May 13 - Over the next several months, the nymph stage of the tick, which has the highest virulence of disease, will be present. They're the size of a sesame seed or smaller but can transmit the potentially debilitating Lyme disease. Later in the summer, we will see more of the mature ticks, which are also capable of spreading the illness.

If Lyme disease is diagnosed early, antibiotic treatment usually gets rid of the infection quickly and completely so that no further complications develop. Since antibody production will not be present in the first 30-45 days, the ``confirmatory'' ELISA done at the time of the bulls eye rash may come out negative, regardless of the state of infection. According to the CDC, Lyme is a clinical diagnosis The surveillance criteria (cases that need reporting) is specific to a positive ELISA followed by a western blot, requiring 2 of 3 bands on the IgG and 5 of 10 on the IgM . The CDC states this should not be used for diagnostic purposes.

Go to a doctor for treatment if you see these symptoms:
* A "bulls eye" type rash or an overall expanding body rash, with flu-like symptoms
* Achy joints with a headache
Other tick born illnesses present in Oregon, include Babesia, a malaria type illness which can cause night sweats, fevers, liver abnormalities, and night terrors, Ehrlichia (HGE or HME)- which usually causes a high fever (over 102) and severe headache and general body rash, and Rocky Mountian Fever. All of these need medical attention as well.

There are two standards of care for treatment of early lyme disease.

According to the International Lyme and Associated Disease Society, a bite without symptoms may use 100 mg of doxycycline twice daily for 4 weeks. Symptoms such as an EM rash (40%), or headache and flu-like symptoms within 30 days of hiking, camping, fishing or other outdoor activities can indicate the need for 6 weeks of 200 mg doxycycline twice daily.

The other standard of care allows a single dose up to three weeks of antibiotic. According to studies by Datwiller, a single dose up to two weeks of treatment may be effective. Studies by Steere et al, also indicate 10 days and also three weeks of treatment is all that is necessary. however, both of these researchers have also participated in ``cost of treating studies'' which are heavily relied upon by insurers to dictate ``standard of care''.

If Lyme disease goes undetected or is not properly treated, problems involving the skin, joints, nervous system, and heart may develop weeks, months, or even years later. These problems usually improve after antibiotic treatment, but in some cases the disease may cause permanent damage.

Recent studies show that most people with Lyme disease who are diagnosed early and treated appropriately with antibiotics have no long-term disabilities resulting from the disease.

Many cases of ``post lyme disease syndrome'' (PLDS), according to recent research are ``persistent lyme disease,'' which was either untreated or undertreated, and warrants further treatment. Late persistent lyme disease treatment is typically a long-term combination therapy, administered by a specialist in late lyme disease, who endorses long term treatment without the use of steroids.

For more information on Lyme Disease, please see:

You just continue to amaze me with your stamina, intelligence, and kind heart...

Thank you once again for working so hard to bring this important information to light!

Much love, and congrats too ,
M