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Survival guide presentation online
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  • (“Healing Lyme” pg. 17 – Lyme spirochetes have also been found in biting flies, mites, fleas and , mosquitos. Transmission to humans has been documented from biting flies (Connecticut and Germany) and from mites (Russia) and is considered to have occurred from mosquitos through mechanical transfer – e.g. squashing a feeding mosquito.
  • During growth, L spirochetes shed “blebs” = granules of DNA plasmids – these bind circulating IgM & help evade immune detection e.g. like a plane releasing a spray of metal fragments to confuse radar readings – blebs are taken up by different human cells then CD8(=) cells actively kill those cells….speculation as to the autoimmune aspects of Lyme borreliosisWithin 24 hours of entering the Cerebral spinal fluid spirochetes encyst – When they are starved, they encyst and can do so within one minute.
  • Bb video – click to play
  • Accurate between 4% - 65% - better off to flip a coinPush your Dr to adhere to the guidelines of the PHAC and MOHLTC – you DO NOT need lab confirmation
  • Dr. Murakami states:There are two spots on the map that indicate BC and Ontario having recorded more cases, but I believe this is from my testing of patients from American labs and another physician, an infectious diseases specialist, in Ontario who is treating Lyme disease openly.
  • 2 explanations for this - that the Americans are wrong about the statistics from their CDC in Atlanta or 2) more onerous and neglectful, our testing methods are inadequate as are diagnostic acumen by the physicians of Canada.
  • Video trailer of UOS – click to start
  • Transcript

    • 1. A Lyme & Other Tick-Borne Disease Survival Guide Pests Protection/Education & Politics CanLyme, LAG, LDAO, ILADS, Murakami
    • 2. Bulletin EVENTS:Lyme/Walk Brampton ON, May 19th 2012 inChingaucousy Park on May 19, 2012 from 11a.m.–2 p.m. Registration forms available at www.lymewalkbrampton.ca Mark your calendars!
    • 3. LDAO Spring Meeting – Sat. May 5, 2012 The Fireside Room Compass Point Bible ChurchKerns Campus, 1500 Kerns Rd., Burlington 1:30pm - 3:30pm Speaker - John Scott Songbirds Disperse Lyme Disease Vector Ticks Across Canada John will be presenting the power point presentationthat he gave at the ILADS Conference in Toronto last October; based on his recently published scientific article.
    • 4. MAY is Lyme Disease Awareness Month Town of Caledon Month of May as “Lyme Disease Awareness Month 2012” Thanks to the support from Patti Foley, Regional Councillor Ward 5 for Bolton. BramptonMay 2012 will be declared “Lyme Awareness Month”!
    • 5. Lyme Action GroupAdvocacy – improved public policyPublic awarenessNot-for-profitPatient groupA.K.A - LAG
    • 6. Canadian Lyme Disease FoundationFederally registered charityPromoting● Research● Education● Diagnosis● TreatmentCurrent goal● Fund pathology research defining true prevalence in CanadaA.K.A - CanLyme
    • 7. Lyme Disease Association of OntarioSupport / information to Lyme patients & familyPublic awarenessConduct/publish research in scientific journalsNon-Profit Charitable OrgNext meeting in Burlington on May 5th 2012A.K.A – LDAO
    • 8. International Lyme and Associated Diseases Society• Non-profit, international, multi-disciplinary medical society• Forum for health science professionals to share their wealth of knowledge• Provides informational exchange amongst physicians who treat Lyme and other tick-borne diseases• Dedicated to diagnosis & appropriate treatment of Lyme & associated diseases
    • 9. • Advocate of and strongly supports physicians & health care professionals engaged in such treatment• Research and educationA.K.A - ILADS
    • 10. Dr. E. Murakami Centre for Lyme Research, Education & Assistance Society• Not-for-profit Corporation with charitable status• Provides unbiased, double blind, peer reviewed facts on Lyme and Co-Infections to those who need to know; doctors and patients alike.• Educates the people in the Medical Community• Supports Lyme patients and families• Works with governing bodies and assists in making permanent changes to our existing protocols for the diagnosis and treatment plans for Lyme in Canada.
    • 11. • Dr. Murakami is a true hero for the Lyme community and travels across Canada to educate the Public, Physicians & Natural Practitioners• Dr. Murakami offers FREE advice to both Physicians and patients alike: Phone 1-604-869-992 or by email www.erniemurakami@hotmail.com
    • 12. Pests Info “bite” (pun intended) - 800 species of ticks havebeen described - ticks occur with their hosts throughout the world
    • 13. Ticks in CanadaDeer Tick A.K.A Blacklegged Tick /Ixodes Scapularis● Not all are infected with Borrelia• Primary vector in Ontario• A two-year life cycle• Anti-freeze like compounds in bodies and can be found all year long... including wintertime● Also vector of Babesia, Ehrlichia, Bartonella
    • 14. Blacklegged Tick as a Nymph; the size most likelyto infect you as you are less likely to see it
    • 15. Western Blacklegged Tick Ixodes pacificusVector of:• Lyme Disease• Babesia• Ehrlichia• Bartonella
    • 16. Lone Star Tick Amblyomma americanumVector of: Female with• Lyme disease also called white spot on STARI or Masters‟ back disease• Ehrlichia• Q Fever• Tick Paralysis• Tularemia• Bartonella Male
    • 17. American Dog Tick Dermacentor Variabilis Vector of: • Rocky Mountain Spotted Fever • Ehrlichia • Tick Paralysis Female • Tularemia • Bartonella Male
    • 18. Rocky Mountain Wood TickDermacentor Andersoni. Vector of: • Colorado Tick Fever • Q Fever • Rocky Mountain Spotted Fever • Tick Paralysis • Tularemia • Bartonella
    • 19. This and Dermacentor Variabilis (2 previous slides) have been shown to carry Lyme but it is still under study as to their ability to pass it on to humans3.Dermacentor ticks may attempt to feed on an infected host(mouse, bird, etc.) enough to become infected with Lymebut be shooed off before the feed is complete. They thenmay complete their feed on a human host so it is theorizedthat there may be some level of transmission to humansby Dermacentor ticks.
    • 20. Brown Dog Tick - Rhipicephalus SanguineusVector of:• Q Fever• Bartonella Shown to transmit Rocky Mountain Spotted Fever to humans.  Shown to carry Lyme but it is still under study as to their ability to pass it on to humans3
    • 21. Ixodes Angustus - a competent vector inexperiment2.Ixodes dammini - it was shown to be the samespecies as Ixodes scapularis in 1993.Ixodes spinipalpis is implicated as a vector as well.Ixodes muris has shown to be a weak vector ofLyme disease and more research is needed.Even soft shell ticks can transmit borreliosis tohumans
    • 22. • Ixodes spinipalpis - implicated as a vector• Ixodes muris – shown as a weak vector of LD• More research is needed• Even soft shell ticks can transmit borreliosis to humans1 (CanLyme)Not enough research being conducted in CanadaANY Tick bite could be a serious life changing event
    • 23. *Download from www.lymeontario.org New Research - 1 Journal of Applied Ecology doi: 10.1111/j.1365-2664.2012.02112.x Predicting the speed of tick invasion: an empirical model of range expansion for the Lyme disease vector Ixodes scapularis in Canada Patrick A. Leighton1* Jules K. Koffi 2 - Yann Pelcat 2 Nicholas H. Ogden 1,2 L. Robbin Lindsay3 1 = Faculty of Veterinary Medicine, University of Montre´ al, 3200 Sicotte, C.P. 5000, Saint-Hyacinthe, QC J2S 7C6, Canada; 2 = Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Saint-Hyacinthe, QC, Canada; and 3 = Zoonoses and Special Pathogens Division, Public Health Agency of Canada, National Microbiology Laboratory, Winnipeg, MB, Canada
    • 24. Summary Points :• Previously projected range increases for I. scapularis based on temperature suitability, but to what extent this is matched by actual tick range expansion is unknown. I. Scapularis - Single tick species
    • 25. • Model projections suggest that I. scapularis range will expand c. 46 km/ year in the coming decade, with climate warming expected to increase the rate of spread. This expansion is likely to result in a substantial increase in human Lyme disease risk, with the proportion of the human population of eastern Canada inhabiting areas with established tick populations increasing from 18% in 2010 to over 80%by 2020.
    • 26. • Pg.2 (excerpt) No study has sought orprovided empirical support for theinfluence of either long or shortdistance dispersal mechanisms on thepattern of I. scapularis invasion excludes research by John D. Scott et al from 1994 to 2012 & other scientific researchers
    • 27. • Pg. 7 (excerpt) Establishment and growth of tick populations across southern Canada, where human populations are concentrated, is likely to result in a steep increase in human contact with ticks carrying Lyme disease and other tick-borne diseases.
    • 28. What Is Missing?• Not looking at other vectors-I. scapularis• Not looking at other hosts e.g. coyote, wolf, certain bird species, human• Not looking at other means of transmission e.g. congenital, neonatal (breastfeeding), sexual, blood etc• Relying on faulty testing to determine risk and partial infection rates due to faulty statistics based on positive tests only.
    • 29. Where is the public and medicalsociety‟s education on the“other tick-borne diseases”?
    • 30. New Research - 2 J. Parasitol., 98(1), 2012, pp. 49–59 F American Society of Parasitologists 2012WIDESPREAD DISPERSAL OF BORRELIABURGDORFERI–INFECTED TICKSCOLLECTED FROM SONGBIRDS ACROSSCANADAJohn D. Scott, John F. Anderson*, and Lance A. Durden - ResearchDivision, Lyme Disease Association of Ontario, 365 St. David St.South, Fergus, Ontario, Canada N1M 2L7. e-mail: jkscott@bserv.com
    • 31. Summary Points:• Tested12 known tick species and 3 undetermined tick species Ixodes affinis is reported in Canada for the first time Ixodes auritulus for the initial time in the Yukon• Ticks sampled from 42 bird species / subspecies
    • 32. • First records of 3 tick species co-feeding on bird species• New records of tick hosts; 2 bird species• The presence of B. burgdorferi in Ixodes larvae suggests reservoir competency in 9 bird species
    • 33. • Study results suggest that songbirds infested with B. burgdorferi – infected ticks have the potential to start new tick populations endemic for Lyme disease.• Songbirds have the propensity for short and long distance dispersal of attached ticks(Anderson and Magnarelli, 1984; Scott et al 2001; Reed et al 2003; hamer etal 2011)
    • 34. Because songbirds disperseB. burgdorferi-infected ticks outside their anticipatedrange, health-care providers are advised that peoplecan contract Lyme disease locally without anyhistory of travel
    • 35. History1883 – described in medical literature1921 – speculation about blacklegged tick involvement1975 – outbreak in Lyme, CT1981 – Dr. Willy Burgdorfer – Isolated bacteria under microscope – Borrelia Burgdorferi
    • 36. About Spirochetes• Over *300 different species are identified• Lyme causing spirochetes are “Borrelia”• 37 species of Borrelia spirochetes have been discovered• about 12 are associated with thecondition known as Lymedisease or borreliosis (Niscigorska-Olsen and others 2008). “Healing Lyme” by Stephen Harrod Buhner
    • 37. The Bacteria “Borrelia Burgdorferi”Borrelia - Survival Forms: • Spirochete • Cyst / Blebs/ Biofilm • Cell Wall Deficient Borrelia Cyst Form Spirochete
    • 38. BacteriaReal-time high resolution imaging (U Calgary, 2008)
    • 39. BacteriaImage 2 of 3 (bacteria exits blood vessel)
    • 40. BacteriaImage 3 of 3 (bacteria in surrounding tissue)
    • 41. About Borrelia Spirochetes• 3 main Lyme causing Borrelia• Burgdorferi – primary to USA / Canada. * There are over 100 strains in the US ILADS• Afzelii and Garinii – primary to Europe & Asia NOTE: ALL 3 exist on all 3 continents And multiple infections are common
    • 42. •9+ other B species cause “Lyme-type infection” againwith numerous sub-species• ALL grouped as “Borrelia burgdorferi sensu lato” = in the broad sense.•Do not like blood environment = oxygen
    • 43. Like highly viscous mediums • collagenous tissues • aqueous humor of the eye • organs such as the brain, heart bladder • synovial fluid of joints • the central nervous system (convert to cyst within 24 hr)
    • 44. • Slow reproduction = doubling in 12-24hr Since most antibiotics kill bacteria only when they are dividing, this longer doubling time necessitates the use of relatively longer treatment courses for Lyme disease
    • 45. • Can alter geno-type so offspring are better adapted to survive in new host• Long life span• Very hard to grow in laboratories; hard to research• The largest DNA replicons of any known bacteria
    • 46. Researchers at Rocky Mountain Laboratories where Dr.Burgdorfer discovered B burgdorferi 2001 report: that it contains at least six times as many genes as that of Treponema pallidum, the spirochete which causes syphilis
    • 47. • Findings of Casjens et al 2000 helped to explain decades of studies which have shown that mammals, whether human or animal, are unable to eradicate the spirochete even if their immune systems are completely intact Studies: Liang et al 2004a, Liang et al 2004b, Liang et al 2002, Seiler and Weis 1996, Dattwyler et al 1989
    • 48. How Borrelia Thrives and Persists• Ticksaliva inactivates our complement system the “innate immune system” borrelia use this weakened defense to invade host  enhanced further if host is already immune compromised
    • 49. Lyme spirochetes determine host DNA fromtick‟s blood meal, weave the DNA into theirstructure and from that DNA determine how toalter physiologically to survive host immunesystem.
    • 50. • Known as a “stealth pathogen” can exchangesurface outer protein for another, quickly and often, toevade the immune system and pathophysiologicalmechanisms“B burgdorferi, the principal organism associatedwith Lyme borreliosis, is one of the most complexbacteria known to man.”
    • 51.  as the immune system or antibiotics, recognizes & targets them they change with the same effect as a criminal changing appearance or clothing to avoid identification by police.
    • 52. • Highly sensitive to tiny chemical shifts • Good for them – food, sugars, fats • Bad for them – High oxygen concentrations So sensitive they can sense if a tick feeds on a host they are present in and if that tick is not infected they will go into blood stream and quickly relocate to new tick bite site
    • 53. Organism can burrow into and between healthybody cells, especially in the connective tissuesof the joints, and thus evade detection anddestruction by the immune system andantibiotics.
    • 54. • Can identify and adhere to different kinds of cells in host; specific ones to help them move to their preferred sites e.g. Moving to areas high in collagen (which they love) like joints, aqueous humor of the eyes, meninges of the brain, skin, heart tissue• They exchange information with each other
    • 55. They Hide in the Lymph NodesProfessor Nicole Baumgarth, an authority on immune responses at the UCDavis Center for Comparative Medicine."At first it seems counter intuitive that an infectiousorganism would choose to migrate to the lymph nodeswhere it would automatically trigger an immuneresponse in the host animal, but B. burgdorferi haveapparently struck an intricate balance that allows thebacteria to both provoke and elude the animals immuneresponse."
    • 56. • During growth, L spirochetes shed “blebs” Blebs = granules of DNA plasmids• These blebs bind circulating IgM antibodies & help evade immune detection  like a plane releasing a spray of metal fragments to confuse radar readings.
    • 57. Blebs are then taken up by different human cellsThen CD8 cells actively kill those cellsCausing speculation as to the autoimmuneaspects of Lyme borreliosis
    • 58. IMPORTANTTesting for Babesia, Anaplasma (a rickettsialbacterium), Ehrlichia and Bartonella (other tick-transmitted organisms) should be performedThe presence of co-infection with these organisms pointsto probable infection with the Lyme spirochete as wellIf these co-infections are left untreated, their continuedpresence increases morbidity and prevents successfultreatment of Lyme disease
    • 59. Other TransmissionLyme spirochetes have been found in: • biting flies, mites, fleas and, mosquitos • breast milk, tears, urine, semen, vaginal fluids OTHER tick-borne infections have been found to be transmitted via blood transfusions
    • 60. “The data demonstrate that B. burgdorferi can survive theblood processing procedures normally applied to transfusedblood in the USA. Since hematogenous spread of thespirochete seems to occur early in the illness, primarily insymptomatic patients, the risk of transfusion-associatedLyme disease may be small. However, the possibility ofsurvival of B. burgdorferi under blood banking conditionswarrants a heightened awareness of this potential problem.”Borrelia burgdorferi: survival in experimentally infected human blood processed for transfusion.SourceMeningitis and Special Pathogens Branch, Centers for Disease Control, Atlanta, Georgia 30333.
    • 61. DocumentedFrom biting flies (Connecticut and Germany)From mites (Russia)It is considered to have occurred from mosquitosthrough mechanical transfer e.g. squashing a feedingmosquito References in “Healing Lyme” Safe sex is advised
    • 62. New study highlights need for additional research on sexbased differences in the effectsof early Lyme disease.Study showed • Numerous symptoms reported more often by women than men • Women were less likely to seroconvert on the antibody testsStudy suggests • An immunological variation in response to Borrelia burgdorferi between women and menLauren A. Crowder, M.P.H of the Lyme Disease Research Foundation, LuthervillMD
    • 63. Dr Murakami states that men tend toremain asymptomatic and may in factbeinfected more than oncebefore becoming symptomatic
    • 64. Protection
    • 65. ProtectionKeep property grass cut shortWalk in center of pathways if availableAwareness of habitat (long grass, marshes)Established host populations e.g.deer, birds, rodents, coyote, rabbits
    • 66. "We sat on logs for only five minutes at a time, and in 30percent of the cases, it resulted in exposure to ticks," saidRobert Lane, professor in the Division of Insect Biologyat UC Berkeleys College of Natural Resources and leadinvestigator of the study. "It didnt matter if we sat onmoss or the bare surface; the ticks were all over the logsurface. The next riskiest behavior was gatheringwood, followed by sitting against trees, which resulted intick exposure 23 and 17 percent of thetime, respectively."The study, published in the current issue of the Journal of Medical Entomology, is the firstquantitative analysis of human behaviors that may increase the risk of tick exposure in Californiashardwood forests
    • 67. • Wear light-coloured clothing, long sleeves, pants tucked in, closed footwear• DEET-containing repellants or bio- friendly alternatives BioUD, Picaridin.• Wash & dry clothing – Dryer on high heat one 1hour
    • 68. Tick check!A full body examinationincludingarmpits, hairline, ears, navel,groin area, behind theknees, in between toesEspecially children!
    • 69. Natural Options• “Mosquito Barrier” yard sprayor similar product(made from concentrated garlic)• A DIY personal spray mix made from a blend of essentialoils e.g.lavender, citronella, cedar, eucalyptus, peppermint, lemongrass, rose geranium in almond oil & neem oil base.
    • 70. • Theraneem Organix “Neem Oil for Garden” sold at health food stores or online• Theraneem Organix“Herbal Outdoor Spray” Personal bug repellent• Pine Tar Soap – shavings in a spray bottle with warm water & shake until dissolved
    • 71. Plants: • Lavender • Citronella • Rosemary • Sage • Catnip • Pennyroyal • Rose Geranium • Mexican Marigolds • Marigolds • Calendula • and then Borage, chrysanthemums, cosmos, rue, and sunflowers are general pest repellant flowers
    • 72. Tick Removal DO NOT remove an attached tick using: Vaseline Nail polish Hot match / flame Ointment – Or other caustic fluid DO NOT squeeze the tick bodyDoing any of the above will cause the tick to regurgitate its gut contents
    • 73. Safe Tick RemovalFine Point TweezersGrip head/mouthpiece firmly snug against skinPull straight out – do not twistEnsure mouthpart is outMake note of: – Date/time – Where on the body – Area of outdoor activity
    • 74. Tick‟s Mouthpart / Hypostome
    • 75. Un-engorged Blacklegged TickFemale Blacklegged Tick feeding Engorged Blacklegged Tick
    • 76. Safe Tick Removal Intradermal blister technique ● Developed by Canadian Doctor Ernie Murakami of Murakami Centre for Lyme in BC ● Only in doctors officeAvailable to watch on youtube
    • 77. STRAW AND KNOT METHOD Developed by Dr. Murakami1) Ordinary drinking straw place it at a 45 degree angle with one open end over the tick (the straw is simply being used as a guide to direct the knot)2) Next, take a length of thread and tie a loose knot at the top or midsection of the straw.3) Slide your knot down the straw to the site. Position the knot underneath the ticks belly, so that the knot will encircle the embedded part only.4) Slowly tighten the knot to close snugly around the jaws5) Remove the straw and pull the thread in a steady upward motion. This will cause the tick to detach, without regurgitation. Available to watch on youtube.
    • 78. Safe Tick RemovalSpecialized removal tools● Camping supply storesSave tick for testing!!
    • 79. Save Tick For Testing!• Best option is a Physician removing tick• If you remove a tick – save it in an old pill bottle with a damp piece of paper towel• Either – Bring it to your Physician - Bring it to the Public Health DeptIt will be sent to the Parasitologist, CentralLaboratory, 81 Resources Rd., Etobicoke ON M9P3T1 * Request that it be tested for Borreliaand other tick-borne pathogens
    • 80. Document BitePhotograph a rash if present● Include ruler● Successive days to show expansion● Seek medical attention● Watch for subsequent rashes
    • 81. RashLess than 50% have rash; • 30-50% in Adults • Less than 10% of children • Sometimes single rash • Sometimes multiple rashes • Sometimes subsequent rashes months to years laterAtypical and Typical rash formations
    • 82. Typical Formation Bulls-eye • Only 9% of rashes are the “bulls-eye” type • Red circumference with central clearing • Often starts in 3-30 days – may start weeks to months later • Gradually expands and eventually disappears • Sometimes warm to touch
    • 83. Homogeneous• Has uniform reddish colour• Expands as Bb infection spreads• More people have this type than the bulls-eye
    • 84. Atypical Formation• Slides A & B • Multiple blotchy • Occur later as secondary rashes • Indicates dissemination of Bb•Slide C Painless bluish-red swelling or nodule on ear (more common in Europe)
    • 85. •Slide D – Acrodermatitis chronica atrophicans (ACA) • Bluish-red inflammatory lesions on extremities: buttocks, limbs, hands etc. • Develops slowly with wasting of skin (atrophy) Rash - Like hives (Not Shown)
    • 86. Fast Facts• Lyme is fastest growing vector- borne disease• 85% do not recall tick bite
    • 87. Some Early SymptomsRash, variety (less than half of patients)Flu-like illness (fever, chills, sweats, muscles aches,fatigue, nausea and joint pain) followed byintermittent illnessRinging ears, tremors, pain, arthritis, stiff neck,headacheSudden unexplained change in healthBell‟s palsyLab tests may be negative in the first 4-6 weeksAntibiotics can cause a false negative result
    • 88. Lyme SymptomsJoints and Musculoskeletal Symptoms Joint pain and/or swelling Stiffness of joints, back, neck Muscle pain, cramps Headache, persistent and severe Jaw painNeurological Symptoms Twitching of facial or other muscles Numbness and tingling Weakness or partial paralysis Light-headedness or dizziness Poor balance, difficulty walking Burning and stabbing pains
    • 89. Neurological Symptoms continuedRestless legsMemory loss (short or long term)Confusion (difficulty with thinking)Speech difficulty (slurred or slow, word finding)Seizures/stroke symptomsBlurry or double vision, sight changeSensitivity to light and flashing lightsSound sensitivityTinnitus (ringing)
    • 90. Psychological SymptomsMood swings, irritabilityUnusual depressionPanic/anxiety attacksAggression/rageObsessive-compulsive behaviorParanoiaSuicidal thoughts
    • 91. Respiratory/Circulatory SymptomsRecurring bronchial infectionsShortness of breathChest pain/rib sorenessHeart palpitations, murmurs, valve prolapse, heartattack
    • 92. Other SymptomsInsomnia or sleeping too muchNight sweats or chillsSwollen/painful lymph glandsLoss of sex driveChemical sensitivity/increased allergic reactionsSore throatWeight gain/lossSkin changes/nodules under the skin, drynessFull lists available in LDAO brochurewww.canlyme.com & www.ilads.org
    • 93. Fast Facts•25% of Lyme patients are children•50% have no history of tick attachment
    • 94. Children• Young children may not be able to explain what they are feeling• Children born with tick-borne infections (AKA congenital, in utero, transplacental) OR infection acquired as a neonatal, may not recognize symptoms as “abnormal”
    • 95. For example:If your knees have always hurt, you reallydon‟t know what it means for them NOT to
    • 96. Some “Red Flags” For Chronic Disseminated Lyme Disease & Other Tick-Borne Infections In Children• Frequent visits to Dr; has many, varied complaints• Symptoms that have eluded diagnosis• A high number of school absences• Is sick frequently, “comes down with everything that goes around”suspect immune suppression due to chronicinfection
    • 97. • Sudden changes of behavior; quiet child has become loud and aggressive, active child has become passive, happy child has become weepy and sad, calm child has started throwing fits and tantrums
    • 98. • A history of such diagnoses as • juvenile rheumatoid arthritis (JRA) • hypercholesterolemia • migraines • Crohn‟s disease • gastritis • maturation delay •Autism • attention deficit/hyperactivity disorder (ADHD) and learning disabilities.  especially a previous diagnosis of JRA if the child has also been diagnosed with ADHD and/or migraines.
    • 99. Child has history of symptoms that do not neatly fitinto any diagnostic category: • Low energy in the absence of anemia • Frequent urination in the absence of a urinary tract infection • Visual problems with a normal ophthalmologic exam
    • 100. • Stomach pains, vomiting and abdominal cramping without obvious pathology• Frequent fevers OR low body temp• Clumsiness• Frequent “growing pains” without typical symptoms• Insomnia unresponsive to the usual treatments
    • 101. Nurse/Dr „s Exam – May Notice• A tendency towards distractibility / hyperactivity• It is often difficult to get the child to stop talking or sit still long enough for vital signs to be taken• The child may be hypersensitive to touch and may wince when the blood pressure is taken
    • 102. • May avert their eyes to the light of an opthalmoscope or complain that the lights in the room are too bright• Reflexes may be so brisk that even brushing against the leg will cause the child‟s lower leg to kick forward
    • 103. Lyme Patients in GeneralBecome more vulnerable to other infections andhealth issues like:Mycoplasma, Brucelliosis, Leptospirosis, Yeast(Candida), Epstein Barr virus, H. Pylori, Chlamydiapneumoniae, Mold, Mercury toxicity....and more
    • 104. The exact role that other tick-bornediseases and opportunistic illnessesplay in the disease course is poorlyunderstood, and known treatmentoptions are not always effective.
    • 105. Misdiagnosis1.5 million Canadians suffer from diseases ofunknown origin (Health Canada – Stats Can 2010CCHS) e.g.● Arthritis● Fibromyalgia / Chronic Fatigue● Multiple Sclerosis (MS)● Lou Gehrigs Disease (ALS)● Alzheimers● Parkinsons● Crohns● Autism
    • 106. Dont waste time (Canada) Testing● PHAC Guidelines recommend treatment even in absence of lab confirmation● Flawed 2-tier protocol (ELISA / Western Blot)● ELISA false negative results common; 4-65% accuracy has been reported● New C6-Peptide but still with B31 Western Blot  in 25 years only B burgdorferi strain B31 has being tested for in humans
    • 107. • Specialized, accredited tick-borne illness labs(USA) with a good quality Western blotinclude: • IGeneX.com(California) • Glongen.com • mdlab.com (Medial Diagnostics Lab) Request free test kit & bring to Dr for blood requisition then overnight courier blood to lab with payment
    • 108. Why?Untreated Lyme is...● Debilitating● DegenerativeBest outcome from...● Early diagnosis● Prompt treatment
    • 109. Cases on the Rise (USA)Annual reported cases (CDC)
    • 110. Infections (USA)Reported Cases (CDC, 2010)
    • 111. Cases on the Rise (Ontario)Annual reported cases (Ont. Ministry of Health)
    • 112. Tick Prevalence (Canada)Ticks per human population (CMAJ, 2009)
    • 113. World Health Organization Global Prevalence Map Areas infested with Lyme disease (in red) are north and south of the 49th parallel. Note that Alaska, which is more northerly than most of Canada, is completely red, stretching below the 49th parallel and into the United States.
    • 114. Eurosurveillance Global Incidence Graph International studies of incidence of Lyme disease per 100,000• Canada is 0.115 per 100,000, contrasted with 36 per 100,000 for Czech Republic which is on a similar latitude as Canada• Canada averages about 6 cases per year, per province by the ELISA test, yet across the border every north central, north eastern states reports an average of 1,000 cases annually.
    • 115. Risk of Infection (USA) Infected tick populations (Yale Public Health, 2006) Map shows a sharp demarcation of diminished Lyme disease by the ELISA testCanada = 2 cases per million; total of about 80 cases in2008 per Public Health Agency Canada Immediately across the border 49th parallel there is in the USA, 70 cases per million
    • 116. Disease Comparison (USA)Approximate annual cases (CDC) West Nile Lyme Aids
    • 117. The US CDC has recently published 2008 cases of Lymedisease35,198 reported422,376 estimated actual cases(using an error factor of 12x)It is a well known fact that when the US has 422,376 casesthen Canada will have approximately 10% yet only 80cases are reported for the year 2008 by Public HealthAgency of Canada.The estimated actual cases in Canada must be over 40,000(Dr. Murakami)
    • 118. Disease Comparison (USA) Approximate annual cases (CDC)Due to faultytests, actual Lymecases estimated at400,000 cases peryear*Most endemicStates borderCanada West Nile Lyme Aids
    • 119. Politics
    • 120. IDSAInfectious Diseases Society of America● Treatment guidelines, 2006● Chronic Lyme doesnt exist (Post Lyme Syndrome)Antitrust investigation, 2008● Conflicts of interestNew guidelines review, 20092006 guidelines upheld, 2010
    • 121. “Cure Unwanted? Exploring the Chronic Lyme Disease Controversyand Why Conflicts of Interest in Practice Guidelines May Be Guiding Us Down The Wrong Path” American Journal of Law & Medicine 2012 The American Journal of Law and Medicine has stepped up and voiced their opinion on the situation surrounding Lyme and Chronic Lyme and faulty guidelines etc.
    • 122. AJLM Re: Antitrust investigation, initiated byRichard Blumenthal, 2008 • Findings deeply troubling • IDSA failed to conduct screening process for conflict of interest for its (Lyme) panel members • Pervasive conflicts of interest
    • 123. • Authors of guidelines had significant connections to drug companies, related patents and Lyme diagnostic tests• Several authors were paid by Insurance companies to corroborate treatment plans that denied treatment for chronic Lyme disease
    • 124. • Some received fees for acting as expert witnesses in medical malpractice suits related to Lyme disease  All stood to gain financially if the narrow definition of Lyme disease remained the same
    • 125. • IDSA acted with conflict of interest by enabling the panel chairperson (who himself held a bias against the existence of Lyme disease) to select a like-minded panel without any scrutiny by the IDSA oversight committee
    • 126. • Panel refused to accept potential panelists who believed in the existence of chronic Lyme disease – these panelists were told the panel was full - then the panel was later expanded• Panel excluded evidence of chronic Lyme disease
    • 127. Legislative SolutionsLyme doctor protection● California● New York● Rhode Island● Connecticut● Minnesota● MassachusettsNo such protection in Canada(or other US States)
    • 128. Canadian ExperienceDoctors persecuted for treating Chronic Lyme● Dr. P. Williams, 2004 (Ajax, ON)● Dr. E. Murakami, 2008 (Hope, BC) – More than 20 patients out of “permanent” wheelchairs● Dr. J. Krop, 2010 (Mississauga, ON)● Dr. H. Baghdadlian, 2011 (Toronto, ON)Common themes● Patient outcome is not a factor● Doctors put license at risk for treating Chronic Lyme
    • 129. Vancouver, British ColumbiaMarketwire – Jan. 20, 2008Canadian Lyme Disease Foundation: Feds say„NO‟ to access of Freedom of InformationRequest on Serious Health Matter; NationalSecurity Cited
    • 130. Positive DevelopmentsLyme and Tick-Borne Disease Research Center, ColumbiaU. Med. Center, NY (2007)Lyme Action Group (2008)Anonymous $0.5 million donation to CanLyme (2009)Dr. E. Murakami Lyme Society (2009)Ontario government Lyme awareness campaign (2010)New support groups taking political action
    • 131. Lyme Awareness (Ontario)Campaign fails to address flawed testing protocolFails to warn of all tick dangersFails to inform re: Alternate transmissions“Detected early, Lyme disease can be treated withantibiotics, curing most cases. Untreated, Lymedisease can begin to attack the central nervoussystem, the brain or the heart.”
    • 132. Lyme Awareness (Ontario)Chatham Public Health and Rondeau Provincial Park(2010)● Blenheim, ON
    • 133. Lyme Awareness (Ontario)Public Health Ontario (April 2012)● Update on Lyme Disease Prevention and Control – What testing problem? – Referenced outdated, minimalistic & exclusionary science – Beware of US tests – Chronic Lyme doesnt exist
    • 134. Political ActionLyme Action Group● Ontario Ministry of Health● Ontario Public Protection & Prevention● Canadian Blood Services● Ontario OmbudsmanCanLyme● Federal Ministry of Health● Public Health Agency of Canada● National Microbiology Laboratory (Winnipeg, MB)
    • 135. Local Action
    • 136. Canadian ActionSchmidt Report, BC (2010) - on Chronic Lyme Disease inBritish Columbia Schmidt Report Shows: *Tests are unreliable *Doctors not trained *Chronic Lyme being ignored *New BC clinic announced56-page document, obtained via FOI request by along-time Lyme sufferer.
    • 137. Political AwarenessSarnia-Lambton MPP Bob Bailey● Petition to Ontario Legislature● Endorsed by +100 municipalitiesNickel Belt MPP Frances Gélinas● Wall of Hope, Queens Park
    • 138. Media Coverage
    • 139. Books
    • 140. Multi-Award Winning Documentary Film• Exposes the hidden story of Lyme disease USA• Controversies of this fast growing epidemic• Thousands go undiagnosed or misdiagnosed each year• Follows the stories of patients and physicians fighting for their lives and livelihoods DVD copies available at www.underourskin.com
    • 141. Conferences
    • 142. A Lyme Disease Survival GuideBe informed!Be aware!Be warned! You are your own best advocate
    • 143. A Lyme & Other Tick-Borne Disease Survival Guide Thank you! Please visit us online www.canlyme.com www.lymeactiongroup.blogspot.com www.lymeontario.org www.ilads.org

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