May is Lyme Disease awareness months and I am thrilled to see various media outlets focusing on educating the public on vector borne illnesses. The recent New York Times Article published May 1st, 2018 “Tick and Mosquito Infections Spreading Rapidly, C.D.C. Finds,” touched on reasons why tick and other insect related diseases are on the rise. The article gives reasons such as climate change, increased surveillance by physicians, lack of vaccines and increased travel.
We are discussing more than just Lyme disease including “…tick borne diseases, … anaplasmosis, babesiosis, Rocky Mountain spotted fever, rabbit fever, Powassan virus and other ills, some of them only recently discovered” the article mentions.
Often when you hear about Lyme disease from friends, physicians or in the media, especially cases of Lyme that are refractory to treatment, one should consider that we are talking about a collection of infections such as those listed above.
In my clinical practice it is unusual to see a patient with just one vector borne illness. When I educate physicians and the public on these infections I always urge to check for Lyme and various other coinfections such as discussed in this piece.
One important infection that needs to be mentioned is Bartonella. It often causes significant neurologic and neuropsychiatric symptoms including encephalitis –inflammation of the brain, which can be subtle. This infection is very difficult to diagnose and often more difficult to treat then Lyme Disease due to its ability to evade the immune system by staying in intracellular spaces. Specialty labs are often required to diagnose Bartonella.
The New York Times article states: “For most of these diseases, there are no vaccines and no treatment, so the only way to fight back is through mosquito control, which is expensive and rarely stops outbreaks. Miami, for instance, was the only city in the Western Hemisphere to halt a Zika outbreak with pesticides.”
I find that one can treat these infections with great degree of success when they are all identified and treated at the same time. Therefore, coming up with the proper treatment plan entails:
Take extensive history
Perform physical exam
Methodically review past medical records
Order various blood work through multiple labs
Perform detailed neurologic work up
Furthermore, controlling the insect population and protecting recurrent re-exposure is the number one way we will prevent increasing number of tick borne diseases that can alter our immune system and intern lead to lifelong medical and neurologic disorders.
The three things that everyone should do to prevent tick bites are:
1. Protect your yard. 90% of people get exposure to tick bites in their yard. Therefore having a deer fence to decrease the number of wild animals coming into your yard is important. Spray your yard regularly with pesticides to reduce the tick population and use products such as tick tubes to decrease the spread of Lyme disease to ticks by field mice.
2. Protect your pets. Dogs can bring ticks into your home which will not only expose them to Lyme disease but will expose you and your family to it as well. Talk to your veterinarian about proper immunization / protection. Consider Vanguard and Simparica vaccines for your dogs.
3. Protect yourself. Wear insect protective clothing such as @DrFridKidswear (Instagram/Facebook) www.drfrid.com, which is tick protective clothing for kids ages 2-14 embedded with permethrin by Insect Shild technology . It is so important to protect children because in my clinical experience, recurrent re-exposure to tick bites is what leads to life altering chronic medical conditions. Tick checks after spending time outdoors is also recommended.
In good health,
ELENA FRID, M.D. ABPN, ABCN
ADULT AND PEDIATRIC LYME EXPERT
BOARD CERTIFIED NEUROLOGIST & CLINICAL NEUROPHYSIOLOGIST
151 E 62nd, STE 1A New York, NY 10065 | T: 212-288-8832
Dr. Elena Frid, a board-certified neurologist and clinical neurophysiologist who practices in New York City, is a member of the International Lyme and Associated Diseases Society. Her website is www.elenafridmd.com. Follow her on Instagram, Facebook, and YouTube.
Dr. Frid is a physician specializing in Lyme disease and sees patients with this condition - which is not universal among physicians. For more information about Lyme disease contact Dr. Frid
follow Dr. Frid on Instagram @drelenafrid.
May is Lyme Disease Awareness Month. To show our support and dedication to the prevention of Lyme disease and tick-borne illnesses, we have taken 30-50% OFF our DrFrid KidsWear apparel for the entire month of May. We want every child to have PROTECTION and SAFETY while enjoying the OUTDOORS.
LONDON UK - MAY 12th
PANDAS/PANS & ASSOCIATED DISORDERS
Join me and my colleagues for an afternoon of discussions on how some infections can trigger PANDAS/PANS and other brain disorders and find out the most common symptoms and the most common infectious agents. We will review the current testing methods and available treatments, present and analyse several case studies of patients, the advantages of using certain biomarkers, the reason these are selected and the information they provide for both the professionals and parents. The afternoon will include recently published scientific literature on these conditions.