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Lyme disease usually responds well to antibiotics


Chico Enterprise-Record (Chico, CA) – Thursday, April 6, 2000

Author: LARRY MITCHELL – Staff Writer

Lyme disease shouldn’t scare Northern Californians, an expert on infectious diseases
 said in Chico on Wednesday.

It’s true Butte County is one of five places where most of California’s Lyme disease
has been reported lately, Dr. Chinh Le pointed out during a lecture to local health-care
 providers.

But people should be able to protect themselves against the disease, caused by the
bite of certain ticks, he said. And even if they should get the illness, only rarely is it
impossible to cure.

Le, a Santa Rosa physician who has worked on Lyme disease for the U.S.

Centers  for Disease Control, was guest speaker at a noon forum sponsored by the
Butte County Health Department and Enloe Medical Center.

He spoke to more than 100 health professionals at Enloe’s Esplanade Building.

He said new cases of Lyme disease almost always respond well to antibiotics. And
he said almost all chronic cases can be cured, also. He suggested some who think
they have chronic Lyme may in fact have other ailments, and they should explore that
possibility.

Le is chair for infectious diseases at Kaiser Medical Center in Santa Rosa. Sonoma
County and also Butte, Humboldt, Mendocino and San Diego counties have reported
most of the state’s Lyme disease cases over the last few years. Butte County leads
the state, with 89 cases since 1996. Humboldt is second, with 60 cases in that period,
followed by Sonoma with 54, San Diego with 32 and Mendocino with 29.

Butte County tops the list because of a “spike” of 53 cases reported in 1997. Since then,
the numbers have tapered off. Thirteen cases were reported in 1998, and 18 were
reported last year. So far, one case has been reported this year. This pattern repeats
what’s been seen in other north-state counties where Lyme disease is moderately common,
Le said. People will suddenly become aware of Lyme disease , and a bunch of chronic
cases will be diagnosed, he said. In following years, the numbers taper off.

Le and Dr. Mark Lundberg, Butte County’s health officer, noted chronic Lyme disease
remains controversial. Lundberg said local physicians feel compassion for those who
believe they have chronic Lyme . They also feel frustrated at being unable to help many
of these patients. Most of the cases reported in Butte County have been chronic – that
is, patients have suffered symptoms for a number of years before being diagnosed with
Lyme disease . Lundberg noted most local cases have been reported by a few doctors.

Asked about chronic Lyme , Le said although the Lyme bacterium can be tenacious,
he doesn’t believe it can survive onslaughts of antibiotics lasting several months. It
shouldn’t be necessary for patients to take antibiotics for a year, or years, he said.
He said in rare cases true chronic Lyme turns into an auto-immune disorder, which
keeps the patient feeling ill.

But in other cases, people who believe they have chronic Lyme probably have some
other ailment that ought to be addressed, he said. It’s a disservice if health-care
providers keep focusing on Lyme , when the patient really may be suffering from
multiple sclerosis or depression, he said.

Determining if someone has chronic Lyme should be quite clear-cut, he said. Tests
should turn up objective findings, such as memory loss, neurologic impairment and
antibodies in the spinal fluid.

In spring, the Western black-legged tick, which can carry Lyme disease , is most
active. Le recommended taking precautions. If you go hiking in brushy, grassy
country, go at mid-day when the ticks are less active, he said. Hike in the middle
of the trail, and wear light-colored clothing so it’s easier to see a tick if it gets on
you. Repellent may be helpful, he said.

As for the new vaccine, it appears to work, but long-term side effects are unknown.
For that reason, as well as the expense, probably only those who are frequently in
tick country should consider being vaccinated, he said.

It’s important to look for ticks after you’ve been out in nature and remove them if
you find them, he said. It’s probably useless to have a tick tested if you think it bit
you. A tick has to be embedded in your body for at least 24 hours to transmit the
disease . The best thing to do if you believe you’ve been bitten is watch for symptoms,
like the characteristic rash and a flu-like illness, he said. Then, a few weeks of
antibiotics will knock out the disease .

“You’re probably very safe in California,” Le said. In the West, Lyme ticks live in
native grass and brush. In the East, they inhabit those areas and also “suburban
landscaping.”