Apr 042012
This entry is part 1 of 1 in the series Lyme Disease in Groton

Deer tick and dog tick size comparisonNIH

2012 Could be a bad year for ticks and tick-born illnesses

As we reach the end of a mild winter here in Groton, entomologists are warning that the unseasonably warm winter is extending the season of activity for ticks. Several posters on Groton”s Talk About Groton email list have already noted they had been removing ticks from their pets or themselves all winter long.

And that is likely to mean a surge in reports of Lyme disease and other tick-born illnesses.

I”ve been dealing with this dreaded disease for the past five years on a personal level as it has affected my family, friends and neighbors and yes, my dog. This blog will eventually cover a range of topics including how to better protect yourself and your yard from ticks, what to do if you have been bitten by a tick and current resources for a wide range of information.

Many of you know that in its chronic form, Lyme disease is a controversial diagnosis. As we progress further with this page, I”ll provide information regarding both sides of the controversy and the two standards of care for diagnosis and treatment of persistent or chronic Lyme disease.

Public Health entomologist Richard Pollack spoke on public radio WBUR on March 8 explaining that the mild temperatures and no real snow pack this winter has spurred year round activity for ticks. Lack of snow could lead to a drier spring and summer -— a health hazard for deer ticks. Pollack added, however, that it was difficult to predict the tick population as it is so dependent on weather. Ticks thrive in warmer, moist environments.

Because Groton has been referred to as an endemic area for Lyme disease and other tick-borne infections over the last several years, more residents seem to have a keener interest in this topic, especially as we approach spring and begin spending additional time outdoors. For that reason, I”m working on the creation of a Lyme resource page in order to make current information more readily available. (I want to thank Art Campbell, publisher of The Groton Line, who encouraged me to move forward with this project.)

As tick-borne illness continues to reach more areas of the United States, Canada and the rest of the world, awareness is growing, as well. As a result, we”re beginning to see more research taking place than ever before and I”ll include further information regarding cutting edge research, as it becomes available.

My goal with these articles is to bring forward pertinent information and how it relates to us on a local level, whether it is specific to Groton, the Nashoba Valley, Middlesex County and or the Commonwealth of Massachusetts. For example, specific to the state level with local ties to Groton, two pieces of legislation have already been signed into law by Governor Deval Patrick regarding Lyme disease and other tick-borne infections.

In 2010, the physicians” protection bill, which was written to protect the freedom of Massachusetts doctors to treat Lyme disease comprehensively, according to their best professional judgment. That treatment may include extended antibiotic treatment beyond 30 days, if deemed necessary by the attending physician. It is hoped that the legislation would eventually encourage more physicians in the Commonwealth to treat patients with persistent Lyme symptoms as many of these patients have to travel to other states to seek further care. That legislation was initially sponsored by Groton”s then State Representative, Bob Hargraves, in 2009. Some 28 State Senators and Representatives joined Hargraves (Ret. R-Groton) as co-sponsors of this bipartisan legislation. Representative Hargraves was described by his peers as “relentless” in his drive to pass this law. Massachusetts was the fourth state to pass physician protection legislation. For a complete copy of the legislation, see http://lymepedia.org/massachusetts-lyme-disease-law/ .

Last June, in 2011, Governor Patrick signed a bill into law establishing a commission “for the purpose of investigating and studying the incidence and impacts in the Commonwealth of Lyme disease and other tick-borne diseases, including but not limited to anaplasmosis, babesiosis, bartonellosis, and ehrlichiosis.”

Formation of the commission is under way as appointees are being contacted. Originally, the commission”s initial report was to have been completed by next month. But due to a slow start up, the deadline for the report will be extended. The purpose of this group includes conducting a Lyme disease public health clinical screening study in high risk regions. Another important goal is to develop educational materials and training resources for detecting signs and symptoms of tick-borne illnesses in schools to be used by health care providers and school health personnel.

The commission will include three members of the State Senate and House of Representatives; the Commissioner of the Department of Public Health or a designee; the Commissioner of the Division of Health Care Finance and Policy or a designee, three members of local boards of health from different Lyme endemic areas of the state; the Director of the State Laboratory Institute or a designee; the State Epidemiologist or a designee; and four members to be appointed by the Governor, one shall be a physician specialized in infectious disease, one of whom shall be a professional member of the International Lyme and Associated Diseases Society, and two members who shall be considered experts in the treatment or research of Lyme disease. There shall be four public members, two of whom shall be patients or family members of patients; and two shall be members of Lyme and other tick-borne diseases organizations representing diverse regions across the state.

The legislation also seeks state-wide surveillance and testing for tick-borne diseases, while educating the state-wide medical community about all aspects of Lyme disease—both acute and chronic. The commission will investigate the viability of funding research through grants and federal funds, to determine the feasibility of citing a research facility in Massachusetts. Finally, the commission will review current mandatory reporting procedures to promote improved compliance. (Poor infectious disease reporting standards combined with current Lyme disease testing being often inaccurate, the Center for Disease Control has noted that Lyme disease cases may be under reported by a factor of 10.)

The original legislation to form the Lyme disease commission stemmed from an investigation lead by Representative David Linsky (D-Natick), chairman of the House Committee on Post Audit and Oversight. State Representative Sheila Harrington (R-Groton) was a member of that committee and also co-sponsored the original legislation to establish a Lyme disease commission. In the report from the Post Audit Committee, Linsky referred to Lyme disease as a “public health crisis” with over 4000 cases reported in the state (in 2009, the last year the official numbers were available prior to the report being generated). The complete report is available at http://www.malegislature.gov/committees/187/document/house/h46/lymediseasereport.

Additional Sources of Lyme Disease Information

Two Standards of Care for Lyme Disease