By Rabbi Yair Hoffman for 5tjt.com

There are growing cases of Lyme Disease happening in the Five Towns and Far Rockaway area.  Lyme Disease can be much more serious than we think.  It may also be much more prevalent than we think.

As we speak, however, there is a great debate going on as to whether there are only 350,000 cases of Lyme Disease a year, or whether there are millions.  More on this debate later.

Regardless as to who is right, all agree that if Lyme Disease goes undetected, it can, in some cases be a parental nightmare. A local parent whose child is suffering from the disease has requested that an article be written in order to increase awareness – so that others will not have to struggle unnecessarily – as these parents have.  A brief check with some local medical people revealed that there are more than a few local cases.  The disease generally has a season – between May and September, but it is often missed and sometimes just comes to light well into winter.

WHAT IS LYME DISEASE?

Lyme Disease is an infection caused by a bacteria that is carried by ticks.  The ticks are called “black-legged ticks” or “deer ticks.”  The bacteria is called, “Borrelia bacterium.” The ticks are commonly found in wooded areas, but lately they have been showing up in all sorts of areas – even in backyards.  All fifty states in America are reporting an uptick (sorry) in Lyme disease.

Shockingly, it is one of the most unresearched type of infections in the world.  The rates of infection have tripled since most parents were in camp themselves.  The CDC says that there has been a 320% increase in the past 20 years.  They say that the cause is because of more migratory birds coming into the United States that carry the tick.  The Hudson Valley seems to be the biggest hot-spot in the United States, according to Dr. Richard Horowitz, a Lyme disease expert in the New York Metropolitan area.

If the tick stays on the body for more than 36 hours – there is a much higher chance of developing an infection.

DR. HOROWITZ’S THEORY

Dr. Horowitz, however, has another theory that the CDC doesn’t talk about. The theory may or may not be true, but Dr. Horowitz has presented it in his book and in various interviews.  He claims that 5% of Americans suffer from something called “Chronic Fatigue Syndrome.”

That translates to 18 million people.  Dr. Horowitz is of the opinion that many of those suffering from CFS are actually suffering from a tick-born disease that they were unaware of.  Dr. Horowitz says that Lyme Disease has many cousins too, and he points out that every two years they discover a new Borrelia species.  Whether he is right or not, however, 350,000 cases a year is also way too much.

TICK SPIT

Moving on to the less controversial area, how does one get Lyme Disease?  Ticks feed on blood.  It could be rodent blood, snake blood, animal blood or people blood.  Ticks bite people or animals that have the bacteria and spread it all around through their spit.  Their spit has:

• Anesthetic components in them so people won’t smush them when they bite or feed.
• It has anticoagulant components so that the blood will continue to flow.
• It also has immunosuppressant components so that the body won’t attack it while it feeds.

The average tick bite injects some 70,000 bacteria into the blood stream through its spit.  The bacteria is a type known as spirochetes.

It is interesting that it is not the bacteria itself per se that causes problems – it is the body’s response to the bacteria.  The good news is that it is a vector-born disease which means you cannot get it from another person.  You can, theoretically, get it from a tick that bit a person who has it and has passed it on to you.  But that usually doesn’t happen.

EARLY SYMPTOMS

Between 3 and 30 days after the tick bite, a common symptom that develops is a bulls-eye rash – it is called this because the rash has a red center to it.  There are also shakes, fever, joint and muscle pain.  In short – flu-like symptoms.

LATE SYMPTOMS ARE MUCH WORSE

Later symptoms of Lyme disease can affect your joints, can give arthritis and can affect the victim’s neurological system.    Some less common long-term symptoms are that it can give the victim

• A facial droop, a palsy, and can also cause meningitis.
• It can also cause tingling in the hands and feet
• It can cause deafness.
• It can cause numbness in any part of the body.
• It can cause an inflammation of the heart muscles called Myopathy. This can lead to an irregular heartbeat.

**IMPORTANT MITZVAH!!!**

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EASILY TREATED

What is sad is that it is easily treated with common anti-biotics.

According to the Mayo Clinic, oral antibiotics are the standard treatment for early-stage Lyme disease. These usually include doxycycline for adults and children older than 8, or amoxicillin or cefuroxime for adults, younger children, and pregnant or nursing women.

Doctors usually prescribe a 14- to 21-day course of antibiotics.

If the disease involves the central nervous system, the doctor may recommend treatment with an intravenous antibiotic for 14 to 28 days. This is effective in eliminating infection, although it may take time to recover from symptoms.

Intravenous antibiotics can cause various side effects, including a lower white blood cell count, mild to severe diarrhea, or colonization or infection with other antibiotic-resistant organisms unrelated to Lyme.

After treatment, a small number of people still have some symptoms, such as muscle aches and fatigue. The cause of these continuing symptoms, known as post-treatment Lyme disease syndrome, is unknown. Treating with more antibiotics doesn’t help.

Some experts believe that certain people who get Lyme disease are predisposed to develop an autoimmune response that contributes to their symptoms

WHO SHOULD GET TESTED?

If you went hiking or were near birds, deer, mice, or horses and you are feeling one of the symptoms you should get tested.

How do they test for it?  They can do a culture of Borrelia from skin, blood, or from cerebral spinal fluid (CSF). They can also test genetic material by polymerase chain reaction in skin, blood, or synovial fluid.

To get a differential diagnosis, you need a two-tiered serological testing is performed for differential diagnosis of Borrelia infection. The first-tier detect specific antibodies (IgM and IgG either together or separately), The second tier consists of standardized immunoblotting.

PREVENTION

If you do go hiking, doctors recommend that you cover all exposed parts of the body and also use a tick repellent.  Ranger Ready Permethrin 0.5% is a good repellant.  It is a clothing-worn Repellent and has zero smell. It is available on Amazon and costs about ten dollars.

It may also be worthwhile to own a tick removal tool. The HomeSake Tick Removal Tool removes the entire head and body of the tick. It is also available on Amazon for about $4.

A FASCINATING RAMBAN

On his way down from Sinai about to give the Torah to Klal  Yisroel, Moshe heard the shouts of the people.  Yehoshua explains these sounds by saying, “Kol Milchama Bamachane – the sound of battle is in the camp” (32:17).

Moshe corrects Yehoshua and says, “It is not the sound of victory, nor the sound of defeat: I hear the sound of distress.”  The Ramban explains that Moshe is telling Yehoshua that a leader must be fully conversant in the details and minutia of day-to-day things.

Essentially, what Moshe Rabbeinu is conveying to Yehoshua is that everyone has got to be on top of his game.  This author believes that a correct understanding of this Ramban includes parents – not just leaders. It also includes knowing about Lyme Disease. And not just knowing how to distinguish between sounds.

**IMPORTANT MITZVAH!!!**

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The author can be reached at [email protected]