Saturday, July 11, 2009

Combating Hysteria

All who have met me in my 30 something years of working with the city, know that I am a fairly no nonsense kind of guy when it comes to m work (I won't go to out of work or non-work areas with that attitude though).
When the data has been against the city, I stand against the city, when the data does not support what the public thinks, I am sorry, I will not make things up for anyone's convenience.
StamfordNotes has a quick review of the new "documentary" about Lyme and I also heard some discussion on NPR concerning the info on the movie.
I have a rather strange stand when it comes to Lyme disease, there is a lot of unnecessary hysteria over the disease and a lot of mind boggling complacency also.
The complacency comes in the form of doctors not being proactive when it comes to treating when symptoms are present, preferring to rely on blood tests.
I take my cue in this from the state health department lab, which a number of years ago (10?), stopped offering a blood test for Lyme, even tho it is on the significant illness list of reportable diseases. Their Reasoning? The test was inaccurate! That was more than enough for me. After years of working on it, the tests still relies on an antibody response from humans to be effective. We do not all get the rash, we do not all or can identify that lousy feeling that comes form the infection. Those are immune responses, without them, the test will not work.
Now for the hysterical part. Lyme is every where, it is spreading, it will get us all.
Partly true, mostly because of man. An environmental organization in Westchester presented that the rapid spread of Lyme has been mostly because of our own push into the suburbs and the decline of predators of the white footed mouse.
Well we know that the deer population explosion is due to us and our desire to protect "Bambi", but what woth the mouse?
The mouse is the primary vector of Lyme disease, not deer. They get infected and stay so for their entire 3 year life. The deer do not get and can not pass on Lyme.
We have given them great hiding spots in loose stone walls and have pushed creatures like owls out of the area. Even the raccoon population has decreased by over 95% since 1`990 (this is due to rabies, not specifically man) and they did feast on the mice as well.
But Lyme disease has remained at a constant infection level since 1989 (when we did the first testing), It has not increased in prevalence and the reality is that we were very late is discovering something that has been in this country for long before we were.
So whay is not every one crippled with Lyme?
Thjat is the next point of hysteria - when doctors prescribed antibiotic for just about everything, a person with sudden aches would go on a quick course and weather theree were other things involved or not any possibility of Lyme disease was stopped in its tracks.
The organism is very susepible to antibiotics. Its effects may linger for years, but that is not the disease anymore, it is not dissimilar to syphilus in that way, if you do not treat it early, you will always have a "marker" showing you have been exposed.
Quick treatment works!
The studies on the single dose have been performed and by several orginizations, the New England Journal of Medicine and the Chicago Journal of Medicine are a couple.
It works, convincing doctors of that is a different sstory, the CDC refers to those orginizations in regards to the single dose of doxycycline within 72 hours of a tick bite, other wise it is 4 weeks.
Convincing people who have not discovered a problem until months after and having doctors who now are reluctant to treat gives great rise to hysteria.
It is actually understandable, but it is not the end of the world and we are not all going to be horribly crippled by untreatable Lyme.
And yes I have had Lyme, twice and do understand it well.
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