Category Archives: Lyme disease

Lyme Disease – deer cull up & vehicle collisions down

These minutes from the Lyme Disease Study Committee -

Town of Medfield Lyme Disease Citizen Study Committee

Meeting Minutes – Monday, Jan 13, 2014 – 7:00 pm

Attendees: Chris Kaldy (Chair), Frank Perry, Barry Mandell, Erica Reilly, Carolyn Samson, Pete Peterson
Minutes – reviewed meeting minutes from Nov 18 (no December meeting)

 

Controlled Hunt Fall 2013 – Season finished

Frank reported that 40 deer (to be confirmed) were culled this season from all over town.  Feels the hunters who did best were those working in teams.  We did not receive any negative feedback this season.  Mike Francis would like to hold a cookout for Dover & Medfield hunters.

Ideas to improve next year’s hunt, address town land use and illegal hunters more clearly:

  1. Update Hunting Season sign to say No Hunting except by permit.
  2. Create a permanent sign to post on town land and add the second sign in season.  Maybe Jason Spiess can produce these for us.
  3. Evaluate all hunters since now 3 seasons and some have not taken any deer.
  4. Require some community service hours of all hunters.
  5. Reaffirm at Selectmen’s meeting our authority to be the only group that can issue hunting permits.
  6. Obtain key to gate at entrance to water department land.
  7. Request additional budget to purchase a couple trail cameras and tree stands (for our “community”) as well as a stipend for Barry’s service.
  8. Encourage private owners to use our program rather than private hunters.
  9. Consider when to do background checks again.

 

Barry reported he’s collecting data from animal control officers on the number of deer collisions in Medfield and neighboring towns for the past years, including Millis, Medway, Franklin, and Bellingham.  Data to date:

2009    ‘10       ‘11       ‘12       ’13                   Average over 5 yrs

Medfield           41        59        43        29        18                    38

Dover               41        46        38        38        41                    41

 

Actions:

  • Chris to remind hunters to remove stands by end of January.
  • Frank to confirm deer taken and send list to Mike Francis.
  • Frank & Barry to collect hunter logs.
  • Chris to contact Mike Francis about cookout.
  • Carolyn to find out our current budget balance and if we can spend it on items other than those in our original budget, i.e. trail cameras, tree stands, Barry.
  • Chris to ask Evelyn to be on Feb 4 Selectmen’s meeting agenda
  • Chris to find out Denise Garlick’s office hours to meet to discuss hunting rules.
  • Chris to finish pamphlet.

 

 

Tick & Lyme Education / Website

1.  Tick Check Posters – Carolyn received new batch

  • Carolyn will take new ones to Nancy to distribute in schools.

 

2.  Sports Coaches – Erica and Carolyn decided the best way to reach kids’ parents would be to have a tick notice added to the emails sent out by the coaches to the parents, rather than relying on the coaches or coaches’ meetings to inform parents and kids.

  • Erica & Carolyn will contact spring sport coaches (baseball, soccer, lacrosse) at the appropriate time and give them blurb for emails.

 

3.  Park & Recreation – new director coming on

  • Erica will meet with new director to educate him/her on ticks and offer signs to be put up around McCarthy Park.

 

4.  New ‘N Towne

  • Carolyn will check in with President to be ask if they’re still handing out data at newcomers’ meetings and if blurb could be added to emails as well as on website.

 

5.  Recent articles in our favor discussed -

1.  Article in Time Magazine (Dec 9) reported on the need to manage various overabundant wildlife species by responsible hunting.

2.  Article in Boston Globe (Dec 9) reported how 2 state Senators (Robert Hedlund, Weymouth, and Richard Ross, Wrentham) recovered from bad cases of Lyme disease.

3.  Article in Boston Globe (Dec 13) reported carditis from Lyme disease caused 3 deaths, indicating that Lyme can be fatal.

 

 

Other

1.  Scout Project – Chris reported that Robert hung 10 owl boxes in the water department land by Wheelock and so has completed his project for us.

 

 

 

Next Meeting:  Monday, Feb 10, 2014 in the Warrant Meeting Room at Town Hall, 7 pm

Submitted by Chris Kaldy

Lyme Disease national info

This email with interesting info from the Congress on Lyme Disease-

  • more ticks because of global warming
  • Lyme disease only receives $25 million from NIH compared with $3 billion for HIV/AIDS and $112 million for Hepatitis C, despite Lyme incidence being magnitudes greater at 300,000+ new Lyme cases per year in US as compared to 50,000 new cases of HIV/AIDS and 17,000 new cases of Hep C”

was shared by Erica Reilly of our Lyme Disease Study Committee -

From: Nancy Dougherty
Subject: Senate Briefing on Lyme Disease
Date: December 9, 2013 at 10:00:46 PM EST
To: undisclosed-recipients:;

Dear friends,

I attended a Senate briefing in Washington DC last week sponsored by the Tick-Borne Disease Alliance (TBDA) to address the national health crisis of Lyme and tick-borne diseases.  The briefing was aimed at advancing Senate Bill S.719, the Lyme and Tick-Borne Disease Prevention, Education, and Research Act. Lyme disease is a major public health problem and testimonies from prominent physicians, advocates and chronic sufferers were compelling.  Senate staffers heard loud and clear that current diagnostics are unreliable, hundreds of thousands of patients are suffering, global warming is accelerating the worldwide epidemic, and more research funding is vitally needed.

Washington is starting to recognize the magnitude of human suffering and economic burden [$3B+ in US] created by Lyme and tick-borne diseases.  Staffers from Rep. Chris Gibson, (R-NY), Senator Kirstin Gillibrand (D- NY) and Senator Bob Casey’s (D- PA) offices told me fighting Lyme disease is a priority and they will work to improve education for awareness & prevention and funding for research to improve diagnostics & treatments. However, the Lyme disease community needs to unite toward these common goals.  Senator Gillibrand, along with Senators Richard Blumenthal (D-CT), Jack Reed (D-RI), and Sheldon Whitehouse (D-RI) are cosponsoring S.719, which would establish a Tick-Borne Disease Advisory Committee and invest additional federal funds into Lyme disease research and education.  Congressman Chris Smith (R-NJ), founder and co-chair of the Lyme Disease Caucus in Congress, has sponsored similar legislation in the house (HR610 and HR611).

Lyme disease only receives $25 million from NIH compared with $3 billion for HIV/AIDS and $112 million for Hepatitis C, despite Lyme incidence being magnitudes greater at 300,000+ new Lyme cases per year in US as compared to 50,000 new cases of HIV/AIDS and 17,000 new cases of Hep C (sources: NIH and CDC websites).

David Roth, Co-Chairman of TBDA, stated “National Institutes of Health (NIH) found that the impact of Lyme disease on physical health status was at least equal to the disability of patients with congestive heart failure, osteoarthritis and greater than those observed in type 2 diabetes”.  Dr. Patricia DeLaMora, Assistant Professor of Pediatrics, Pediatric Infectious Diseases, Weill Cornell Medical Center, said “Children are disproportionately affected by Lyme disease. We need accurate diagnostics and a well-educated medical community. The current diagnostics for Lyme disease are unreliable in the early stages when recognition and treatment are vital, and cannot accurately distinguish between old and new infections.” John Donnally, a 24 year old Lyme disease survivor and advocate who just completed a 3500 mile cross-country cycling public awareness TBDA campaign “Bite Back for a Cure”, conveyed “the epidemic is pernicious and rampant and a meaningful number of people do not get better”. Additional testimony from patient advocates, Karla and Victoria Lehtonen and Kelly Downing, illuminated their devastating stories of multiple systemic Lyme disease that baffled numerous medical experts due to inadequate diagnostics, resulting in ongoing symptoms including severe neurological impairment.  Karla quoted Dr. John Aucott’s research as indicating a significant percent of patients fail treatment and go onto chronic illness.  Dr. Richard Ostfeld, PhD, disease ecologist and Lyme disease specialist at Cary Institute, said “climate change is broadening the geographic range of ticks and their pathogens and the public health impact is getting worse”. When Heather Thompson (entrepreneur & Bravo Housewife of NYC) posed the question, “Do any of you want Lyme Disease?”, there was an uncomfortable silence.  A universal conclusion was the need for more research for tick control, diagnostics and therapeutics. 

Another important event in Washington last week was the FDA’s approval of Gilead’s Hepatitis C drug, Sovaldi, on Friday.  This novel oral drug is a direct-acting antiviral agent effective across a range of Hep C genotypes, adding an important weapon to the therapeutic armamentarium for anti-HCV therapy.  Why is this important or relevant for Lyme disease?  Because it shows that investment in research can produce significant innovation that will substantially improve patients’ lives!  This is an important shift in the treatment paradigm for Hep C patients since the need for side-effect inducing interferon shots will be reduced or eliminated.  It’s also a model for future Lyme disease therapeutics that could potentially, like Sovaldi, target disease specific mechanisms with improved efficacy and work in a range of genotypes.  Also, it’s important to recognize that innovations for illnesses such as HIV/AIDS, Hep C, Cancer and other illnesses depend upon a collaborative national network of clinical research centers for testing innovative diagnostics and therapeutics.  This is presently non-existent for Lyme disease, so there is much work ahead to improve outcomes for patients with Lyme disease as compared with these other illnesses.

Dr. John Aucott has a nationally recognized leading-edge Lyme disease clinical research program at the Lyme Disease Research Foundation that is generating scientific evidence to enhance the understanding of the pathophysiology of the illness and enable the progression of improved diagnostics and therapies. However, at the briefing, it was acknowledged that programs of this caliber are not sustainable indefinitely without government support.  For more information about the Lyme Disease Research Foundation, please visit www.LymeMD.org/.  Donations to fund this vital research are greatly appreciated and will make a meaningful difference in advancing the Lyme disease field.

Thank you for your interest in keeping abreast of Lyme disease issues. Wishing you good health and an enjoyable holiday season with family and friends.

All the best,

Nancy

Nancy Dougherty

Lyme Disease Research Foundation
617-686-8185
Please follow me on twitter @NancyNDougherty

Deer hunt

At the Lyme Disease Study Committee meeting last night it was shared that we are at the height of the annual rut, when the deer are moving around more than any other time of year looking to mate, so be especially careful when driving this week.

Also -

  • 21 deer culled so far in first month of the hunt this year with more than a month to go, versus 29 in each of the last 2 years
  • lots of illegal hunting is happening in town, which the town hunters monitor, control, and end
  • only female ticks carry Lyme Disease; only half the female ticks carry Lyme Disease; only a fifth of the nymphs carry Lyme Disease
  • tick bites tend to effect the person for about a month
  • deer vehicle collisions average between 30-50 per year in town

Dover Lyme Forum on Medfield.TV

From Erica Reilly of the Lyme Disease Study Committee -

Here is the listing of when the Medield TV stations will run the Dover Lyme Forum.
Thanks
Erica

Here’s the current airing schedule.  A total of 63 runs so far. Have a good week.               -hong-

+ Sun 09/22/13 06:00 PM Channel 08/47 (Public)
+ Sun 09/22/13 09:00 AM Channel 08/47 (Public)
+ Sat 09/21/13 03:00 PM Channel 08/47 (Public)
+ Sat 09/21/13 01:00 PM Channel 08/47 (Public)
+ Sat 09/21/13 07:00 AM Channel 08/47 (Public)
+ Fri 09/20/13 10:00 PM Channel 08/47 (Public)
+ Fri 09/20/13 01:00 PM Channel 08/47 (Public)
+ Fri 09/20/13 05:00 AM Channel 08/47 (Public)
+ Thu 09/19/13 08:00 PM Channel 08/47 (Public)
+ Thu 09/19/13 11:00 AM Channel 08/47 (Public)
+ Wed 09/18/13 06:00 PM Channel 08/47 (Public)
+ Wed 09/18/13 09:00 AM Channel 08/47 (Public)
+ Tue 09/17/13 08:00 PM Channel 08/47 (Public)
+ Tue 09/17/13 03:00 PM Channel 08/47 (Public)
+ Tue 09/17/13 07:00 AM Channel 08/47 (Public)
+ Mon 09/16/13 10:00 PM Channel 08/47 (Public)
+ Mon 09/16/13 11:00 AM Channel 08/47 (Public)

Deer counted on Martha’s Vineyard

A professor uses his specially created instrument to do an aerial count of deer on Martha’s Vineyard, as first step to seek to correlate deer densities with occurrences of Lyme Disease.  See the article here.

Mosquito & tick control

Commonwealth of Massachusetts information, including videos, on dealing with Mosquitos and ticks.  Click here.

Weston votes for hunting deer

The May 15 annual town meeting (ATM) warrant article to ban hunting in Weston failed by a resounding vote of about 75% to 25%.

Great report last night from Chris Kaldy of the Lyme Disease Study Committee to the Board of Selectmen.  Selectmen voted to change their mission to include deer management for purposes of improving public safety (we are averaging 46 deer/vehicle collisions a year), reducing the ecological damage to the forests caused by the current over grazing by deer, as well as reducing Lyme disease.

Lyme disease talk 4/23 in Weston

Weston Conservation Commission presents
Deer Management Forum
Tuesday, April 23, 2013
7:30 p.m. – 9:00 p.m.
Weston Community Center (Great Room)
Alphabet Lane, Weston

Lyme, Ticks, Deer, and Mice: What are the Connections?

Dr. Sam Telford of Tufts University will discuss the complex
relationship between tick‐borne illnesses, ticks, and their hosts,
and what practical approaches communities can take to reduce the
incidence of these diseases.

Use of Contraception for the Management of Deer Populations
Dr. Allen Rutberg, Director of the Center for Animals and Public
Policy at the Tufts‐Cummings School of Veterinary Medicine, will
discuss successes and challenges in using contraception to manage
deer‐human conflicts.

Deer Biology and Management Options
Dr. John McDonald, Assistant Professor at Westfield State
University will discuss deer survival, movements, and population
dynamics in Massachusetts.

Please contact the Weston Conservation Commission at 781‐786‐5068 or Conservation@westonmass.org for more information.

High Lyme disease rate in town

State Report on Lyme Disease

From Nancy Schiemer of the Lyme Disease Study Committee -

Commonwealth of Massachusetts
Lyme Disease in
Massachusetts
A Report Issued by the Special Commission
to Conduct an Investigation and Study of the
Incidence and Impacts of Lyme Disease

February 28th 2013
Members of the Commission
Commissioner of the Department of Public Health . . Dr. Catherine M. Brown (Designee)
Commissioner of the Division of Health Care Finance & Policy . Ms. Jen Gorke (Designee)
Director of the State Laboratory Institute. . . . Dr. Linda Han (until 9/13/2012)
House 1 . . . . . . . Representative David P. Linsky
House 2 . . . . . . . Representative Carolyn Dykema
House Minority Leader’s Appointment . . . . Representative Bradford R. Hill
Infectious Disease Specialist . . . . . Dr. Sam T. Donta
International Lyme and Associated Disease Society . . Dr. Sheila Statlender
Local Board of Health 1 . . . . . . Dr. Louis E. Fazen
Local Board of Health 2. . . . . . Ms. Joanne Martel, RN
Local Board of Health 3 . . . . . . Dr. Barbara Roth-Schechter
Lyme and Other Tick-Borne Diseases Organization 1 . . Ms. Patricia McCleary
Lyme and Other Tick-Borne Diseases Organization 2 . . Ms. Brenda J. Boleyn
Public 1 (Patient or Family Member of Patient) – Senate . . Ms. Kristen Alexander
Public 2 (Patient or Family Member of Patient) – House . . Ms. Lisa Donahue
Senate 1 . . . . . . . Senator Susan Fargo
Senate 2 . . . . . . . Senator Daniel A. Wolf
Senate Minority Leader’s Appointment . . . . Senator Richard J. Ross
State Epidemiologist . . . . . . Dr. Alfred DeMaria Jr.
Treatment or Research of Lyme Disease Expert 1 . . Dr. Sam Rountree Telford III
Treatment or Research of Lyme Disease Expert 2 . . Dr. Thomas N. Mather
Massachusetts House Post Audit and Oversight Committee Staff
Katelyn Kelly

TABLE OF CONTENTS
EXECUTIVE SUMMARY . . . . . . . . 1
GLOSSARY OF TERMS . . . . . . . . 3
TASKS WITH WHICH THE COMMISSION IS CHARGED. . . . 6
Massachusetts State Surveillance and Reporting . . . . . 7
Massachusetts Department of Public Health Lyme Disease Surveillance Activities . 7
Other Statewide Lyme Disease Surveillance Activities . . . . 7
Potential Benefits of Enhancing Lyme Disease Surveillance . . . . 9
Potential Activities for Enhancing Surveillance of Lyme Disease in Massachusetts . 10
Education and Awareness . . . . . . . . 13
Education for Prevention . . . . . . . . 13
Education for the Medical Community . . . . . . 15
Co-infections . . . . . . . . . 17
Critical Need for More Research . . . . . . . 17
Partnerships . . . . . . . . . 18
Implementation Advisory Committee . . . . . . 18
True Costs of Lyme Disease in Massachusetts . . . . . 18
Insurance and Liability . . . . . . . . 19
Prevention . . . . . . . . . . 24
Vaccination . . . . . . . . . 25
Environmental Interventions . . . . . . . 25
Education . . . . . . . . . 30
Funding . . . . . . . . . . 32
REFERENCES . . . . . . . . . 34

EXECUTIVE SUMMARY
In accordance with Section 181 of Chapter 68 of the Acts of 2011, the Commonwealth of
Massachusetts established the Special Commission to Conduct an Investigation and Study the
Incidence and Impact of Lyme Disease. The twenty-one member Commission was comprised of
individuals from a wide variety of backgrounds and was put in place in order to provide the most
comprehensive overview and insight into the various issues that surround this disease. The
members ranged from state legislators and state agency representatives to experts in treatment
and research to members of the public and Lyme disease activists. Upon the formation of the
Commission the members broke into five sub-commissions; State Surveillance and Reporting,
Education and Awareness, Funding, Prevention, and Insurance and Liability Issues in order to
address all tasks issued to the Commission under the Massachusetts General Acts of 2011. The
sub-commissions met on a regular basis and the full Commission came together once a month to
discuss each group’s findings. The following is a compilation of each sub-commission’s report
and it presents an overview of the Commission’s findings and recommendations for the state to
enact and enforce in order to ensure that the Lyme disease epidemic is controlled and that future
infections can be prevented.
The Commission discovered that the current state laboratory reporting is an obvious
strength for statewide surveillance in helping to gain a better idea of trends across the
Commonwealth. However, it fails to capture reports of Lyme disease for which laboratory
testing is not routinely reported or is not performed at the appropriate stage of the disease. The
Commission believes in the importance of enhancing current Lyme disease surveillance methods
in order to better determine disease burden, geographic distribution, risk groups, clinical features,
and changes in epidemiology over time, which then can be translated into data to assist the
Massachusetts Department of Public Health (MDPH) in targeting high-risk areas. The
recommendations of the Commission include evaluating the current laboratory-reporting
practices in order to gather more pertinent information surrounding the disease by updating the
current forms, as well as updating the reporting systems to an electronic format in order to
provide more easily presented and accessible data. Having school nurses provide surveillance
information regarding students would be another useful tool in surveillance. An all-payer claims
database analysis would also help determine the costs associated with the treatment of this
disease. Improved laboratory diagnostic methods are necessary in ensuring accurate diagnosis
and therefore that accurate treatment plans are being prescribed and seroconversion studies might
help identify whether the quality and completeness of surveillance data is proportional to the
amount of resources invested in the collection of data.
The most important focus of the Commission is the education and awareness of Lyme
disease. Educating the public for prevention is the key aspect in helping to prevent transmission
and therefore avoiding many of the difficulties that can arise for patients following infection. The
Commission recommends that appropriate knowledge, attitudes, and practices (KAP) surveys are
developed in order to establish a basis for targeting education and for the development of an
engaging and educational health promotion campaign to be distributed in communities. State
funding and advertisement subsidies should be provided to towns for tick bite protection and
tick-borne disease (TBD) prevention promotions. Recommendations for education of the medical
community include that healthcare providers be apprised of the spectrum of Lyme disease
(especially regarding relapsing or persisting symptoms), be made aware that currently published
recommendations and guidelines regarding treatment of Lyme disease are based on limited data,

that recommendations regarding antibiotic treatment of patients with persisting or relapsing
symptoms are based primarily on the results of one clinical trial, and remind physicians of the
Physician Protection Act; Section 12DD of Chapter 112 of the Massachusetts General Laws,
which protects doctors from facing disciplinary action should they choose to diagnose and treat
according to clinical criteria.
In order to educate physicians and other healthcare providers the Commission
recommends that this report be sent to each provider from provider-enrolled organizations, the
report be disseminated in medical publications and be accessible online. There should also be
support for professional educational forums across the state. It is also recommended that MDPH
communicate the limitations of laboratory testing to healthcare providers in Massachusetts and
regularly review its educational materials relative to new information pertaining to Lyme
disease. Although there is general agreement that published guidelines have never been intended
to replace clinical judgment, the differences in approach to treatments have led to a continuing
controversy that has significantly impacted the delivery of care for Lyme patients in
Massachusetts. This controversy underscores the compelling need for serious national
investments in scientific research directed at diagnosis and treatment options; both better Lyme
diagnostics through testing that is not dependent upon the production of antibodies and more
clinical research relative to treatment protocols. Establishing partnerships between local boards
of health and community spaces is important in ensuring the distribution of this material. The
implementation of an advisory committee is also essential in fulfilling these recommendations.
While the Physician Protection Act protects physicians from liability, it is not a guarantee
of treatment. Therefore, mandatory Lyme disease insurance coverage needs to be enacted in
Massachusetts. The Commission also recommends that a mechanism be devised to oversee
potential violations of the insurance mandate, should it be adopted, and to investigate reports of
potential discrimination against patients with Lyme disease.
In addition to education, other modes of prevention can provide protection from
infection. The Commission believes that the Pesticide Bureau should add specific tick-relevant
training though the pesticide licensing exam materials; look into spraying to control ticks;
implement a study to be conducted the State Reclamation Board to determine what extra funds
would be needed for each mosquito control district to expand the scope of their work to include
tick control measures; have the Department of Conservation and Recreation examine options for
reducing tick habitat; conduct a study to determine how to ensure compliance for tick control on
school properties; have MassWildlife study the costs and benefits of expanded access to
crossbow hunting; and have the Massachusetts Division of Fish and Wildlife explore the costs
and benefits of changing the archery safety zone to 150 feet of an inhabited dwelling to allow
greater access to sites for deer management.
The Commission recommends that state provide funding to provide the public and
medical community the most up-to-date materials regarding prevention, as well as diagnostic
tools and treatment practices and that the Commonwealth support state and federal funding for
tick-borne disease research.
It is important to note that the Commission members participated as individuals, and as
such, have voted to move the aforementioned recommendations forward. However, their
identification as Commission members does not imply full endorsement of all recommendations
or the official positions of agencies or organizations for which they work.