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Florida Lyme: Of Course It is Here!

I love Florida. It has much to love, including the fact we have less tick-borne illness than other states. But less does not mean none. I have seen cases of Lyme, mild America Babesia, Erlichia and other infections from different types of ticks diagnosed in SW Florida.

Some physicians and health officials assume Florida Lyme disease comes from travel to states in the North, which have very high Lyme rates. While I have seen patients catch it during a brief trip to Northern states, some caught it in Florida. They have not traveled North.

Below is Sample Evidence of Florida Lyme

Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) Tables (Morbidity) for Florida: As of week 52 of 2000 (ending December 30, 2000), 50 provisional case reports for Lyme disease in Florida were accepted and reported by the CDC for 2000. For 1999, 59 case reports for Lyme disease in Florida have been accepted and reported by the CDC. Including the 59 cases for 1999 and the 50 cases for 2000, the grand total of CDC reported Lyme disease for Florida, for the years 1982-2000, is 441 cases.

[Editorial comment from www.geocities.com/HotSprings/Spa/6772/florida-federal.txt -- These numbers are likely "the tip of the iceberg".]

Sources: CDC: MMWR Morbidity Tables - See Table II, part 2 for this year's reported cases of Lyme disease http://wonder.cdc.gov/mmwr/mmwrmorb.asp CDC provisional cases for Lyme disease for 2000 (week ending 30 December 2000 - see second image of Table II)

www.cdc.gov/mmwr/preview/mmwrhtml/mm4952md.htm CDC MMWR:Notice to Readers: Final 1999 Reports of Notifiable Diseases www.cdc.gov/mmwr/preview/mmwrhtml/mm4937a5.htm

Lyme Disease in the South

From Infections in Medicine®

David N. Reifsnyder, MD, Clearwater, Fla

Introduction

Dr Jerome Goddard's column on Lyme disease in the South is very timely.[1} All too often, physicians are led to believe that Lyme disease does not occur in the South. I am located in Clearwater, Fla, and have treated many patients for Lyme disease, a number of whom have acquired it in Florida.

In fact, the very second case of Lyme disease I ever saw, some 17 years ago, was acquired in Clearwater. A 23-year-old waitress who had not traveled outside the Tampa Bay area developed a flu-like illness with multiple lesions characteristic of erythema migrans [the bulls-eye rash—my insert]. Her symptoms were classic for early Lyme disease even though at that time there had been no reports of Lyme disease acquired in Florida. Nevertheless, I treated her with doxycycline, and her symptoms disappeared and her rash cleared promptly. Meanwhile, I had sent a sample of blood to Dr Allen Steere's laboratory for testing. The test came back with a positive IgM assay for Lyme disease. On further questioning, the patient remembered having a "mole" on her shoulder that she was thinking of going to the dermatologist about when it disappeared. This was probably a tick that had attached to her while she was gardening and had become engorged.

Subsequently, I have treated numerous individuals who have acquired their Lyme disease in Florida -- some on the East Coast; some in northern Florida (usually while hunting), Pinellas County, and Hillsborough County. Some of these have had positive blood tests, others have had only positive urine tests, and some have had negative blood and urine tests but have responded completely to antibiotics. [Italics and bold fonts in this paragraph are mine]

For the full article, of which this is a mere sample, log onto Medscape, and register in 2 brief minutes, and the article is free. The link for the entire article is: www.medscape.com/viewarticle/410165


Here are links to two other articles on Florida Lyme including a testimony by one of our East Coast mayors.


J Med Entomol. 1996 May;33(3):297-318

Ixodes (Ixodes) scapularis (Acari:Ixodidae): redescription of all active stages, distribution, hosts, geographical variation, and medical and veterinary importance.

Keirans JE, Hutcheson HJ, Durden LA, Klompen JS.

Institute of Arthropodology and Parasitology, Georgia Southern University, Statesboro 30460-8056, USA.

The blacklegged tick, Ixodes (Ixodes) scapularis Say, 1821, is redescribed, based on laboratory reared specimens originating in Bulloch County, Georgia. Information on distribution, host associations, morphological variation, and medical/veterinary importance is also presented. A great deal of recent work has focused on this species because it is the principal vector of the agent of Lyme disease (Borrelia burgdorferi Johnson, Schmidt, Hyde, Steigerwaldt & Brenner) in eastern North America. Its distribution appears to be expanding, and includes the state of Florida in the southeastern United States north to the provinces of Nova Scotia and Prince Edward Island, Canada, west to North and South Dakota, United States, and south to the state of Coahuila, Mexico. Although I. scapularis feeds on at least 125 species of North American vertebrates (54 mammalian, 57 avian, and 14 lizard species), analysis of the U.S. National Tick Collection holdings show that white-tailed deer, Odocoileus virginianus (Zimmermann), cattle, Bos taurus L., dogs, Canis lupus L., and other medium-to-large sized mammals are important hosts for adults as are native mice and other small mammals, certain ground-frequenting birds, skinks, and glass lizards for nymphs and larvae. This tick is a polytypic species exhibiting north-south and east-west morphological clines. Analysis of variance and Student-Newman-Keuls multiple comparisons revealed significant interpopulational variation that is expressed most significantly in the nymphal stage. Nymphs from northern (Minnesota, Massachusetts, Maryland) populations had relatively larger basis capituli with shorter cornua (except Maryland) than southern (North Carolina, Georgia) populations. Midwestern populations (Minnesota, Missouri) differed from eastern populations (Massachusetts, Maryland, North Carolina, Georgia) in idiosomal characters (broader scuta, larger coxae III, and IV). In addition to Lyme disease, this tick is also a primary vector of the agent of human and rodent babesiosis, Babesia microti Franca. Under laboratory conditions it has transmitted the agents of deer babesiosis, Babesia odocoilei Emerson & Wright, tularemia, Francisella tularensis McCoy & Chapin, and anaplasmosis, Anaplasma marginale Theiler. Moreover, I. scapularis can reach pest proportions on livestock, and females can cause tick paralysis in dogs.

PMID: 8667375 [PubMed - indexed for MEDLINE]


J Med Entomol. 1995 Jul;32(4):402-6

Evaluation of Ixodes scapularis, Amblyomma americanum, and Dermacentor variabilis (Acari: Ixodidae) from Georgia as vectors of a Florida strain of the Lyme disease spirochete, Borrelia burgdorferi.

Sanders FH Jr, Oliver JH Jr.

Department of Biology, Georgia Southern University, Statesboro 30460-8056, USA.

The ability of three common tick species from Georgia to maintain and transmit the causative agent of Lyme disease, Borrelia burgdorferi, was compared under laboratory conditions. A B. burgdorferi cotton rat isolate (MI-6) from Florida was selected as a strain from the south, and the SH2-82 isolate from New York was used as a positive control. Amblyomma americanum (L.) and Dermacentor variabilis (Say) did not transmit the MI-6 isolate from inoculated hamsters to naive laboratory mice, and nymphal ticks did not maintain this isolate transstadially. Ixodes scapularis Say transmitted both isolates to laboratory mice. There was a significant difference in the percentage of transmission of the two isolates. I. scapularis also transmitted the MI-6 isolate to two of three cotton rats. This study adds support to the premise that I. scapularis is probably the main tick vector of B. burgdorferi in the southeastern United States.

PMID: 7650697 [PubMed - indexed for MEDLINE]


Support and education group: www.lymenet.org

After you talk with some of these folks in this Lyme support and education group, I doubt any one will doubt the presence of Lyme in Florida. But perhaps I am biased. My dog got infected in Florida from a dog tick in my cozy development -- far from any forests.

Surprisingly, his simple titer was positive. One expert Lyme veterinarian told me that while the ELISA titer is junk in humans, it is a little better in dogs. The common human test used on most people, is more reliable when used on a hound. What more is there to say?

To Your Health!

Dr. J



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