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: 2275 | 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: 2275 | 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: 96222 | 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: 2275 | 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: 2275 | 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
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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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twoangie
Frequent Contributor (1K+ posts)
Member # 1636
David - You may want to limit or expand the search terms in order to find the information you want. If you see something you need to help you with your research, please let me know and I will see if I have it.
Thanks,
Angie
-------------------- I surf to serve! Posts: 1993 | From Charlotte, NC, US | Registered: Sep 2001
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twoangie
Frequent Contributor (1K+ posts)
Member # 1636
posted
Oh, and Connie, nice work and thanks for the reports!
Angie
-------------------- I surf to serve! Posts: 1993 | From Charlotte, NC, US | Registered: Sep 2001
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I'm wondering about the "medical Milgrimizing" that doctors are being forced into by their medical societies.
You may remember the studies that Stanley Milgrim did whereby the majority of people could be pressured into giving research subjects extremely painful electri shocks when told to by "authorities". What are the psychological costs to doctors I wonder who knuckle under to authority knowing in their heart that they are damaging a patient, perhaps irreversably, by withholding adequate treatment.
-------------------- "Help Or Be Helpless" Please visit "Activism" board daily. See the threads regarding the IDSA Guidelines crisis and the threads about Dr. Charles Ray Jones and decide how best to help today! Posts: 1265 | From does not list | Registered: Jun 2004
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twoangie
Frequent Contributor (1K+ posts)
Member # 1636
posted
Here's the problem with the studies on Lyme in North Carolina. The "researcher", Dr. Breitschwerdt, is making a name for himself by making this state look basically clean and of the disease. This is the second time he has done this. His so called research flies in the face of studies like those Connie has shown on the deer as well as studies we have had on raccoons which show an incidence of about 27% infection rate in the state. Now, raccoons need to be bitten twice by an infected tick to become infected with the disease so the fact that 1/4 of them are infected is nothing to ignore. The research is older but I think it is still relevant. No one has gone in and sanitized this state so that we are now clear of the disease. These raccoons are also a reservoir for the disease - as are the deer and the mice...and the birds that fly here which are both infected and carrying infected ticks from other states. No anti-tick/disease protective bubble enclosing this state...that I know of, at least.
I have a copy of this 2004/2005 study but I don't have the following one from 1988.
Anyway, food for thought, here is are some abstracts from our resident trouble maker:
VECTOR-BORNE AND ZOONOTIC DISEASES Volume 5, Number 2, 2005
The Dog as a Sentinel for Human Infection: Prevalence of Borrelia burgdorferi C6 antibodies in Dogs from Southeastern and Mid-Atlantic States
ASHLEE W. DUNCAN, MARIA T. CORREA, JAY F. LEVINE, and EDWARD B. BREITSCHWERDT
ABSTRACT
Lyme disease is the most frequently reported human vector-associated disease in the United States. Infection occurs after the bite of an Ixodid tick that is infected with Borrelia burgdorferi. Dogs have often been reported to serve as effective sentinel animals to assess the risk of human B. burgdorferi infection. Based on published data of human Lyme disease case numbers and our clinical impressions, we hypothesized that canine exposure to B. burgdorferi would be lower in North Carolina when compared to the exposure in Virginia, Maryland, and Pennsylvania.
To address this hypothesis, we evaluated B. burgdorferi exposure status utilizing a specific and sensitive C6 peptide-based enzyme-linked immunosorbent assay. Our convenience sample included 1,666 canine serum samples submitted to the Vector-Borne Disease Diagnostic Laboratory from North Carolina (n 987), Virginia (n 472), Maryland (n 167), and Pennsylvania (n 40). Comparisons among states were made using the Chisquare test or the Fisher's exact test; p-values were adjusted for multiple comparisons using the Bonferroni correction. A Chi-square test for trend was used to determine if there was an increase in the frequency of seroreactors associated with the geographical origin of the samples. The proportion of seroreactive dogs in North Carolina was markedly lower (p 0.008) than that observed in dogs from Virginia, Maryland, and Pennsylvania.
These results support the hypothesis that B. burgdorferi transmission seems to occur infrequently in North Carolina dogs as compared to dogs residing in other southeastern and mid-Atlantic states. Furthermore, they support the utility of dogs as a sentinel to characterize the risk of B. burgdorferi transmission to humans in a defined geographical location.
Antibodies to Borrelia burgdorferi in dogs in North Carolina.
Greene RT, Levine JF, Breitschwerdt EB, Berkhoff HA.
Department of Companion Animals and Special Species Medicine, School of Veterinary Medicine, North Carolina State University, Raleigh 27606.
An indirect immunofluorescence assay was used to detect antibodies against Borrelia burgdorferi in sera from 600 dogs in 1983 and 402 dogs in 1985. In 1983, the overall prevalence rate of dogs with B burgdorferi titers greater than or equal to 1:64 was 3.6%, whereas in 1985, the prevalence rate was 2.7%.
An unexplainable higher seroprevalence was detected in 1 group of dogs tested in 1983. These dogs were from the southern coastal plains of North Carolina. In the dogs tested in 1985, this regional difference in sero-prevalence was not noticed. Statistical differences were not noticed (P greater than 0.05) between dogs from 2 sources or when gender was considered. Seemingly, the prevalence of anti-B burgdorferi antibodies in dogs in North Carolina was low.
PMID: 3288020 [PubMed - indexed for MEDLINE]
-------------------- I surf to serve! Posts: 1993 | From Charlotte, NC, US | Registered: Sep 2001
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ConnieMc
Frequent Contributor (1K+ posts)
Member # 191
posted
OMG, twoangie is back!
Welcome. Please feel free to share anything you think that might help. I, for one, would like to see Engel OUT. He is not doing his job of protecting the citizens of NC. We have proof.
Let's send some Lyme ticks in to him. Walking a mile in our shoes just might help him understand how serious this disease can be.
Posts: 2275 | From NC | Registered: Oct 2000
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posted
Ok, nice information. I'm familiar with the good vet doctor at the university of NC State.
I had the chance to speak extensivly with him at a recent Lyme Disease conference. It seems that he genuinly believes his hypothesis concerning dogs as some kind of unique way to discover the risk of Lyme disease in a given state.
On one hand, this is an excellent Idea and it makes a whole heck of a lot of sence, on the other hand, one piece of science doensn't simply cancel out all the other available data by a slight of hand. It must also be explained scientifically.
I don't doubt that he really did find very little borrelia burgdorferri in dogs in NC, but at the same time, how can we explain the infectivity rates of the other animals in this state??
What this tells me is that unfortunatly the south has a much more complicated natural lifecycle for borrelia burgdorferri than that which is found in the northern states, possibly due to evolutionairy migration from the south to the northern states, ie: it orginiated down in this area, which explains the abundance of genetic diversity found in the southern strains of B. B., and it also explains why the lifecycle of this bacteria is much more complicated in the south.
As evolution progressed north, the life cycle became much more efficient, and the genetic diversity of Borrelia became much less common, which is why up north we generally find only Borrelia Burgdorferri sensu stricto, but we commonly find Borrelia Burgdorferri sensu lato in ticks collected in the southern US.
My point is that while he made a good attempt, it was based on a faulty assumption, and science depends on the assumptions one makes when testing any theory. If your assumption is false, you can't test anything based upon a false premice.
It may be that the dog was not important in the natural life cycle of the lyme bacteria in the cycle in NC, and for unknown reasons, it was better for the bacteria to be maintained in nature through raccoons, deer, mice, and other animals.
It may be due to some other phenomina not yet understood, but it certainly is not due to a lack of Lyme Disease.
Also, I don't believe that the Borrelia Lonestari is the only applicable answer to explain this Lyme Disease in the south as does the Doctor from NC State. If this were the answer we were looking for, its presence would be much higher than the 2 percent that we find in Lone Star Ticks from the south.
While I do believe such a Lyme Disease exists form B. Lonestari, I think the vast majority of Southern Lyme Disease cases represent infection from Borrelia Burgdorferri Sensu Lato, similar to what one might find in Europe.
While in the North, most lyme disease cases represent infection with Borrelia Burgdorferri sensu stricto.
As a note, my hypothesis is based on the overwhelming cases of Lyme Disease in the south not testing strongly positive on Lyme Disease CDC standard tests, BUT they would be positive if the standards were of the EU Western blot interpretation which considers only 3 bands to be a positive IGG.
Also, because those in the south are tested for antibodies against sensu stricto, this is inappropriate for serological purposes if the infection is due to sensu lato.
A good try by Dr. B in NC, but unfortunatly, the science is much more complicated than just testing dogs for B. B. sensu stricto.
It would be nice if it were that easy, it sure would be nice.
But, as we have all been humbled by Lyme, perhaps Dr. B in NC should have some humble pie, and be a good scientists and find a way to actually study the life cycle in NC so we can accuratly predict the chances of aquiring Lyme Disease based on real epidemiology.
Posts: 559 | From Cary, NC | Registered: May 2006
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northstar
Frequent Contributor (1K+ posts)
Member # 7911
posted
I wonder how he gathered his dogs.......are they truly equal samples? What part of the states did he collect them?
This has been a major gripe of mine: the geographical diversity of the states, i.e. mountains to beaches. The mts. of NC are not like the mts. of Pa. nor western Va.
Eastern NC reminds me of NJ, and eastern shore of Maryland.
Also, I wonder what the rate of occurrance was for the 2005 sample? Rates for 1988, although low, reflect 18 year old data, and since then, there has been a lot of development in NC, allowing for more contact.
At least he was fair in saying "uncommon" rather than Engel/s "rare". However, when one has lyme, these words have no meaning. Doctors still need to know how to recognize and diagnose properly, and at least consider it in a differential dx, rather than ignore/deny.
N.
Posts: 1331 | From hither and yonder | Registered: Sep 2005
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lymednva
Frequent Contributor (1K+ posts)
Member # 9098
posted
I find the info about the different types of bb in the north vs. the south interesting because I believe I was infected in my childhood which was spent in Oklahoma. For these purposes that would be the south, I believe. That would help explain why I am not showing positve on the tests yet.
-------------------- Lymednva Posts: 2407 | From over the river and through the woods | Registered: Apr 2006
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posted
I was also wondering about the dogs -- are they house dogs or farm dogs -- big difference I would think. Were the dogs protected/treated with frontline or some other tick repellent?
Raccoons, mice and squirrels etc are outside 24/7 -- would expect much greater exposure.
Recently read an abstract on lizards in South Carolina and some other Southern state (forget which one). May have indicated babesia exposure instead of Lyme -- will look for this.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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posted
These are all good questions. I especially like the idea relating to the incredibly diversity present in NC geologically speaking.
This may explain why the life cycle of Borrelia is so extremely complicated in NC.
Here is a relavent example. B.B. is commonly found in the coastal plains, even to some extent in dogs, but not so in the mountains, or in the peidmont.
Interestingly, the greatist percentage of Lyme cases are from the mountain region, yet the coastal plain has the greatist percentage of infected dogs??
The bacterial lyme cycle is indeed much more complicated in the South than in the north, my guess is the complexity is on the order of several magnitudes(meaning factors of 10)
You're correct about recent studies demonstrating B. B. sensu lato in animals from the southern states.
There were two stuides from a Flordia researcher named Clark that demonstrated infectivity rates above 50 percent for several animal species. The key was that she changed the technique of testing that had been previously done. She was testing for Borrelia genus wide, and then she correlated all Borrelia into subspecies, and found an extremely high prevelance of Borrelia burgdorferri sensu lato, and much less sensu stricto, though it had been present.
The reason her reseach can't be held to the same argment pertaining to the difference between previous studies is that she did not directly argue against previous studies. Previous studies only looked for Borrelia Burgdorferri sensu stricto. She didn't do that, she looked for all Borrellia. The rate of infection was extremely high.
Posts: 559 | From Cary, NC | Registered: May 2006
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See info on ticks found on lizards in North Carolina -- only deer ticks -- no Lone Star ticks.
Also note that 54 mammals, 57 birds and 14 lizard species are known to harbor ticks. Kind of makes it hard to say that only dogs or deer or mice are relevant.
Bea Seibert
Posts: 7306 | From Martinsville,VA,USA | Registered: Oct 2004
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twoangie
Frequent Contributor (1K+ posts)
Member # 1636
posted
Hi Connie! I sent you a couple of things. Check your mail. Seeing me back on Lymenet probably shocked you out of a year's growth!
Lymescience,
From what I have been told about Breitschwerdt, the biggest problem with this man is he does not like that it is called "Lyme" Disease. He wants to prove, in the strictest sense, that it is not a big problem here. Thus, studies looking for sensu stricto and ignoring sensu lato. I think it is downright disgusting and a huge threat to the health of those who live here. If you are the person infected with Borrelia and seeking medical help, does it matter THAT much which specific strain you were infected with? Esp if the fact that you were infected with sensu lato instead of sensu stricto means that you will now be totally denied ANY antibiotics or medical treatment because some Nazi researcher thinks the issue is the name, not the disease! Disgusting man.
Also, as for the fact that they are using dogs...something that weighs heavily on the picture of using southern dogs, to my way of thinking, is the fact that our dogs are quite likely more heavily protected from fleas and ticks down here. No one wants their dog to bring fleas into the house or even to have fleas jumping on them if their dogs live outside. I have little doubt that we use more flea and tick repellants than in the north because we have no other choice since the flea and tick season is longer here.
Now, his "random" sample also came from vets. I see a lot of problems here. For one, dogs under the care of a vet will likely be more to have an educated owner and be more heavily protected from fleas and ticks. For another, if any of these dogs had been sick, then there is the very likely possibility that they may have received antibiotic treatment sometime prior to the time the blood samples were drawn and sent to Breitschwerdt. They could have been given antibiotics in the past by the vet who sent the sample or the owners may have even been doctor shopping and their dogs may have been given antibiotics by a prior vet. The antibody response of a dog infected with Lyme will drop if they have been given antibiotics. Also, even infected dogs only seem to have a window of opportunity to show the infection. Furthermore, what was the lifestyle of the dogs? What are their ages? In other studies, it has been show that dogs that hunt are more exposed and have higher infection rates. Age also plays a factor and, if I remember correctly, dogs under 2 years are less likely to show infection.
There are a LOT of factors that come into play when using a domesticated animal and trying to pass it off as a "sentinel" for a disease. In many cases the dogs may be house pets with less risk than the children playing in the woods next door - or even dogs playing beside children in the woods while the dog is on Frontline, Advantix, Hartz or some other powder or collar but the child is completely unprotected. When I was bitten, my dog was on Frontline and I wasn't even wearing so much as a hat, much less a bug repellant!
When you use the word sentinel, I believe you have a HUGE responsibility to find an animal to fill that role that is at a GREATER risk than the human it is supposed to alert to danger, not less. Canaries went in the coal mines because they rapidly succumbed to the dangerous gases, their risk was much greater than that of the miners which gave the miners enough time to get out of the mines safely. In this case, dogs are better protected and humans seem more likely to be the sentinels for dogs. How messed up is that?!
By the way, Lymescience, did you send me an email? I haven't seen one yet. Let me know what you need and I will see if I have the studies.
David, I sent you an email but that's the first time I've tried using the Lymenet message thing so I'm not certain it worked. Let me know if you didn't get the message and I'll try again.
Cheers,
Angie
-------------------- I surf to serve! Posts: 1993 | From Charlotte, NC, US | Registered: Sep 2001
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twoangie
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Member # 1636
posted
Oh, Lymescience, do you have the name of Clark's studies? I wanted to check and see if I have them.
Thanks,
Angie
-------------------- I surf to serve! Posts: 1993 | From Charlotte, NC, US | Registered: Sep 2001
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posted
In one of the articles I posted previously, it mentions the white footed mouse as being a good sentinel species. Mouse, not dog.
I have the full text of an article on Lyme borreliosis in the southern U.S., says strains in the south more genetically diverse [could be missed in testing] and that enzootic cycles more complex, etc. Do you have this one angie?
This is the kind of info that should be supplied to the newspapers covering the Jemsek story. They have an obligation to present information that is accurate about the risks of tickborne disease in the state, and the fact that state officials are doing their best to conceal this. If people don't know it is risky, they won't take precautions. Then they will get infected, won't get appropriate treatment because docs will think this is a zebra disease in NC, instead of a horse. Then there will be more chronic cases, people with wrecked finances and lives who can't get treatment either.
Rounding up this kind of information and posting it on lymenet is only useful if people learn from it and make sure the media have better facts for their stories. This is the perfect follow up to the Jemsek coverage.
Posts: 8430 | From Not available | Registered: Oct 2000
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northstar
Frequent Contributor (1K+ posts)
Member # 7911
Page 1 A RTICLE Prevalence of Borrelia burgdorferi Sensu Lato Infection Among Rodents and Host-Seeking Ticks in South Carolina
(one sentence stated "endemic" to So. Carol.) Also, ixodes affinis more prevalent than i.scapularis in Coastal areas (hopefully I remembered that correctly).
"Our data suggest that I. scapularis may be only minimally involved in the endemic main- tenance of B. burgdorferi in coastal South Carolina, and that I. affinis and I. minor may play more signif- icant roles in maintaining and amplifying the fre- quency ofinfection among populations ofreservoir competent rodent hosts."
N.
[ 18. June 2006, 02:02 PM: Message edited by: northstar ]
Posts: 1331 | From hither and yonder | Registered: Sep 2005
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posted
Thanks northstar. Could you do your link in a tiny url? This one makes the page go too wide to read easily.
Posts: 8430 | From Not available | Registered: Oct 2000
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northstar
Frequent Contributor (1K+ posts)
Member # 7911
posted
Lou, I would love to, but I dont know how! N./
Posts: 1331 | From hither and yonder | Registered: Sep 2005
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paste your long url in the box on this page and it will produce a tiny url that works the same way. Then paste the tiny url you have made onto the lymenet page. You can edit your post to do this by clicking on the little pencil.
Posts: 8430 | From Not available | Registered: Oct 2000
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posted
Here are the links to the Clark studies from the department of public health for the state of Florida. Seems like this state is taking Lyme more seriously.
If Dr. B is doing as you say, then he is acting unethically. Lyme Disease is known to result from more than one genospecies of Borrelia.
If B. Lonestari was causing all the problems, then they should have been identified in many more of the skin lesions that Dr. Masters has provided. So far, I'm not aware that many, if any EM lesions from Masters are from Lonestari.
However, microbiologically speaking, these EM's are filled with spirochetes of Borrelia genus.
Unfortunatly, it does matter which strain you are to be infected with. European strains, or Borrelia Burgdorferri sensu lato produce other skin manifestations of Lyme Disease that are supposedly not found here.
I'm a living example of that. See attached picture of my foot. This is ACA, caused by Borrelia Burgdorferri Sensu Lato. This only occurs in Lyme Disease, and is a late stage skin manifestation. However, this is not something that happens with sensu stricto, to my knowledge.
Also, the reason its important to identify strain diversity is that it affects our Western blots.
The EU had to adopt a strategy of only 3 bands for IGG positivity because they primarily had sensu lato.
They also found that they couldn't use B31 as we do here in the USA.
If this were acknoledged, then the US would have to scrap its current tests, and adopt the testing methods more closely to the EU, and this would result in many more patients being identified.
Appl Environ Microbiol. 2005 May;71(5):2616-25. Related Articles, Links
Molecular identification and analysis of Borrelia burgdorferi sensu lato in lizards in the southeastern United States.
Clark K, Hendricks A, Burge D.
Department of Public Health, University of North Florida, Jacksonville, FL 32224, USA. [email protected]
Lyme borreliosis (LB) group spirochetes, collectively known as Borrelia burgdorferi sensu
lato, are distributed worldwide. Wild rodents are acknowledged as the most important reservoir
hosts. Ixodes scapularis is the primary vector of B. burgdorferi sensu lato in the eastern
United States, and in the southeastern United States, the larvae and nymphs mostly parasitize certain species of lizards. The primary aim of
the present study was to determine whether wild lizards in the southeastern United States are naturally infected with Lyme borreliae. Blood
samples obtained from lizards in Florida and South Carolina were tested for the presence of LB spirochetes primarily by using B. burgdorferi
sensu lato-specific PCR assays that amplify portions of the flagellin (flaB), outer surface protein A (ospA), and 66-kDa protein (p66)
genes. Attempts to isolate spirochetes from a small number of PCR-positive lizards failed. However, PCR amplification and sequence analysis
of partial flaB, ospA, and p66 gene fragments confirmed numerous strains of B. burgdorferi sensu lato, including Borrelia andersonii, Borrelia bissettii, and B. burgdorferi sensu stricto, in blood from lizards from both states.
B. burgdorferi sensu lato DNA was identified in 86 of 160 (54%) lizards representing nine species and six genera. The high infection prevalence and broad distribution of infection
among different lizard species at different sites and at different times of the year suggest that LB spirochetes are established in lizards in the southeastern United States.
J Clin Microbiol. 2004 Nov;42(11):5076-86. Related Articles, Links
Borrelia species in host-seeking ticks and small mammals in northern Florida.
Clark K.
Department of Public Health, University of North Florida, 4567 St. Johns Bluff Rd., Jacksonville, FL 32224, USA. [email protected]
The aim of this study was to improve understanding of several factors related to the
ecology and environmental risk of Borrelia infection in northern Florida. Small mammals and host-seeking adult ticks were collected at
several sites, and specimens were tested for the presence of Borrelia species, primarily by PCR amplification. Tissues from some vertebrates and
ticks were initially cultured in BSK-H medium to isolate spirochetes, but none were recovered. However, comparison of partial flagellin (flaB),
66-kDa protein (p66), and outer surface protein A (ospA) gene sequences from DNAs amplified from small mammals and ticks confirmed the presence
of several Borrelia species. Borrelia lonestari DNA was detected among lone star ticks
(Amblyomma americanum) at four sites. Borrelia burgdorferi sensu stricto strains were detected in all small mammal species tested and in A.
americanum, Ixodes affinis, and Ixodes scapularis ticks. Borrelia bissettii was found in a cotton mouse and cotton rats and in I. affinis ticks. The study findings extend the known geographic distributions of B. lonestari
in A. americanum and of B. burgdorferi sensu lato in A. americanum, I. affinis, I. scapularis, and small mammals to new sites in Florida. The presence of B. burgdorferi sensu
stricto strains in host-seeking lone star ticks at two sites in Florida suggests that A. americanum should still be considered a possible
vector of B. burgdorferi sensu lato.
PMID: 15528699 [PubMed - indexed for MEDLINE]
Posts: 559 | From Cary, NC | Registered: May 2006
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You should get several studies takling about the complicated life cycle of Borrelia in areas of the country that are not well studied
Posts: 559 | From Cary, NC | Registered: May 2006
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posted
That is my foot. This is a good reason why strain diversity does matter. I don't have sensu stricto, I have sensu lato, hence I also have ACA.
Posts: 559 | From Cary, NC | Registered: May 2006
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posted
Somewhere I have an article that showed a patient tested positive for a european type of borrelia. This patient was one in a study done in GA by Rahn, who is a steerite, and formerly at Yale. Editing to add the pubmed url for the article. Abstract mentions B. garinii.
This patient had previously traveled to Europe but had been bitten recently in the south, so it was unclear as to where he got this species. The full text is available free after registering. Got some good stuff in it.
But am guessing that they should really be doing more testing to see what other borrelias are out there, and not producing positive ELISAs for that reason. If you don't look for it, you don't find it. Which seems to be the guiding principle in public health as regards lyme. There is plenty of published info in the lit as to genetic variability not detectable with current tests.
Lymescience, hope you and connie and others are going to run with this ball. Remember to keep it comprehensible to outsiders, simple.
[ 18. June 2006, 03:39 PM: Message edited by: lou ]
Posts: 8430 | From Not available | Registered: Oct 2000
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northstar
Frequent Contributor (1K+ posts)
Member # 7911
Genetic Heterogeneity of Borrelia burgdorferi Sensu Lato in the Southern United States Based on Restriction Fragment Length Polymorphism and Sequence Analysis
Sensu lato is a broad group containing different subspecies, such as
sensu stricto andersonii bisettii garinii
According to this paper, of which I understood zip about the method, there were strains detected in the south, that resembled the above in certain markers.
This could be another reason for seronegativity. Garinii is a European strain?
N.
Posts: 1331 | From hither and yonder | Registered: Sep 2005
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Lou, Do you think it would make any difference to try and contact that NC State professor doing the dog studies?
It seems he is not looking broad enough in his C6 peptide studies.
If I were to show him my foot, the picture I just posted, which clearly is ACA, do you think he would redo the dog tests, and expand the testing to include genus wide Borrelia?
"Background: Acrodermatitis chronica atrophicans (ACA) is the third or late stage of European Lyme borreliosis (LB)."
The important thing is that I've never been to Europe. The only other "foreign country" I've been to was a Carribian island, however I already had Lyme at that time.
Posts: 559 | From Cary, NC | Registered: May 2006
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