50 Frequently Asked Questions & Answers

1. Is Lyme disease caused by a virus, bacteria, or a parasite?

Lyme disease is caused by a spirochetal bacteria.

2. Who is the doctor that identified the spirochete that causes Lyme disease?

Dr. Willie Burgdorfer identified the spirochete responsible for Lyme disease
 (Borrelia burgdorferi) in the early 1980's.

3. How long after a person is in contact with an infected source will Lyme disease symptoms appear?

Lyme disease symptoms may appear days, weeks, months or years after the initial infection.

4. How many species of ticks carry the Lyme disease spirochetes?  

At least nine species of ticks, six species of mosquitoes, 13 species of mites, 15 species
 of flies, two species of fleas, and numerous wild and domestic animals (including 
rabbits, rodents, and birds) have been found to carry the spirochete that causes Lyme 

5. Does a "bulls-eye" rash go away without treatment?

A Lyme rash (ECM) will often disappear on its own without treatment, but it may 
linger for quite some time. It may reappear later as a single rash or emerge as multiple rashes.

6. Does a Lyme rash occur at the site of the bite or elsewhere?

The ECM rash may appear at the site of the tick bite or elsewhere on the body. Not
 everyone will get a rash (approximately 50%) and some people will have multiple rashes.  Less than 10% of children get a rash.

7. If prescribing doxycycline for a tick bite, what precautions should be advised while
 taking the medication?

Patients should be advised that taking doxycycline may cause sun sensitivity. 
Doxycycline should not be taken with milk or other dairy products since these
 products may inhibit absorption of the antibiotic.  Doxycycline is not recommended
 for children since it may cause discoloration of their teeth.  Doxycycline may also
 promote yeast and fungal overgrowths which should be prevented and addressed if they occur.  Nausea,
 vomiting, and diarrhea are some of the possible side effects of Doxycycline.  

 control pills may not be as effective while taking Doxycycline and additional
 precautions to prevent pregnancy may be necessary.  Doxycycline should not be taken 
with antacids or supplements that contain calcium, iron, magnesium, or sodium
 bicarbonate.  Doxycycline use may cause liver problems or bruising.  People taking
 Doxycycline should be advised that severe allergic reactions may occur and if there 
are any problems while taking Doxycycline, they should be reported to the doctor.  For more information please check with your doctor or pharmacist.

8. What tick borne diseases have been detected in patients?

Lyme disease (Borrelia burgdorferi), Anaplasma phagocytophilum (HGA), Babesia microti, Babesia duncani, Bartonella henslea, Bartonella quintana, Bartonella elizabethae, Rocky 
Mountain Spotted Fever (Rickettsia rickettsii), Rickettsia montanensis, Brucellosis, Ehrlichia chaffeensis (HME), Southern
 Tick-Associated Rash Illness (STARI), Morgellons, Tularemia (rabbit fever)- and possibly
 Leptospirosis are some illnesses that may be passed to animals or 
humans by ticks and other vectors.

9. If a patient previously had Lyme disease and is bitten by another infected tick, are they immune to Lyme disease?

No, they are not immune.  Multiple bites may expose people to a number of other
 tick borne diseases in addition to the same or new strains of Lyme disease.

10. Is a lumbar puncture required to confirm neuro-Lyme? Why?

No!  Lyme disease, as stated by the CDC, is a "clinical diagnosis". Research 
indicates that less than 20 percent of people with Lyme Disease have shown a positive 
reading when testing spinal fluid.

11. What are the most common diseases that are often mistaken for Lyme disease?

There are many different diseases or conditions that are found in patients with
 Lyme disease.  All too often Borellia organisms are not considered as the
 source for patients complaints and their symptoms.  For example, an
 ophthalmologist may diagnose any of the following conditions: conjunctivitis, ocular
myalgias, keratitis, episcleritis, optic neuritis, pars planitis, uveitis, iritis, transient
or permanent blindness, iritis, photophobia, temporal arteritis, vitritis, Horner's
 syndrome, ocular myasthenia gravis, or Argyll-Robertson pupil which may or may not be Lyme or tick borne disease related. All of the
conditions listed above have been documented in Lyme disease patients and many of these 
diseases or conditions improve with proper antibiotic therapy.  

Urologists, for
 example, may not realize that recurring bladder infections or swollen testicles can be caused by spirochetal organisms.  Infectious Disease specialists often dismiss
 patients concerned about Lyme disease because many are under the assumption that 
Lyme disease is very 'rare' and/or they are not familiar with the various signs and
 symptoms of the disease due to their limited definition of it.

Lyme disease can be misdiagnosed as: 
Chronic Fatigue Syndrome, Multiple Sclerosis, Alzheimer's, Parkinson's disease,
 Lupus, Lou Gehrigs (ALS) disease, Guillian-Barre Syndrome, Polymyositis,
Hepatitis, cardiac disorders, fibromyalgia, TMJ, ringworm, Tullio phenomenon, 
encephalitis, ADD, ADHD, meningitis, depression, panic disorders, Bell's palsy,
 candidiasis, chronic mononucleosis, hypoglycemia, scleroderma, Epstein Barr
virus, autoimmune diseases, Bannwarth's syndrome, various cancers, 
kidney disease, Raynauds syndrome, stress-related illnesses, sleep disorders,
 thyroid problems, vasculitis, anorexia, agoraphobia, cerebrovascular disorders, 
arthritis, connective tissue diseases, hearing disorders, Crohn's disease, purpura,
 pseudotumor, Sjogrens syndrome, stroke and respiratory insufficiency.

12. If a person has an EM rash and a negative ELISA test should they be treated for Lyme? How?

Yes!  An EM rash alone is diagnostic for Lyme disease.  Current guidelines approved by 
ILADS (International Lyme and Associated Diseases Society) recommend oral
 therapy for at least 6 weeks for both adults and children when a rash is present. 
 Lyme patients who are pregnant have special recommendations to help protect themselves 
and their unborn child.  According to the CDC, Lyme disease is a "clinical 
diagnosis" and negative tests are not to be used to rule out the disease.

13. Are there any studies or literature on Lyme disease? 

There are over 18,000 published medical studies, abstracts, videos, websites, educational articles and brochures concerning Lyme and other tick borne illnesses.  

14. How many different strains of the spirochetes have been
identified to date in the United States and world wide?

Eight different species and over three hundred strains of spirochetes that cause 
Lyme disease and Lyme-like symptoms have been identified world wide.  To date, more than 100
 different strains have been identified in the United States.

15. What is STARI?

STARI is one strain of spirochete (over 300 known) that was discovered in ticks and humans in the southeastern sections of
the United States within the past few years.  It causes Lyme-like symptoms, but is not
 normally detected by the current standard Lyme tests. STARI (Southern
Tick-Associated Rash Illness).

16. What is WA-1 or Babesia ducani?

WA-1 (Babesia ducani) is a recently identified strain of Babesiosis found infecting a number of 
people who also have Lyme disease.  There have been tests
 developed to identify this specific strain in humans, but the tests are not performed at
 all labs.  To test for this strain of Babesiosis, physicians should have blood sent to quality labs specializing in tick borne disease detection, such as Igenex Lab in Palo Alto, CA.  A growing number of patients have been diagnosed with this Babesia strain that was originally described as a "west coast" strain when it was detected in Washington state patients.  It is now being detected in many east coast patients.

17. Approximately how many Lyme disease patients are co-infected with Babesiosis?  What is the most effective treatment for Babesiosis?

Estimates from labs, support group leaders and doctors offices indicate that 
approximately 25-50 percent or more of patients with Lyme disease are also co-infected with Babesiosis.  Unfortunately, many patients are never tested so the 
numbers may be even higher.

A combination of Atovaquone (Mepron-750 mg. 2x daily) and Azithromyacin 
(Zithromax- 250- 500 mg day) is considered to be the best known treatment for Babesiosis at this time, with a duration of several months in some patients.  Some
 patients may need extended treatment or need to be retreated if symptoms persist or return.  The Mepron/Zithromax protocol is reported to be less toxic than 
the quinine sulfate and clindamycin combination that was once used and there are
 fewer side effects reported with this treatment.

18. What percentage of people with Lyme disease remember having a rash or remember 
being bitten by a tick?

Various studies show that anywhere from 20-80 percent of seropositive Lyme
disease patients with active symptoms do not recall a rash.  Less than 50 percent of 
Lyme patients remember being bitten by a tick.  Children experience a Lyme rash less than 10% of the time.

19. After a person is bitten by a tick, how soon is it before the spirochete can be found in the spinal fluid?

Reports indicate spirochetes can disseminate quickly through the body (in as 
little as 4 hours in some cases) and it has been detected in the brain within 24 hours of exposure.  In addition, spirochetes are able to change forms and 
remain undetected.  The old 'wait and see' if symptoms appear
 before treating theory allows the organism to go unchecked, causing multiple
 problems.  Late treatment also decreases the chance for a full recovery.

20. What signs and symptoms would lead a doctor to suspect a Babesia infection in a
 patient?  How many strains of Babesiosis have been identified and how many are
 commonly tested in commercial labs?

The following signs/symptoms may be present in those infected with Babesiosis:
 fatigue * arthralgias* myalgia* drenching sweats* headaches* emotional
lability* depression* dark urine* splenomegaly* dizziness* nausea and 
vomiting * cough * dyspnea* fever* chills* hepatosplenomegaly* jaundice* 
malaise* shortness of breath* bleeding tendencies*, bruising* thrombocytopenia* 
hemoglobinuria* hyperesthesia* pulmonary edema* encephalopathy* low to
 normal range leukocyte counts* possible elevated levels of dehydrogenase,
 bilirubin, transaminase* anorexia*

Approximately 25%- 66% of Babesia patients have been reported to be co-infected with 
Lyme disease. The symptoms may continue for long periods of time, subside,
 then return.  A low Babesiosis titer (IgG) often indicates a chronic infection.  An
 acute or current infection may show a higher reading on the IgM test initially.
  There are over 100 species of Babesia in the United States, but only ONE or TWO
 species are currently detected by commercial labs.

21. What does the typical Lyme rash look like?

There is no "typical rash" that all patients get when infected with Lyme disease. 
Many people do not remember a rash, or even a tick bite.  If a rash does appear, it 
may range from a light pink color to blazing red, to blue, to purple depending 
on the skin color, the type of rash and possible co-infections.  The ECM rash can be
 as small as a quarter, be present in several locations, or be large enough to cover the
 entire back of an adult. The rash may be mistaken for an insect bite reaction or 
ringworm.  It may be hot to touch, it may flake or swell.  It may be well formed and
 expanding or have uneven or raised edges. It may disappear and return later and it
 may be slightly itchy in some individuals.

Borrelial lymphocytoma may appear on the earlobe, the scrotum, or on the nipple of
 the breast. It may be bright red to a bluish color and may disappear and return 

The ACA rash (acrodermatitis chronica atrophicans) may have the appearance of a
 scleroderma rash and is often noticed on the feet and ankles and/or the hands in the earlier stages of presentation. It 
may appear elsewhere on the body and can cause neurological damage and affect underlying organs.

Photos of some Lyme rash presentations:  http://picasaweb.google.com/home?tab=Fq

22. Do people with babesiosis have a rash? 

Many patients infected with Babesia organisms do not present with a rash,
 however, they may appear jaundiced and some may have a petechial rash.

23. Do people with Bartonella have a rash?

The rashes/lesions that are typically associated with Bartonella may not be present in
patients or may not be noticed. If there is a rash/lesion, it may appear to be a small 
reddish brown lesion (often mistaken for an insect bite).  It may heal without 
intervention. The patient exposed to Bartonella may have urticaria, vesiculopapular
 lesions, or erythema nodosums. Many Bartonella patients have swollen and/or
 tender lymph nodes which may become infected.

Photos of some Bartonella rash presentations:  http://picasaweb.google.com/home?tab=Fq

24. How do you test for and treat (which drugs) the "cyst or L-form" of Lyme

Specific tests have been developed to identify some of the various forms of
 spirochetes using dark field microscopes. Tindamax, which has been shown to burst the
 cell walls of the cyst form, is currently being prescribed to patients.  Normally Tindamax is
 prescribed along with other antibiotics (Doxycycline), since it is not effective on the 
intact spirochetes.

For more information on cysts, L-forms and biofilms: https://sites.google.com/site/getitrighttreatthebite/more-information

25. What has the CDC determined to be the proper testing procedure for confirming that
 a patient does or does not have Lyme disease?

TRICK question- The CDC states emphatically that Lyme tests are NOT to be used 
to exclude a diagnosis of Lyme disease.  A negative test is NOT to be considered
 absolute by any means, nor is it to be used to indicate a cure.  As the CDC states, 
Lyme disease is a "clinical diagnosis".  No test has been developed that can confirm 
if a patient is cured.  A negative test does NOT indicate a cure.

26. What is the two tier testing procedure set up by the IDSA/CDC for testing patients 
suspected of having Lyme disease and what are the most common problems with this

The CDC and IDSA recommends an ELISA (titer) first,
 which, under the best circumstances, only identifies a small percentage of infected patients.  An ELISA therefore, should NOT be used as a screening test due 
to the notoriously unreliable results.  The IDSA guidelines state, if the ELISA is positive, physicians 
are to perform a Western Blot test.  Under the best circumstances a Western Blot only
 positively identifies 70-80 percent of those who have been exposed.  Most tests will not be able to detect exposure for several weeks to a month after being bitten since antibodies do not build to a detectable level until that time.  

Most labs do not report 
specific bands on the Western Blot tests, hindering the experienced physician and
 the diagnosis even further.  The restrictive criteria to determine a "positive test" and the 2-tiered method allows many cases of Lyme disease to be 

The CDC dictates which specific bands on a Western Blot are to be used 
to consider a Lyme test "positive".  When the list was originally developed, certain bands specific for 
Lyme disease were not included; however if these bands are positive it confirms
 exposure even though it is incorrectly reported to the doctor and patient as a "negative" test. 

Many "borderline" tests are reported to patients as being negative, 
and many positive tests are incorrectly reported to be "false-positive" because physicians are 
not familiar with reading the test results, nor with the multiple symptoms that can occur
 in a person with Lyme disease.  Many
 patients with chronic Lyme disease have low titers or seronegative results.  The best approach to help prevent developing Lyme disease is to treat the bite.  To date, most other prevention measures have failed.  Get it Right, Treat the Bite!  www.TreatTheBite.com

27. Which bands normally show up first on a Western Blot test?  Which bands are 
specific for Lyme disease?  Which bands normally appear after the patient has had 
Lyme for at least one year?

The first Western Blot band to show positive can be the 41KD band followed 
intermittently by the 23KD band.  Bands 18KD, 23-25KD, 31KD, 34KD, 37KD, 
39KD, 83KD and 93KD are specific for indicating Bb (Lyme) exposure.  The problem is they
 may not show up early in the infection, may not appear for a year or more, 
or may not show up at all.  The presence 
of the 41KD band, in a Lyme patient, along with one of the specific bands listed above indicates a person
 has been exposed to Lyme disease and appropriate treatment should be initiated.

28. Why would a Lyme test not be accurate?

1. Antibiotic use prior to testing  
2. Patient has been on steroids or cancer drugs
 3. Antibodies are bound by bacteria
  4. Immunosuppression
  5. The bacteria has shifted forms (L-form, cyst form)
  6. Lab standards for cut off are too high
  7. The test was performed too soon, before antibodies have a chance to develop
  8. Bands are for reporting purposes, not for clinical diagnosis and are being misunderstood
 9. Using labs that do not specialize in tick borne illnesses
  10. Contamination of specimens
  11. Various strains of the organism (over 300 known) are not identified using standard tests  12. Biofilms or cyst forms

29. Can bismuth be used for Lyme patients?

Studies have shown that bismuth will penetrate Borellia cyst walls.  Intestinal 
problems are especially common in children with Lyme disease and bismuth
 compounds may eventually prove to be effective in treating the cyst form of the 
bacteria in the intestines.  Check with your doctor for updated information concerning bismuth and other cyst busters (Tindamax).

30. What are the symptoms of Bartonella?  What is the standard treatment for Bartonella 
and how long should a person be treated?

Common symptoms of Bartonella include fatigue, swollen lymph nodes, 
encephalopathy, headaches, cognitive dysfunction, various rashes/lesions, vision problems,
numbness, and tingling.  Reports indicate Doxycycline along with an additional antibiotic may be effective in treating 
Bartonella.  Rifampin has also been used in combination with Doxy, but is not as
 successful when used alone.  Several other antibiotics have been reported to be successful in 
Bartonella treatment and new discoveries are being reported.  Antibiotics have been prescribed for over one year to 
attempt to eradicate the persistent Bartonella bacteria.

31. If a patient is infected with Lyme, Babesiosis, and/or Ehrlichiosis, which infection should be treated first?

In co-infected patients, experts have noted that treating Babesia first has been proven to be more effective,
 however, in acute situations, treatment for all infections should be considered.

32. Where would you send blood and tissue samples to have the best available tests performed
 on Lyme patients?

IGeneX Lab in California performs a variety of tests for tick borne diseases (PCR,
 urine tests- DOT, RWB- Reverse Western Blots, Lyme, Babesia, Erhiclia, and
 Bartonella).  Igenex reports all WB bands, providing more factual results in the 
clinical setting.  www.Igenex.org  

33. What is a "Lyme Dot"?

Lyme Dot is a urine test performed by Igenex Lab which detects spirochete residue 
in urine samples after an antibiotic "challenge". 

34. What is an ACA?

ACA (acrodermatitis chronica atrophicans) is a skin rash often seen in patients
 with late stage chronic Lyme disease. The ACA rash indicates ongoing chronic Lyme 
infection.  Link http://picasaweb.google.com/home?tab=Fq

35. What is a Herxheimer "herx" reaction?

Jarisch-Herxheimer's reactions (herx) often occur during antibiotic therapy for spirochetal 
infections and may be fatal in some cases.  A 'herx' occurs when the spirochetes die 
off and produce toxins which can overwhelm a person's body if not quickly cleared.  Patient's symptoms may become much worse during the reaction. 
 According to the expert tick borne disease treating physicians, due to the replication cycle of the spirochete, treatment for Lyme should continue 
for several months after all Jarisch-Herxheimer reactions have ceased and all symptoms have cleared, or the patient is very likely to relapse.

36. How does prednizone or steroids help Lyme patients?

Trick question- Do not take steroids if Lyme disease is even suspected, unless it is a life threatening emergency.  Steroids
 suppress the immune system and allow the spirochetes a non-challenged environment in which to
 multiply.  Many people who now suffer with chronic cases of Lyme disease were 
given steroids and are now chronically ill, disabled or have died.  If you must take steroids it is recommended to take antibiotics during that time.

37. Approximately how many Lyme cases are reported to the State and CDC?

The CDC reports over 300,000 new cases of Lyme disease each year are occurring in the USA.  

To check individual state's numbers please see the maps and charts provided by the Lyme Disease Association: www.LymeDiseaseAssociation.org  

38. What are the signs or symptoms of Lyme disease?

Lyme is a multi-systemic disease (travels throughout the body) that can cause a variety of signs and symptoms.  It can negatively affect any and all organs.

Lyme disease can produce symptoms that can go dormant (sometimes 
for years), can migrate, return, disappear, or change day by day.  Symptoms can be
 aggravated by stress, medications, weather, and other outside influences.  Symptoms
 may tend to worsen on four-week peaking cycles. SOME of the symptoms that may 
be found in those with Lyme disease include: 

Flu-like symptoms, headaches (mild to severe), recurring low grade fevers or
 fevers up to 104.5 degrees. Usually in the first few weeks Lyme disease fevers 
tend to be higher. (Patients with chronic Lyme disease often tend to have a "normal
temperature" below 98.6 degrees, therefore, a slight rise in temperature may be all
 that is noted.) 

Often patients exhibit fatigue (mild to extreme), joint pain (with or
 without swelling), muscle pain, connective tissue pain, recurring sore throat 
(sometimes only on one side of the throat), swollen glands (come and go), varying 
shades of red on ear lobes and pinna, malar rash, cold hands and feet in a warm
environment, weakness, lightheadedness, eczema and psoriasis, painful or itching
 skin, flushing, night or day sweats, inordinate amounts of sweating, anhydrosis
 (inability to sweat), or dermatitis (acrodermatitis chronica).

 There may be a rash, but it isn't noticed or does not appear in all cases (approximately 50% of patients).

The rash 
may be basically circular or oval-shaped with outward spreading, however, other variations are seen. 
 The rash may be singular or multiple, at the site of a bug bite or in another location,
 warm to touch, or slightly raised with distinct borders. In dark skinned individuals
 the rash may appear to be a bruise.

Numbness, sleep disturbances, vertigo, hearing loss, feelings of being off-balance,
 unexplained weight gain or loss, and feeling "infected" are also problems associated 
with Lyme disease. 

Symptoms may develop that include: panic attacks, anxiety,
 depression, mild to severe cognitive difficulties, mood swings, coma, seizures,
 dementia, mania, biploar disorders, vivid nightmares, stammering speech, confusion, 
memory loss (short or long term), "brain fog", vibrating feeling in head or other parts of the body, 
topographical disorientation and environmental agnosia.

Some patients have problems with numbers and sequencing, disorganization of 
thoughts, rambling on in great detail while talking, frequent errors in word selection
 or pronunciation, changes in personality, short attention span, Tourette
 manifestations, OCD (obsessive compulsive disorder), raging emotions and cranial 
nerve palsies.

Patients have reported bladder disfunction (neurogenic bladder with either
hesitancy, frequency, loss of bladder awareness, urinary retention, incontinence or
symptoms of UTI, and chronic pyelonephritis). Intersitial cystitis, irregular or
 severe menstrual cycles with decreased or increased bleeding, early menopause, a
 new onset of P.M.S. symptoms, or disturbed estrogen and progesterone levels are
documented in many cases. 

Other problems include the possibility of altered pregnancy outcomes, 
severe symptoms during pregnancy, abdominal bloating, irritable bowel syndrome, 
abdominal pain and cramping (may appear to be ulcers), loss of sex drive, testicular
or pelvic pain, breast pain, and fibrocystic breast disease.

 Diarrhea (which can come and go or last for months with no explanation),
 constipation (which can be severe enough to cause blockage), irritable bowel 
syndrome, spastic colon, nausea, stomach acid reflux, gastritis, abdominal myositis,
 and indigestion are some of the gasto-intestinal disorders reported. 

In addition, patients often demonstrate a higher occurrence of various types of cysts or tumors (liver, breast, bone, ovary, skin, pineal gland, muscles and kidney). 

Some Lyme patients are diagnosed by
 eye care professionals and have been documented as suffering from one or 
more of the following disorders: conjunctivitis, ocular myalgias, keratitis,
episcleritis, optic neuritis, pars planitis, uveitis, iritis, transient or permanent
 blindness, iritis, photophobia, temporal arteritis, vitritis, Horner's syndrome, ocular 
myasthenia gravis, and Argyll-Robertson pupil. Often eye problems in Lyme patients require changing prescriptions for glasses more often than normal and may require several prescriptions for varying distances. 

Heart-related problems are associated with Lyme disease and can include: mitral 
valve prolapse, irregular heart beat, myocarditis, pericarditis, enlarged heart,
 inflammation of muscle or membrane, shortness of breath, strokes, and chest pain. 
Twitching of facial muscles, Bell's palsy, tingling of the nose, cheek or face are
 also reported. 

In addition, there may be chest pain or soreness, enlarged spleen, liver
 function disorders, tremors, extreme sensitivity to being touched or bumped, 
burning sensations, stiff neck, meningitis, and encephalitis. Patients may experience continual or recurring infections (sinus, kidney and urinary tract are most common).

Patients may suffer from a weakened immune system, the development of new
 allergies, recurring upper respiratory tract infections (causing, or worsening of 
pre-existing sinusitis, asthma, bronchitis, otitis, mastoiditis), and allergic or chemical 

Other noted problems include: T.M.J., difficulty swallowing or 
chewing, tooth grinding, arthritis (in small joints of fingers and larger, weight 
bearing joints), Osgood-Schlatter's Syndrome (water on the knee), bone pain,
 gout-like pain in toes, muscle spasms and wasting, to the point of dislocating joints and tearing 
muscle tissue, leg and hip pain, "drawing up" of arms, "growing pains" in children,
tendonitis, heel pain, carpal tunnel syndrome, and paravertebral lumbosacral
 muscle strain/spasm.

Some patients tend to suffer from a monthly "flare-up" of symptoms as the
 spirochetes reproduce and/or die off.

39. When testing by EEG and MRI, what are the results that may indicate Lyme disease 
could be a problem?

Some EEG's have been abnormal showing bilateral sharp waves and some slowing.
 CAT Scans are usually normal.  A number of MRI's have shown evidence of increased signal in the white matter, which may resemble what 
is seen in patients diagnosed with MS.

40. What are the symptoms and signs in a patient with Ehrlichiosis?

Symptoms of Ehrlichiosis may include: high fever, chills, muscle pain, headaches, 
confusion, nausea and vomiting.  A few patients may develop a rash similar to Rocky Mountain Spotted Fever.  If Ehrlichiosis is suspected, treatment should begin immediately.

41. Is Babesia a bacteria, protozoan, virus, or parasite?

Babesiosis is caused by a protozal parasite which should be treated with antiviral medications
 and an antibiotic combination. Antibiotics alone are not effective for treating Babesiosis.

42. Is Ehrlichiosis or Anaplasmosis more common in Maryland?

Both tick borne diseases are prevalent in New Jersey and are responsible for infecting both animals and humans.  Serology tests for both should be performed if either disease is suspected.

43. Approximately how many late cases of sero-negative Lyme patients will become
 sero-positive after successful treatment?

It has been reported that increasing numbers of seronegative patients who were
 diagnosed clinically and treated for Lyme disease, converted to seropositive after
 the start or completion of antibiotic therapy.  Unfortunately, physicians unfamiliar with 
Lyme disease often refuse treatment to seronegative patients even when they have 
active symptoms and a history of exposure.  The CDC states Lyme disease is a clinical diagnosis and negative
 tests should not be used to rule out the diagnosis.

44. Why do some patients respond to certain antibiotics and others do not respond?

Certain gene-types, spirochetal loads, various strains, co-infections, prior health 
issues, delays in treatment, immune system activity, and many other factors 
contribute to the success or failure of antibiotic therapy.  A one size fits all approach is not advised.  Each patient's history and clinical picture should be considered by experienced 
physicians prior to and throughout treatment.

45. How high of a dose of doxycycline is needed for adults to allow the 
medications to be bactericidal instead of bacteriostatic?

The typical doses (100 mg 2 X day) of Doxycycline that were prescribed by many
 doctors were, according to experts, not high enough to be considered bacteriostatic (killing action) for Lyme disease.  To
 enhance antimicrobial action several additional agents are now prescribed along with
 the antibiotics in order to increase effectiveness.  Additionally, the recommendations for Doxycycline doses now range from 300-600 mg a day unless contraindicated.  If necessary, Doxycycline or other antibiotics can be administered by IV to keep blood levels high, or administered in combination with other antibiotics (such as cyst busters).  For more information: http://ilads.org/lyme_disease/B_guidelines_12_17_08.pdf

46. What medications are prescribed to remove Lyme disease 
neurotoxins from the body?

Welchol, Questran, and herbs are sometimes used to assist in removing toxins.  Other methods have also been found useful for some people.  Patients should check with their doctors for more in-depth information. 

47. Should a patient with Lyme disease be restricted from donating blood?

Anyone who has Lyme disease or any of the tick borne co-infections should not donate blood or be an organ donor. Blood bank conditions (storage) do not kill spirochetes and some tick borne disease organisms have been passed on to recipients of blood donations causing a worsening of their condition, disability and even death.

48. What special precautions should be taken with pregnant women who contract Lyme 

There are recommendations for treating pregnant women infected with Lyme and 
other tick borne illnesses.  All pregnant patients should be tested for co-infections and should be 
aware that breast milk may be capable of passing infections to children.  Cord samples, blood and tissue can be sent for PCR testing to check for Lyme and other tick borne diseases, although a negative test would not indicate a newborn has not been infected.  For more information on pregnancy and Lyme:  https://sites.google.com/site/marylandlyme/pregnancy-lyme

49. What are the symptoms of Brucellosis?

Fever, chills, headaches, excessive sweating, fatigue, back pain and joint pain are
 some of the symptoms that may be present in a person infected with Brucellosis.

50. How do you properly remove a tick?  Where can the tick be sent for testing and what 
are the costs? 

To remove an attached tick- Do not touch the tick with your fingers or squeeze it. Use fine point tweezers to grasp the tick as close to the skin as possible. Pull
 the tick out in the opposite direction from the way it entered with a smooth motion. 
Do not twist or crush the tick. Clean the wound with soap and water, or rubbing alcohol, to help prevent a
 secondary infection.  www.TreatTheBite.com

Place the tick, dead or alive, in a plastic baggy with a cotton
ball that is slightly damp.  Contact a lab that 
performs tick testing, such as IGeneX Lab, to determine the current shipping methods 
and prices for tick testing.  The current cost to test an individual tick (or up to 20
 ticks together) is approximately $50.00- $65.00 for each tick borne disease test ordered.  www.Igenex.com

Please feel free to share this information with others.  Thank you!

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