Interesting article on Tick Removal

[metastable]

http://theconversation.com/tackling-the ... oval-26306

Something I didn't realise:

But the species of ticks prevalent in those places are not associated with possible tick paralysis or potentially serious allergic reactions caused by Ixodes holocyclus. Australians need a different approach and there’s growing consensus that killing the tick in place may be best way to minimise the risk of severe allergic reactions.

Killing ticks

Killing ticks is tricky. Some insecticides may be effective but involving any substance (such as methylated spirits, nail polish, alcohol or petroleum jelly), or physical disturbance (such as the use of forceps) that agitates the tick is likely to cause it to inject more saliva and toxins into the skin, resulting in a more severe reaction.

The Australasian Society of Clinical Immunology and Allergy (ASCIA) recommends using aerosol “freezing” sprays normally associated with wart treatments. These products are widely available from pharmacies and they rapidly kill the tick in place, minimising potentially serious reactions.

Once killed, the tick can then be left to fall out naturally.

What we really need are clinical trials assessing the effectiveness of these currently recommended tick removal techniques and the likelihood of preventing or minimising allergic reactions. Fortunately, this is the focus of the recently formed Tick-induced Allergies Research and Awareness (TiARA) group.

I looked on the Allergy page they linked to in the article and it has this

Ether-containing aerosol sprays are currently recommended for killing the tick. Aerostart® and other similar products have been used extensively to kill ticks in allergic patients. It should be noted that these products are not registered for use in humans and contains benzene but there is long term experience with these products which have been shown to be very effective in treating those with serious tick allergies.

The use of other ether-containing sprays such as Wart-Off Freeze® (and similar e.g. Elastoplast Cold Spray®) has also been effective. These products will continue to be studied and advice updated as experience increases.

If available, liquid nitrogen applied by a doctor should also (in theory) be effective.

[photohiker]

I'll leave it to the researchers to work it out, but I am sceptical that Lyme Disease does not exist in ticks in Australia. If Lyme Disease is here, the longer the tick is attached the higher the possibility that you will be infected.

Whatever the reality of Lyme disease, killing the tick in situ and leaving it to fall out 'naturally' on it's own doesn't sound like a good plan to me. Killing the tick does not neutralise the bacteria, virii and toxins the tick carries! Even when it is dead it's mouth parts are inserted into your skin and there is nothing to stop transfer of infective agents.

[cams]

Interesting. My mate developed some reactions to eating meat after we spent an unplanned night in the bush and had a few ticks. Not sure if they still persist.

I also don't like the idea of leaving it to fall off. I'll probably try a combination of the two though. Use the freeze spray to kill it then get it off. I use a fine pointed scalpel to get in under its head then flick it off. Avoids squeezing it.

[photohiker]

Avoiding squeezing it is important. I carry the tick twister gadget, It overcomes the barbed traction of the tick's mouth parts.



You don't want any of that left behind...

[Brett]

Man... I'm never going to look at the little black blob stuck in my leg, the same way again!

[DARRIN-G]

Thanks if on the track i won't squeeze them, as I remove them straight away .I'll flick them out with my little buck knife.Prevention better than cure .Rubbing a little vicks vapor rub on shoes etc at the start keeps off leaches and or bushmans insect repelant, yeah if using vicks just clean your hands well, as it tends to burn your eyes n other sensitive areas.

[markg]

There are a lot of confirmed cases of Lyme disease in OZ already. The govt just won't admit to it. Not long ago a young girl got it and the aussie authorities denied it. The girls doctor sent blood samples to the US for analysis and guess what? Lyme disease. There was a report on 4 corners last year about this very topic.

[GPSGuided]

I couldn't understand the motive for denying the existence of local Lyme's disease, hence the benefit of doubt for the government's position. Similarly, the motives of the proponents for pushing the issue so hard.

[photohiker]

I couldn't understand the motive for denying the existence of local Lyme's disease, hence the benefit of doubt for the government's position. Similarly, the motives of the proponents for pushing the issue so hard.

So you are defending the governments position?

I can understand proponents pushing hard. Undiagnosed Lyme disease is a world of pain. If the government isn't accepting it in the face of a bunch of people in that position then I'd expect them to push back hard. What other motives would you suggest?

[David M]

I keep this tick removal tool in my first aid kit. It is designed for European and North American ticks, I trust it works on Aussie ones....

http://www.tickremover.com/

[David M]

Discussion of Lyme Disease on ABC Background Briefing:

http://www.abc.net.au/radionational/pro ... 12/4675072

[GPSGuided]

So you are defending the governments position?
I can understand proponents pushing hard. Undiagnosed Lyme disease is a world of pain. If the government isn't accepting it in the face of a bunch of people in that position then I'd expect them to push back hard. What other motives would you suggest?

I'm not defending but finding it odd why there's a special interest group that is kicking up an *&%$#! to seek recognition that Australia has endemic Lyme disease. To me, presence or absence of a disease is based purely on medical diagnostics and is treated accordingly. To make such a scene made me wonder whether the special interest group can benefit from it. Are they trying to sell vaccine or some other forms of preventative treatment? On the government side, I can't really think of any reason why they would want to deliberately hide it. As for the various academic specialists in infectious diseases, I'd think they are most well qualified to diagnose and differentiate this condition. All a bit weird.

In terms of people suffering from "Lyme disease like conditions", it may well not be Lyme disease but some others. Success with antimicrobial therapy may mean little to the cause of the initial symptoms and signs. If the specialists are seriously questioning the diagnosis of Lyme disease in those GP diagnosed patients, then I would tend to believe the specialists. Not as if Lyme disease is an unknown condition but a case where all specialists in infectious diseases would have learnt or possibly with personal clinical experiences in its diagnosis and treatment there in N America.

[icefest]

So you are defending the governments position?
I can understand proponents pushing hard. Undiagnosed Lyme disease is a world of pain. If the government isn't accepting it in the face of a bunch of people in that position then I'd expect them to push back hard. What other motives would you suggest?

I'm not defending but finding it odd why there's a special interest group that is kicking up an *&%$#! to seek recognition that Australia has endemic Lyme disease. To me, presence or absence of a disease is based purely on medical diagnostics and is treated accordingly. To make such a scene made me wonder whether the special interest group can benefit from it. Are they trying to sell vaccine or some other forms of preventative treatment? On the government side, I can't really think of any reason why they would want to deliberately hide it. As for the various academic specialists in infectious diseases, I'd think they are most well qualified to diagnose and differentiate this condition. All a bit weird.

In terms of people suffering from "Lyme disease like conditions", it may well not be Lyme disease but some others. Success with antimicrobial therapy may mean little to the cause of the initial symptoms and signs. If the specialists are seriously questioning the diagnosis of Lyme disease in those GP diagnosed patients, then I would tend to believe the specialists. Not as if Lyme disease is an unknown condition but a case where all specialists in infectious diseases would have learnt or possibly with personal clinical experiences in its diagnosis and treatment there in N America.

At the risk of this ending up like the debate on statins and saturated fat we had here recently, I mostly agree with GPSG in this regard. 

As yet there is little evidence of an environmental reservoir in Australia. The American strain of bacteria doesn't seem to be able to grow in Australian ticks.

As far as the government pushing against the presence; I would like to call you out and mention that there is currently a review of that very topic. http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-lyme-disease.htm
In the end, the clinical index of suspicion for lyme disease is incredibly low here, for good reasons.

[photohiker]

Good references there icefest!

I think we can shut down the idea that the government is denying anything to do with Lyme disease when there is a comprehensive investigation like that in progress! Hopefully one of the results will be an effective local diagnosis and testing strategy regardless of the results of whether or not there is a local risk.

[icefest]

If you get the chance, the scoping study is a decent and mostly bias-free literature review on the topic.

You can find it here: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-lyme-disease.htm/$File/scoping-study-2013.pdf

[GPSGuided]

Good link Icefest and thanks for digging it out. It confirms my take and confidence in the health departments when it comes to these technical issues. Those lay Lyme disease "supporters" should just let the experts sort these issues out.

[photohiker]

Good link Icefest and thanks for digging it out. It confirms my take and confidence in the health departments when it comes to these technical issues. Those lay Lyme disease "supporters" should just let the experts sort these issues out.

Well, maybe.

But also, maybe the issues are being sorted out because of their activism...

[GPSGuided]

Well, maybe.
But also, maybe the issues are being sorted out because of their activism...

There are more appropriate issues for activism. A disease condition is defined on technical ground and activism takes away the objectivity. Not appropriate. In any case, no one is stopping anyone from receiving full Lyme disease therapy. If a patient gets diagnosed as having Lyme disease by his/her doctor, then so be it, just treat it. If it "works", fine. If it doesn't work, try something else. No need for a national campaign to force the country to recognise the patient as having Lyme disease. A very odd behavioural characteristic and not the way how a good medical system works.

[icefest]

Well, maybe.
But also, maybe the issues are being sorted out because of their activism...

There are more appropriate issues for activism. A disease condition is defined on technical ground and activism takes away the objectivity. Not appropriate. In any case, no one is stopping anyone from receiving full Lyme disease therapy. If a patient gets diagnosed as having Lyme disease by his/her doctor, then so be it, just treat it. If it "works", fine. If it doesn't work, try something else. No need for a national campaign to force the country to recognise the patient as having Lyme disease. A very odd behavioural characteristic and not the way how a good medical system works.

This issue is that the activists want access to long term high dose antibiotics, and many medical practitioners disagree as this creates an incredibly prolific breeding ground for antibiotic resistance.
That's the crux of the issue.

Also, this is a pretty crap 1500th post :'(

[GPSGuided]

This issue is that the activists want access to long term high dose antibiotics, and many medical practitioners disagree as this creates an incredibly prolific breeding ground for antibiotic resistance.
That's the crux of the issue.

Let me help you up to 1501!

The antibiotics used to treat Lyme disease are all common unrestricted A/Bs and the diagnosing GP can prescribe them long term. It's like a storm in a tea cup and I am still not clear on their motives.

[icefest]

The antibiotics used to treat Lyme disease are all common unrestricted A/Bs and the diagnosing GP can prescribe them long term. It's like a storm in a tea cup and I am still not clear on their motives.

GPs can prescribe many of the antibiotics. The issue is whether they should.

While the recommended 30 days of doxy or amox are very much like the storm in the teacup, over two years of high dose antibiotics will result in some resistance. This is what advocates are saying is necessary and what is opposed by a large part of the medical community. http://puu.sh/8Xlk9.png

UpToDate (arguably one of the best "evidence-based clinical decision support resources") does not support this continuous treatment.
PM me for an excerpt.

[photohiker]

Well, maybe.
But also, maybe the issues are being sorted out because of their activism...

There are more appropriate issues for activism. A disease condition is defined on technical ground and activism takes away the objectivity. Not appropriate. In any case, no one is stopping anyone from receiving full Lyme disease therapy. If a patient gets diagnosed as having Lyme disease by his/her doctor, then so be it, just treat it. If it "works", fine. If it doesn't work, try something else. No need for a national campaign to force the country to recognise the patient as having Lyme disease. A very odd behavioural characteristic and not the way how a good medical system works.

Isn't the issue for Lyme disease diagnosis in Australia is a lack of adequate testing resources for the bacteria? That would mean there is a low chance of diagnosis in the first place. I don't know this is the case, but that is what I have picked up along the way. I've come across a few horror stories of people who have not had a diagnosis before things went downhill.

I also don't know all the motives behind the activism, but on the other hand the disease has a low profile here and if it is missed then the outcomes can be pretty drastic. I think the medical system is robust enough to accept input from the public, even if it comes from activists. If the activists are wrong, then all will be revealed as it was in the vaccination debacle, but hopefully a lot faster!

[GPSGuided]

GPs can prescribe many of the antibiotics. The issue is whether they should.

Given there already are proponent GPs out there, it's hardly an issue for a SIG to jump up and down about. If it's diagnosed as Lyme disease, then one does not need the Federal Govt's permission to initiate and continue treatment. As for minimising A/B resistance in the community, that's not a basis to deliberately deny the presence of Lyme diseases (if true). It's a fact based decision process and I don't see how the issue of A/B resistance comes into the equation.

[icefest]

I thin we're arguing the same thing..

Given there already are proponent GPs out there, it's hardly an issue for a SIG to jump up and down about. If it's diagnosed as Lyme disease, then one does not need the Federal Govt's permission to initiate and continue treatment.

I agree.

As for minimising A/B resistance in the community, that's not a basis to deliberately deny the presence of Lyme diseases (if true).

I agree, there is no denial, just little evidence for a large environmental reservoir.

It's a fact based decision process and I don't see how the issue of A/B resistance comes into the equation.

Yes, fact based. The issue is the non-following of treatment guidelines. (i.e when it is not fact-based anymore)

Canberra based infectious diseases clinician and academic Professor Peter Collignon says, ‘Some people want ... an antibiotic called ceftriaxone for instance which is ... one of our critically important or last-line antibiotics, and they want to take that for a year or more. Now I think the evidence for doing that is pretty flimsy.’

[GPSGuided]

Isn't the issue for Lyme disease diagnosis in Australia is a lack of adequate testing resources for the bacteria? That would mean there is a low chance of diagnosis in the first place. I don't know this is the case, but that is what I have picked up along the way. I've come across a few horror stories of people who have not had a diagnosis before things went downhill.

I also don't know all the motives behind the activism, but on the other hand the disease has a low profile here and if it is missed then the outcomes can be pretty drastic. I think the medical system is robust enough to accept input from the public, even if it comes from activists. If the activists are wrong, then all will be revealed as it was in the vaccination debacle, but hopefully a lot faster!

I think it's reasonable for SIG to raise awareness and increase the level of suspicion amongst the public and professionals, but not beyond when there are dubious facts. As much as Lyme disease is not as well known as a local disease, there's sufficient expertise locally to make an accurate diagnosis. Simply, there are enough specialists who have textbook/journal knowledge as well as many with personal experiences in treating such there in N America (a common country for postgrad training) and Europe. If there indeed is a concentration of Lyme disease sufferers here, I'd be surprised if they weren't picked up and confirmed by our experts. As for determining the presence and absence of the bacteria in our local tick population, that's a field that's way beyond the expertise of GPs and lay members of the SIG. As I said, I saw no reason why the department would deliberately deny the presence of Lyme disease if it's truly present. There's just no reason nor historical precedents in cover ups of such.

[GPSGuided]

It's a fact based decision process and I don't see how the issue of A/B resistance comes into the equation.

Yes, fact based. The issue is the non-following of treatment guidelines. (i.e when it is not fact-based anymore)

Canberra based infectious diseases clinician and academic Professor Peter Collignon says, ‘Some people want ... an antibiotic called ceftriaxone for instance which is ... one of our critically important or last-line antibiotics, and they want to take that for a year or more. Now I think the evidence for doing that is pretty flimsy.’

I don't think our points of view are in conflict. I just don't think the concern on A/B overuse and resistance is a primary decision point. When the evidences for local Lyme disease is still scratchy, concern for A/B resistance doesn't even have to come into play.

[Onestepmore]

I read somewhere that there may also be reluctance to accept the presence of the Lyme disease in Australia because it then opens up a huge potential insurance liability problem and duty of care issues to protect outdoor workers adequately from tick exposure. It often causes long term joint, immune system, chronic fatigue and associated depressive syndromes, which would then go on to be Work Cover compensation claims.
Just another aspect.
My doctor had no qualms about testing my daughter for Lymes a couple of years ago.

I use the little plastic hooked tick twisters for people and pets. There is also another easily used device like a flat disposable blade with a hole you slide the tick into.
I wouldn't use any method that might stimulate it to empty it's gut contents into you as it dies.

[markg]

Who saw the report on thursday about Lyme disease ? More evidence of it in OZ.

[ULWalkingPhil]

I don't know if it was Lymes Disease, but my nephews friend got a tick in a reserve backing my sisters home a few weeks ago, he spent the next 2 weeks in hospital.

Nasty critters those ticks. I had one gouge into me half way through the Cannondale great walk a couple years back, I could not complete the walk, taken me a couple weeks to fully recover.

I hate them.

Sent from my GT-N5110 using Tapatalk

[Gadgetgeek]

I don't fully understand it, but Lyme has been very polarizing in North America, and there is a lot of weird politics surrounding it. I think a large part of the activism here is a view that all governments are the same, or that all medical practitioners are the same, and that without a large activist presence we will see the same results here as are in North America, the US specifically. For some reason Europe doesn't seem to have a problem accepting that Lyme is there, but weirdly it doesn't seem like any of that research gets into north america. The long term research into Lyme has been very poor. Often with front-line doctors not testing beyond the basics, and since funding is so limited for it, we don't really know how effective that testing is. It doesn't help that the weird politics surrounding it has lead to all kinds of conspiracy theories, but really stupid policy decisions. Ontario was lauded for being one of the first to approve a lyme vaccine, but it turns out it didn't work, wasn't well tested and now the people who got it don't know if the symptoms they have are from actual lyme, or the vaccine, or something else. Qualitative symptoms are really problematic. But given the research funding that gets dropped into other new insect borne illnesses, like West Nile and the like, I just don't understand why Lyme is causing so much trouble. This one should be easy to crack. But then again it could be that all of the people with trouble are the statistical outliers, and we all have it? And once the big West Nile scare was burned out, I know a few people who were left without answers. I have a friend who got very sick with West Nile as a teen, and it really did a number on him, but since almost no one in his demographic got sick, there wasn't much of a focus on him. He's also got a recently diagnosed (genetic) chronic condition, and has no way of knowing if they have interacted in any way, or what. But point is, West Nile was never political. Lyme always has been, and I just don't understand why.