Tuesday, June 24, 2008

More Ticks and I get ticked off!

Okay we are approaching a lull in the tick season - I said approaching, because right now is the most dangerous time. The ticks that are active are only about 18% infected, but they are small, so most normal people will miss them and even vigilant tick checkers will miss them until they are engorged. And if they are engorged and they are infected, the chances, sadly are very good that the Lyme has been passed on. So why am I ticked off? because of the many submissions in the past month, there have been a lot of engorged nymphs and many of these have been children and the friggin' MD will not do anything until the tick tests positive and a blood test is positive.
Now this is not the CDC's recommendation, this is the MD's own cautious use of antibiotics. I am sure to get some MD mad at me, but the truth is the blood test is still just not good enough. A positive engorged tick is enough. Symptoms are enough. A blood test is just being stupid.
Now here is the real tripper - a single dose of Doxycycline has been shown to be more than 95% effective if administered within the first 72 hours of finding the tick, otherwise it takes 4 weeks of treatment if done within the first 3 months of the infection. This is fairly standard for a spirochete (just like syphilis). This treatment was verified in the New England Journal of Medicine, before it became a CDC recommendation, which is why I go the next step.
So in January of this year the same journal found that there is another disease to be concerned with, something cat lovers know as cat sratch fever caused by an intracellular bacterium Bartonella. While most scientist were studying babesiosis and ehrlichiosis (now called Human granulocytic ehrlichiosis (HGE)) a small group found that the Bartonella was more likely associated with a co-infection with Lyme and the probable cause of the 'long term' Lyme. This might also explain the 5% that the single dose didn't work on (my supposition).
Okay so I am long winded and technical - well thats who I am, I guess.
There are plenty of MDs who take tick-borne diseases seriously, what is wrong with these pediatricians?
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