Well, it turns out that more than a few of our readers know that Borrelia burgdorferi is not the Italian chef that invented the hamburger! There were many thoughtful letters received from our readers in response to the articles on Lyme disease. I could not move on to another topic without first sharing some of these insights with the rest of you.
But first, however, I must offer a disclaimer (maybe I have been spending too much time with lawyers
): my base of knowledge is finite. (On second thought, I’ve never heard a lawyer make that statement!) A great deal of what I know about conditions such as Lyme disease stems from personal experience and information gleaned from sources such as the U.S. Center for Disease Control (CDC) website and the various medical journals to which I subscribe. While this literature is peer reviewed and generally based on sound research, it’s not infallible.
A common thread in the feedback we received was regarding the CDC map of Lyme disease distribution across the U.S. (found at www.cdc.gov). I guess more than a few of you who live in areas where the CDC says the risk of contracting Lyme disease is “little or none” have some personal experience refuting this claim! One of the problems with the demographics of disease is that accurate mapping relies on accurate reporting. It is entirely possible that the prevalence of a disease may be grossly misrepresented if it is not being reported. The CDC relies on reporting from physicians and laboratories, and physicians, in turn, rely on the CDC for information. It’s easy to see the inherent weaknesses of demographic statistics in this process.
Some of our sharp readers noticed that the illustrations in previous columns featured the common dog tick rather than the so-called “deer tick” or black-legged tick. There are good-quality pictures of both the black-legged tick and of Erythema migrans, the rash often associated with Lyme disease, on the CDC website.
[Editor’s note: Dr. Sayre did not select or review the illustrations for his column. The Court Report staff takes full responsibility for what were intended to be artistic, not scientific, illustrations of ticks in general, and we apologize for any confusion this created.]
There were lots of suggestions regarding the prevention of tick bites and the removal of ticks. One reader, a chemist and a scout leader, recommended the use of a compound commonly used on animals to treat tick infestation. It is called permethrin, and it can be obtained at many feed and garden stores. I instantly recognized this as the ingredient found in some over-the-counter treatments for head lice, as well as in the lotion commonly used to treat scabies. (It should be noted that permethrin in large doses is toxic to mammals as well and has been reported to cause lung cancer in mice.)
Finally, it was suggested that greater emphasis be placed on the need to avoid squeezing the body of the tick when removing the critter. In the Court Report July/Aug 2008 issue I stated, “The tick should be grasped as close to the skin as possible (using tweezers) and gently pulled straight up from the skin surface.” Truly, it is important to grasp just the head of the tick during its removal, to avoid injecting the Lyme organism subcutaneously. Some simple instruments are available to facilitate this process, including a device called the Tick Key, available for about $5 at thetickkey.com.
Some of the other issues raised by readers are beyond the scope of this column, but I appreciate all of you who took the time to write. It is my hope that this final article on Lyme disease has been helpful. As always, I welcome your feedback!