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The Seattle Times 10 July, 2021 - 02:01pm 26 views

There’s a Vaccine for Lyme Disease. So Why Can’t We Get It?

New York Magazine 10 July, 2021 - 07:00am

It’s yet another frustrating aspect of this mysterious disease. One bite from a tiny, hard-to-detect tick can lead to a host of odd symptoms, including arthritis, serious cardiac issues, and neurological damage in the most severe cases. The disease is easy to treat once you get a diagnosis, but that can be elusive. And while work is underway to develop a new and better vaccine, it may take years to come to market. Here’s what we know about how the disease works, and what you can do to stay safe.

Lyme disease is caused by a bite from a deer tick, also known as black-legged ticks or Ixodes scapularis. The tick attaches by jamming a barb-lined spear into your skin, gluing itself in place with a sticky substance, and injecting a fluid into the wound that prevents the blood from clotting. That’s gross, but it’s not health-endangering.

The problem is when the parasite has itself been parasitized by a spiral-shaped bacteria called Borrelia burgdorferi or one of its closely related cousins. As the tick slurps up your blood, bacteria make their way from its gut to its salivary glands and then into your body.

For the Borrelia, this is a terrible tragedy. The bacteria was hoping to find itself was inside the body of one of its natural hosts: a mouse, bird, or deer. It has evolved to live inside these animals as a harmless passenger. “Through evolution, parasites come to an agreement with their hosts that they won’t harm each other,” says Sam Telford, a professor of epidemiology at the Tufts Cummings School of Veterinary Medicine who’s a leading expert on Lyme disease.

When a host animal is bitten by another tick, the bacteria will move on, and the endless dance will continue. But humans are a dead end: It’s unlikely that any human suffering the deeply uncomfortable effects of Borrelia infection will be wandering around in a woodsy habitat where it might get re-parasitized by another tick. So as nasty as Lyme disease is for us, for the Borrelia, it’s the end of the road.

After hatching out of an egg, the deer tick passes through three stages: larva, nymph, and adult. At each stage, the tick must find a new host and feed. Since when they hatch they are uninfected by Borrelia, larva can’t cause Lyme disease. And adult ticks are easy to feel and spot when they crawl on you, so they’re also unlikely to latch on and pass along the disease. The really dangerous vectors are the nymphs, about 15 percent of which carry Borrelia and which are so tiny — less than a tenth of an inch long, about the size of a poppy seed — that it’s very difficult to see them. Most people who come down with Lyme disease don’t notice that they’ve been bitten.

Tick nymphs are active in the spring, lurking in tall grass or shrubbery, waiting for a host to drop down onto. Since this time of year is also when human beings are most likely to be frolicking amid the greenery with lots of tasty exposed flesh, Lyme disease cases spike around now.

Compared to malaria, which is caused by single-cell organisms that can be seen teeming in each drop of blood under the microscope, Borrelia infects the human body in relatively low concentrations. In about three-quarters of all cases it causes a circular, itchy rash called Erythema migrans around the site of the original tick bite. Beyond that, it’s not clear exactly why the bacteria makes us sick. In many people, the infection doesn’t cause any symptoms. For the unlucky, the disease hits hard, with a suite of symptoms that includes fever, muscle aches, joint pain, nausea, and a general sense of feeling absolutely miserable. If left untreated, Lyme can lead to arthritis, neurological disorders like partial facial paralysis, or cardiac disease.

For me, the worst part was shooting headaches so intense they’d wake me up in the middle of the night. The constant pain made me so uncomfortable that my personality was changing: I became impatient, sullen, short-tempered. When my doctor’s office called to say that my test results had come back positive, I was elated: I knew that within a day or two of starting a course of antibiotics, I’d gotten a reprieve from a misery that otherwise could have dragged on until God knows when.

The first case of Lyme wasn’t discovered until 1975, when two mothers in Lyme, Connecticut, pressed for scientists to explain why children in their neighborhood were coming down with a form of arthritis.

A half-century later, Lyme disease is all over the place. The Centers for Disease Control estimates that as many as half a million Americans come down with it each year, and cases are reported in all 50 states, as well as in Europe and Asia. But it isn’t spreading, in the way that a disease like COVID spreads, by being passed from person to person. Instead, the bacillus has been there all along, weaving its way between tick and warm-blooded hosts. What’s different is that we’ve inserted ourselves into this ancient dance. “We’ve created the conditions over the last 40 or 50 years,” says Telford, by increasingly building housing in areas that were once forest or farm fields, allowing foliage to grow up of the kind that deer like to eat, and by stopping hunting that would otherwise keep deer populations in check. “There have always been little patches of vegetation that no one ever stumbled across,” Telford says. “With suburbanization these have grown up and spread.”

After Borrelia burgdorferi was identified in 1983 as the cause of Lyme disease, researchers went to work developing a vaccine, and in short order they found success. SmithKlineBeecham tested its three-dose LYMErix vaccine on some 10,000 volunteers and found that it was 76 percent effective, with no significant side effects. In 1998 the FDA approved it, and areas where the vaccine was widely administered showed sharp drops in Lyme disease.

In a perfect world we’d still be using LYMErix today, and hundreds of thousands of people might have been spared the disease, including me. But it was not to be. Within a year of the vaccine’s introduction, anecdotal reports began circulating about possible side effects. The media reported on the plight of “vaccine victims,” and a Philadelphia law firm filed a class-action lawsuit against SmithKlineBeecham. The furor prompted the FDA to review the safety data; it concluded that the concerns were unwarranted. But the damage had been done. Demand for the vaccine fell off so precipitously that the manufacturer simply pulled it from the market.

That’s not the end of the story, though. Pfizer has teamed up with the French pharmaceutical company Valneva to develop a new Lyme disease vaccine called VLA15 that will target a broader range of Borrelia subspecies, meaning that it will, hopefully, have a significantly higher overall efficacy. Currently undergoing phase 2 trials, the vaccine is unlikely to see approval before 2025.

Meanwhile, earlier this year a company called MassBiologics began phase 1 trials of a shot called Lyme PrEP that contains monoclonal antibodies against Borrelia. Unlike a vaccine, this doesn’t prod your immune system to take up arms against the invader, but instead delivers the antibodies that can kill the bacteria all by themselves. While the approach has been proven 100 percent effective in animal tests, according to the researchers, the work isn’t as far along as the VLA15 vaccine, so it’s probably further from approval.

Ticks have been called the dirty syringes of the animal kingdom, swapping infected blood indiscriminately among their hosts. So if Lyme disease were the only thing we could get from these vermin, we’d be lucky. But we’re not. There are a half-dozen or more other tick-born pathogens that can get passed on along with Borrelia, including Babesia microti and Anaplasma phagocytophila (both of which can cause fever and death). “When someone is diagnosed with Lyme disease they should at least be tested for other pathogens,” Telford says.

While waiting for new treatments to come along, your best bet is to take some simple precautions to avoid encountering Borrelia in the first place: Wear long-sleeved clothes when in tick habitat, apply DEET insect repellent, and check yourself for embedded ticks. If worse comes to worst and you come down with symptoms, talk to your doctor about getting tested. Antibiotics like doxycycline are highly effective against the disease even in its more serious later stages.

After all, says Telford, Lyme disease is a drag, but you shouldn’t let the fear of it ruin your life: “People should enjoy the outdoors,” he says.

Toyota announced Thursday that its political action committee would no longer make donations to Republican members of Congress who objected to certifying the presidential election results in January, after uproar over news that the automaker’s corporate PAC had supported those lawmakers at a higher level than other PACs.

“Toyota is committed to supporting and promoting actions that further our democracy,” the company said in a statement Thursday. “We understand that the PAC decision to support select Members of Congress who contested the results troubled some stakeholders. We are actively listening to our stakeholders and, at this time, we have decided to stop contributing to those Members of Congress who contested the certification of certain states in the 2020 election.”

Supporters of President Donald Trump overran the U.S. Capitol on Jan. 6, in large part to protest the certification of Joe Biden’s victory because Trump asserted, and they might have believed, that the election was “stolen.” The violent siege left five people dead, including a police officer; two other officers who were on duty that day later died by suicide.

How to prevent and remove ticks

KWCH 09 July, 2021 - 07:27am

Dr. Amy Seery says anytime you are in really grassy areas ticks can be a concern, she says it is the smaller ones that are the most dangerous because they carry the most diseases. To prevent them from latching on she says you can do these things:

Tuck long parks into socks, tuck your shirt into pants, have good footwear, and pretreat your clothing.

She says overall you just want to make it hard for the ticks to get to the skin and attach themselves. However, when you get home Seery says to check your skin surfaces closely. She also emphasizes checking your hair, because it can be on the scalp. If you do find a tick Seery says there’s a specific way to remove it.

“If you do see a tick using a pair of tweezers grasp at the base of the head and give it a gentle tug. If you do see any more parts of the tick it is a good idea to see your doctor to make sure any remaining parts are removed because it can be a point of infection,” said Seery.

Seery says if the area starts to get red, painful to the touch, or starts to ooze anything you need to go to your doctor immediately. She added do not use heat, fire, alcohol, or vaseline to try and remove ticks.

For your pets Christy Fischer from Wichita Animal Action League recommends getting a prescription from your veterinarian. She says the most common ones are Simparica or Nexgard which take care of fleas and ticks and lasts for 30 days. She says there is also Bravecto which lasts for 90 days. Fischer says to try and stay away from topical medications, because they just might not work. She says they can also cause a slight chemical burn to the skin on some animals. Fischer says if you notice a tick on your pet you can remove it with tweezers, and they even have special ones at pet stores you can buy as well.

”If your dogs and cats are not on some sort of flea and tick medicine it is important to check them frequently. Ticks tend to be around the ears, inside the ears, between the toe pads, but they can be anywhere on the animal. Ticks cause a number of tick born illnesses and those can be deadly without treatment,” says Fischer.

Fischer says another issue is that baby ticks can just hang on the fur of your pet, so even if they are on the oral medication she says you can take a lint roller and roll your pet before you bring them inside. She says that can help get them off their fur.

Never Skip a Shower After Being Outdoors Due to Ticks, CDC Warns

Best Life 09 July, 2021 - 07:16am

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Showering after doing this can prevent you from getting a multitude of diseases.

If you've been spending time outside, you'll want to take a shower as soon as possible after you come in. The CDC says that taking a shower within at least two hours of coming indoors has been "shown to reduce your risk of getting Lyme disease and may be effective in reducing the risk of other tickborne disease." According to the agency, showering can help wash off unattached ticks from and it also can be a time in which you can do a full-body tick check. You should be checking in and around your hair and ears, under your arms, inside your belly button, around your waist, between your legs, and on the back of your knees, per the CDC.

While it's a good idea to never skip a shower after being outdoors, you'll especially want to adhere to this safety guidance when coming in from a tick-infested area. According to the CDC, "ticks live in grassy, brushy, or wooded areas," but they can also be found on animals. "So spending time outside camping, gardening, or hunting could bring you in close contact with ticks," the agency says. The CDC adds that many people actually end up getting ticks just by being in their own yard or neighborhood.

Some parts of the country are more prone to ticks as well. According to the CDC's Tick Bite Data Tracker, the Northeast sees the most emergency department visits for tick bites, with 108 per 100,000 visits being tick-related. This area includes the following states: Virginia, West Virginia, Maryland, Delaware, Connecticut, Massachusetts, New Jersey, Rhode Island, Pennsylvania, New York, Vermont, New Hampshire, and Maine.

According to the CDC, a tick bite can lead to several different types of tickborne diseases like Lyme disease, Rocky Mountain spotted fever, Colorado tick fever, Tularemia, Anaplasmosis, and Powassan virus infection. Fortunately, the agency also says that many tickborne diseases can have similar signs and symptoms, so they're easier to spot. These include fever, chills, aches, pains, and rash.

"Early recognition and treatment of the infection decreases the risk of serious complications. So see your doctor immediately if you have been bitten by a tick and experience any of the symptoms described here," the CDC advises.

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