collecte section Bourgogne

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la maladie de lyme est dangereuse mais on peut en guérir...mais il faut des années

Lyme disease is dangerous but curable

Seacoast cases have swelled over the past 10 years
A female deer tick.Courtesy photo
Lyme disease may be one of the most frightening, yet misunderstood diseases. It is often missed or misdiagnosed, sometimes for so long the effects can be devastating.
Lyme disease is contracted from the bite of an infected deer tick.

At a glance

Avoiding Tick Bites
Stay on trails outdoors: Avoid areas of overgrown brush and tall grasses. Wear light-colored clothes so ticks can be easily seen. Wear a hat, long-sleeved shirt and long pants tucked into boots or socks. Check yourself often for ticks. Use insect repellent containing DEET or permethrin (follow directions).
Removing an Attached Tick
Remove the tick promptly: The sooner you remove it, the less chance of infection. Use tweezers to grasp the tick's mouthparts at the surface of the skin. With a steady motion, gently pull the tick straight out. Wipe the bite area with an antiseptic, or wash with soap and water. Be alert for symptoms of illness over the next 7-10 days. Do not squeeze the tick. Do not rub petroleum jelly on the tick. Do not use a hot match or cigarette. Do not pour kerosene or nail polish on it. Wash immediately with soap and water, and if you suspect Lyme, save the tick in a jar to bring to the doctor's office.
"We have had a rapid increase of Lyme in the past 10 years," said Dr. Jodie Dionne-Odom, N.H. deputy state epidemiologist. "It peaked in 2008, at 1,300 cases. Currently, it is down to about 1,200 yearly reported cases. This only represents the documented cases. Some people are never reported."
The rate of N.H. cases is similar to other New England states. Dionne-Odom said cases are moving northward, with the greatest prevalence now being in the Seacoast.
"We do educational seminars for physicians and the community," she said. "Most primary-care doctors and pediatricians are well versed in the disease and its symptoms."
The trademark bull's-eye rash is usually present, but not always, and finding the infected tick right away makes the difference. Dionne-Odom said it takes 24 to 36 hours for the tick to regurgitate the contents of its stomach into the blood stream and that's where the bacteria live. Caught early, a short course of antibiotics is usually effective. She stressed Lyme disease is curable. Even if it crosses the blood brain barrier, IV antibiotic therapy can be used effectively.
"The problem is that many people do not recognize what they have, may not get the rash or see the tick," she said.
Ticks tend to attach to warm, moist areas, like the back of the knee, neck or groin.
"Undetected, the bacteria will cause organ or joint damage and those can be hard to repair," Dionne-Odom said. "Some people go years before diagnosed. Lyme encephalopathy, that cognitive damage to the brain, requires further testing to determine damage."
Katherine Lagassie, 18, of Maine, is struggling with college because of her Lyme disease. She was diagnosed as a high school freshman but she and her family, who all have Lyme disease, believe she contracted it at the age of 8.
"When I got sick, they at first dismissed Lyme because I never got the bull's-eye rash," she said. "I started going to doctors at the age of 10. I was always sick."
Lagassie was chronically exhausted. Her muscles ached so badly she could no longer ride her bike or swim in the family pool.
"At 10 years old, my back hurt so badly, I would have to lie on the floor," Lagassie said. "I was tested for everything — arthritis, even MS. I spent months at home, not being able to go to school. I just stayed in bed."
Finally, Lagassie said, in a last-ditch effort, a Kennebunk doctor tested her for Lyme disease. It was positive. Lagassie was treated with antibiotics and naturopath medications, 32 pills a day. Eventually, her diagnosis included a secondary infection, babesiosis, requiring a second type of treatment. She still takes myriad medications, designed to keep her immune system strong.
"If I crash, I don't come back easily," she said. "When I started college, I was pre-med. I had to adjust that because I could not handle the work load. I still plan to be in health care, but have lowered my sights to a less strenuous course of study. I had to arrange for extended test times, because of my cognitive difficulties. I sometimes get so anxious and paranoid, I can't recover information I know I have inside."
Brian Lagassie, Katherine's father, said that since the medical community often does not recognize chronic Lyme disease, insurance plans will not cover many treatments.
"At points, her treatments were costing $1,400 a month," he said. "Disability laws refuse her aid, because while she can't work, they refuse to acknowledge it. Face to face, you'd never know how devastating this is for her. Lyme disease patients are much where AIDS patients used to be. They are stuck in between, and the medical community needs to recognize the human side."
A common sign of Lyme disease is a red bull's-eye rash expanding rash 2 inches or more in diameter, which appears between three days and a month after the tick bite. People with Lyme disease might get chills and fever, headaches, or muscle and joint pain, and often feel tired. Early symptoms resemble the flu. They can come and go. Many people don't get the rash and may have false negative tests.
There are three stages of the disease. Stage 1 is localized, meaning the disease has not yet spread to the blood stream and the body. In stages 2 and 3, there are varying degrees of dissemination through the blood stream, with accompanying joints, muscles and organs affected.
If Lyme disease isn't treated properly, other signs can appear weeks or months after the tick bite. These include arthritis, numbness or paralysis, often in the face muscles, problems with heart rhythm and problems with memory or concentration.
The blood test for Lyme disease is called ELISA. If it is positive, a western blot test can confirm the diagnosis. A regimen of high doses of antibiotics is generally begun within 72 hours of the discovery of the tick.
Complicating diagnosis is that ticks can transmit other diseases simultaneously, including anaplasmosis and babesiosis. Symptoms can be similar, but both require different courses of treatment. If not recognized as parallel infections, treatment will be ineffective.
Dr. David Itkin is an infectious disease specialist and the epidemiologist for Portsmouth Regional Hospital. He said there is no scientific basis to support long-term symptoms people claim as being part of their Lyme disease.
"More I would say it's the way disease affects the person," he said. "For some, their immune system takes longer to recover. The symptoms are similar to chronic fatigue syndrome, and appear to be the after-effects of the disease, as the immune system rebuilds."
Itkin said there is also no documented evidence to say Lyme causes cognitive defects. The question is how to treat those patients who do seem to be suffering from an undefinable ailment.
"We now have a greater recognition of this disease as a moving target," he said. "Fifteen years ago, it was not here. It was in Ipswich, Cape Cod, but in the last decade it has been moving northward."
Testing for Lyme disease is not done routinely. Itkin said he'd be more likely to test based on presentation.
"A landscaper with the suspect symptoms is more likely to be tested than an 89-year-old man who lives in a nursing home and never goes outdoors," Itkin said. "Lyme does not present as respiratory problems, or with diarrhea. We need to rule out the obvious and test what fits as suspicious for the disease."
Some cases are more serious, requiring IV antibiotic therapy. Itkin said a Seacoast hospital recently treated a case of Lyme carditis, meaning the patient's heart had become involved.
Otherwise, a 14-28 day course of antibiotics is what he would prescribe for those with general symptoms such as Lyme arthritis.
David Hunter heads the Greater Manchester Lyme Disease Support Group. He said the group, started about four years ago, has more than 500 members from southern New Hampshire and Massachusetts.
"Twelve years ago, my daughter was diagnosed," Hunter said. "We lived in Connecticut at the time and she was in the eighth grade. When she was diagnosed, I thought it would be easy. Then she proceeded to miss high school. She was a number one student, soccer player, cello player, and she lost it all. So, I got involved. I was looking for answers and I found controversy. People in school, who should have supported her, said she had 'school phobia.' Suddenly her friends thought she was weird and they abandoned her."
Hunter's daughter is now 26. She still suffers symptoms but succeeded in getting her GED and graduating from the University of New Hampshire with high honors.
Hunter continues the support group, gives talks whenever asked and recently started a teen support group.
"Our meetings are always well attended," he said. "There are always people wanting to share their stories and get information. My mission is to make people understand."
To learn more about the support group, call Hunter at 660-3425.
At a glance
Avoiding Tick Bites
Stay on trails outdoors: Avoid areas of overgrown brush and tall grasses. Wear light-colored clothes so ticks can be easily seen. Wear a hat, long-sleeved shirt and long pants tucked into boots or socks. Check yourself often for ticks. Use insect repellent containing DEET or permethrin (follow directions).
Removing an Attached Tick
Remove the tick promptly: The sooner you remove it, the less chance of infection. Use tweezers to grasp the tick's mouthparts at the surface of the skin. With a steady motion, gently pull the tick straight out. Wipe the bite area with an antiseptic, or wash with soap and water. Be alert for symptoms of illness over the next 7-10 days. Do not squeeze the tick. Do not rub petroleum jelly on the tick. Do not use a hot match or cigarette. Do not pour kerosene or nail polish on it. Wash immediately with soap and water, and if you suspect Lyme, save the tick in a jar to bring to the doctor's office.