may be effective in treating
Bartonella. Rifampin has also been used in combination with Doxy, but is not as
successful alone. Several other antibiotics have been reported to be successful in
Bartonella treatment. Antibiotics have occasionally been used for over a year to
attempt to eradicate the persistent bacteria.
31. If a patient is infected with Lyme, Babesiosis, and/or Ehrlichiosis, which infection should be treated first?
In co-infected patients, treating Babesia first has been proven to be more effective,
however, in acute situations, treatment for all infections should be considered.
32. Where would you send blood and tissue samples to have the best available tests done
on Lyme patients?
Igenex Lab in California performs a variety of tests for tick borne diseases (PCR,
urine tests- DOT, RWB- Reverse Western Blots, Lyme, Babesia, Erhiclia, and
Bartonella). Igenex reports all WB bands, providing more factual results in the
clinical setting. Bowen Lab in Florida is licensed to perform tests in which
spirochetes in various forms can be detected and photographed from tissue and
blood samples. They are also able to identify several strains of Babesia and
Ehrlichiosis. MDL Lab in NJ is also used by many physicians treating Lyme
patients.
33. What is a ?Lyme Dot? ?
Lyme Dot is a urine test performed by Igenex Lab which detects spirochete residue
in urine samples.
34. What is an ACA?
ACA (acrodermatitis chronica atrophicans) is a skin rash normally seen in patients
with late stage Lyme Disease which is usually attributed to Borrelia afzelii. It is
sometimes mistaken for scleroderma. The ACA rash indicates ongoing chronic
infection.
35. What is a Herxheimer reaction?
Jarisch-Herxheimer?s reactions often occur during antibiotic therapy for spirochetal
infections and may be fatal in some cases. A ?herx? occurs when the spirochetes die
off and produce toxins. Symptoms may become much worse during the reaction.
Due to the replication cycle of the spirochete, treatment for Lyme should continue
for several months after all Jarisch-Herxheimer reactions have ceased and all symptoms have cleared or the patient is likely to relapse.
36. How does prednizone help the Lyme patient?
Trick question- NEVER take steroids if Lyme Disease is even suspected! Steroids
suppress the immune system which allows the spirochetes a non challenged place to
multiply. Many people who now suffer with chronic cases of Lyme Disease were
given steroids and are now chronically ill, disabled, or have died.
37. Approximately how many Lyme and Babesia cases are reported in Maryland?
At this time, Babesia cases are not reportable in Maryland. Maryland ranks sixth in
the nation for the most cases of Lyme Disease. There were over 4,000 cases reported
in Maryland in the 1990?s. It is estimated that this figure should be at least ten times
higher, therefore, about 40,000 cases are suspected. Consequently, over 30,000 cases
were missed. Since some Lyme patients are treated ?clinically?, blood tests are not
always ordered. This reduces the actual number of reported Lyme Disease cases in
Maryland.
38. Since Lyme is a multi-systemic disease, list 20 of the over 150 documented signs,
symptoms, or indications that someone may have Lyme?
Lyme disease can have a wide range of symptoms, which can go dormant (sometimes
for years), can migrate, return, disappear, or change day by day. Symptoms can be
aggravated by stress, medications, weather, and other outside influences. Symptoms
may tend to worsen on a four week peaking cycle. SOME of the symptoms that may
be found in those with Lyme disease include:
Flu-like symptoms, headaches (mild to severe), recurring low grade fevers or
fevers up to 104.5 degrees. Usually in the first few weeks of Lyme disease fevers
tend to be higher. (Patients with Lyme disease often tend to have a "normal
temperature" below 98.6 degrees, therefore, a slight rise in temperature may be all
that is noted.) Often patients exhibit fatigue (mild to extreme), joint pain (with or
without swelling), muscle pain, connective tissue pain, recurring sore throat
(sometimes only on one side of the throat), swollen glands (come and go), varying
shades of red on ear lobes and pinna, malar rash, cold hands and feet in a warm
environment, weakness, lightheadedness, eczema and psoriasis, painful or itching
skin, flushing, night or day sweats, inordinate amounts of sweating, anhydrosis
(inability to sweat), or dermatitis (acrodermatitis chronica).
There may be a rash, but it isn't noticed or does not appear in all cases. The rash
may be basically circular with outward spreading, however, other varieties are seen.
The rash may be singular or multiple, at the site of a bug bite, or in another location,
warm to touch, or slightly raised with distinct borders. In dark skinned individuals
the rash may appear to be a bruise.
Numbness, sleep disturbances, vertigo, hearing loss, feelings of being off-balance,
unexplained weight gain or loss, and feeling "infected" are also problems associated
with Lyme disease. Symptoms may develop that include: panic attacks, anxiety,
depression, mild to severe cognitive difficulties, mood swings, coma, seizures,
dementia, mania, biploar disorders, vivid nightmares, stammering speech, confusion,
memory loss (short or long term), "brain fog", vibrating feeling in head,
topographical disorientation, and environmental agnosia.
Some patients have problems with numbers and sequencing, disorganization of
thoughts, rambling on in great detail while talking, frequent errors in word selection
or pronunciation, changes in personality, short attention span, Tourette
manifestations, OCD (obsessive compulsive disorder), raging emotions, and cranial
nerve palsies.
Patients have reported bladder disfunction (neurogenic bladder with either
hesitancy, frequency, loss of bladder awareness, urinary retention, incontinence or
symptoms of UTI, and chronic pyelonephritis). Intersitial cystitis, irregular or
severe menstrual cycles with decreased or increased bleeding, early menopause, a
new onset of P.M.S. symptoms, or disturbed estrogen and progesterone levels are
documented in many cases. Other problems include altered pregnancy outcomes,
severe symptoms during pregnancy, abdominal bloating, irritable bowel syndrome,
abdominal pain and cramping (may appear to be ulcers), loss of sex drive, testicular
or pelvic pain, breast pain, and fibrocystic breast disease.
Diarrhea (which can come and go or last for months with no explanation),
constipation (which can be severe enough to cause blockage), irritable bowel
syndrome, spastic colon, nausea, stomach acid reflux, gastritis, abdominal myositis,
and indigestion are some of the gasto-intestinal disorders reported. In addition, patients demonstrate a higher occurrence of various types of cysts (liver, breast, bone, ovary, skin, pineal gland and kidney). Some Lyme patients are diagnosed by
their eye care professionals and have been documented as suffering from one or
more of the following disorders: conjunctivitis, ocular myalgias, keratitis,
episcleritis, optic neuritis, pars planitis, uveitis, iritis, transient or permanent
blindness, iritis, photophobia, temporal arteritis, vitritis, Horner's syndrome, ocular
myasthenia gravis, and Argyll-Robertson pupil. Often eye problems require a
changing of prescription glasses more often than normal.
Heart-related problems are associated with Lyme disease and can include: mitral
valve prolapse, irregular heart beat, myocarditis, pericarditis, enlarged heart,
inflammation of muscle or membrane, shortness of breath, strokes, and chest pain.
Twitching of facial muscles, Bell's palsy, tingling of the nose, cheek or face are
reported. In addition, there may be chest pain or soreness, enlarged spleen, liver
function disorders, tremors, extreme sensitivity to being touched or bumped,
burning sensations, stiff neck, meningitis, and encephalitis. Patients may experience continual or recurring infections (sinus, kidney and urinary tract are most common).
Patients may suffer from a weakened immune system, the development of new
allergies, recurring upper respiratory tract infections (causing, or worsening of
pre-existing sinusitis, asthma, bronchitis, otitis, mastoiditis), and allergic or chemical
hypersensitivity's. Other noted problems include: T.M.J., difficulty swallowing or
chewing, tooth grinding, arthritis (in small joints of fingers and larger, weight
bearing joints), Osgood-Schlatter's Syndrome (water on the knee), bone pain,
gout-like pain in toe, muscle spasms to the point of dislocating joints and tearing
muscle tissue, leg and hip pain, "drawing up" of arms, "growing pains" in children,
tendonitis, heel pain, carpal tunnel syndrome, and paravertebral lumbosacral
muscle strain/spasm.
Some patients tend to suffer from a monthly "flare-up" of symptoms as the
spirochetes reproduce and/or die off.
39. When testing by EEG and MRI, what are the results that may indicate Lyme Disease
could be a problem?
Some EEG's have been abnormal showing bilateral sharp waves and some slowing.
CAT Scans have usually been normal. A number of MRI's have been abnormal
showing evidence of increased signal in the white matter which may resemble what
is seen in patients with MS.
40. What are the symptoms and signs in a patient with Ehrlichiosis?
Symptoms of Ehrlichiosis may include: fever, chills, muscle pain, headaches,
confusion, nausea, vomiting, and a few patients have a rash.
41. Is Babesia a bacteria, protozoan, virus, or parasite?
Babesiosis is caused by a protozal parasite which is treated with antiviral medication
and an antibiotic. Antibiotics alone are not effective for treating Babesiosis.
42. Is HGE or HME more common in Maryland?
Both HGE and HME have been responsible for infecting animals and humans in
Maryland. Serology tests for both should be performed if Ehrlichosis is suspected.
43. Approximately how many late cases of sero-negative Lyme patients will become
sero-positive after successful treatment?
It has been reported that increasing numbers of seronegative patients who were
diagnosed clinically and treated for Lyme Disease, converted to seropositive after
the completion of antibiotic therapy. Unfortunately, physicians unfamiliar with
Lyme Disease are refusing treatment to seronegative patients even when they have
active symptoms. The CDC states Lyme Disease is a clinical diagnosis and negative
tests should not be used to rule out the diagnosis.
44. Why do some patients respond to certain antibiotics and others not respond?
Certain gene types, spirochetal loads, various strains, co-infections, previous health
issues, delays in treatment, immune system activity, and many other factors
contribute to the success or failure of antibiotic therapy. One size does not fit all. Each patients history and clinical picture should be considered by experienced
physicians prior to treatment.
45. How high of a dose of doxycycline or tetracycline is needed for adults to allow the
medications to be bactericidal instead of bacteriostatic?
The ?typical? doses (100 mg 2 X day) of Doxycycline that were prescribed by many
doctors were not high enough to be considered bacteriostatic for Lyme Disease. To
enhance antibiotic action several other agents are now being prescribed along with
the antibiotics in order to increase effectiveness. In addition, the recommendations for doxycycline doses now range from 300-600 mg a day. If necessary, doxycycline can be administered by IV to keep blood levels high.
46. What are the two most common medications prescribed to remove Lyme Disease
neurotoxins from the body?
Welchol and Questran are the most commonly prescribed medications ordered to remove toxins.
47. Should a patient with Lyme Disease be restricted from donating blood?
Anyone who has Lyme Disease or any of the co-infections often found in Lyme
patients should not donate blood or organs.
48. What special precautions should be taken with pregnant women who contract Lyme
Disease?
There are special guidelines for treating pregnant women infected with Lyme and
other tick borne illnesses. Physicians are advised to contact the International Lyme
and Associated Diseases Society (ILADS) for specific treatment guidelines and
precautions. All pregnant patients should be tested for co-infections and should be
aware that breast milk may also pass the infection to children. Newborns should
have cord samples and tissue sent for PCR testing to check for Lyme Disease.
49. What are the symptoms of Brucellosis?
Fever, chills, headaches, excessive sweating, fatigue, back pain, and joint pain are
some of the symptoms that may be present in a person infected with Brucellosis.
50. How do you properly remove a tick? Where can the tick be sent for testing and what
are the costs? How do you package the tick for shipment? Does the tick need to be alive
for testing?
To remove an attached tick- Do not touch the tick with your fingers or squeeze the
tick. Use fine point tweezers to grasp the tick as close to the skin as possible. Pull
the tick out in the opposite direction from the way it entered, with a smooth motion.
Do not twist or crush the tick. Clean the wound with alcohol to help prevent a
secondary infection. Place the tick, dead or alive, in a plastic baggy with a cotton
ball that is slightly damp. Contact your local health department or a lab that
performs tick testing, such as Igenex Lab, to determine the current shipping methods
and prices for tick testing. The current cost to test an individual tick (or up to 20
ticks together) is approximately $50.00 for each tick borne disease.
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