ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
Hearing just ended about 1/2 hour ago.
Charges were that he was treating people with experimental medicine with no evidence that he was informing them of this. Also that he was not following accepted practices in NC.
Dr. Jemsek was found guilty on both charges.
He lost his license for 1 year - with a stay. That means that he can still practice, and the board will be meeting with him in July to discuss the parameters.
Basically, they will probably watch him like a hawk for the year and as long as he is good, they will then go their merry way.
I do not have the energy to go through all the happenings of today. I was at the medical board for 15 hours today. =:-0
Dr. Jemsek spoke with us after the decision. He feels it is an acceptable outcome. Could have been much worse.
They do realize he provides valuable services to the community and don't want to strip him of his practice.
It was high anxiety in there during the wait.
There were about 6 people there who were routing for his downfall. We all had several good debates.
Brian Fallon MD and Steven Phillips MD testified today. Very interesting and impressive.
More later....
Posts: 2276 | From NC | Registered: Oct 2000
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Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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shazdancer
Frequent Contributor (1K+ posts)
Member # 1436
posted
Very sad to hear, Connie, but glad that it wasn't worse. I'm not sure how the State of NC could advocate a particular standard of care for Lyme disease statewide, in the face of there being two standards of care.
After you have rested, I hope you will come back to us with a plan to approach this problem at the state level, while we continue to advocate for the federal Lyme bill which will bring more to light about the true nature of this disease and its treatment.
That said, I think it behooves our LLMDs to protect themselves. They need to be sure to inform every patient that there are TWO standards of care, and to delineate for the patients what their options are, and what treatment plan the doctor recommends. Then have the patient SIGN a form stating that (s)he has understood the two options that are available. and which one is chosen.
Thank you so much, Connie, cbb, and everyone who took so much time out of their lives and money out of their pocketbooks to support Dr. Jemsek.
Respectfully, Shazdancer
Posts: 1558 | From the Berkshires | Registered: Jul 2001
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5dana8
Frequent Contributor (1K+ posts)
Member # 7935
posted
((((((Thankyou connie))))
for all your efforts and time and energy.
And helping Dr.J so much and also for keeping us informed.
Get some much needed rest god Bless You
-------------------- 5dana8 Posts: 4432 | From some where over the rainbow | Registered: Sep 2005
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Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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timaca
Frequent Contributor (1K+ posts)
Member # 6911
posted
Thanks for the update, everyone.
Timaca
Posts: 2872 | From above 7,000 ft in a pine forest | Registered: Feb 2005
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Aniek
Frequent Contributor (1K+ posts)
Member # 5374
posted
What a way to ruin a perfectly relaxing evening. I heard Dr. J speak last year, and it was amazing how he just started treating people with Lyme because they were arriving at his office in need.
I had an incident today where a Dr. wanted to charge me $100 minimum to write a short letter to my employer that I need to move to an office on a floor without construction. I was so angered that a doctor would charge $100 for 5 minutes work (it would cost more if he spent more than 10 minutes on it) because he is clearly thinking of the bottom line before his patients.
Dr. J put his patients first. He did this even before treating Lyme, when he was working primarily with people with HIV/AIDS. My thoughts are with him and all of his patients.
-------------------- "When there is pain, there are no words." - Toni Morrison Posts: 4711 | From Washington, DC | Registered: Mar 2004
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posted
I have a different perspective on these medical board hearings, which may not be popular, but I do believe that, while they cause significant short term pain, the end result will be long term benefit.
While I would never advocate that a Lyme specialist run out and get him/herself in trouble, if these hearings are going to happen, then maybe we could view them like this:
Every time a Lyme doc is hauled before a medical board, the doctors on these boards are forced to listen to very compelling testimony by leading authorities on the forefront of chronic Lyme disease treatment and research, people like Drs. Fallon and Phillips.
Additionally, these hearings, in large part due to patient support, receive a considerable amount of press, raising the profile of Lyme in the communities where doctors are being tried, and even nation/worldwide.
Each hearing which results in charges being dropped, or a doctor not losing his license beyond some relatively short period of time (as opposed to being revoked), is a win.
The outcome of Dr. J's hearing is not the end of the world. It sounds like mistakes were, indeed, made, even if they have since been corrected. Other doctors will change their procedures which will prevent them from meeting the same fate as Dr. J.
Please consider, and capitalize upon, the positive. It sounds like that is what the good doctor is doing.
-------------------- Suzanne Shaps STAND UP FOR LYME Texas (www.standupforlyme.org) (Please email all correspondence related to protecting Texas LLMDs to [email protected] with copy to [email protected]) Posts: 977 | From Austin, TX, USA | Registered: May 2004
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5dana8
Frequent Contributor (1K+ posts)
Member # 7935
posted
tickendntx
I beg to differ.
There's just no way to put a positive spin on this.
This sets a very bad example for the others doctors that may have been riding the fense on treating chronic lyme. They have to be hearing this and say I don't want that kind of trouble.
Also for the future. It says that "yes we can take away your doctors and their rights and if you don't follow the CDC way of treating chronic lyme you'll face this too."
They are trying to frighten other doctors into submission.
The thought that the medical community can drag our doctors threw the mudd and humilitate them this way sadden's me.
And not to mention the thought of going without treatment and the how many people this coming year will be sick and have no where else to turn.
Sorry,I just can't see the positive now, or probably ever.
posted
When the man is your doctor and the doctor for your children, it is quite hard to look at the positive.
Posts: 799 | From home | Registered: Sep 2004
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posted
Connie, Thanks for letting us know. And thanks to you and everyone else who worked so hard to help Dr. Jemsek.
Although this is really sad, I think I know why some have said it's a good outcome.
I know that in NYS, once a doctor is actually charged with professional misconduct, well over 90% end up losing their licenses. So I guess a one year suspension is not as bad as a revocation.
But it's all so upsetting in general, since we know that doctors are being targeted just because they treat chronic Lyme disease with more antibiotics than the IDSA would like. SUre, it sounds like Jemsek made some errors, but I doubt that there is any doctor in the world who has not.
I was struck that the newspaper articles were pretty balanced. Often when any physician has a license suspended they manage to make him look like Dr. Frankenstein in the press. But this, particularly that second article, seemed pretty good.
I hope the NC group will let us know if there is anything that the Lyme community can do now. The parameters that are set for his suspension could not only affect the way Dr. Jemsek practices, they could affect the way the public and other doctors see what happened here. Ellen
--------------------
Posts: 819 | From New York, NY | Registered: Oct 2001
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bettyg
Unregistered
posted
Connie and all other NC supporters,
So sorry to read this of his being found guilty. Thanks for the links ladies. There has been good coverage about the number of supporters who came, etc.
It is discouraging to know they will be attacking other GOOD LYME LITERATE MDs who are HELPING us.
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Connie and all else who were there - thanks so much for keeping us up to date, it helped alot and meant so much.
[ 16. June 2006, 07:03 AM: Message edited by: lymesux ]
Posts: 799 | From home | Registered: Sep 2004
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treepatrol
Honored Contributor (10K+ posts)
Member # 4117
posted
Our LLMD's need to cross every T and dot every eye. They need all to get together and work out stategies and maybe a standard protocol or steps that meet every little jot and tiddle of laws in each state. Beside whats in place now because one slip and the otherside comes down on them and they have more money on there side.
Its a freakin shame they just cant treat and be done with it.
The reason that patient felt worse was probaly herxing and this disease will not be put in a bottle easily.
If this was any other Dr say one treating just cancer or just aids this wouldnt even have happened.
-------------------- 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.
posted
Yes, I think the news coverage was more balanced than it might have been without the efforts of NC and other lymies who provided a lot of background information to the media.
However, they are going to keep using the lousy CDC standards and the incompetent IDSA guidelines to nail our doctors until no one will help us. I don't think I am going to be able to get IV to try to reverse the muscle wasting that is caused by neurological lyme. In a year or two it is likely that I will be unable to use arms or legs, talk, swallow, or breathe. Because I have had IV in the past, this means I probably won't be able to get anymore. But that IV worked, when the pills did not, and it has brought me back from the edge before. I think I and some others are going to pay the price for this harrassment.
The only way to stop this campaign against us is to go on the offense. Defense gets us "balanced" coverage in the news and suspended licenses with penalties still to come. I wonder if they put off the penalties to a time when so many patients were not around to object?
I wonder if those patients who testified against him, especially that woman who said she felt better now off abx, will realize what they have done later. When she gets worse again, because she didn't get enough abx. I frankly hope that happens to her. Ignorant people can cause a lot of damage. Of course, the most damage is caused by ignorant and greedy professionals, not patients. Thinking now about ins cos, CDC, and IDSA.
People need to realize that some of them are going to the lymie graveyard, like me, if they don't get more active in opposing this criminal incompetence of the medical establishment.
Posts: 8430 | From Not available | Registered: Oct 2000
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Your thoughts are exactly what was repeated in Dr. J's office.
-------------------- Stella Marie Posts: 694 | From US | Registered: Apr 2005
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char
Frequent Contributor (1K+ posts)
Member # 8315
posted
What can you say about what is going on? Ugh!
The Charlotte Observer article says that Dr. Jemsek will face board again in July...Is that next July? I am having trouble reconciling this with the one year suspension where he can still practice...
Anyone?
I was at the hearing-in overflow area as such a few number were allowed in the hearing.
I met so many wonderful people from here and other folks while I was there.
I am grateful for that. and the fact that we will continue to fight together.
Connie- you were there 15 hrs! Sounds like a killer to me! Hope you can get some good rest. Thanks for report!
david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
This is unfortunate but is could have been much worse.
Does anyone know the details of the compainants?.
I would think that action is not brought against a Dr, unless there are complaints.
All to often these complains are by family members who are looking for someone to blame for the death or illness of a family member OR as a tool in a vendeta against a spouse...
Having seen this process occur with a local Dr. I just shake my head in disgust in the way these people treat the Dr who tried to help in what ever way possible......
With all the resources available today, particulalry the internet, the people would have had clear oppertunity to switch Dr's or question the treatment....
Bettyg, have you come across any legal cases like this?
Posts: 1184 | From north america | Registered: Feb 2003
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MagicAcorn
Frequent Contributor (1K+ posts)
Member # 8786
posted
I'm sure the support of the doctor by many patients helped in this case. You should all be very proud of yourselves. Had you not shown such support the outcome probably would have been worse.
-------------------- Posts: 1279 | From In hiding | Registered: Feb 2006
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ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
quote:Originally posted by char: What can you say about what is going on? Ugh!
The Charlotte Observer article says that Dr. Jemsek will face board again in July...Is that next July? I am having trouble reconciling this with the one year suspension where he can still practice...
Anyone?
I was at the hearing-in overflow area as such a few number were allowed in the hearing.
I met so many wonderful people from here and other folks while I was there.
I am grateful for that. and the fact that we will continue to fight together.
Connie- you were there 15 hrs! Sounds like a killer to me! Hope you can get some good rest. Thanks for report!
Char
Here's an email from Beth which might explain things a little better. If you look at it this way, the outcome was the lesser of the evils. There were lots of ugly things that came out the first day. And this very easily could have ended up a complete license revocation. No kidding.
Hello Everyone, I apologize if this note is a little rattled but I am exhausted and experiencing a lyme flare right now. Just got home from DR. Jemsek's hearing. The results are in. Let me explain the possible outcomes before I give you results.
1. Dismissal 2. Suspension with stay 3. Active suspension 4. License Revocation
These are basically the possible outcomes in declining order. DR. Jemsek was given a 1 year suspension of his license with a stay. This means in essence he can still practice. In July it will be decided under what conditions he can practice for that year. For what I know about this type of thing ,this was the best possible outcome that we could expect and I count this as a victory for the lyme community. As we find out more info we will let you know. So with a smile on my face and a prayer in my heart I will go to bed. I have to say that in the testimony this afternoon I feel the medical board really started to get a feel for what a wonderful, brilliant and compassionate doctor DR. Jemsek is. Good night, Beth
posted
Well, good people, as I have said before, welcome to Nazi America. The real issue here is one of stupidity, arrogance and ignorance. Which is usually the basis of a police state. What this now means is that nobody can treat lyme disease anymore with anything except something totally stupid that does not work. All it means is that the money grubbing swine with MDs who do not give a hoot about anything but their pocket books will be taking the gullible public-ie YOU, your families and your neighbors- for a very expensive ride fueled with snake oil.
In the meantime, we will still be sick and we will not be able to get any care at all excpet the medical equivalent-and a very expensive equivalent it is-of sugar pills. So why bother with going to doctors in the first place. That is a total waste of time. What is needed is an underground railroad or whatever to Mexico and treat ourselves. Cause you ain't gonna get treatment here otherwise. This is an unmitigated disaster and anybody who thinks other wise is being, dumb, real dumb.
Why is it that people in the lyme community have just lain around and their duffs and done little or nothing while the insurance companies and the quacks and the incompetent fools in the federal government have gone out and cut their throats. To say the least, I am just sick over all of this. Thomas Parkman
-------------------- Thomas Parkman Posts: 341 | From Columbia SC 29206 | Registered: Feb 2003
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bettyg
Unregistered
posted
quote:Originally posted by david1097:
Bettyg, have you come across any legal cases like this?
David, no, I haven't! I'm brand new to all these LLMD health dept. hearings.
Also David, I didn't work directly for a lawyer! I did type daily LEGAL CONTRACT agreements which co-workers wrote, I typed, and then the attorneys checked them to make sure everything was worded legally.
I hope that clarifies that. They only allow a set amount of room in signature line, and I've used it ALL!
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And what's he gonna do for the next year? Treat people with max 6weeks of Doxy?
Michael
-------------------- I'm not an MD. The above is IMO and in my experience as well as from health related books.
I've had symptoms consistent with neurological Lyme disease since 1986. Was diagnosed with Lyme in 2004. Am feeling better now than ever before. Posts: 702 | From NY | Registered: Jul 2004
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posted
AFter reading the article I received in my in box, I have a great deal of respect for Dr. J.
I am wondering what the next step is. How can we help?
Would it help to write the board he will be seeing in July? Would it help if we got together by each state's lyme support group and send out information as a group?
I can also see many lyme specialists doctor's office creating a form for their patients to sign if they have not done so all ready to avoid this legal issue.
Posts: 89 | From AZ | Registered: Mar 2006
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ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
It is a cool experience indeed to get involved in Lyme advocacy. This week I met Tincup, Robi (she was my roommate - we had a blast!), Lymescience, Char, Melanie, and a few others. My brain feels a bit fried right now, so not sure I can rehash much until I get a little more rest.
Yes, the board members were forced to listen to Lyme experts, and I think that aside from the negativity brought out on Wed, they actually seemed genuinely interested in the expert testimony by Drs. Fallon and Phillips on Thurs. The questions from the board members following these experts indicated to me that the experts succeeded in "educating" the board members, which is the purpose of an expert - to EDUCATE.
The positive spin is that this info is out.
Dr. J will be OK. As long as he endeavors to jump through all the hoops they place before him over the next year, he will be OK. His practice grew very quickly and the growing pains were hard, but things are definitely much more streamlined and strict policies set to deal with some of the negative issues which came out on Wed.
Other LLMDs will learn lots from the results of this hearing.
I believe that the board members ultimately decided to compromise. Dr. J has 1200 HIV/AIDS patients. If the Charlotte area was to lose him, it would create havoc in the medical system there. No way they could absorb that many patients into the local medical system. Aside from that, many of these patients are Medicaid or Medicare.
As more pours out of my brain, I will post.
But let's be positive and consider this the best case senario under the circumstances. The NCLDF will continue working to get the word out here in NC.
Posts: 2276 | From NC | Registered: Oct 2000
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quote:Originally posted by ConnieMc: For what I know about this type of thing ,this was the best possible outcome that we could expect and I count this as a victory for the lyme community. .............................. I have to say that in the testimony this afternoon I feel the medical board really started to get a feel for what a wonderful, brilliant and compassionate doctor DR. Jemsek is. Good night, Beth
[/QB]
Sounds good to me! I know it's not exactly what everyone wanted, but it's way better than it could have been.
-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96239 | From Texas | Registered: Feb 2001
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posted
Connie Mc: You are a breath of fresh air. Thank you.
-------------------- Suzanne Shaps STAND UP FOR LYME Texas (www.standupforlyme.org) (Please email all correspondence related to protecting Texas LLMDs to [email protected] with copy to [email protected]) Posts: 977 | From Austin, TX, USA | Registered: May 2004
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posted
Hey guys, here's an idea from my boyfriend who is a lot more shaken than I am about the outcome, which is pretty bad. Dr. Jemsek. is such a great, great man.
Soooo.... he came up with this:
Every Lyme patient should report every doctor that has ever misdiagnosed/mistreated them to their respective medical board. This would overwhelm the medical community to such a point that they'd have no choice but to leave our poor LLMDs alone.
I think it's a great idea, I mean, how many ducks have each of us seen?
-------------------- Sometimes when I say �Oh, I�m fine� I want someone to look me in the eyes & say �tell the truth�
ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
quote:Originally posted by AP: Hey guys, here's an idea from my boyfriend who is a lot more shaken than I am about the outcome, which is pretty bad. Dr. Jemsek. is such a great, great man.
Soooo.... he came up with this:
Every Lyme patient should report every doctor that has ever misdiagnosed/mistreated them to their respective medical board. This would overwhelm the medical community to such a point that they'd have no choice but to leave our poor LLMDs alone.
I think it's a great idea, I mean, how many ducks have each of us seen?
You have no idea how many times I said that in the past few days, that the idiots who let me deteriorate over a few years are left to continue to hurt people. WHAT'S THE DIFFERENCE? The board accused Dr. J of misdiagnosing at least 10 patients. I say again: WHAT'S THE DIFFERENCE?
I, for one, like the idea. All it took for the medical board to bring these charges were a few letters from people who were unhappy with Dr. J because they thought they were misdiagnosed.
Why can't we do this to other docs?
Posts: 2276 | From NC | Registered: Oct 2000
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posted
AMen, i see Dr. J (and do my kids) because 20 or so doctors misdiagnosed me and them), i'm with you.
Posts: 799 | From home | Registered: Sep 2004
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posted
Several years ago I reported two doctors for this very reason and not just for ignorance, but disrespect and dishonesty.
The medical board of the state was known for doing nothing, and that is what they did with my complaints. A while later, they were replaced because of the stink raised in the papers about their reputation (not lyme related). I think if a lot more people did this, it would help. However, you have to be careful not to let them use the complaint investigation as a way of fishing for details about your current treatment and doctor.
Posts: 8430 | From Not available | Registered: Oct 2000
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ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
There is very little chance of contracting Lyme Disease in NC says Dr. Engle, the NC epidemologist. He testified against Dr. J in the hearing.
He is an idiot. Here's why:
LYME DISEASE PROFILE, FORT BRAGG, NORTH CAROLINA, 20 OCTOBER, 3 NOVEMBER, and 28 NOVEMBER 1990
DEPARTMENT OF THE ARMY U.S. Army Environmental Hygiene Activity - North Fort George G. Meade, Maryland 20755-5225
[Seal of Department of Defense, United States of America]
REPLY TO ATTENTION OF: HSHB-AN-P 07 MAY 1991
LYME DISEASE PROFILE NO. 16-61-0504-91 FORT BRAGG, NORTH CAROLINA 20 OCTOBER, 3 NOVEMBER, and 28 NOVEMBER 1990
1. REFERENCES. See Enclosure (Encl) 1.
2. AUTHORITY. AEHA Form 250-R, HSC, 22 September 1990.
3. PURPOSE. To assess the risk of Lyme disease to Fort Bragg personnel by examining deer for the tick vector, Ixodes spp. and to assay ticks for the Lyme disease etiologic agent, Borrelia burgdorferi, IAW para 10-7.f., AR 40-5.
4. GENERAL.
a. Personnel Contacted. See Encl 2.
b. Survey Conduct. The survey was conducted by Mr. Karl Neidhardt, Entomologist, U.S. Army Environmental Hygiene Activity - North (USAEHA-N), Fort George G. Meade, Maryland, on 20 October 1990. Assistance was provided by MAJ William Nusz, D.V.M. and his staff, Veterinary Services (VET Svc), Fort Bragg Medical Department Activity (MEDDAC). Collections on 3 November and 28 November were conducted by VET Svc personnel trained during the 20 October visit. Ticks collected were forwarded to this Activity for testing.
c. Survey Site. Fort Bragg is located in North Carolina, approximately 10 miles northwest of Fayetteville, in Cumberland and Hoke Counties. The area is in the sand hills area of the coastal plain region, a transition area between the coastal plain and piedmont regions.
d. Technical Assistance. Technical assistance or further informal advice may be obtained by contacting Mr. Karl Neidhardt, Entomological Sciences Division (ESD), USAEHA-N, Commercial Phone 301-766-5281/6502 (DSN 923-5281/6502).
5. METHODS.
a. Tick Collection. The heads, ears, and necks of 45 shot white-tailed deer (Odocoileus virginianus) were examined immediately before or after the weighing and tagging process. The hair was stroked contrary to the natural lay, using the hand edge, and ticks were removed from the exposed skin using fine-point (No. 5) jeweler's forceps. Examination time-per-carcass varied from 2 to 10 minutes, with an average time of 5 minutes per deer. Collected ticks were placed in labeled, 20 ml humidified vials and kept cool (1.5 - 4.5 degrees C). Ticks were returned to this Activity for identification and testing.
b. Tick Testing. Ticks were assayed via Direct Fluorescent Antibody (DFA) testing using antibody conjugate from Kirkegaard and Perry Laboratories, Inc. to determine infection rates of the Lyme disease spirochete, B. burgdorferi. This conjugate is affinity absorbed to minimize cross reactivity with other spirochetes. In most cases, spirochetes observed looked like classical B. burgdorferi spirochetes. Assays were performed by personnel of USAEHA-N, Fort George G. Meade, Maryland.
c. Blood Samples. Blood pooled in the body cavities of 40 shot deer was collected using clean plastic (4 ml) disposable pipettes. Blood samples were not taken from carcasses that were rinsed with water or otherwise treated in a manner which might contaminate or eliminate the sample. Samples were placed in 7 ml labeled tubes, spun, sera were separated, and frozen (-8.5 degrees C) until testing could be performed. Sera were assayed via Indirect Fluorescent Antibody (IFA) tests by personnel of the Regional Veterinary Laboratory, Fort Geoge G. Meade, Maryland for Lyme disease antibody. Sera were also assayed by the William Beaumont Army Medical Center Regional Veterinary Laboratory, Fort Sam Houston, Texas for Leptospirosis, Brucellosis, and Bluetongue. Leptospirosis assays were conducted via macroscopic slide agglutination antibody tests against Canicola, Pyrogenes, Icterohaemorrhagiae, Grippotyphosa, Pomona, and Hardja serovars. Brucellosis assays were conducted by slide agglutination against Brucella abortus antigen. Bluetongue assays were conducted by Agar Gell Imuno Diffusion antigen tests against Bluetongue virus.
6. RESULTS. Results of tick collection, tick testing, and deer serum analysis are presented in Encls 3 and 4.
7. DISCUSSION.
a. Tick Species. Ixodes spp. ticks collected during this survey appeared to have taxonomic characteristics indicative of Ixodes scapularis. Selected specimens were submitted to the Curator, U.S. National Tick Collection, Institute of Arthropodology and Parasitology (Georgia Southern University) for further taxonomic evaluation. Tick surveillance reported on by Apperson and Levine in 1989 and 1990 (references 4 and 5), in North Carolina, documented no Ixodes spp. or other species of tick on 769 deer examined from the mountain region, no Ixodes spp. and only six Amblyomma americanum on 465 deer from the piedmont region, but Ixodes spp. on 54 percent of coastal plain deer. Amblyomma americanum were collected from 44 percent of the coastal plain deer. Findings for Fort Bragg, in this study, were consistent with the findings of Apperson and Levine. Fort Bragg, located in the sand hill transition area between the piedmont and the coastal plain, had Ixodes spp. (n=85) and Amblyomma americanum (n=64) ticks on 24 percent and 14 percent of 46 deer examined, respectively. No Dermacentor albipictus or other species of tick were collected from deer.
b. Tick testing. Ixodes spp. ticks (n=72) tested for the presence of B. burgdorferi showed a 19 percent infection rate. Ten tested Amblyomma americanum, an incriminated potential secondary vector, were not infected with spirochetes. In their studies Apperson and Levine found no Fort Bragg ticks [I. scapularis (n=9), A. americanum (n=308)] harboring spirochetes. State wide they found 2/195 (one percent) I. scapularis and 9/1836 (less than 1 percent) A. americanum, infected. All ticks tested were adults.
c. Deer Serology. Three percent (n=40) of deer sera tested by the Fort Meade Regional Veterinary Laboratory Division were found to be positive for B. burgdorferi antibody, indicative of exposure to B. burgdorferi, the causative agent of Lyme disease. These results support the finding of spirochete infected ticks and their potential for vectoring B. burgdorferi. Forty sera tested by the William Beaumont Army Medical Center Regional Veterinary Laboratory Division, at the request of the Fort Bragg VET Svc, were negative for Leptospirosis and Brucellosis. Thirty percent of those samples tested positive for Bluetongue. Results point to the possibility that deer could serve as a source for infections in domestic livestock. Implications of these findings will be addressed by veterinary personnel.
d. Epidemiology. Sixty-one human Lyme disease cases were reported in North Carolina in 1989 (reference 3). Between 1984 and 1989, 102 indigenous cases of Lyme disease were reported in North Carolina (reference 6). Lyme disease was reported in each of the three major geographic regions of the state: mountain, piedmont, and coastal plain. Six cases of Lyme disease were reported at Fort Bragg in 1988. This author learned of two additional cases among Fort Bragg wildlife workers which were not reported to the Army Surgeon General's Office.
8. CONCLUSIONS. Ticks capable of transmitting Lyme disease (Ixodes spp.) were present on more than half of the deer examined during this study at Fort Bragg. Spirochetes indicative of the causative agent for Lyme disease, B. burgdorferi, were detected in 19 percent of the adult Ixodes spp. ticks tested via DFA, from Fort Bragg. One of a total of 40 serum samples (3 percent) taken from white-tailed deer showed a positive antibody titer indicating exposure to the Lyme disease etiologic agent. This information, along with reports of 61 human Lyme disease cases contracted in North Carolina in 1989 and six human cases diagnosed at Fort Bragg in 1988, unequivocally indicates that there is a risk of contracting Lyme disease at Fort Bragg. Increases in tick abundance, percent of deer parasitized by Ixodes spp. ticks, and tick spirochetal infection rates, were noted as compared to the results of Apperson and Levine (references 4 and 5) for the period 1983 to 1987.
9. RECOMMENDATIONS. Recommendations are not keyed to, and do not stem from, specific operational deficiencies but are presented as a framework for an integrated Lyme disease management plan, based upon the results of this survey.
a. Emphasize public awareness programs to educate troops, dependents, civilian employees, and visitors on personal protective measure and Lyme disease IAW paras 2-5.1.(2) and 2-6., AR 420-76; para 10-7.b. and 10-18., AR 40-5. Methods should include, but are not limited to:
(1) distribution of Lyme disease handouts such as tick identification cards (USAMD-7/89), pamphlets, and fact sheets (suggested copy provided to MEDDAC personnel).
(2) publicizing the risk of Lyme disease on post TV and post newsletter and especially prior to the high-risk months (May thru July).
(3) making available to the installation population, video and 35mm slide format presentations on Lyme disease that have been previously provided by this Activity.
b. Submit any collected tick specimens (both field-collected or ticks that have been removed from individuals) alive for identification and DFA testing to USAEHA-N, Fort George G. Meade, MD 20755-5225 (para 10-7.f., AR 40-5).
c. Stock Permanone Trademark (NSN 6840-01-278-1336, box of 12 cans $36.99) and 3M Trademark Insect Repellent (NSN 6840-01-284-3982, box of 12 tubes, $29.30) for distribution. Emphasize tick habitat avoidance and the proper wearing of clothing and use of repellents (para 10-18.a., AR 40-5).
d. Report all confirmed and suspected cases of Lyme disease [e.g., suspicious febrile illnesses, arthralgias, rashes, (Erythema Migrans)] by special telegraphic report [MED-16(R4)] for all soldiers and civilian beneficiaries (para 3-2., AR 40-5).
e. Identify high risk foci in cantonment areas via tick dragging/flagging, small mammal trapping, and tick assay for B. burgdorferi. Sampling should be performed in spring or early summer when Ixodes spp. nymphs (the life stage responsible for most human Lyme disease infections) are active. Post DA poster 40-5, and thereby identify high risk areas [para 2-6.a.(1), AR 420-76; para 10-7, and 10-18., AR 40-5].
f. Avoid high tick population areas for troop training or recreation. Such areas can be identified by tick dragging or flagging prior to use. Case by case surveillance is necessary due to the patchy distribution of Ixodes spp. [para 2-6.a.(1), AR 420-76; paras 10-4.a., 10-18. and 14-2.c., AR 40-5].
g. Eliminate tick habitat in heavily used, infested areas (e.g., wooded recreation areas) by removing low brush and leaf litter. Tick infestations should be verified via tick flagging or dragging prior to habitat modification. Clearing should be done in low risk months (i.e., January and February) [paras 2-5.k. and 3-2.c., AR 420-76; paras 10-7. and 14- 3.a.(3), AR 40-5].
h. Prepare, as a contingency, to treat high-use areas with pesticides to decrease tick numbers if surveillance reveals high tick numbers and if nonchemical control techniques (e.g., brush removal, mowing, raking) do not provide adequate control [paras 10-4.a. and 14-3.a.(3), AR 40-5; paras 3- 2.c. and 4-1.a., AR 420-76].
--------- Trademark Permanone is a registered trademark of Fairfield American Corp., Rutherford, NJ 07070 Trademark 3M is a registered trademark of Minnesota Mining and Manufacturing Co., St. Paul, MN 55133-3053
[signature]
KARL NEIDHARDT, RPE Entomologist Entomological Sciences Division
APPROVED BY:
[signature]
JAMES T. KARDATZKE, PhD, RPE MAJ, MS Chief, Entomological Sciences Division
Enclosure 1
REFERENCES
1. AR 40-5, Preventive Medicine, 15 October 1990.
2. AR 420-76, Pest Management Program, 3 July 1986.
3. Lyme Disease Surveillance Summary, Vol. 1., No. 2., Centers For Disease Control, August 20, 1990.
4. Charles S. Apperson, Jay F. Levine, and William L. Nicholson, "Geographic Occurance of Ixodes scapularis and Amblyomma americanum (Acari: Ixodidae) Infesting White-tailed Deer in North Carolina", Journal of Wildlife Diseases, 26(4), pp. 550-553, (1990).
5. Jay F. Levine, Charles S. Apperson, and William L. Nicholson, "The Occurrences of Spirochetes in Ixodid Ticks in North Carolina", Journal of Entomological Science, 24(4), pp. 594-602, (1989).
6. Jay F. Levine, DVM, MPH, Charles S. Apperson, PhD, Richard A. Spiegel, DVM, William L. Nicholson, MS, and Catherine J. Staes, BSN, MPH, Raleigh, North Carolina, "Indigenous Cases of Lyme Disease Diagnosed in North Carolina", Southern Medical Journal, 84(1), pp. 27-31, (January 1991).
7. Sonenshine, Daniel E., Ph.D., and Jay F. Levine, "Lyme Disease in Virginia and North Carolina", Old Dominion University Research Foundation, April 1988.
Enclosure 2
PERSONNEL CONTACTED
1. LTC Donald P. Driggers, Entomological Consultant, Preventive Medicine Consultant Division, Office of the U.S. Army Surgeon General.
2. MAJ William Nusz, DVM, Director Clinical Veterinary Services, Fort Bragg MEDDAC, HSC.
3. Dr. Charles Apperson PhD, Professor, Department of Entomology, North Carolina State University, Raleigh, North Carolina.
4. Mr. Richard Choice, Supervisory Microbiologist, Fort Meade Regional Veterinary Laboratory, WRAMC, HSC.
5. Mr. Mike Hunnicutt, Wildlife Biologist, Natural Resources Branch and Deer Hunt Coordinator, Directorate of Engineering and Housing, Fort Bragg, FORSCOM.
Enclosure 3
LYME DISEASE/TICK SURVEY RESULTS FORT BRAGG CHECK STATION, NORTH CAROLINA 20 OCTOBER, 3 and 28 NOVEMBER 1990
20 Oct 3 Nov 28 Nov TOTAL # (%) # (%) # (%) # (%) ===========================================================================
=========================================================================== Collector: Karl Neidhardt Deer sex/age: Most deer were at least 1.5 years old and there were twice as many female as male deer. Percentages are rounded off to the nearest integer ===========================================================================
Enclosure 4
WILLIAM BEAUMONT ARMY MEDICAL CENTER REGIONAL VETERINARY LABORATORY DIVISION FORT BRAGG DEER SERA TEST RESULTS
20 Oct 3 Nov 28 Nov TOTAL # (%) # (%) # (%) # (%) ===========================================================================
Deer blood samples tested 23 8 9 40
Leptospirosis test positive 0 0 0 0
Brucellosis test positive 0 0 0 0
Bluetongue test positive 6(26) 1(13) 5(56) 12(30)
--------------------------------------------------------------------------- Collector: Karl Neidhardt Deer sex/age: Most deer were at least 1.5 years old and there were twice as many female as male deer. Percentages are rounded off to the nearest integer ==============================================================
Posts: 2276 | From NC | Registered: Oct 2000
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posted
People in North Carolina should be sending the info Connie has posted about infected ticks in the state to the governor with a demand that the state epidemiologist be fired.
This would also be good ammo for contacts with the media. Quote the state epidemiologist and then present them with the evidence that he doesn't know diddley squat.
Posts: 8430 | From Not available | Registered: Oct 2000
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david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
<<< WARNING >>> Lou <<< WARNING >>>
The report is 13 years old, and the data even older.
In any correspondance, one needs to simultaneouly present a complimentary report that shows that once Lyme is established in a resorvoir population of deer it spreads to the rodents and from that point does not self extinguish thereby remaining a PERMANENT threat. These refereces do exist.
This is a super important point.
Posts: 1184 | From north america | Registered: Feb 2003
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Lou, I like the way you think. Come Monday, I'm going to get on this point very soon. Jeff Engle should be fired. His "expert" epidemology is crap, and harmful to the people of North Carolina.
David, can you send me the science behind what you just alluded to?
Posts: 559 | From Cary, NC | Registered: May 2006
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timaca
Frequent Contributor (1K+ posts)
Member # 6911
posted
I am very interested in writing the medical board with the following points...if it would do more good than harm to Dr. J:
I live in Arizona...I have lyme disease..lyme is everywhere...AZ, N.C. NY...everywhere.
I spoke to or was evaluated by 17 different doctors in the state of AZ. No one knew why I went from a serious athlete to someone who could not function.
I finally found Dr. F and was evaluated at Columbia and given the diagnosis of "probable" lyme since my lab tests were highly suspicious of, but not diagnostic for, lyme disease.
IV antibiotics were recommended by Dr. F.
It took over 4 1/2 months of IV antibiotics for me to feel somewhat human again.
My medical costs last year were over $65,000.
The IDSA guidelines which most medical boards consider the standard for lyme care are outdated and would have left me a very ill woman.
Long term antibiotics are NECESSARY for some people with lyme disease.
Doctors need to be educated on how to diagnose lyme disease....and be aware that the tests for lyme are poor at best. If I (and all of you) had been diagnosed earlier, our outcomes would have been better.
What is an address to that medical board???
Timaca
Posts: 2872 | From above 7,000 ft in a pine forest | Registered: Feb 2005
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posted
Yes, david, I know it is older data. However, there definitely is newer stuff, some of which I have posted here before. See this thread for more documentation of lyme in north carolina:
ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
You guys are great. I was thinking along the same lines. The state epidemiologist is not protecting the people of NC.
I have received responses from the governor's office in the past when writing them about these issues. Dr. J wrote a letter to Dr. Engle and the members of the NCLDF were copied on it. Will see if I can post it here. Dr. J is a genius and he made his case well. I asked him if the governor had knowledge of his letter, and he said he did. So it can be a springboard for other letters.
Lymescience, let's get together on this issue. I will send you an PM with my contact info, etc.
We will keep digging and will pull out as much "evidence" as we can.
ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
quote:Originally posted by lou: Yes, david, I know it is older data. However, there definitely is newer stuff, some of which I have posted here before. See this thread for more documentation of lyme in north carolina:
Sure!! Two heads are better than one, then again, with Lyme, two heads may only equal one
This man needs to be replaced by someone who cares about the people of this state. At the very least, he should be alerting the public about a Lyme Disease like illness transmitted by the Lone Star tick, and that it may be rather prevelent in NC.
However, I believe we have both a Lyme like Disease, and Lyme Disease, both transmitted by ticks.
But if this was an honest man, who cared about the public health, he would at least acknowledge a tick bourne Lyme like illness and put out an advisory on what the Lone Star Tick looks like and that people, and physicians should take this threat seriously as no one knows the natural history of this borrelia infection.
Posts: 559 | From Cary, NC | Registered: May 2006
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In the free full text article of this one is a map with their suggested areas of suitable habitat for the deer tick, which shows NC in the thick of things.
The map has been removed by the moderators, guess it took up too much space. So, if you want to see the map, the direct link is:
Except for the already established habitat, the rest of this is based on climatic data, extrapolating where ticks could show up next. I don't agree with all of it. For instance, KY and some other states shown as low risk. Why would they be any different? Certainly not from weather or humid conditions or vegetation. So, you would have to take the prediction here as limited and rather conservative, but the red areas which show already established habitat are unassailable. And NC has got red areas.
[ 18. June 2006, 08:32 AM: Message edited by: lou ]
Posts: 8430 | From Not available | Registered: Oct 2000
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5dana8
Frequent Contributor (1K+ posts)
Member # 7935
posted
Hi Connie
Can you also pm me with contact information. I would like to wrire a letter to the state epidemiologist also.
Thanks again Connie for all your work.! You are an angel
And thanks also Lou for the links!
They will come in handy to have updated information
posted
Thank you Connie and Beth. I will try to stay positive, but right now it is a bit difficult.
Thanks to all who were able to go and those who wrote letters.
I am now heading back to OR in a few days, which is known as one of the worst states about treating lyme. I need to go to CA to see a llmd. Thank heavens for him and the new law in CA.
-------------------- tj Posts: 296 | From Portland, OR | Registered: Jun 2003
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david1097
Frequent Contributor (1K+ posts)
Member # 3662
posted
I will try to dig up the papers that have been published on mice as a resovoir. Some have been tracking mouse populations and comparing them to LD rates in humans. As it turns out, when there is a year when trees have a bumper crop of nuts, the mouse population increases with some time delay as does the LD incidence rate. This can account for LD in humans where there are few cervid resorvoir hosts to be found.
On the <>, I just wanted to make sure that anyone writting in with serious concerns and complaints of professional incompetance has the correct caliber ammunition and sufficient amount for the artillery that they want to lob into the recipients lap. If you come up short, the whole thing can just be dismissed using slight of hand....like it just another nutcase.....
Also it is clearly professional incompetance to profess to be an expert in a scientific area where one is not, if there is a professional certifying agency, that may be the better route to file a complaint, there is also the civil route for those directly affected. Those that are privy to the full testamony might also look for some more glarring errors in testamony by other who claimed to be experts, I am sure there are.
I don't think you could find a law firm that could dedicate staff and the time and have the passion for justice in this matter that you can find as an aggregate resource on this board. The only thing is, what ever is compiled by the contributors MUST conform to high standards and be absolutely complete so that it is irrefutable.
I might seem to be a hard A$$ on diagnosis and treatment to some on lymenet, but to retain credibility when trying to fight your way through the system you need lots of heavy duty armour, which in the case of the academic world is facts that are provided in published and verified findings. Conjecture or ANYTHING controversial or subject to interpretation or wiggle room with be shot down in 2 micro seconds by those that have the upper ground.
I will see what i can find.
Posts: 1184 | From north america | Registered: Feb 2003
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twoangie
Frequent Contributor (1K+ posts)
Member # 1636
posted
Does anyone know the address to the CDC in North Carolina? I was contacted by them several years ago to determine whether or not to include me in their reported number of Lyme Disease cases. They never told me if they included me or not. I always wondered and now, with Engel on record that he threw out many of Dr. Jemsek's reported cases, I'd like to know how they ended up classifying me. Personally, I think a class action suit against that group would be warranted for purposely deflating the risk. Igenex IS a reputable lab, tests for MORE bands (thus making them even more reliable!) and their results should not be able to be ignored just because some flake doesn't want their results included in the state's report.
Now, on to the topic of citing research. I want you folks to know that I abused myself quite a bit in order to spend a great deal of time, over 200+ hours, in the past months gathering actual research articles. I currently have around 2,200 at my finger tips. Maybe another 100 more when I finish sorting and titling some that are on my zip drive that I have not gotten around to yet. While that sounds like a lot, I'm still missing soooo many and what I am able to obtain is still quite limited. The bulk of my information is from the past 10 years. However, if there is a study you know about that you need, please post the name of the study, the year, and the name of a researcher or two if you can. Most important is the name and the year. I should be able to locate it, if I have it, with that information.
Now, if I send you a copy of a study, please understand that you can NOT forward it onward because I am concerned that I could be legally responsible. For that reason, I will keep track of who receives copies of which studies. There are groups on the internet who are selling access to research studies and I am not doing that, want no part of what they are doing and do not want them to profit off my work and put me at risk legally by taking studies I have obtained. Thus, I am making this offer quite tentatively and will likely limit most of the studies I send out to people who are more heavily into research than the average patient/poster. No offense to anyone but a lot of these studies are pretty long and technical. You can get at the heart of the information primarily from the abstracts which anyone can access on NCBI.
Take care,
Angie
-------------------- I surf to serve! Posts: 1993 | From Charlotte, NC, US | Registered: Sep 2001
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posted
Angie, thats wonderful that you have collected that much research, it puts my research collection to shame.
I'm very interested in recieving copies of research you've collected.
I'll send you a pm with my Email address.
Thanks for offereing, and I won't be selling this info to anyone, I just want to dork out and learn more about Lyme.
Posts: 559 | From Cary, NC | Registered: May 2006
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