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The Lahey Clinic Medical Center

Lahey Clinic Medical Center in Burlington encompasses an ambulatory care center serving more than 3,000 patients each day, a 317-bed hospital and a Level II Trauma Center (as certified by the American College of Surgeons).

With more than 39 medical and surgical specialties and various ancillary services, including on-site Pharmacy, Laboratory Medicine, Anesthesiology and Radiology, Lahey Clinic embraces the unique vision that Frank Lahey, MD, had when he founded a group practice in 1923: that every component of a patient’s health care would be coordinated under one roof. Lahey specialists share expertise and work closely together to ensure all of a patient’s medical needs are met.

Lahey Clinic Medical Center is a teaching hospital of Tufts University School of Medicine. In addition, many of our physicians hold teaching assignments at Harvard Medical School and Boston University School of Medicine.

Like its approach to patient care, Lahey Clinic Medical Center's research efforts often cross medical disciplines. At any given time, there are roughly 300 scientific studies under way at the Clinic. By offering patients the chance to participate in clinical trials, we provide access to the latest treatment options available.

A recent facility expansion on the Burlington campus added medical/surgical beds, operating rooms, a new and expanded surgical intensive care unit, new clinical space for the Institute of Urology, and new space for the Sophia Gordon Cancer Center.



Lyme Disease and Other Tick-Borne Illnesses in the Northeast









Scientists Find New Tick-Borne Disease


Heading into peak season, Lyme disease

victim hopes to spread the word


Lyme disease sufferer Barbara Smith and members of the Westport Lyme Disease Awareness and Education Committee will hold a Lyme Disease Awareness Fair from 9 a.m. to 2 p.m. Sunday, May 16, at the Westport Grange to tell people about the symptoms of Lyme and provide tips for protecting people, pets and property from ticks.

Westport resident Barbara Smith never imagined something as tiny as a deer tick could wreak such havoc in her life. But since a diagnosis of Lyme disease in July 2008, she has experienced firsthand the devastating effects that tick-borne diseases can have.

It started with what she thought was the flu, because she didn't have all of the telltale signs of Lyme disease. Then there were tremors, swollen glands and strange neurological symptoms such as panic attacks

and headaches.

Smith was treated for Lyme disease several times, but her symptoms persisted until doctors came up with a second diagnosis: neuro-Bartonella, a co-infection that often intensifies the symptoms of Lyme disease. It is not unusual for ticks to transmit more than one disease when they bite, experts say.

It was months later that the Bartonella was adequately treated, and it is only recently that Smith has been improving.

"I'm doing much, much better," she said, adding that she is trying alternative therapies to clear the remaining bacteria from her body.

"There is hope; it just takes a very long time," Smith said.

Smith's story is enough to make someone want to stay inside with their pants tucked into their socks, but Smith's goal is not to scare people.

"It needs to get more attention, not to frighten people, but to make them more aware," Smith said.

Smith emphasized that ticks can be a year-round problem, but for most people, now is the time they begin thinking about the creepy critters and the diseases they carry.

It is not usually dog ticks but the smaller, pinhead-size deer ticks that often carry Lyme disease, which they get from sucking the blood of deer or white-footed mice, the main carriers of Lyme in the region. People become infected when ticks take a blood meal from a human host after picking up the disease from a mouse or deer.

According to the Massachusetts Department of Public Health, Lyme disease usually manifests itself as a target-shaped rash and flu-like symptoms, but left untreated, it can lead to more serious problems, such as chronic joint pain, nerve damage and heart problems.

Priscilla Matton, an entomologist for the Bristol County Mosquito Control Project, said adult deer ticks have an increased chance of carrying Lyme disease because they have taken more blood meals than younger nymph ticks, but nymphs are still a bigger risk.

Because of their small size, they are less likely to be detected on one's skin and could stay on for the 24 to 48 hours generally thought to be the time needed to transmit the disease.

"The longer it's attached, the longer it's had to feed and regurgitate the bacteria," Matton said.

May, June and July is peak season for deer tick nymphs, making it the time when people are most likely to contract Lyme disease. Then the population distribution will change again toward the fall.

"Right now we're seeing the adults, and in the summer we're going to start to see the nymphal, and back come the fall, that's when we're going to see the adults again," Matton said.

The Centers for Disease Control and Prevention keeps provisional records on Lyme disease for 2009 and 2010 as part of its Morbidity and Mortality Weekly Report. From the beginning of the year until April 10, 1,829 cases of Lyme disease were reported to the CDC, compared to 2,976 by the same date in 2009.

New England has had 151 reported cases so far this year, compared to 935 at this time last year. Massachusetts has not reported any cases this year, but last year at this time it had reported 330 cases.

The CDC data only indicate when a case was reported and from which state the person with Lyme disease lives, not necessarily where and when that person contracted Lyme disease.

But the fact that the numbers are so much lower than last year is surprising.

David Simser, an entomologist for the Cape Cod Cooperative Extension, emphasized that it is provisional data and is not complete, because physicians might delay in reporting a case.

"There's a year lapse before things get reported," he said, explaining that doctors have to fill out forms about each case, then supply them to the state Department of Public Health, which reports the numbers to the CDC.

"So it's not like we have an up-to-date window" on the situation, he said.

So will just as many people contract Lyme disease this year as last? Not necessarily, Simser said. Tick numbers tend to fluctuate on a two-year cycle that matches the life cycle of a tick. Simser said that for the past eight to 10 years, entomologists have observed that even-numbered years tend to have fewer ticks than odd-numbered years. Fewer ticks would mean fewer chances to get Lyme disease.

Another thing that affects tick numbers is the harshness of the winter. If conditions are extremely cold, many adult ticks will die out during the winter months and the following spring and summer will produce a smaller tick population. But most winters — including this past one — are mild enough that the majority of ticks survive.

"Usually they're pretty resilient," Simser said.

One might think an extremely rainy March might affect tick populations one way or the other, but that is not the case, Matton said.

"It doesn't affect tick numbers, because they'll just hide," she said.

"But if it's raining, then you're not exposed, because you're not putting yourself out there."

When the weather is nice enough to venture outside, there are still plenty of ways to protect oneself against ticks.

Insect repellents with DEET can be sprayed on exposed skin, and sprays with permethrin work well on clothing or camping gear, Matton said.

After being outside, people should check themselves for ticks and place clothes in the dryer for 15 to 20 minutes to kill any ticks on their clothes.

If you find a tick attached to your skin, pull it off immediately with tweezers and save it between two pieces of tape or in a plastic bag. That way, Matton said, if you develop Lyme symptoms later, you will have the tick to show a doctor.

Finally, although ticks can be found many places, a greater percentage of ticks found at higher humidity and near rivers will have Lyme disease, she said.

However, it's not necessary to hide in the house until next winter, said D'Arcy MacMahon, executive director of the Lloyd Center for the Environment in Dartmouth.

People "should not let the presence of ticks deter them from enjoying a nice walk in the woods on our wonderful trails, but (they should) protect themselves with some insect repellent and check themselves over afterwards," MacMahon said.

"I think most of the staff has at one time or another been bitten by a tick, but we're all still reasonably healthy and sane."


On the rise

The Lyme disease rate in Massachusetts per 100,000 people is on the rise.

  • 1992: 3.7
  • 1998: 11.4
  • 2006*: 22.3

* The most recent data

Source: CDC

As autumn speeds toward winter, pet owners and those who still venture outdoors are making a potentially dangerous discovery: The hills and fields are alive with ticks that spread debilitating Lyme disease.

The fall surge in tick activity has more to do with the life cycle of the tiny parasites than with the weather, said John Carroll, an entomologist with the U.S. Department of Agriculture's research center in Beltsville, Md.

Starting in the middle of October, adult deer ticks begin to emerge from the leaf litter, a layer of fallen leaves and other decaying organic matter, and crawl up tall grasses, unkempt brush and other vegetation in search of host animals on which to feed. These ticks ate their last meal in June and were dormant most of the summer as they shed their skin and transformed from juvenile ticks, or nymphs, into adults.

"What we are seeing now are the ones that fed on animals in the late spring and summer and are now looking to get another meal," Dr. Carroll said.

Adult deer ticks are about the size of a sesame seed and are easier to spot than the smaller nymphs, which can be as small as a poppy seed. Both can spread Lyme disease when they bite their host and stay attached for 24 hours.

During their nearly two-year life span, ticks feed just three times for about a three- to five-day period, Dr. Carroll said. In the spring, humans are more likely to contract Lyme disease from nymphs, which start feeding in May. Larvae — baby ticks that are younger than nymphs — tend to feed in the summer months.

The fall boom of adult deer ticks typically lasts through November and starts to slow in December as it grows colder and the ticks head back into the leaf litter. But a 50-degree Fahrenheit day in the middle of winter could make the ticks active again, Dr. Carroll said.

Vets across the area say that spring and fall are the times of year when ticks and tick bites are most common.

Other tick experts point to the weather as a reason for the high number of ticks this fall.

"We are having milder and milder falls and early winters ... so that just pushes back the time when these ticks are moving around," said James Griffith, professor of medical laboratory science at UMass Dartmouth. "So on the one hand, given the weather, there could be more ticks, but that isn't to say there's going to be more Lyme disease."

It is estimated that more than half of deer ticks carry Lyme disease, and many also carry other diseases.

Many northeastern states, Wisconsin and Minnesota have rates of Lyme disease that are significantly higher than the rest of the country, according to the Centers for Disease Control and Prevention. The Lyme disease rate in Massachusetts continues to rise, the CDC reported. The rate of infection per 100,000 people was 3.7 in 1992, jumped to 11.4 by 1998 and was 22.3 in 2006, the last year for which figures were available.

Dr. Griffith said that the fall marks an increase in the field mouse population, another animal that could help Lyme disease spread if multiple ticks bite an infected mouse. Other animals can cause a spread of the disease as well.

"Here in Southeastern Massachusetts where you can't discharge a firearm inside a municipal boundary, we have a very high deer population," he said.

The increased incidence of Lyme disease, coupled with symptoms that manifest themselves weeks to months after a person is infected, have people seeking medical treatment during any season.

"We do see cases really throughout almost the whole year," said Judy Menard, director of infection prevention for Southcoast Hospitals Group. But, she added, "this time of year you might see a little bit of a resurge."

If Lyme disease is caught in its early stages, it usually can be treated with antibiotics taken by mouth, Ms. Menard said. Later stages of the disease require stronger treatments, including antibiotics by IV for several weeks. "It's more invasive," Ms. Menard said.

The disease can have devastating effects on its victims. Assonet resident Dianne Nassr got bit by a deer tick while at her son's baseball game five years ago. Although she received antibiotic treatment right away, symptoms of fatigue and joint pain lingered for years.

"I was so tired that I couldn't get out of bed until noontime," she said.

It wasn't until two years later that she found relief, when she tried a therapy called Theta healing, which heals using mind, body and spirit. She now operates her own Theta healing business in Fall River.

Mark Perry wasn't so lucky. After getting bit by a tick in fall 1999, the New Bedford resident suffered from fevers, pain and insomnia. Doctors tested for Lyme disease, but because the tests check for antibodies and not the bacteria itself, the test gets less accurate over time. His tests came back negative.

Meanwhile, Mr. Perry's symptoms had progressed to memory loss, vision loss and "problems with critical thinking," he said.

"Mentally, I was feeling every day I was losing my mind more and more."

It wasn't until earlier this year that he was accurately diagnosed as having Lyme disease and started to see a specialist in New York. Now he receives antibiotics by IV every day at home, and he is improving.

"I'm so much better," Mr. Perry said. "I have a long, long way to go, but I'm so much better than I was."

Mr. Perry used to be a strategy and leadership development consultant, but the Lyme disease took a toll on his cognitive abilities. He doubts he will be able to perform that job again.

"I will make significant improvements, but chances are neurologically I won't ever improve enough to go back to what I was doing."

Animals too, can be harmed from the effects of the disease, said Dr. Gerald Pietsch, the veterinarian at Anchor Animal Hospital in Dartmouth. He treats animals, mostly dogs, suffering from Lyme, with symptoms ranging from limping and swollen joints to kidney failure in rare cases. Tests can diagnose whether the symptoms are indeed Lyme disease and if the disease is an active infection that warrants treatment, usually 30 days of antibiotics.

"The very best method of protection is not to get ticks," Dr. Pietsch said. That means staying on marked trails or avoiding the woods all together during peak tick times, checking oneself and one's pet for ticks after a walk and using a topical tick medication on pets. Dogs can get vaccinated against Lyme disease if they do not already have the bacteria; it is effective for 85 percent of dogs.

The most important thing to remember, Dr. Pietsch said, is that there is no season that is "safe" from ticks or their diseases.

"An animal can be infected with Lyme disease any time of the year," he said.

Standard-Times staff writer Becky W. Evans contributed to this story.

Contact Jennifer Lade at jlade@s-t.com



The Insanity of Chemical Warfare 

The NAZI connection with Lyme Disease and the chemical warfare experimentation

that still lingers today in our own backyards!

 Plum Island, Lyme Disease