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Source: http://www.connpost.com/localnews/ci_9380479
Health experts say Lyme cases to soar
JENNIFER DUVAL
Article Last Updated: 05/26/2008 12:26:32 AM EDT
Headaches, joint pain, fatigue and fevers ? it may feel like the flu, but from May until August, risks are higher for Lyme disease to be the symptom-causing culprit instead.
According to the state Department of Health, Lyme disease, a bacterial infection caused by the bite of an infected blacklegged tick, can cause flu-like symptoms, and may be accompanied by a bulls-eye shaped rash surrounding the tick bite. In 2007 the Department of Health recorded 3,058 cases of Lyme disease in Connecticut; roughly one person in 1,000 was infected. This year's numbers could see a significant increase, according to Grace Kim, an infectious disease specialist at St. Vincent's Medical Center in Bridgeport. She said doctors have seen a "tremendous" increase in tick bites already this year.
"During the winter, many ticks will either die or hibernate," said Kim. "This year, we've had a relatively mild winter with no prolonged hard freeze, which is why, when it warmed up, the ticks were ready to go."
An increase in tick bites may or may not lead to more cases of Lyme disease. The Department of Health says that if ticks are removed within 24 hours of attachment, the chances of getting the disease from an infected tick significantly decrease. Often, however, tick bites will go entirely unnoticed until a patient complaining of fatigue and joint pain undergoes testing.
Randall Nelson, the public health veterinarian of vector-borne diseases for the state Health Department, suggests people send any ticks they may find on themselves to their local health department, which will then forward them for testing to the Agricultural Experiment Station in New Haven. Last year, however, only about 2,600 ticks were submitted, while there were more than 3,000 reported cases of Lyme disease.
"People don't always know they have been bitten," said Kim. "In many cases, the bites are in places where people don't see them, like behind the knee. They will have symptoms that may mimic the flu, and some people's skin may be too dark to see the light pink rash around the bite."
In an attempt to jump-start Lyme disease awareness in Connecticut, Gov. M. Jodi Rell declared May Lyme Disease Prevention Month.
Her announcement came only days after the Infectious Diseases Society of America and Attorney General Richard Blumenthal reached a May 1 settlement in an antitrust investigation into the IDSA's treatment guidelines for Lyme disease. The IDSA has agreed to create a new panel to review Lyme disease guidelines, particularly in relation to long-term treatment options for people who suffer from chronic symptoms.
"It's always good," said Kim, "to review and make sure we're doing something right, and this is an area that requires much more research into both the diagnosis and treatment processes."
Prior to the settlement, IDSA was accused by Blumenthal of having "improperly ignored, or minimized consideration of alternative medical opinion and evidence," because of undisclosed financial interests in Lyme vaccines, patents, and test kits.
The IDSA has publicly denied these claims in a statement on its Web site, calling the accusations "unfounded," as it reiterated its viewpoint that long-term antibiotic treatment of Lyme disease can be "ineffective, and expensive, and potentially harmful."
Doctors, however, said that while a long-term, or four-week course of intravenous antibiotics can be incredibly dangerous, it is occasionally necessary for patients with severe cases of Lyme, though the treatment should be used sparingly because of the risk of contracting sepsis, an infection of the bloodstream.
"You have to understand that I'm a specialist," said Kim, "so I get the more difficult cases and I probably prescribe intravenous antibiotics for maybe two patients a month ? those who are affected in the nervous system, heart or joints. The whole process is dangerous, and there is up to a 1 percent chance you can get sepsis, which is immediately life-threatening."
St. Vincent's, however, is known for its Picc Out Patient Service program. It was the first hospital in Connecticut to utilize ultrasound technology to insert the Picc lines used for receiving intravenous antibiotics.
"The Picc lines allow patients to have intravenous antibiotics once a day, usually for 28 days," said Donna Caserta, the nurse who heads up the POPS program at St. Vincent's. "It allows them not to be in the hospital 99 percent of the time."
Caserta said the program saves patients time because after they are trained by visiting nurses, they can administer antibiotics to themselves at home in as little as 10 minutes each day. The IDSA and much of the medical community, however, are still skeptical about the benefits of intravenous antibiotics for Lyme treatments.
"Those who rely heavily on it are definitely in the minority," said Kim.
While the antitrust settlement may make it easier for hospitals to gain approval for intravenous antibiotic treatment of serious Lyme sufferers and also ease the approval process making it easier for patient coverage, the previous standards will remain in effect until the IDSA has chosen a new board.
Health experts say Lyme cases to soar
JENNIFER DUVAL
Article Last Updated: 05/26/2008 12:26:32 AM EDT
Headaches, joint pain, fatigue and fevers ? it may feel like the flu, but from May until August, risks are higher for Lyme disease to be the symptom-causing culprit instead.
According to the state Department of Health, Lyme disease, a bacterial infection caused by the bite of an infected blacklegged tick, can cause flu-like symptoms, and may be accompanied by a bulls-eye shaped rash surrounding the tick bite. In 2007 the Department of Health recorded 3,058 cases of Lyme disease in Connecticut; roughly one person in 1,000 was infected. This year's numbers could see a significant increase, according to Grace Kim, an infectious disease specialist at St. Vincent's Medical Center in Bridgeport. She said doctors have seen a "tremendous" increase in tick bites already this year.
"During the winter, many ticks will either die or hibernate," said Kim. "This year, we've had a relatively mild winter with no prolonged hard freeze, which is why, when it warmed up, the ticks were ready to go."
An increase in tick bites may or may not lead to more cases of Lyme disease. The Department of Health says that if ticks are removed within 24 hours of attachment, the chances of getting the disease from an infected tick significantly decrease. Often, however, tick bites will go entirely unnoticed until a patient complaining of fatigue and joint pain undergoes testing.
Randall Nelson, the public health veterinarian of vector-borne diseases for the state Health Department, suggests people send any ticks they may find on themselves to their local health department, which will then forward them for testing to the Agricultural Experiment Station in New Haven. Last year, however, only about 2,600 ticks were submitted, while there were more than 3,000 reported cases of Lyme disease.
"People don't always know they have been bitten," said Kim. "In many cases, the bites are in places where people don't see them, like behind the knee. They will have symptoms that may mimic the flu, and some people's skin may be too dark to see the light pink rash around the bite."
In an attempt to jump-start Lyme disease awareness in Connecticut, Gov. M. Jodi Rell declared May Lyme Disease Prevention Month.
Her announcement came only days after the Infectious Diseases Society of America and Attorney General Richard Blumenthal reached a May 1 settlement in an antitrust investigation into the IDSA's treatment guidelines for Lyme disease. The IDSA has agreed to create a new panel to review Lyme disease guidelines, particularly in relation to long-term treatment options for people who suffer from chronic symptoms.
"It's always good," said Kim, "to review and make sure we're doing something right, and this is an area that requires much more research into both the diagnosis and treatment processes."
Prior to the settlement, IDSA was accused by Blumenthal of having "improperly ignored, or minimized consideration of alternative medical opinion and evidence," because of undisclosed financial interests in Lyme vaccines, patents, and test kits.
The IDSA has publicly denied these claims in a statement on its Web site, calling the accusations "unfounded," as it reiterated its viewpoint that long-term antibiotic treatment of Lyme disease can be "ineffective, and expensive, and potentially harmful."
Doctors, however, said that while a long-term, or four-week course of intravenous antibiotics can be incredibly dangerous, it is occasionally necessary for patients with severe cases of Lyme, though the treatment should be used sparingly because of the risk of contracting sepsis, an infection of the bloodstream.
"You have to understand that I'm a specialist," said Kim, "so I get the more difficult cases and I probably prescribe intravenous antibiotics for maybe two patients a month ? those who are affected in the nervous system, heart or joints. The whole process is dangerous, and there is up to a 1 percent chance you can get sepsis, which is immediately life-threatening."
St. Vincent's, however, is known for its Picc Out Patient Service program. It was the first hospital in Connecticut to utilize ultrasound technology to insert the Picc lines used for receiving intravenous antibiotics.
"The Picc lines allow patients to have intravenous antibiotics once a day, usually for 28 days," said Donna Caserta, the nurse who heads up the POPS program at St. Vincent's. "It allows them not to be in the hospital 99 percent of the time."
Caserta said the program saves patients time because after they are trained by visiting nurses, they can administer antibiotics to themselves at home in as little as 10 minutes each day. The IDSA and much of the medical community, however, are still skeptical about the benefits of intravenous antibiotics for Lyme treatments.
"Those who rely heavily on it are definitely in the minority," said Kim.
While the antitrust settlement may make it easier for hospitals to gain approval for intravenous antibiotic treatment of serious Lyme sufferers and also ease the approval process making it easier for patient coverage, the previous standards will remain in effect until the IDSA has chosen a new board.