Author Topic: Lyme disease  (Read 9164 times)

Callum

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Lyme disease
« on: June 26, 2013, 07:56:09 AM »
All of our team leaders at the centre need to be ever vigilant with the youngsters we are responsible for about their exposure to Lyme disease. So far none have contracted it but two of our instructors did and very unpleasant it was for one of them. Luckily, because we are vigilant about this disease it was spotted early in both of them and treatment was quick.

It is contracted via ticks, something we get a great deal of in the Lakeland Fells, so covering legs and arms is a must when tick numbers are at their peak and looking out for the following signs and symptoms:
•skin rashes
•headaches
•fevers
•depression

If it is untreated serious complications can arise.

So a feature on BBC R4 yesterday grabbed our attention, a trial is going on in Germany and Austria with a vaccine for this disease and initial results are very encouraging, according to the report is that it may be available in the UK within the next three years and it is something I most certainly will be encouraging all of our team leaders to consider.

Pete McK

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Re: Lyme disease
« Reply #1 on: June 26, 2013, 10:59:48 AM »
Is it easy to spot Cal and do you treat the tick bite if you have one on you?

Doubtless with the kayaking you also watch out for Weil’s disease, although I know the UK suffers less with this than many European countries.

boogyman

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Re: Lyme disease
« Reply #2 on: June 26, 2013, 08:17:50 PM »
If you react "rapidly" Lyme's disease is easy to treat -- with antibiotics.

BUT... the first recognizable symptom appears several weeks after the tick bite, in exactly the same place of the bite, and then:
- you have to remember you had a tick bite there
- the GP has to recognoze it as such
- and treat it immediately

Jan, an acquaintance of mine got a tick bite, his GP dismissed the symptoms as something different, and now since years Jan's life is hell -- and will never get better. Most days he has very much pain, some days are bearable. He's declared "disabled" forever.

Callum

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Re: Lyme disease
« Reply #3 on: June 27, 2013, 09:53:15 AM »
Some story Boogyman!

Pete, the death of Great Britain's double Olympic champion rower Andy Holmes MBE from Weil's disease – Latin name leptospirosis - really brought home the seriousness of this disease for canoeists and divers, or anyone who comes into contact with lakes and rivers, and we improved our procedures at the centre, which had been covering cuts, scratches or sores with a waterproof plaster and of course watching out for any symptoms, to now every participant showering after going out on the river.

captain paranoia

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Re: Lyme disease
« Reply #4 on: June 27, 2013, 05:47:18 PM »
We encountered a lot of ticks on a DofE bronze practice a couple of weeks ago, brushing through recent undergrowth.

I'm aware that infection can be very unpleasant, and I raised the risk assessment severity to 4 (serious injury) out of 5 (death) when I revised it last year, and added follow-up checks as a mitigation action.

http://www.bada-uk.org/learn/FAQ/faqborreliosis.php
« Last Edit: June 27, 2013, 05:49:34 PM by captain paranoia »

Callum

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Re: Lyme disease
« Reply #5 on: June 28, 2013, 06:05:14 AM »
CP I was not aware that there was a website dedicated to ticks, it is v. good, thx for the link :)

adi

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Re: Lyme disease
« Reply #6 on: June 29, 2013, 12:25:41 AM »
Lyme Disease is nasty, Hard to diagnose and hard to treat. I would put it on par with both TB and histoplasmosis, Which as you know I have had to deal with both. Lyme Disease is another Disease that the UK is lacking in knowledge of, diagnoses of and treatment of.

Here in the UK they once again rely on Blood tests for diagnosis, which is the same for TB and histoplasmosis but I can tell you these sort of diseases are sneaky little buggers and blood tests are not very effective. In France they test for Lyme's by taking a muscle biopsy which is considered a far better test. Here in the UK the treatment is with a long course of old style anti antibiotics, You have guessed it similar to TB and histoplasmosis. These drugs were developed back in the 50s and 60s and are very harsh often making the patent fill worse than they where before taking them. The dose is often for a long time. I see in the article above they say a 3 week course of drugs but in reality it is much longer. In most cases I know of the patents where on the same treatment pattern as I was with TB and histoplasmosis, which is a minimum of 6 months treatment.

Be aware of the sort of websites like the one posted, OK they are a registered charity but that is no means a test of there professionalism. Charities like this are often set up by ex suffers or headed up by Doctors that do not necessarily know the true facts and go on what medical journals or information from the net, which is often out of date. On the site posted I could not find any reference to any medical professional or body, that rings alarm bells for me.

Another alarm bell is this sentence taken from their permissions page. I quote "Special acknowledgements go to Gardensafari.net, Centres for Disease Control and Prevention (CDC), Derm Atlas, The State of Queensland (Department of Employment, Economic Development and Innovation), CSIRO Livestock Industries, Hilton Pond Centre, Dr Adam Smith, Jeff Hahn and H3D." Found here http://www.bada-uk.org/homesection/legal/Permission.php This again suggests that it is someone acting outside of the medical profession.

I will gladly put some limited information together when I have time and will add it to the first aid page. I say limited because good reliable information on Lymes is limited and hard to come by. I also say when I get a moment. This is the 3rd week I have worked 12 to 16 hours a day, 7 days a week preparing for late entry to have a booth at the Outdoor Show in Friedrichshafen, Germany starting on the 11th of July and I am only 2/3 of the way completed And once I have completed set up I will be in Germany for the 4 days running the booth by myself. And on return I need to start again for the Trade show up in the Lakes which the name of has escaped me then getting ready for the OTS. So once I get a couple of minutes over the summer I will post something but please be patent.         
« Last Edit: July 02, 2013, 12:41:04 AM by adi »
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

captain paranoia

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Re: Lyme disease
« Reply #7 on: June 30, 2013, 12:43:47 AM »
I don't think BADA underplays the problems of Lyme disease, or tries to say that treatment is simple, or that a cure is guaranteed.

BADA seem to be trying very hard to raise awareness of Lyme disease in the UK, where a common reaction from GPs is "we don't get Lyme disease in the UK".  The information may not be perfect, but it certainly isn't trying to make out that Lyme disease is nothing to worry about.

I'd certainly welcome any further, referenced information on better treatment regimes than those suggested by CDC or BNF.

adi

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Re: Lyme disease
« Reply #8 on: June 30, 2013, 01:02:05 AM »
I'd certainly welcome any further, referenced information on better treatment regimes than those suggested by CDC or BNF.

See this is where the problem lies. The CDC refer the reader to the USA and they say that treatment is normally swift which is true if reported early and treated early.

The BNF is a register of drugs and does not address conditions directly.

The official information is weak at best which is the same for many diseases. Medicine is very archaic in that if they find a treatment that works they continue to use it and stop looking for better treatments.

CDC info on Lynes can be seen here http://www.cdc.gov/lyme/   
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

adi

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Re: Lyme disease
« Reply #9 on: June 30, 2013, 01:32:40 AM »
Callum said he was not aware of a website for ticks, well there are a couple dedicated to lymes. they are

http://www.cdc.gov/lyme/
http://www.wadhurst.demon.co.uk/lyme/
http://www.bada-uk.org/


Then if you search lymes disease there are thousands of sites with medical information

And every body with a connection with the outdoors seem to have a page about it and most disturbing I have recently seen websites dedicated to baby well being and new mothers have started adding pages about Lymes.

Most of these sites just recycle information from other sites but my point is and if the reaction of GP's is we don't get Lymes here in the UK something is failing.   
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

Pete McK

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Re: Lyme disease
« Reply #10 on: July 01, 2013, 07:34:14 AM »
Adi, we have had to remove ticks, from walking through the local fells, and always do it with a tick remover (actually got it for our dog). Do you know what the best advice is to put on the small wound?

Lyle Brotherton

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Re: Lyme disease
« Reply #11 on: July 01, 2013, 08:10:33 AM »
The tropical medicine doctor who I consulted prior to my extended trip to the Amazonian Rainforest, advised me to carry Pfizer’s Chlorohexidine and Cetrimide Steritube, which is and antiseptic and detergent solution for small cuts and abrasions. I took a box; they contain 30mls ampoules and stain the area yellow so you can see where the solution has got to.

I replaced it with Savalon spray, because I like it’s pump dispenser to help flush out any debris in the wound BUT looking at the label it does not appear to contain the Chlorohexadine, so maybe I will go back to the more expensive Pfizer product AND Pete I don’t know if it helps with Lyme disease.

« Last Edit: July 01, 2013, 08:18:32 AM by Lyle Brotherton »
“Opinion is the medium between knowledge and ignorance” - Plato

adi

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Re: Lyme disease
« Reply #12 on: July 01, 2013, 05:32:45 PM »
Adi, we have had to remove ticks, from walking through the local fells, and always do it with a tick remover (actually got it for our dog). Do you know what the best advice is to put on the small wound?

My advice is to wipe the area with a sterile wipe before and after removing the tick but there is a caveat and that is do not touch the tick with the wipe. The reason is if the substance irritates the tick the tick will disengage. The problem with that is if the tick is irritated it needs to eject the contents of it stomach in to you to be able to disengage this is how most Lyme's is passed on. So clean the area away from the tick. Using a pair of iris forceps (the sort with a fine curve). Grasp the tick as close to your skin as possible being careful to avoid squeezing the engorged body. pull the tick out with out twisting.   As advised by the Liverpool School of Tropical Medicine and the London Hospital for Tropical Diseases.     

I have just checked the NHS choice and they advice much the same

Quote
Ticks

If you have been bitten by a tick (a small arachnid), remove it as soon as possible to reduce the risk of getting a tick-borne infection, such as Lyme disease (a bacterial infection that causes a rash).
To remove the tick:
Use tweezers, wear gloves or cover your fingers with tissue to avoid touching the tick.
Grab the tick as close to the skin as you can, and gently pull straight up until all parts are removed.
Do not twist or jerk the tick as you are removing it because this may cause the mouth parts to break off and remain in your skin once the tick has been removed.
Wash your hands with soap and water.
Using petroleum jelly, alcohol or a lit match to remove a tick does not work.
After the tick has been removed, clean the tick bite with soap and water or an antiseptic, such as an iodine scrub.
Do not scratch the bite because this will cause further swelling and increase the chance of infection. Most tick bites will heal within three weeks. See your GP if you develop:
a rash
a temperature of 38C (100.4F) or over (fever)
You may need antibiotics to prevent Lyme disease.

http://www.nhs.uk/Conditions/Bites-insect/Pages/Treatment.aspx

Please please do not use these. If you have them keep them for your pets only


I have seen doctors use these, I have seen them on Forestry Commission and Local Council posters telling people use one of these tools to remove ticks.

These tools were invented as a pet product, It has never been test on people by any medical testing organisation nor have any medical approval.

There is a suggestion as yet unproven that the best course of action might be to not remove the tick at all and let it do its own thing but that is only a theory with no scientific evidence.

Ok I best post an image of iris forceps for you so you know what I am talking about



Lifesystems have some tick removers that are very good, I have one and can recommend them but Iris Forceps are cheaper and are useful in the first aid kit for other things not tick related.   

« Last Edit: July 01, 2013, 05:45:23 PM by adi »
"We do not belong to those who only get their thought from books, or at the prompting of books - it is our custom to think in the open air, walking, leaping, climbing or dancing, of lonesome mountains by preference, or close to the sea, where even the paths become thoughtful." Friedrich Nietzsche

captain paranoia

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Re: Lyme disease
« Reply #13 on: July 01, 2013, 06:23:17 PM »
> but my point is and if the reaction of GP's is we don't get Lymes here in the UK something is failing.

Sadly, it appears something is failing in the UK.  That's why BADA exists; to try to educate GPs to the problems of Lyme disease.  Its FAQ section addresses the difficulties of getting a diagnosis (due to inadequacies in awareness and the diagnostic tests that exist), and the differing opinions on the best form of treatment, the difficulty of treating well-established infections, and the problems of after-effects of infection.  I have no connection with BADA (other than possibly buying my tick twister from one of their stands at a show), but their website seems fairly balanced to me, providing information on a fairly technical subject at a level that can be understood by most readers.

I've got two friends who both suffered long-term problems from Lyme disease, and had to undergo extensive, prolonged antibiotic therapy.  Fortunately, this therapy was eventually successful.  The level of treatment that is required seems to depend on the degree to which infection has become established; the disease may be caught early and treated with a shorter course of antibiotics

Whilst the CDC is indeed a US organisation, it has a worldwide remit, and has a worldwide reputation.  My (outdated) copy of BNF discusses both drugs and the conditions they are used to treat.

> Please please do not use these. If you have them keep them for your pets only

What is the problem with the tick twister, Adi?  It appears to be an effective way of removing ticks without squeezing the body, since the V-slot can be inserted cleanly between the skin and the tick's body. You say that it hasn't been medically trialled, but have tweezers been medically trialled as being suitable for removing ticks without encouraging infection?

captain paranoia

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Re: Lyme disease
« Reply #14 on: July 01, 2013, 06:28:55 PM »
BTW, you said this earlier:

"On the site posted [BADA-UK , I assume] I could not find any reference to any medical professional or body, that rings alarm bells for me."

I note that the charity President is Dr James Logan.  I'm assuming that this is the same Dr James Logan who is with the Department of Disease Control at the London School of Hygiene and Tropical Medicine:

http://www.lshtm.ac.uk/itd/dcd/
http://www.lshtm.ac.uk/aboutus/people/logan.james