NEWARK – More than two times as many cases of the tick-borne Lyme disease have been reported to the Licking County Health Department thus far this year, as compared to all of 2018. And the amount confirmed is even more noteworthy.
There were 17 suspected, two probable and three confirmed cases last year for a total of 22. Through Wednesday morning, there were 52 total cases, with the vast majority being confirmed.
In 2017, it was 16 suspected and 10 confirmed for a total of 26 cases.
A 2017 alert, issued by Gale Neville, Licking County Health Department Infectious Disease Nurse, said that prior to 2010, there were no known established populations of blacklegged ticks, or deer ticks, in Ohio. Since then, the tick has been found in at least 60 Ohio counties including Licking, and spreads Lyme disease through its bacteria-infected bite.
Typical symptoms include fever, headache, fatigue and a characteristic “bulls-eye” skin rash. Most cases can be treated successfully with a few weeks of antibiotics. But if untreated, the infection can spread to joints, the heart and the nervous system. Early treatment is key for the disease, so the quicker it’s detected, the better the outcome for the patient.
“Because Lyme disease symptoms are common to many other illnesses, including common viral infections, and because Lyme disease transmission is fairly new to Ohio, it is often mis-diagnosed and under-reported,” Licking County health commissioner Joe Ebel said last month. “Increased public education and (medical) provider awareness results in higher case counts. However, a Lyme diagnosis is sometimes missed until the symptoms have progressed.”
Local residents dealing with the disease have expressed their frustrations about how misunderstood the disease is and how long it often takes to diagnose it, often with debilitating results.
Amanda Johnson’s daughter Emery, a freshman at Granville, was diagnosed with Lyme disease in the third grade and now has Juvenile Idiopathic Arthritis. She is the oldest of her four children.
“She was at a local week-long summer camp after her second grade year, and we picked her up and immediately drove to Hilton Head,” Johnson recalled. “Well, there was a red, raised area on her hand. When we got there, it was swollen and huge. We took her to Urgent Care, and it was the classic bulls-eye rash. They gave her some cream.”
After a week at the beach, the whole hand was swollen, and Emery came back and started third grade, but her teacher could immediately tell something was wrong.
“She was tired, lethargic, freezing,” Amanda said. “We suspected Lyme disease, and had talked to a mom whose daughter had it.” But medical providers would not test for it until eventually, the Johnsons went to Cleveland, where Emery was diagnosed with the arthritis.
And later, she was finally diagnosed with Lyme disease at Cincinnati Children’s Hospital.After six weeks of medicine, Emery’s teacher finally noticed a change.
“She said, ‘your daughter is a totally different student,” Amanda said. “I wish I would have known more. She was almost in a daze for a whole year.”
Johnson, now a financial advisor for Edward Jones, worked for 18 years in medical sales and was a dietician.
“I quit my job for four months, because we were constantly in doctor appointments,” Amanda said. “My husband and I spent thousands, because a lot of it was out of pocket. Some of the medications made her violently ill. It was very frustrating. We went through injections, infusions, EKGs and MRIs.”
Emery’s hand joints are permanently damaged, but she leads a fairly normal life. However, the arthritis still flares up, and she still goes to a specialist.
“They didn’t want her playing sports, but we wanted her to, so she could become herself,” Amanda said. She currently plays freshman and reserve volleyball at Granville.
Kristy Hawthorne, administrative assistant for the Licking County Soil and Water Conservation District. has had to scale back her active life after being diagnosed with Lyme disease in July.
“I went to Urgent Care on July 1, and got the results back July 7,” Hawthorne said. “I had one blood draw, which they ran multiple tests off of. I’m not sure exactly when I contracted it. I live out in the country and am outside a lot for work. So I’m prone to be in areas where ticks are at. I’d been bitten before. I drive by that sign on Route 16 warning about ticks, but I never thought it would affect me.”
The bullseye rash was on a different part of her body from where the bite was, she said. Through her research, she found that about 30 percent of cases do not have the bullseye rash. She also learned about nymphs, a smaller version of the tick, which was found on her.
“The smaller nymphs are more concerning, because nymphs are the size of a pinhead,” Hawthorne said. “They’re very small, they’re tougher to spot and they stay attached longer.”
She did 28 days of antibiotics treatment, but was still having the symptoms.
“The fatigue mimics the flu,” Hawthorne said. “I’m very active but I’ve had to pull back. It’s changed my life. I went to a doctor of infectious disease specialist, and he said I didn’t have the three things they look for in Lyme disease: swollen joints, Bell’s Palsy or heart arrhythmia.”
Eventually, her family physician found had she had low thyroid levels, and her Vitamin B12 and Vitamin D were down.
“I’ve increased my intake to help with the fatigue, muscle and joint soreness,” Hawthorne said. “It will take a few weeks to be effective. I have to be mindful of my self care. I have to eat healthy and listen to my body.”
It’s been quite the education for Hawthorne and Johnson, who have conducted plenty of their own research. There are support groups on Facebook.
“I have a friend who has it who avoids natural sugars, like in fresh fruits,” Hawthorne said. “Another friend had a daughter who had symptoms, but wasn’t diagnosed until a year later.
“If you think you have it, have a good conservation with your doctor and ask for the test,” Hawthorne said. “Try to get the word out about it to medical professionals. I’ve started my own health journal. It’s a misunderstood disease, and nothing is really clear cut.”
Johnson said she had two mothers call her this summer who were at their wits end, because they suspected their kids had Lyme disease. Ultimately, one of them did, and one of them didn’t.
“I want to help other people,” she said. “We have seen the light. She (Emery) does not have cancer and she’s not dying. We’ve tried to make the most out of a bad situation.”
“Follow your gut,” Johnson added. “Don’t stop. Walk into your doctor’s office and say, ‘I want myself, or my child, tested.’ You may have to pay out of pocket, but pay out of pocket. If you or they have a rash, or don’t have a rash, if you or they have a fever, or unexpected stiffness or joint pain, get tested. It’s just a blood test, not bone marrow.”
Olivia Biggs, public information officer for the Licking County Health Department, said they have tried to stay ahead of things.
“We started educating the medical providers in 2017 with Health Alert Network (HAN) messaging about the emergence of Lyme,” she said. “The biggest thing we noticed early on during our suspected Lyme disease investigations were that cases had no listed travel outside of Licking County. Further information collected suggested exposures occurring in Licking County.
“This was something new regarding Lyme disease and something we continued to monitor to see if it was legit. We did establish that it was legit here in the county,” Biggs added. “And not long after that, ODH (Ohio Department of Health) started to address the emergence of blacklegged ticks in Ohio.”
Biggs said numbers of cases reported will rise as awareness is raised, for both the public and health providers.
“We expect it, but it’s best to accurately diagnose our patients,” she stressed. “The only way to get the data is if providers test for it and we get positives.”
Tick-borne diseases (Anaplasmosis, Babesiosis, Lyme disease and Rocky Mountain spotted fever) mostly occur during spring and summer, although blacklegged ticks are active and may transmit disease the year around in Ohio. Suspected or confirmed cases should be reported to the health department within one day of a diagnosis. It is essential there is both clinical and laboratory evidence of infection, the health department said.
dweidig@newarkadvocate.com
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Twitter: @noz75
CDC tick bite prevention tips
Avoid ticks by walking in the center of trails and avoiding wooded and brushy areas with high grass and leaf litter.
Repel ticks on skin and clothing by using repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours. Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth.
Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin. It remains protective through several washings.
Find and remove ticks from your body by bathing or showering as soon as possible after coming indoors (preferably within 2 hours) to wash off and more easily find ticks that are crawling on you. Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair. Examine gear and pets.
Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors.
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**Comment**
With all the information coming out on ticks and the illnesses they carry, patients are still not believed, and are denied testing and treatment. Many doctors will give you disinformation on what you have to have in order to be infected. Please know Lyme disease can mimic over 300 diseases and look very differently from person to person.
This shouldn’t still be happening, but it still is.
My best advice is to completely bypass mainstream medicine which is still in a coma regarding tick borne illness. Get to an ILADS trained doctor right away where you stand a chance of getting better.
Also, please note the statement, “We did establish that it was legit here in the county…And not long after that, ODH (Ohio Department of Health) started to address the emergence of blacklegged ticks in Ohio.”
Dr. Dashore on Representative Chris Smith’s legislation called the Kay Hagan Tick Act Bill after former U.S. Senator Hagan who recently succumbed to Powassan Virus
Newcastle University Research Fellow, Newcastle University
Disclosure statement
Katarzyna Mickiewicz receives funding from European Research Council. This work was funded by a European Research Council (grant number 670980) to J.E. The contribution of L.D., R.P., J.H. and P.D.A. to this work was supported by the NIHR Newcastle Biomedical Research Centre awarded to the Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University. We thank Agata Starosta and Andreas Weiser for providing pMCL200 yfp plasmid. Zebrafish work was carried out with Prof. Serge Mostowy (London School of Hygielne and Tropical Medicine)
Researchers have evidence of another method that bacteria use to avoid antibiotics. Sirirat/Shutterstock
Widespread antibiotic use is largely to blame for the emergence of antibiotic resistant bacteria, which is currently one of the biggest threats to global health. Not only does antibiotic resistance already cause an estimated 700,000 deaths a year, it’s also made numerous infections, including pneumonia, tuberculosis, and gonorrhoea, harder to treat. Without knowing how to stop bacteria from developing antibiotic resistance, it’s predicted that preventable diseases could cause 10m deaths a year by 2050.
Some of the ways that bacteria become resistant to antibiotics is through changes in the bacteria’s genome. For example, bacteria can pump the antibiotics out, or they can break the antibiotics down. They can also stop growing and divide, which makes them difficult to spot for the immune system.
However, our research has focused on another little known method that bacteria use to become antibiotic resistant. We have directly shown that bacteria can “change shape” in the human body to avoid being targeted by antibiotics – a process that requires no genetic changes for the bacteria to continue growing.
Virtually all bacteria are surrounded by a structure called the cell wall. The wall is like a thick jacket which protects against environmental stresses and prevents the cell from bursting. It gives bacteria a regular shape (for example, a rod or a sphere), and helps them divide efficiently.
Human cells don’t possess a cell wall (or “jacket”). Because of this, it’s easy for the human immune system to recognise bacteria as an enemy because its cell wall is noticeably different. And, because the cell wall exists in bacteria but not in humans, it’s an excellent target for some of our best and most commonly used antibiotics, such as penicillin. In other words, antibiotics targeting the wall can kill bacteria without harming us.
However, bacteria can occasionally survive without their cell wall. If the surrounding conditions are able to protect the bacteria from bursting, they can turn into so-called “L-forms”, which are bacteria that don’t have a cell wall. These bacteria were discovered in 1935 by Emmy Klieneberger-Nobel, who named them after the Lister Institute where she was working at the time.
In a lab, we often use sugar to create a suitably protective environment. In the human body, this change in form is typically triggered by antibiotics that target the bacteria’s cell wall, or certain immune molecules – such as lysozyme, a molecule that’s present in our tears which helps protect us from bacterial infections.
Bacteria without a cell wall often become fragile and lose their regular shape. However, they also become partially invisible to our immune system, and completely resistant to all types of antibiotics that specifically target the cell wall.
Scientists long suspected that L-form switching might contribute to recurrent infections by helping bacteria hide from the immune system and resist the antibiotics. However, it was difficult to find evidence for this theory due to the elusive nature of L-forms and lack of appropriate methods to detect them.
Watching bacteria change shape
Our study, published in Nature Communications, looked specifically at bacterial species associated with recurrent urinary tracts infections (UTIs). It found that many different bacterial species – including E. coli and Enterococcus – can indeed survive as L-forms in the human body. This is something that has never been directly proven before. We were able to detect these sneaky bacteria using fluorescent probes that recognise bacterial DNA.
We tested urine samples from elderly patients with recurrent UTIs by growing them in a petri dish high in sugars. Not only did this environment help protect bacteria from bursting, it also isolated the L-form bacteria that were present in these samples. In a separate experiment, we were able to see the whole process take place in living zebrafish embryos in the presence of antibiotics.
After the antibiotic was removed, the bacteria transformed back from L-forms to their regular form with cell walls. (Credit to Newcastle University, UK)
Importantly, our study shows that antibiotics need to be tested in conditions more reflective of the human body. The ones that are currently used in the medical laboratory don’t provide enough protection for delicate L-forms to survive.
Before we can fully understand how important L-form switching is compared to other forms of antibiotic resistance, further research using more patients will be needed. It will also be important to investigate what role L-forms may play in other recurrent infections, such as sepsis or pulmonary infections.
Until now, research into L-forms has been a controversial field, but our hope is that these findings will motivate more research into L-forms in disease situations. Our hope is that these findings will help find a way to clear these sneaky bacteria from our body. Combining cell wall active antibiotics with ones that would kill L-forms might be one solution of fighting antibiotic resistant infections.
Our battle with bacteria is ongoing. As we come up with new strategies to fight them, they come up with ways to fight back. Our study highlights yet another way that bacteria adapt that we’ll need to take into account in our continuing battle with infectious disease.
Mattman, an expert on spirochetes and the cell wall deficient form, isolated living Borrelia spirochetes in mosquitoes, fleas, mites, semen, urine, blood, plasma and Cerebral Spinal Fluid. She discovered that this bacteria is dangerous because it can survive and spread without cell wall (L shape). Because L-forms do not possess cell wall, they are resistant to antibiotics that act upon the cell wall. https://madisonarealymesupportgroup.com/2019/04/02/transmission-of-lyme-disease-lida-mattman-phd/
The evidence suggests the amount of antimicrobials used in food production internationally is at least the same as that in humans, and in some places is higher. For example, in the US more than 70% of antibiotics that are medically important for humans are used in animals.
This form of antimicrobial usage is likely to rise because of the economic growth, increasing wealth and food consumption in the emerging world.
When properly used, antibiotics are essential for treating infections in animals, but excessive and inappropriate use of the drugs is a problem.
A considerable amount of antibiotics are used in healthy animals to prevent infection or speed up their growth. This is particularly the case in intensive farming, where animals are kept in confined conditions.
Some suggest that stopping the use of antibiotics for growth promotion would be significant, particularly in lower-income settings, and would be unjustified without clearer evidence of the extent of the threat to human health.
In a literature review of published peer-reviewed research articles carried out as part of the report, only 5% of the 139 academic papers identified argued there was not a link between antibiotic consumption in animals and resistance in humans, while 72% found evidence of a link. The report’s authors suggest this supports a link and provides enough justification for policy makers to aim to reduce the global use of antibiotics in food production to a more appropriate level.
Some last-resort antibiotics for humans are being used extensively in animals, and there are no replacements currently on the way. This was illustrated by a recent study from China, which identified a gene responsible for colistin resistance in bacteria from livestock, also covered by Behind the Headlines.
There is concern over the potential for pollution from antimicrobial manufacture – for example, if untreated waste products containing high levels of end-products or active ingredients are discharged into water courses.
To correctly interpret the serological markers of Lyme disease, it is very important to determine the region’s infection rate. The aim of this study was to ascertain the prevalence of specific antibodies against Borrelia burgdorferi in a rural district in northern Spain.
METHODS:
The presence of IgG antibodies against B. burgdorferi was determined by qualitative enzyme immunoassay in the serum of 1,432 people divided into 3groups: 316 blood donors, 432 individuals who attended the hospital without infection and 684 for whom Lyme serology testing was specifically requested as part of a differential diagnosis. In the latter group, the presence or absence of an occupational risk factor was recorded.
RESULTS:
Antibodies against B. burgdorferi were detected in 189 individuals (13.2%): 16 (5.1%) in the blood donors group, 62 (14.4%) in subjects who attended hospital without infection and 111 (16.2%) in subjects in whom a differential diagnosis of Lyme disease was requested (p < 0.0001). In subjects with an occupational risk factor, the prevalence was 23.5%, peaking at 45.8% in men over 65 years.
CONCLUSION:
Our study showed a high prevalence of antibodies against B. burgdorferi and higher than that seen in other areas with similar characteristics in Spain. However, our results are similar to those published from other European regions. The prevalence in the blood donors group was lower than that observed in the other groups. Older age, the male gender and occupational risks were associated with a higher prevalence of Lyme disease.
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**Comment**
Please remember that tests which look for antibodies are insensitive – missing many who actually are infected. I was told by the most experienced practitioner in Wisconsin that some of the sickest patients NEVER test positive.
The organism doesn’t hang out in the blood but sequesters in tissues.
The question of what causes eating disorders has puzzled the medical community since “wasting disease” was first described in the 17th century. Today, researchers and clinicians agree that, in addition to psychosocial and environmental risk factors, there is a strong biological basis to these disorders. Now, new data from a Massachusetts General Hospital researcher suggests that exposure to common childhood infections, such as strep throat or bronchitis, may significantly raise a person’s risk of developing anorexia nervosa, bulimia nervosa and other eating disorders.
“Infections, by and large, have typical behaviors associated with them, and among those most commonly reported is loss of appetite.”
Results of the population-based study, published in JAMA Psychiatry, found that infections that required hospitalization or treatment with anti-infective medications, such as antibiotics, antifungals or antivirals, increased the risk of developing an eating disorder by as much as 39%. The multi-institutional study, which analyzed the health histories of more than 500,000 adolescent girls in Denmark, also found that recurrent infections and repeated treatment increased the risk.
Infections and Behavior
“Infections and inflammation more broadly have been recognized to play a role in psychiatric diseases like schizophrenia, but this has been less explored in eating disorders,” says Lauren Breithaupt, PhD, a clinical psychologist in the Mass General Eating Disorder Clinical and Research Program, and lead author of the study. “We’re hoping that a better understanding of the relationship between the immune system and disordered eating will help identify a mechanism behind the increased risk and biochemical changes we see happening.”
Lauren Breithaupt, PhD
As an observational study, the findings don’t point to a single cause or effect, but one possible explanation, according to Dr. Breithaupt, is that the infection or treatment of the infection disrupts the gut microbiome, which in turn alters the brain’s neurobiological reward system. Another possibility is the body’s own inflammatory response. Inflammatory proteins have been shown to cause changes in behavior, such as loss of appetite.
“Infections, by and large, have typical behaviors associated with them, and among those most commonly reported is loss of appetite,” Dr. Breithaupt says. “If you’re already at risk for an eating disorder, this period of no appetite could have a priming effect.” Although more research is needed, Dr. Breithaupt is encouraged the findings further enforce the biological nature of the disease.
Eating Disorder Stereotype
“Eating disorders have long been seen as social constructs — think of the stereotype of the wealthy white girl who isn’t eating because she wants to look a certain way,” says Dr. Breithaupt. “It’s taken a lot of evidence — more than most other mental illnesses — to blow that stereotype out of the water. We now know that the rates are similar across the world and across cultures. We’re even seeing that there may not be as big a gender discrepancy as we previously thought.”
Despite mounting biological evidence, there is still a great deal of confusion in the medical community about how to diagnose and treat eating disorders. Dr. Breithaupt is hopeful that the team’s findings can lead to increased awareness of the signs and symptoms and that more hospitals and treatment centers adopt a more scientific approach to treating these diseases.
The Role of Philanthropy
“The Eating Disorders Clinical and Research Program at Mass General offers gold standard evidence-based treatment for eating disorders, but we receive so many referrals per year that unfortunately we can’t treat every patient who seeks services,” she says. “That’s why philanthropy is so important to the growth of our program. The work that we do is often funded by individuals and families who have been touched by these diseases.”
The other key to advancing the understanding and treatment of eating disorders, Dr. Breithaupt says, is education.
“In order to identify biological markers, we need larger sample sizes and data sets, which requires individuals with the disorder to come forward and to participate in research,” she says. “By educating the public about the biology underlying eating disorders, we can break down barriers and overcome the stigma.”
To learn more about how you can support eating disorder programs and research at Mass General, please contact us.
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**Comment**
Great read and a fantastic reminder that eating disorders often have a biological basis.
In addition, Lyme can trigger a condition known as pediatric acute-onset neuropsychiatric syndrome (PANS) which in turn can also cause eating disorders. http://www.childrenslymenetwork.org/children-pans-pandas/ PANS, similarly to Lyme, still has not been accepted by mainstream medicine despite thousands upon thousands suffering from both.
Hypoglycemia can also be a player. And according to this article, insulin resistance “causes the body to have problems metabolizing carbohydrates into biological energy called ATP. This energy is essential in the production of feel good neurotransmitters such as serotonin. Thus without that energy the person may tend to feel depressed. The unabsorbed carbohydrates are converted to, first, glycogen and then into fat cells. Thus we find that depressed people may be overweight AND depressed. They are not depressed because of obesity, but because of insulin resistance!! (MedicalNewsToday 8 Oct 2009) See also Hemat.” http://www.hypoglycemia.asn.au/2011/eating-disorders-anorexia-and-bulimia/
The article has great advice if you suspect hypoglycemia is your issue:
“If you suspect that an eating disorder is related to insulin resistance (a pre-diabetic condition called hypoglycemia) then have this tested by a doctor. See How to test for hypoglycemia. If found to be positive, encourage your client to adopt the Hypoglycemic Diet.
For most people sticking to a regime of frequent snacks of high proteins (every 2 ½ hours), plus various vitamins and mineral – so as never to feel hungry – should supply sufficient energy from proteins to produce feel good neurotransmitters such as serotonin. This together with regular – but not excessive – exercises should prevent unabsorbed carbohydrates from being converted to fat cells! But keep in mind possible allergies and food sensitivities that may affect the digestive system.”
I knew a patient who was not over weight at all but due to severe hypoglycemia and hypothyroidism they developed eating disorders. When they adopted the hypoglycemic diet and began supplementing with natural thyroid hormone the eating disorders disappeared.
Please spread the word as many doctors will only continue to look at this as a psychiatric problem when there are often biological causes.
