Thomas Budd GVDES: Grade 9 Science

• While other diseases and viruses are making media headlines across the globe, there is a bacterial illness that is infecting unsuspecting individuals at an alarming rate.

• Most British Columbians are unaware that there is a silent plague stalking our wilderness sanctuaries, infecting our wide animals and waiting for unsuspecting nature lovers.

• The bacterium is moving into our suburbs, placing gardeners and beloved pets at greater risk. Humans do not have a natural immunity and can be re-infected at a later time.

• Early symptoms are often mistaken for other illnesses which delays much needed treatment. In fact, many do not realize they have become infected.

• Lyme disease is a silent plague. Little is known and many are unaware of the growing threat.

• The disease was initially recognized in the mid 1970’s.

• It was named Lyme disease after the town of Lyme, Connecticut where it was first observed. There was a high incidence of arthritis in children living in Lyme, Conn.

• Now, LD is the most widespread tick-borne illness in the United States and Canada.

http://www.vrbo.com/23272

Old Lyme, CT - Connecticut

• Lyme disease has been in the US for over 100 years and yet, very little is known and treatment is complicated because LD is difficult to diagnose.

• Found mostly in the Northeast, upper Midwest, northern California, and southern Oregon, cases have been reported throughout the US.

• British Columbia has seen a dramatic increase in reported cases. The disease is also found in Europe and in parts of Asia and Australia.

This presentation is dedicated to my friends,

who have dedicated their lives to uncovering the truth about Lyme

Disease. Their efforts to find answers, treatments and therapies have been relentless. I know that many people will benefit from their life’s work.

Life is not merely to be alive, but to be well.

  Marcus Valerius Martial

“Lyme is a borderless, more widespread and more complex

problem that will affect your practice, without a doubt, in the years to come.

Are we dropping the ball? In many cases...yes. We are not given the facts.

This is not alarmist, but a fact!”

This is a quote found on the Canadian Lyme Disease Foundation Website.

It was addressed to physicians.http://www.canlyme.com/

This Presentation will seek to answer the following questions:

• What is Lyme disease (LD)?• How is LD spread?• What are the symptoms?• What happens to our body systems?• What are the tests for LD?• What are the treatments?• What are the prevention practices.• How can I help to spread the knowledge?

What is Lyme disease (LD)?Lyme disease is an illness

caused by a spirochete bacteria called Borrelia burgdorferi, which is transmitted to animals and man through the bite of infected ticks. Initially Lyme disease can cause a flu-like sickness. Untreated, it may cause a long-term illness that often affects many systems of the body. Other tick-borne diseases are often contracted at the same time.

Different ticks are carriers in the different regions

• Ixodes dammini (the deer tick) in the Northeast and Midwest.– Note: I.dammini was shown to actually be I. Scapularis

in 1993. Ixodes Angustus is another competent vector in central and western US and Canada

• Ixodes scapularis (the black-legged tick) in the South.• Ixodes pacificus (the western black-legged tick) in the

West.• Amblyomma americanum (the lone star tick) found in

several regions. • There is growing concern that Dermacentor variabilis (the

American dog tick) may also be capable of transmitting the disease.

• Remember - Not all ticks are infected and infection rates vary by tick species and geographic region.

Lyme Disease Life Cycle – Deer Tick Deer ticks live for two years and have three feeding

stages: larvae, nymph, and adult.

Microsoft ® Encarta ® 2006. © 1993-2005 Microsoft Corporation. All rights reserved.

The Deer Tick “The Lyme disease bacterium, Borrelia burgdorferi, normally

lives in mice, squirrels and other small animals. It is transmitted among these animals – and to humans --

through the bites of certain species of ticks. “http://www.cdc.gov/ncidod/dvbid/lyme/ld_transmission.htm

Lyme Disease Life Cycle – Deer Tick

• The deer tick is responsible for the majority of LD infections.• Deer ticks live for two years and have three feeding stages:

larvae, nymph, and adult. Each stage takes a single blood meal.• The LD bacteria spread by the deer tick has a two-year life

cycle and begins when a young tick feeds on an infected animal.

• The tick takes the bacterium into its body along with the blood meal.

• The bacterium then lives in the gut of the tick. If the tick feeds again, it can transmit the bacterium to its new host.

• Ticks feed on a variety of warm blooded animals including man, dogs, cats, horses and cows.

• The nymph spreads the bacteria by feeding on larger animals including humans. The adult tick breeds and the cycle begins again.

• The nymphal stage appears to be responsible for most of the Lyme disease cases. Both the larval stage (about the size of a grain of sand) and nymphal stage (about the size of a poppy seed) attach to a variety of small mammals.

• The ticks prefer the white-footed mouse, the main location of the Lyme disease bacteria.

• The adult ticks (about the size of a sesame seed) prefer to feed on white-tailed deer. The entire life cycle requires three separate hosts and takes about two years to complete.

An interesting fact: Deer do not become infected even though ticks feed on them. Even so, they are vital in the life cycle of ticks. They transport ticks and maintain the tick populations

THE DEER TICK• Deer ticks live in grassy

areas (including lawns), and in brushy, shrubby and woodland sites, even on warm winter days.

• They especially like moist climates like the B.C. Lower Mainland and Vancouver Island

• The bite is painless so most victims do not know they have been bitten.

http://www.ent.iastate.edu/imagegallery/ticks/iscapall4wd.html

http://www.cdc.gov/ncidod/dvbid/lyme/ld_rptmthofill.htm

Other Ways to become infected

• Some experts believe that babies may be born infected if the mother is infected, or possibly acquire it through breast milk.

• Others believe there is scientific foundation that LD can be transmitted through a blood transfusion with Lyme-infected blood. Although no cases of Lyme disease have been linked to a blood transfusion, scientists have found that the Lyme disease bacteria can live in blood stored for donation.

• Researchers also think that other ticks and some biting insects such as mosquitoes, fleas, biting flies, and lice may also transmit LD.

• Because LD research is still in the infancy stage, there are many questions and many diverse opinions as to the how the disease is spread.

Ways Lyme Disease is not transmitted

• LD is not transmiited by dogs and cats infected with Lyme disease. While pets do not spread the disease they can bring infected ticks into homes/yards.

• LD is not spread by eating venison or squirrel meat. Remember that hunting and dressing deer or squirrels poses the risk of being in close contact with infected ticks.

Ways Lyme Disease is not transmitted

• From person-to-person - by touching, kissing or having sex with a person who has Lyme disease.

• There is no credible evidence that Lyme disease can be transmitted through air, food, water.

The Beginning Symptoms• A rash or lesion called

erythema migrans appears in about 50% of LD cases.

• Many people do not connect the rash to the tick bite because the rash may not appear until three days up to a few weeks after they were bitten by an infected tick.

• Along with the rash, people may experience flu-like symptoms such as low energy, headache, mild stiff neck, joint and muscle aches, and fever.

• Unfortunately, not everyone develops a rash.• And people fail to notice it if it is in a hard-to-

see location, such as the scalp. • Fewer than half the people who develop LD

recall a rash or a tick bite.

http://images.google.com/images?q=lyme+disease+rash+pictures&hl=en&lr=&sa=N&tab=wi&sourceid=tipimg

• The rash usually looks like an expanding red ring like the one pictured here.

• Sometime the rash has light and dark rings which give it the appearance of a bull's-eye.

• In some cases, the rash has a reddish blotchy formation. • The danger is that the lesions can be confused with

poison ivy, spider or insect bites or ringworm. • Some people develop the flu-like illness without getting a

rash which makes it even more difficult to identify LD.

http://www.health.state.mn.us/divs/idepc/diseases/lyme/images/slide8.gif

Later Symptoms• The later symptoms of Lyme disease can be

quite severe and chronic.– Muscle pain and arthritis, usually of the large joints is

common. – Neurological symptoms, which include meningitis,

numbness, tingling, and burning sensations in the extremities.

– Bell's palsy (loss of control of one or both sides of the face).

– Severe pain and extreme fatigue and depression. – Heart, eye, respiratory and gastrointestinal problems

can develop. • Symptoms are often irregular and can last from

a few days to several months and sometimes years.

Later Stage ProblemsIf LD is left untreated, arthritis will occurs in over 50% of cases. People may experience chronic joint swelling, typically in the knee.

Later Stage Problems

It is not uncommon for LD to lead to chronic problems affecting the nervous system, such as peripheral central nervous system damage, meningitis, encephalitis, motor and sensory nerve inflammation and inflammation of the brain.

Later Stage ProblemsIn 8% of the cases, people will experience irregular heartbeat. Other cardiac problems can arise:

• Enlarged heart and• Acute inflammation

of the tissues surrounding the heart.

“The whole thing with Lyme disease really is diagnosis and treatment,” said David Weld,

executive director of the American Lyme Disease Foundation. “If caught early, you can prevent

later-stage problems.”http://www.medicinenet.com/script/main/art.asp?articlekey=47457

Difficult to diagnose

• Once infection takes place, the bacteria reproduces swiftly and travels throughout the body.

• The damage to body tissues is immediate.• The early symptoms may disappear, but the disease

does not go away.• If left untreated, more serious problems can develop

months to years after the initial contact.• It is common to have LD misdiagnosed because the

symptoms are the same as other illnesses. As a result, treatment is often delayed.

Is there a test for LD?

• According to the U.S Centers for Disease Control and Prevention (CDC) , there is no reliable test for Lyme disease to date.

• They suggest that diagnosis should be based on symptoms, medical history, and exposure to ticks.

• Doctors should not rely exclusively on tests. There are blood tests available but there are problems associated with them.

• If caught in the early stages, doctors can sometimes make a diagnosis based on the classic red rash and a history of likely contact with infected ticks.

• Care should be taken to review the patient's history and thoroughly examine the patient because not all patients with LD will develop the rash and many will not remember the tick bite.

• Blood tests check for antibodies which are produced by the body to attack the bacteria and can be verification of exposure to LD.

• Antibodies can be a false signal because they can remain in the body years after the disease is cured.

• The danger of a wrong “positive test” is the resulting confusion which can lead to the wrong diagnosis and treatment.

• At present, many scientists are working to develope more accurate tests.

The Biggest Danger• The biggest danger for victims is the

failure of tests to detect antibodies (for several reasons) rendering a false negative.

• Treating doctors claim this number to be from 50% to 90%.

• Cure is not a word that most chronic Lyme patients would use because too many relapses occur after the alleged ‘cure’.

• The most common blood test for antibodies used by most family physicians is an ELISA test

• The problem - If the ELISA test is carried out too soon (2 – 6 weeks after the tick bite) the infection is not observed.

• As a result, blood tests are normally not necessary or helpful in early stage disease, but can assist in diagnosis in later stages of LD.

• If the ELISA test is positive, a second test should be performed to confirm the results.

• The second test uses a Western blot test. The results will only be positive if LD infection has occurred. Currently, the Western blot is the most reliable confirmatory test.

• There are other tests put forward by some laboratories but in many cases the accuracy and clinical usefulness of these tests have not been sufficiently established.

The Controversy• The ELISA followed by a western blot is a

highly controversial method which many claim compounds the false negative rate as neither has close to 100% accuracy in detection of antibodies.

• The criteria followed as laid out by the US CDC is hotly debated in that it ignores some antigens that are very specific to the Lyme bacteria.

“Health-care providers are reminded that a diagnosis of Lyme disease should be made after evaluation of a patient's clinical presentation and

risk for exposure to infected ticks, and, if indicated, after the use of validated laboratory

tests. Patients are encouraged to ask their physicians whether their testing for Lyme

disease was performed using validated methods and whether results were interpreted using

appropriate guidelines.” Notice to Readers: Caution Regarding Testing for Lyme

Diseasehttp://www.cdc.gov/mmwr/preview/mmwrhtml/mm5405a6.htm

The Hot Debate• There are others who do not agree

with CDC’s side of the debate.

• Many believe that there are valid opposing viewpoints (which are backed by many peer-reviewed studies showing the CDC criteria are a failure).

The Good NewsThe Good News• Lyme disease is almost always curable if there is an

early diagnosis.• Treatment of early localized Lyme disease usually

involves the oral administration of antibiotics doxycycline, amoxicillin or cefuroxime axetil. administered for 3 to 4 weeks.

• There is consensus that people in the early stages of Lyme disease should be cured within 4 weeks after treatment begins.

Early Diagnosis vitalEarly Diagnosis vital

• A few patients diagnosed with later stages of disease may have persistent or recurrent symptoms.

• Experts believe these patients may benefit from a second 4-week course of therapy. Oral or intravenous antibiotics are used in the treatment.

• Accurate treatment is essential because research has found that longer courses of antibiotic treatment have not been shown to be beneficial and have been linked to serious complications, including death.

http://www.cdc.gov/ncidod/dvbid/lyme/ld_humandisease_treatment.ht

Dr. Brian FallonLonger courses of antibiotics have been shown to be beneficial by Dr. Brian Fallon’s NIH funded study at

Columbia University and from testimony of tens of thousands of

patients.

The Effects of The Effects of Treatment – Treatment –

Early TreatmentEarly Treatment

• During treatment, patients may be extremely tired and feel an achiness through their body.

• These feelings are natural and may continue after treatment.

• Within six months the tiredness and pain usually subsides.

Later Stage Treatment

• People in the later stage of the disease commonly respond slowly to antibiotic treatment.

• When treatment is delayed, many patients continue to suffer from symptoms for years, even when they receive antibiotics.

High Risk PeopleHigh Risk People• People who find enjoyment outdoors are at

risk. Outdoor activities such as gardening, hiking, camping or fishing means going into regions where ticks live.

• People who have outdoor jobs such as landscaping, forestry, and wildlife and parks management.

• Anyone who lives or works in residential areas surrounded by tick-infested woods or overgrown shrubs.

Protection Against Lyme Disease

• Avoid areas that are likely to be infested with ticks, especially in the spring and summer.

• Deer ticks like moist, shaded areas, particularly places that have leaf litter and low-lying vegetation in forested, brushy or overgrown grassy locations.

Protection Against Lyme

Disease• If a person decides to go

into tick habitats, it is important to dress appropriately to keep ticks away from skin:– Wear light-coloured

clothing to help spot ticks.

– Wear long-sleeved shirts– Tucking pants into socks

or boot tops can help keep ticks from reaching your skin.

Some experts advocate the sensible use of environmentally friendly insect repellents containing DEET.

“DEET is one of the safest, most reliable products on the market. Researchers are constantly searching for new repellents and during the past 40 years, nothing has

come close to DEET in terms of repellent efficacy against bites from arthropods (insects and ticks)”

Jonathan F. Day, Professor of Medical Entomology, University of Florida, Florida Medical entomology Laboratory.

http://www.deetonline.org/

• After a day in the woods, complete a meticulous body examination to see if there are any ticks.

• Remember - the best way to prevent Lyme disease is to carry out regular tick checks.

What To Do If Bitten!• If the tick is still attached to the skin,

remove it:– Using fine-tipped tweezers, grasp the

head of the tick close to the skin.– Firmly and steadily pull the tick straight

out of the skin.– Do not twist the tick, or rock it from side

to side while removing it.– Try not to pierce the tick's body, which

has fluids that may cause infection.• After you remove the tick, apply alcohol

to the wound. • Preserve the tick in alcohol and call your

doctor.

http://kidshealth.org/PageManager.jsp?lic=1&article_set=36502&cat_id=20221

http://www.medicinenet.com/script/main/art.asp?articlekey=47856

The Doctor Visit is especially important IF:

• The tick may have been on the skin for more than 24 hours.

• Part of the tick remains in the skin after attempted removal.

• A rash develops of any kind, especially a red-ringed bull’s-eye rash.

• The area looks infected (redness, warmth, swelling, pain, or oozing pus).

• Symptoms develops such as fever, headache, fatigue, chills, stiff neck or back or muscle or joint aches.

Find a Tick – Stay Calm• Do not panic if you find a

tick. Remember only 2% percent of tick bites result in Lyme disease

• The good news - if ticks are properly detached from the skin within 48 hours, they generally do not transmit the disease.

• I chose to name my project: ”Lyme Disease – The Silent Plague” because very few people are aware of the dangers of this disease.

• I asked myself: “How can I help to spread the knowledge?”

• I decided to share the knowledge that I gained from my research by completing this PowerPoint presentation.

• I enjoy being in the outdoors. I know that I am at high risk when I hike and camp in the Lower Mainland. But I do not want to live my life in fear.

• After completing this project, I know the risks, symptoms and treatment of Lyme disease.

• Now, applying the safety measures I learned in my research, I can enjoy nature without worrying that I may become ill.

“The first wealth is health.” Ralph Waldo Emerson

“He who has health, has hope. And he who has hope, has

everything.”Proverb Quote

“To keep the body in good health is a duty...otherwise we shall not be able to keep our mind strong and clear.”

Hindu Prince Gautama Siddharta,

the founder of Buddhism, 563-483 B.C.

I would like to thank two special people who reviewed my research and added their wisdom, knowledge & experience:

Chris Phillips and Jim Wilson

Nothing in this document is to be considered or taken as medical advice. Please contact your doctor for medical advice, diagnosis and treatment.

• http://annals.org/cgi/content/full/127/12/1109• http://www.cdc.gov/ncidod/dvbid/lyme/index.htm• http://www.deet.com/• http://www.ent.iastate.edu/imagegallery/ticks/iscapall4wd.html• http://www.health.state.mn.us/divs/idepc/diseases/lyme/images/slide8.gif• http://health.yahoo.com/ency/healthwise/hw77226• http://images.google.com/images?

q=lyme+disease+rash+pictures&hl=en&lr=&sa=N&tab=wi&sourceid=tipimg• http://kidshealth.org/PageManager.jsp?lic=1&article_set=36502&cat_id=20221• http://lymeproject.com/• http://www.medicinenet.com/lyme_disease/article.htm• http://www.medicinenet.com/script/main/art.asp?articlekey=47856• http://en.thinkexist.com/quotes/proverb/• http://www.vrbo.com/23272• Microsoft ® Encarta ® 2006. © 1993-2005 Microsoft Corporation. All rights

reserved.

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