Archive for June, 2019

Emerging Tickborne Illnesses: Beyond Lyme Disease

https://www.clinicaladvisor.com/home/topics/infectious-diseases-information-center/emerging-tickborne-illnesses-beyond-lyme-disease/

Emerging Tickborne Illnesses: Beyond Lyme Disease

With more than 30,000 cases diagnosed per year, Lyme disease is the most commonly reported vector-borne illness in the United States, and in 2015 it was the sixth most common nationally notifiable disease.

Tickborne diseases in the United States are a significant public health problem, and in the past 50 years scientists have detected at least a dozen new such infections. With more than 30,000 cases diagnosed each year, Lyme disease is the most commonly reported vector-borne illness in the United States, and in 2015 it was the sixth most common nationally notifiable disease.1

Due to increased education and recognition, most practitioners are familiar with the symptomatic presentation of Lyme disease. In stage 1, patients usually exhibit the classic erythematous expanding annular “bulls-eye” rash known as erythema migrans, and approximately 50% experience constitutional flu-like symptoms. In stages 2 and 3, or disseminated Lyme disease, patients may present with Bell’s palsy or other cranial nerve deficits, arthritis, peripheral neuropathies, and cardiac manifestations such as transient heart block and carditis.

Borrelia burgdorferi, the spirochete that causes Lyme disease, is not the only pathogen spread by the deer tick Ixodes scapularis in the northeastern United States:

  • Babesia microti, the agent of babesiosis, and
  • Anaplasma phagocytophilum, the agent of human granulocytic anaplasmosis (HGA; formerly human granulocytic ehrlichiosis) are asserting a presence in similar geographic regions. Coinfection with these organisms is possible.
  • Human monocytic ehrlichiosis (HME), caused by Ehrlichia chaffeensis, is another emerging tickborne disease with similar geography to HGA.

The incidence of babesiosis, HGA, and HME is increasing, and the geographic areas for their tick vectors are expanding. HME and HGA can be serious infections with high rates of hospitalization and complications, particularly when diagnosis or treatment is delayed.

Epidemiology

Babesia microti is the predominant protozoan cause of babesiosis in the United States; occasional sporadic cases of babesiosis caused by other species have been reported. Babesiosis is transmitted by the bite of an infected I scapularis (commonly known as the black-legged or deer tick) (Figure 1), usually in the nymphal or adult stage. The primary carrier of Babesia are white-footed mice, although it is found in other small mammals. Although white-tailed deer are the most important food source for the adult stage of the tick, deer are not infected with B microti.2 Babesia is rarely transmitted by blood transfusion, organ transplant, or vertically during pregnancy. The incidence of transfusion-transmitted babesiosis in the United States is 1.1 cases per million red blood cell units distributed.3

Figure 1. Ixodes scapularis, also known as the deer tick or black-legged tick. Image courtesy of the Public Health Image Library of the Centers for Disease Control and Prevention.

HME is caused by Ehrlichia chaffeensis, anobligate intracellular gram-negative species of rickettsial bacteria that grows within membrane-bound vacuoles in human and animal leukocytes.4,5 Less commonly, human disease is caused by E ewingii, the organism responsible for canine granulocytic ehrlichiosis. The principal vector of E chaffeensis is the lone star tick (Amblyomma americanum) (Figure 2). Other ticks occasionally have been found to contain DNA of E chaffeensis, but their role in transmission is unlikely.4 The white-tailed deer is the main competent reservoir for E chaffeensis, although domestic goats, dogs, raccoons, and coyotes may also carry the bacterium.

Figure 2. Amblyomma americanum, or the lone star tick. Image courtesy of James Gathany from the Public Health Image Library of the Centers for Disease Control and Prevention.

HGA is caused by the gram-negative bacterium Anaplasma phagocytophilum, which is transmitted byI scapularis, the same vector of Lyme disease and babesiosis. I pacificus, the western black-legged tick, is the primary vector of HGA in the western United States. Also similar to Lyme disease, deer and the white-footed mouse are the principal animal hosts for HGA.

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**Comment**

Glad word is getting out about the prevalence of other diseases spread by ticks as most of us are infected with numerous things making our cases more severe, of longer duration, and necessitating numerous medications.

What I am concerned about is the continued effort to put all of this into a 2 minute sound bite.

Nothing about treating this is easy or simple.  It takes education, savvy, experience, and most of all – an open mind.

A few considerations of the article:

  1. Most doctors are NOT aware of the symptoms of Lyme disease which mimics over 300 different diseases:  https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/.  They keep misdiagnosing patients every single day. Doctors are afraid to even treat this and would rather diagnose you with ANTHING other than Lyme/MSIDS. Even if they diagnose you they will treat you with the antiquated and unscientific CDC “Lyme guidelines” which have produced treatment failures since the beginning.  https://madisonarealymesupportgroup.com/2018/12/15/everything-about-lyme-disease-is-steeped-in-controversy-now-some-doctors-are-too-afraid-to-treat-patients/
  2. The three stages of Lyme they present is outdated.  Many never experience some stages or they can jump straight to third stage. This article tells the story of a little girl that within 4-6 hours of tick bite developed facial palsy and couldn’t walk or talk.  That’s fast. I guarantee you, she isn’t the only case like this. In my own case all my initial symptoms were gynecological.  Mainstream medicine would consider Lyme/MSIDS in a million years – yet, that’s exactly what it was: https://madisonarealymesupportgroup.com/2017/02/24/pcos-lyme-my-story/  If doctors fixate on a set prescribed stage order they will miss many people – which they already are.  This is not Simple Simon met a pie-man.
  3. Again, many never get a rash and I never had flu-like symptoms.  I had raging ovarian pain and a swollen knee.

For more on the coinfections listed:

https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/

https://madisonarealymesupportgroup.com/2018/12/02/everything-thats-known-about-ehrlichiosis/

https://madisonarealymesupportgroup.com/2016/03/08/anaplasmosis/

If you also are infected with Lyme as well as other pathogens, you are one sick dog and need a trained ILADS professional.  Contact your local support group for these professionals.

 

 

CORRECTION – 1st Human Bite of Asian Longhorned Tick

Recently this came out:  https://madisonarealymesupportgroup.com/2019/06/09/first-us-human-bite-from-worrying-longhorned-tick-noted-but-its-actually-the-second-human-bite/ and I erroneously stated it was the second bite when in actuality it predates the “supposed” 1st bite by one month making it the legitimate 1st human bite.

Other article found here:  https://madisonarealymesupportgroup.com/2018/10/03/1st-person-bitten-by-east-asian-longhorned-tick/

In sum, the 1st human bite occurred in June, 2018 in a 66 year old man from Yonkers, NY.  The 2nd bite occurred in July, 2018 in Fairfield county in Connecticut.

The good news is no pathogen transmission has occurred here in the US by this tick, although numerous pathogens have been transmitted by it in Asia:

It spreads SFTS (sever fever with thrombocytopenia syndrome), “an emerging hemorrhagic fever,” causing fever, fatigue, headache, nausea, muscle pain, diarrhea, vomiting, abdominal pain, disease of the lymph nodes, and conjunctival congestion, but the potential impact of this tick on tickborne illness is not yet known. In other parts of the world, this Longhorned tick, also called the East Asian or bush tick, has been associated with several tickborne diseases, such as spotted fever rickettsioses, Anaplasma, Ehrlichia, and Borrelia, the causative agent of Lyme Disease.

 

First US Human Bite From Worrying Longhorned Tick Noted (But it’s Actually The Second Human bite)

http://www.cidrap.umn.edu/news-perspective/2019/06/first-us-human-bite-worrying-longhorned-tick-noted

First US human bite from worrying longhorned tick noted

 

In a report last week, researchers described the first human in the United States known to bitten by an Asian longhorned tick, a rapidly spreading invasive species that the US Centers for Disease Control and Prevention (CDC) warned about last year.

Though the 66-year-old man did not get sick, scientists know that Haemaphysalis longicornis can harbor bacteria that can cause human and animal diseasespossibly including Lyme disease—and an investigation into areas where the man lived found the tick in locations other ticks aren’t typically found, which could lead to changes in public health risk messaging.

A team from the CDC, New York, and New Jersey reported the findings on May 31 in Clinical Infectious Diseases.

The tick was found in the United States for the first time in 2017 on a sheep in New Jersey, and since then, the species has been found in at least 10 states, mainly in the eastern states but also Arkansas. It’s still not known how widespread Asian longhorned ticks are in the United States, but health officials are worried, because they are aggressive biters.

Females can produce massive numbers of offspring without mating, and in some parts of the world—such as New Zealand and Australia—the species have reduced production in dairy cattle by 25%.

Ticks found on sunny lawns

According to the new report, a 66-year-old man from Yonkers, New York, removed a tick from his leg in June 2018. He had not traveled outside his home county for the past 30 days, and his only outdoor exposure was his lawn and one other lawn in the same area. His doctor prescribed him a single 200-milligram dose of doxycycline, presuming that the tick was Ixodes scapularis, the most common US Lyme vector.

Later that day, the patient took the tick to the Lyme Disease Diagnostic Center in Westchester, New York. He didn’t have any symptoms at the time and didn’t get sick over the next 3 months.

Testing in New York identified the tick as an Asian longhorned tick nymph, with genetic sequencing adding more evidence affirming the finding. The National Veterinary Services Laboratory in Ames, Iowa, further confirmed the finding.

Tick sampling using corduroy drag cloths found Asian longhorned ticks on the patient’s manicured lawn, some of them in direct sun. More were found in the park across the street from the patient’s house, both in open, cut grass exposed to direct sun and in taller, shaded grass next to the woods. Testing also found ticks on a nearby public trail, in mowed short and midlength grass near the trail edge, both in full sun and partial shade. The discovery of the ticks near the man’s house were the first known collections in New York state.

The authors wrote that finding the ticks on manicured lawns and in open sun may be significant, because public education efforts often stress that Ixodes scapularis ticks—the most common biting tick in New York state—are found in wooded areas or shaded grass.

Next steps for ongoing threat

In a related editorial in the same issue, Bobbi Pritt, MD, MSC, with the division of clinical microbiology at the Mayo Clinic in Rochester, Minnesota, wrote that though the report of a human bite isn’t surprising, it proves that the invasive longhorned tick continues to bite hosts in its newest location.

“This is extremely worrisome for several reasons,” she wrote. One reason is that Asian longhorned ticks can carry several important human pathogens, including the potentially fatal severe fever with thrombocytopenia syndrome (SFTS) virus and Rickettsia japonica, which cases Japanese spotted fever. “While these pathogens have yet to be found in the United States, there is a risk of their future introduction,” she added.

Also, Pritt said several other human pathogens have been detected in the ticks, but it’s not clear the Asian longhorned species are able to transmit them to humans. They include Anaplasma, Ehrlichia, Rickettsia, and Borrelia species. Lyme disease is caused by Borrelia burgdorferi bacteria.

She warned that the organisms are present in states where longhorned ticks have been found and that it’s possible that the tick—known to be an aggressive biter—might be able to transmit Heartland virus, given its close relationship to SFTS virus.

Pritt said it’s clear that the invasive species is here to stay for the foreseeable future, and next steps should include public awareness campaigns that incorporate the new information, easy-to-use resources for labs to identify the tick, and more research to understand the implications of the new findings.

See also:

May 31 Clin Infect Dis abstract

May 31 Clin Infect Dis commentary

Nov 30, 2018, CIDRAP News story “CDC: Worrisome longhorned tick spreading rapidly in US

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**Comment**

The actual first human bite by the Asian Longhorned tick was in 2018 & in Connecticut:    https://madisonarealymesupportgroup.com/2018/10/03/1st-person-bitten-by-east-asian-longhorned-tick/

No pathogen transmission has happened by this tick in the U.S. so far, but as the article states is responsible for numerous diseases in Asia.

A number of concerning issues:

 

Lyme Disease Program At Spaulding Rehab Hospital

https://boston.cbslocal.com/remote-login.php?login=d30dd2af62b1d79d8bd519aaa754439e&id=3859903&u=faf0ad434f0f21a21ef4ec622

Dean Center Treats Long-Term Effects Of Tick-Borne Illnesses

“All of a sudden, the right side of my body was completely numb. My heart was racing. I was disoriented and I said, ‘I think you need to take me to the hospital,’” she remembered.

After the standard antibiotic treatment, Dean still didn’t feel right.

“I’d gone to 12 different specialists and they all had diagnosed me with anxiety.

She had what the Centers for Disease Control calls Post-Treatment Lyme Syndrome. She eventually found a doctor who understood her condition and recovered.

Doctors don’t always know what causes the lingering symptoms, making the diagnosis controversial and it is difficult for many patients to find help.

“There are hundreds and hundreds and hundreds of people who are severely debilitated from this disease and don’t have the access to the care that they need,” Dean said.

She and her family helped create a special program at Spaulding Rehabilitation Hospital that focuses on treating the lingering effects of tick-borne illnesses, like Lyme, including pain, fatigue, and brain fog.

“We have the ability to get them into physical therapy,” explained Dean Center co-founder, Dr. David Crandell. “If people are having problems with fatigue, we’ll work on ways to improve their efficiencies and if they’re having problems with their cognition, we’ll work with our speech and language pathologist to come up with unique management strategies.”

The Dean Center is the only one of its kind in the country and because of that, they have a long waiting list.

“I think if we’re in a position to show how these services help, hopefully, people will adopt those approaches elsewhere,” Crandell said.

In the meantime, the Dean Center is getting ready to open a pediatric Lyme disease center and the hospital hopes to expand services to treat more adults as well.

Dean continues to help raise money for the Center so more people can have access to care that she had.

“I don’t know where I could be if I hadn’t found those physicians who believed that I was really sick,” she said.

For more information on the Dean Center click here.  To make a donation click here.

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**Comment**

I’m waiting on a response from from Ms. Dean on if this center as part of its treatment, prescribes long-term antimicrobials (antibiotics and/or herbals).

The “lingering” symptoms the CDC labels PTLDS in many is active infection that needs to be dealt with.  The reason this is controversial is a long, convoluted story but suffice it to say treatment failures have been noted since the very beginning of this plague and numerous animal and human studies have shown bacterial persistence.  They just don’t want to believe it because it doesn’t fit into the nice square box they’ve put it in. I stumbled on this paper hailing from Canada which does a fantastic job laying it all out:  TheCaseforthePersistenceofLymeDiseaseAfterAntibioticTherapy

Here’s a bevy of studies broken down into categories showing borrelia persistence:  Peer-Reviewed Evidence of Persistence of Lyme:MSIDS copy

So the idea that these lingering symptoms can not be caused by active infections is ludicrous. Mainstream medicine is also ignoring the polymicrobial aspect that many of us are infected with numerous pathogens which research has shown to cause more severe illness of longer duration:  https://madisonarealymesupportgroup.com/2017/07/01/one-tick-bite-could-put-you-at-risk-for-at-least-6-different-diseases/  Read comment after article

https://madisonarealymesupportgroup.com/2016/01/16/babesia-treatment/

Excerpt:

Going back to 1998, it was known that when a patient has Lyme and Babesia, Lyme is found three-times more frequently in the blood, causing greater symptoms, disease severity, and duration of illness:  https://reference.medscape.com/medline/abstract/8637139

https://madisonarealymesupportgroup.com/2017/06/28/concurrent-babesiosis-and-lyme-in-patient/  Great example of a previously healthy 39-year-old male

THE NUMBER OF SYMPTOMS AND DURATION OF ILLNESS IN PATIENTS WITH CONCURRENT LYME DISEASE AND BABESIOSIS ARE GREATER THAN IN PATIENTS WITH EITHER INFECTION ALONE

http://www.lymepa.org/c07%20Lyme%20disease%20and%20Babesiosis%20coinfection.pdf  It also suggests a synergistic inflammatory response to both a parasitemia and an increased spirochetemia. In addition, babesial infection enhances Lyme disease myocarditis in mice, which suggests that coinfection might also synergize spirochete-induced lesions in human joints, heart, and nerves.

Telling quote:

Persistent and debilitating fatigue characterized coinfection.

ANIMAL STUDIES ALSO SHOW ENHANCED SEVERITY WITH LYME & BABESIA

https://www.sciencedirect.com/science/article/abs/pii/S0020751918302406
Similar to humans, B. microti coinfection appears to enhance the severity of Lyme disease-like symptoms in mice. Coinfected mice have lower peak B. microti parasitaemia compared to mice infected with B. microti alone, which may reflect attenuation of babesiosis symptoms reported in some human coinfections. These findings suggest that B. burgdorferi coinfection attenuates parasite growth while B. microti presence exacerbates Lyme disease-like symptoms in mice.

Research on concurrent infection is scant but under appreciated as ticks are coinfected as well as the people they bite. More work needs to be done as well on tick bites potentially reactivating latent infections.

 

 

 

Mum of Three Unable to Eat, Walk, Or Leave Her Bedroom Because of Tick Bites

https://www.mirror.co.uk/news/uk-news/mum-three-unable-eat-walk-16252344?utm_source=facebook.com&utm_medium=social&utm_campaign=mirror_main

Mum-of-three unable to eat, walk or leave her bedroom because of tick bites

EXCLUSIVE: Once a busy career woman, Joanne Baskett, 46, now needs 24-hour care because of Lyme disease
By Matt Roper
Joanne discovered she had been infected by Lyme at least three times
Joanne discovered she had been infected by Lyme at least three times (Image: Joanne Baskett)

Busy mum-of-three Joanne Baskett had no idea the tiny ticks she found on her cat could carry disease, let alone completely destroy her life in just a few years.

A few days later as she was trimming the hedge at the bottom of her garden she found one of the insects buried in her own skin, and removed it with the same tick tool she had used on her pet.

When a red, bullseye rash appeared around the bite she went to her GP, who gave her medicine for ringworm.

And by the time, six weeks later, she came down with a fever and flu-like symptoms, a swollen throat, ear ache and heavy legs, Joanne didn’t imagine it was anything to do with the insect THAT had bitten her in her garden.

In fact Joanne, whose children were six, nine and 13, had been infected with Lyme disease, a bacterial illness spread by the bloodsucking deer tick, which is about the size of a poppy seed.

The disease is rare, with less than a third of deer ticks carrying it, and less than five per cent of bites resulting in an infection.

Joanne was a busy mum and career woman (Image: Joanne Baskett)

Incredibly, though, when Joanne finally discovered what the mystery illness was that was slowing devastating her body, paralysing vital organs including her stomach, bladder and bowel, she found out that she had been very unlucky indeed.

Scientists in America who tested her found she had been infected on at least THREE separate occasions – once in Greece, once in the States and then by the tick in her garden in Swindon, Wilts.

The makeup of Lyme disease is different in each region, and she was carrying four different strains, which she could only have contracted in those countries.

But by the time she had finally been diagnosed, Joanne was a shadow of her former self, bed bound, unable to walk, eat or even wash herself and needing round-the-clock care.

And because the pathogens in her body had suppressed her immunity, Joanne was also fighting HPV squamous cell carcinoma – the early onset of cancer – which has meant she has had 36 surgeries with much of her reproductive and excretory organs removed.

Lyme is spread to humans by the deer tick (Image: Getty Images/iStockphoto)
Yet incredibly she has had no treatment for Lyme disease – the cause of all her problems – despite having three different clinical diagnoses of the illness.

Joanne, 46, says the NHS is “in complete denial” of Lyme, claiming that tests in Britain aren’t thorough enough to test positive for the disease in many cases.

She said: “The NHS won’t treat me. They only us serology testing which looks for antibodies but because I was on steroids at the time I was bitten and couldn’t produce antibodies so they discarded the possibility of Lyme.

“Since then I’ve had diagnoses from three different professionals in Germany, America and Ireland.

“And to my shock I didn’t have just one strain of Lyme like most people, I had four. I had been bitten and infected with Lyme at least three times.

“I tested positive for your strains of Lyme and seven infections caused by Lyme.

“Two were from America, probably picked up when I was in Connecticut in 1993.

“And one was from Europe, which was probably during a backpacking trip in the Greek islands when I was bitten by lots of insects.

Joanne’s stomach, bowels and bladder are paralysed (Image: Joanne Baskett)

“It has ruined by life. I don’t have a life anymore. I’m permanently disabled now, I have spent the last eight years of my life inside my bedroom.

“I have carers coming in three times a day to help undress me, often I’m too unwell to be helped to my wet room so they have to wash me in bed. Sometimes I can’t stand up or even hold anything.

“If I had been diagnosed earlier it would certainly have stopped my illness progressing to the stage it’s at now, which is total bowel paralysis, stomach paralysis and bladder paralysis.

“Slowly but surely my organs are failing on me, and it’s frightening.

“I feel absolutely devastated. Angry isn’t the right word, I would say heartbroken, that my whole life didn’t turn out the way I expected it to, and all because of a tick.

“I don’t know what’s going to happen to me. How long do I have left? My kids have only got me in their life. When I’m not here they won’t have anyone.”

Joanne was an working mum-of-three, an HR consultant travelling around the country to visit clients, when she decided to do some gardening on a hot June day in 2009.

She said: “Three days prior to that, I had been grooming the cat and felt lumps and realised they were ticks, so I removed them with a tick tool. But I never knew they could spread disease, I was totally unaware about that.

“While I was trimming the hedge I found one on my right lower leg.

“I used to tick tool to get it out but it was quite a small one and quite tricky to remove. A few days later I had a rash around where I had been bitten.

“I wasn’t until six weeks later that I began to feel really fluey and not myself.

“My throat was swollen, I had ear ache and heavy legs, and I was getting hot and cold chills.”

Joanne hasn’t left her bedroom for the last eight years (Image: Joanne Baskett)

Joanne’s health quickly went downhill, until the point where she was no longer able to get out of bed.

And her long-term partner left her just a year after her symptoms started, leaving her to look after her three young children alone.

She said: “The disease quickly affected my whole body. I cannot eat because my stomach is paralysed, and my bowels don’t empty without machinery because that’s paralysed too.

“My cognition is very poor so often I can’t think or speak properly. I can’t walk.

“At first my GP said I had fibromyalgia and ME/CFS. I believed that to start with.

“Then a friend told me that a bullseye rash means you have Lyme, and I started to research it. I began to realise that what I had were the symptoms and not the actually illness.

“That’s when I went to a specialist clinic in the States and they found I had four types of Lyme disease. I did tests in Germany and Ireland and the results were the same.

“But when I took the tests back to my GP the NHS didn’t want to know.”

Joanne says she was a “good mum” to her children before she became ill, and “a bit of a foodie”.

She said: “It has been absolutely devastating and soul destroying.

“I haven’t been able to be a proper parent to my children, and they’ve not had a proper mum.

“I wasn’t able to do the things that parents should be able to do, I couldn’t go to their sports days or make them food when they came home.

Joanne has campaigned for a greater awareness of Lyme disease

“They’ve had a really hard upbringing, they’ve seen my struggle so much and even now, seeing my go through so many surgeries, and still now getting better.

“I love cooking and used to love Mediterranean food, I was always cooking fresh meals for my children. But I’ll never be able to eat those foods again.

“Because my stomach is paralysed I vomit everything I eat. I’m now on water, and squares of organic dark chocolate that melt in my mouth.

“That’s all I’ve been able to eat since last year, and I’ve lost 25 per cent of my body weight in that time.”

Joanne believes more needs to be done to warn the public about the dangers of the ticks that carry Lyme.

She said: “These ticks can contain more than four pathogens. If you get bitten by one its touch and go whether you’re going to become disabled or be OK, and we’re not taking it seriously enough.

“I had no idea that tick bites could do this, and ended up losing my home, my career, my partner, everything.

“I’m a completely different person to the one I once was. I worked hard, went to uni, did a lot of extra study to get to where I was, and it was all for nothing. I feel my talent has been wasted.

“Now my brain is affected, my eyesight isn’t good anymore and I my cognition is getting worse.

“If I had known what I know now I might have been able to get help quicker. Now there’s no more time, and it’s very frightening.”

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**Comment**

How many more have to lose their lives to this plague?  How much more suffering has to occur before authorities get their heads out of the sand?

  • First, this is NOT rare!  Do your reading.
  • 22% of deer tick nymphs in Wisconsin are infected with Lyme. The infection rate for adults is around 40-45 %. In some locations infection rates are 75 % of the tick population.
  • Looking at maps and basing diagnostics on where ticks supposedly are and aren’t is asinine.  Research shows birds transporting ticks everywhere.
  • Second, a history of tick bites and you give her ringworm medication?  Really?
  • She gets 3 separate diagnoses and you won’t treat her?  
  • Mark my words – there will be more and more stories just like this one. Things will not change until people in power positions get infected.