When the 'Cure' Doesn't End the Pain
~ Beth Daley
~ Beth Daley
Some Lyme disease patients have symptoms that can linger for years despite standard treatment. Scientists are puzzling over how that can be.
Angry patients question treatment — or lack of it — yet with tests often inconclusive, some doctors think the condition is overdiagnosed. And the split is widening.
BITTEN BY UNCERTAINTY
The height of tick season generally brings a spate of scary stories about Lyme disease and other tick-borne illnesses, and this year's seem especially high on the heebie-jeebies scale.
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| John Johnson, Newser 11:37 EDT August 18, 2013 |
Lyme disease itself has long been confounding, but the Boston Globe today zeroes in on an especially vexing fact: About 25% of patients continue experiencing symptoms — debilitating headaches, sore joints, nausea, etc. — long after they finish the standard month-long treatment of oral antibiotics.
Medically speaking, they should be fine, but they're nowhere near it. Did the bacteria dodge the antibiotics and infiltrate the body's nervous system? Maybe the Lyme triggered a different illness? Should patients stay on antibiotics long-term?
Most specialists thinks the latter is a bad idea for a host of reasons, but it's the only relief for some patients, including the woman featured in the Globe story.
If Lyme sounds awful, it's nothing compared to the emerging threat of the Powassan virus. It is rarer — about 6% of ticks in New York's Hudson Valley were found to carry it in a recent study, compared to about 50% for Lyme — but far more lethal, reports the Poughkeepsie Journal. About a third of those afflicted die.
Last week, Sen. Chuck Schumer called on the CDC to launch a study of the Powassan virus and to expand research into all tick-borne diseases.
Powassan (POW) Virus Basics
Powassan (POW) virus is related to some mosquito-borne viruses, including West Nile virus. The virus is named after Powassan, Ontario, where it was first discovered in 1958. Two types of Powassan virus have been found in North America.
- One type of POW virus is carried by Ixodes scapularis (known as the blacklegged tick or deer tick), the same tick that transmits Lyme disease, human anaplasmosis, and babesiosis. The blacklegged tick is common in many wooded areas of north central, east central, and southeast Minnesota.
- Another type of POW virus is carried by Ixodes cookei, a related tick species that usually feeds on woodchucks or other medium-sized mammals instead of humans. I. cookei has also been found in wooded areas in Minnesota.
A tick needs to be attached to a person for a certain length of time before it can cause disease. This time interval is not known for POW virus, but it is likely much shorter than the time needed for Lyme disease (24-48 hours) or anaplasmosis (12-24 hours).
What type of illness is caused by POW virus?
- POW virus infects the central nervous system and can cause encephalitis (swelling of the brain) and meningitis (swelling of the membranes that surround the brain and spinal cord).
- Signs and symptoms of disease caused by POW virus can include but are not limited to fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, and memory loss.
- About 10% of patients reported with POW virus infection die from their infection, and long-term problems may persist among those who survive. However, it is possible that some people infected with POW virus experience milder illness or do not have any symptoms.
How common is POW disease?
Physician-diagnosed POW disease is very rare. From 1958-2010, fewer than 60 cases were reported in the U.S. and Canada. From 2008-2012, 21 cases of POW disease have been reported in Minnesota alone. These cases had either lived in or visited wooded areas in north central or east central Minnesota.
It is possible that other cases of suspected viral encephalitis or meningitis during times of peak tick-borne disease transmission (May to October) are due to POW virus.
When and where are people at risk for POW virus?
POW virus is found in northern parts of North America and northeast Asia. Initial laboratory testing during 2009 found blacklegged ticks infected with POW virus in parts of north-central and east-central Minnesota, areas highly endemic for other tick-borne diseases such as Lyme disease.
It is possible that people are at risk of infection with POW virus anywhere the blacklegged tick is found. The blacklegged tick is common in many wooded and brushy areas of north central, east central, and southeast Minnesota. This tick is most active from spring until mid-summer and again in the fall.
What is the risk of POW disease in Minnesota?
We believe that the risk of infection with POW virus in Minnesota is low. However, it is a very serious disease. MDH needs to gather more information on how many ticks are carrying POW virus in various parts of the state.
How can people protect themselves from POW virus and other tick-borne infections?
Repellents are important tools in preventing tick-borne illness. They are especially important in preventing POW disease because of its severity and likely shorter tick attachment time needed to transmit the virus. When spending time in wooded or brushy habitat in north central, east-central, and southeast Minnesota, people should protect themselves against tick bites by wearing repellents containing DEET or permethrin.
Other precautions include wearing long pants and light-colored clothing, staying away from the brush and woods, and doing thorough tick checks after spending time in the woods. These precautions are most important from late spring until mid-summer, and again in the fall months, when blacklegged ticks are active.
People should seek medical care if they develop fever, chills, rash, headache, body aches altered mental status, or other signs and symptoms of tick-borne illness after doing outdoor activities in these areas.
Questions/concerns?
Powassan (POW) Virus - Minnesota Dept. of Health
Powassan (POW) Virus. ... Share This; Frequently Requested Materials. Ticks Learn about blacklegged ticks (deer ticks) including their life cycle, feeding habits ...
Powassan Encephalitis - Infectious Disease Epidemiology ...
Powassan. Powassan (POW) virus is a flavivirus and currently the only well documented tick-borne transmitted arbovirus occurring in the United States and Canada.
ATLANTA (AP) — Lyme disease is about 10 times more common than previously reported, health officials said Monday.
/ AP Medical Writer / August 19, 2013
As many as 300,000 Americans are actually diagnosed with Lyme disease each year, the Centers for Disease Control and Prevention announced.
Usually, only 20,000 to 30,000 illnesses are reported each year. For many years, CDC officials have known that many doctors don’t report every case and that the true count was probably much higher.
The new figure is the CDC’s most comprehensive attempt at a better estimate. The number comes from a survey of seven national laboratories, a national patient survey and a review of insurance information.
‘‘It’s giving us a fuller picture and it’s not a pleasing one,’’ said Dr. Paul Mead, who oversees the agency’s tracking of Lyme disease.
Contributing sources:
http://www.bostonglobe.com/metro/2013/06/01/lyme-disease-rise-and-controversy-over-how-sick-makes-patients/OT4rCTy9qRYh25GsTocBhL/story.html
Lyme, tick-borne illnesses get even more terrifying:http://www.usatoday.com/story/news/nation/2013/08/18/newser-lyme-disease-tick-borne-illnesses/2668655/
http://www.bostonglobe.com/news/science/2013/08/17/huge-question-about-lyme-why-some-patients-report-lingering-symptoms/DP82z7oYLdfq8wEQZ7ekaL/story.html
http://newyork.cbslocal.com/2013/08/11/schumer-calls-for-more-research-into-tick-borne-diseases/
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