Target New Jersey; Lyme Disease: In Our Own Backyard

<v Speaker>We have a lot of wildlife through here. There are deer that are under the swing set, <v Speaker>sometimes my children swing set and they drop ticks off of them, which are then a <v Speaker>potential hazard to my children. <v Speaker>This isn't something that you went out and asked for. <v Speaker>This is something that was done to you by a little creature out there <v Speaker>who packs a powerful punch. <v Speaker>I've gotten calls from Garfield, calls that Rutherford, North <v Speaker>Arlington, Fairlawn, Fairfield, all this area that people <v Speaker>have Lyme. They've gotten it in their own backyards. <v Speaker>Just checking here and make sure that... <v Kent Manahan>Seeing a mother check her children for ticks after playing outside is becoming <v Kent Manahan>a more common experience throughout the country. <v Kent Manahan>That's because a particular tick, sometimes smaller than a pinhead,

<v Kent Manahan>carries the microscopic bacterium called a spirochete. <v Kent Manahan>This spirochete causes Lyme disease. <v Kent Manahan>I'm Kent Manahan. During the next hour, we'll examine what Lyme disease <v Kent Manahan>is, how it's treated, and better understand the risks associated <v Kent Manahan>with this spreading disease. <v Speaker>Hi Matthew. How you doing today? <v Speaker>[Matthew: good] Are you? <v Speaker>Any-. <v Matthew>My back hurts, my stomach hurt, my head hurts, and my leg hurts. <v Speaker>And you're doing ok, right? <v Patricia Walsh>It doesn't matter how they look, they can feel like they wish they were dead. <v Patricia Walsh>The pain is so bad and no one understands because, gee, they look good. <v Patricia Walsh>You can't see the pain they're in. You can't measure it. <v Speaker>I hate. this. chair. <v Patricia Walsh>Yeah, you can see a wheelchair. And you can see sunglasses and you can see I.V.

<v Patricia Walsh>insertion. But I mean, you can't even tell most of these kids have catheters <v Patricia Walsh>embedded in their chest or in their arms. <v Patricia Walsh>They're in a lot of pain. <v nurse>One day. I'm gonna hook you up now ok? <v Patricia Walsh>When they talk about the headache, the headache. <v Patricia Walsh>Like no one else has ever had before. This crushing headache in the center of their head <v Patricia Walsh>or the fact that they can't focus. <v Patricia Walsh>Or their joints hurt so badly they can barely walk or move. <v Patricia Walsh>These are things that you cannot see that you cannot test. <v Patricia Walsh>Sure maybe you can even see the sunglasses. <v Patricia Walsh>But you have no idea that they have double vision peripherally. <v Patricia Walsh>Or that they can't focus. Or they have conjunctivitis behind their eyes. <v Patricia Walsh>You don't see those things. But these kids feel the pain. <v Allison Burrell>You just put a piece of tape there. And then, like the nurses do, I remember, <v Allison Burrell>they do this. When the doctor saw me and we told her that we never <v Allison Burrell>had a tick, but we had a rash. <v Allison Burrell>And then she said, how long has the symptoms been?

<v Allison Burrell>My mom told her like because I had blurry vision <v Allison Burrell>and fatigue and everything like that for like <v Allison Burrell>about two years. <v Allison Burrell>And so the doctor said that I might have had Lyme disease for at least two years. <v Patricia Walsh>Most people right in our own communities have no idea how many children are homebound <v Patricia Walsh>with Lyme because they don't see them. <v Patricia Walsh>They're so sick that you don't see them. <v Patricia Walsh>Today, there are kids that couldn't come that are on our list, that are in our group <v Patricia Walsh>that couldn't come because they are so sick. <v Speaker>I had vague symptoms and till about three <v Speaker>years ago when I got awful, awful migraines, headaches. <v Niki Giberson>13 people on our street have Lyme disease, have been diagnosed with Lyme disease and nine <v Niki Giberson>people that I know of at this point do not have it. <v Niki Giberson>10 percent of the population in Port Republic has been diagnosed positively with Lyme <v Niki Giberson>disease. 10 percent.

<v Niki Giberson>You won't get those numbers from the county or from the state or from the nation for some <v Niki Giberson>reason. But. <v Niki Giberson>I'm trying to do the best I can to get the word out, at least so that if you do get a <v Niki Giberson>tick bite, don't ignore it. <v Kent Manahan>Lyme disease can be a very debilitating disease that is sometimes hard to diagnose. <v Kent Manahan>If left untreated, a person with Lyme disease can develop serious arthritis <v Kent Manahan>and have heart or nervous system problems. <v Kent Manahan>What's happening in Port Republic, a small South Jersey coastal town, is not <v Kent Manahan>unusual or even limited to just small towns. <v Kent Manahan>Dr. Durland Fish describes his research in a more densely populated suburban <v Kent Manahan>New York county. <v Dr. Durland Fish>We know that about 70 percent of the people acquired the tick bite at home <v Dr. Durland Fish>on their own, their own property. <v Dr. Durland Fish>That's here in Westchester County may not be true for other areas. <v Dr. Durland Fish>But here in Westchester County, where we have primarily a residential community <v Dr. Durland Fish>nestled in the natural forest habitat.

<v Dr. Durland Fish>Very beautiful. Very nice place to live. <v Dr. Durland Fish>But we have a lot of ticks here in the forest, too. <v Dr. Durland Fish>And people are living in the forest. <v Dr. Durland Fish>And they're finding ticks and they're in their yards. <v Dr. Durland Fish>Sometimes in the lawn, sometimes in the ornamental plantings, sometimes <v Dr. Durland Fish>in the woods, uh, between the properties, but the ticks, <v Dr. Durland Fish>the ticks are there and most of the people are getting Lyme disease from ticks- <v Dr. Durland Fish>tick bites acquired at home. <v Dr. Russel Johnson>Lyme disease is, uh, I think, overdiagnosed, underdiagnosed, <v Dr. Russel Johnson>over-reported and underreported. <v Dr. Russel Johnson>It's very difficult because it is a difficult disease to diagnose. <v Kent Manahan>Throughout the country people have organized self-help groups to better understand <v Kent Manahan>and cope with the difficulties related to Lyme disease. <v Kent Manahan>We attended support group meetings in New York, New Jersey and California. <v Thora Graves>The beginning of my illness was a bull's eye rash. <v Thora Graves>Was on my neck. It went from the rash on my neck to <v Thora Graves>heart palpitations, chest pain, numbness

<v Thora Graves>in my left arm, numbness in my left cheek. <v Thora Graves>Stiff, very, very stiff neck back pain. <v Thora Graves>They thought I had a herniated disc. <v Thora Graves>They were going to do disc surgery in my neck. <v Thora Graves>Then it was possible that I had rheumatoid arthritis, <v Thora Graves>multiple sclerosis, and I was told I had lupus. <v Thora Graves>There's nothing else that I can think of that can mimic so many different things. <v Thora Graves>And because of the bull's eye rash. <v Thora Graves>It was pretty certain that I had Lyme. <v Dr. Leonard Sigal>There's an epidemic of it now for a variety of reasons. <v Dr. Leonard Sigal>And here we sit in the middle of it in New Jersey. <v Kent Manahan>Every county in New Jersey reports Lyme disease. <v Kent Manahan>But the State Health Department reports the incidence of Lyme disease is greater in some <v Kent Manahan>of the coastal counties. Ocean, Atlantic and Monmouth. <v Speaker>My heart breaks for the people that are going in and out of these doctor's offices every

<v Speaker>day and they don't know what they have and they're not being treated. <v Kent Manahan>Betty Gross saw 56 doctors in less than eight weeks. <v Betty Gross>What made me know they were wrong? <v Betty Gross>I never had a negative experience of that nature before. <v Betty Gross>So why would I suddenly viscerally know something was <v Betty Gross>out of kilter? <v Thora Graves>What else could be so bizarre? <v Thora Graves>If you go to the doctor with symptom after symptom, with no answer, you have <v Thora Graves>to have a name for what you're suffering for. <v Thora Graves>And it's, it's Lyme. <v Dr. Leonard Sigal>A good physician is all ears and all sort of sensory organs. <v Dr. Leonard Sigal>And you have to pick up as much information as you possibly can from your patient. <v Dr. Leonard Sigal>And you can't you cannot throw out information because <v Dr. Leonard Sigal>you're not prepared to accept it. <v Dr. Leonard Sigal>Physicians who don't listen are not really very good physicians. <v Kent Manahan>In the early 1960s, Polly Murray moved to the east bank of the Connecticut River <v Kent Manahan>and began having terrible symptoms that kept recurring.

<v Kent Manahan>Rashes, headaches and stiff necks. <v Polly Murray>And then by 1971, my symptoms were so bad that I was hospitalized <v Polly Murray>three times that year. <v Dr. Stephen Malawista>Polly Murray and Judith Mench really discovered <v Dr. Stephen Malawista>Lyme disease. They called our attention to Lyme disease. <v Dr. Stephen Malawista>They had. <v Dr. Stephen Malawista>Children, relatives and neighbors who were having attacks <v Dr. Stephen Malawista>of arthritis. <v Polly Murray>I became quite desperate for a diagnosis and started doing research on my own <v Polly Murray>so that I had looked up all the different differential diagnoses to <v Polly Murray>lupus and to rheumatoid arthritis and two other things that the doctors thought <v Polly Murray>I might possibly have. <v Kent Manahan>In 1977, Good Housekeeping magazine labeled Polly Mary's battle <v Kent Manahan>with Lyme disease. Mrs. Murray's mystery disease. <v Polly Murray>We were all doing reacting the same way, but I couldn't convince any doctors <v Polly Murray>that this was true. <v Dr. Leonard Sigal>Those physicians just didn't want to hear it.

<v Dr. Leonard Sigal>They ignored these housewives and found excuses for not dealing with the problem. <v Kent Manahan>Lyme disease got its name because Polly Murray, who spearheaded initial research <v Kent Manahan>into the disease, lives in Lyme, Connecticut. <v Polly Murray>It was in the fall of 1975 when things got very bad <v Polly Murray>and their, their symptoms were just really very critical that <v Polly Murray>I decided to call the State Health Department and ask if they had <v Polly Murray>known of any other instances. <v Kent Manahan>The public health department in Connecticut suggested she contact Yale's medical <v Kent Manahan>center. <v Dr. Stephen Malawista>When we heard about this, I was the chief of rheumatology. <v Dr. Stephen Malawista>Alan Steerer was my first year fellow who'd just come to learn about rheumatology. <v Dr. Stephen Malawista>And we thought this might be a good project for him to cut his rheumatologic <v Dr. Stephen Malawista>teeth on. <v Speaker>And from October 16th until November 20th, when I saw Alan Steere, I gathered <v Speaker>35 more case histories. I took all these case histories and plus our whole history <v Speaker>of all of our symptoms. And we spent hours going over these lists

<v Speaker>of information that I had. <v Speaker>And then that started really the initiation of the investigation <v Speaker>into Lyme disease, some project. <v Speaker>It's now a disorder that is found worldwide <v Speaker>and 40 on every continent except Antarctica and 43 <v Speaker>of the 50 states. And there's tremendous activity going on in the world <v Speaker>and the further elucidation of a of Lyme disease. <v Speaker>So it turned out that was a very good thing to work on. <v Speaker>Research activities in Lyme, Connecticut, continued using a network <v Speaker>of mothers and children with the disease and their neighbors. <v Speaker>Dr. Steere and Dr. Marla Wistow found 51 people with Lyme disease. <v Speaker>They were children and adults. <v Speaker>A quarter of these patients, when we were asking them what their <v Speaker>history was. Told us that many weeks before <v Speaker>the arthritis occurred, they'd had an expanding red

<v Speaker>rash. <v Speaker>And one patient even remembered having had a tick by finding the agent <v Speaker>in the tick that was causing the disease would not be as quickly discovered <v Speaker>six years later in 1981. <v Speaker>In an activity that has been described as scientific serendipity, Dr. <v Speaker>Willie Bergdoll offer from the Centers for Disease Control Laboratory in Hamilton, <v Speaker>Montana, and Dr. Hawkei Binoche at the State University of New York <v Speaker>at Stony Brook. We're looking for a new strain of Rocky Mountain spotted fever. <v Speaker>Their work brought them to look at a small, newly identified tick, the deer <v Speaker>tick. Dr. Bergdorf, four, asked Dr. Binoche for more of these ticks. <v Speaker>And he said it's going to be a cinch to get hundreds of <v Speaker>Damini. <v Speaker>And he said to me, Dr. Bergdorf didn't find the bacterium <v Speaker>that caused Rocky Mountain spotted fever. <v Speaker>Instead, he found two ticks with another bacterium that led him to search <v Speaker>for a pathogen in an unusual place.

<v Speaker>The mid gut of the tick, I found disparities. <v Speaker>And then came next, a telephone call to Dr. Vonage. <v Speaker>This what we found. We need more ticks and in no time. <v Speaker>We had several hundred takes investigating for aspiring kids and found that <v Speaker>60 percent of them were infected with that spiral. <v Speaker>Dr. Berghofer went on to confirm that the spiral kit was the cause of <v Speaker>Lyme disease. But identifying a new spiral Ketel based disease created <v Speaker>an important concern. <v Speaker>The organism is very similar to the organism that is <v Speaker>causing syphilis. <v Speaker>Syphilis is a highly complex disease and so is Lyme disease, syphilis <v Speaker>was a killing disease. <v Speaker>At the time of Christopher Columbus, mean people died from syphilis <v Speaker>in in large numbers, although the organism is similar and having the same shape is <v Speaker>a very different organism. <v Speaker>And it's been extremely elusive. <v Speaker>Scientists have yet to develop a vaccine for syphilis and like

<v Speaker>syphilis, if the early skin rash of Lyme disease is overlooked. <v Speaker>More complicated neurological symptoms can develop like syphilis. <v Speaker>The spirochete that causes Lyme disease can cross the placenta and is <v Speaker>known to infect the fetus. <v Speaker>Now, in the case of syphilis, you have a high incidence <v Speaker>of infection of the fetus as high as 100 percent in the early <v Speaker>stages of the pregnancy when the moment becomes infected. <v Speaker>We don't have that situation according to Lyme disease. <v Speaker>The good news is that if someone has Lyme is under treatment and then becomes pregnant, <v Speaker>even if the line is not completely gone. Apparently the immune system is strong enough to <v Speaker>prevent it from transmitting to the child. <v Speaker>Likewise, if someone does contract Lyme during pregnancy, even the first trimester with <v Speaker>good treatment, nothing bad usually comes from that. <v Speaker>And I've handled several dozen cases of patients who were pregnant. <v Speaker>The headline with before, during or toward the end of pregnancy and if they're properly <v Speaker>diagnosed and treated. Not a single case of bad outcome resulted. <v Speaker>It looks as though.

<v Speaker>The more we learn about Lyme disease, the more we understand some of the problems that <v Speaker>are caused by syphilis, and we can learn some things from the syphilis <v Speaker>experience that seem to be directly applicable to the organism that causes Lyme <v Speaker>disease. <v Speaker>Although there have been one or more reports that the spy rocket might be transmitted <v Speaker>by other blood sucking insects like mosquitoes, force or deer flies <v Speaker>or even urine from an infected mouse, research to date has been very <v Speaker>clear as far as we know at this point in time. <v Speaker>The only way you can get Lyme disease is by being bitten by a tick that carries <v Speaker>the sparkie. The causes Lyme disease. <v Speaker>Insects that transmit disease to humans and other mammals are called vectors. <v Speaker>Three different, yet very similar ticks are known to carry Borrelia Bergdorf <v Speaker>awry. The spirochete that causes Lyme disease. <v Speaker>In the upper Midwest, primarily Wisconsin and Minnesota, a tick called <v Speaker>ixodes damini is present.

<v Speaker>This tick, known as the Deer Tick, also occurs on the eastern seaboard <v Speaker>from Maine through Maryland and into northern Virginia, in the <v Speaker>south, along the Atlantic seaboard, well into Florida and westward into the central <v Speaker>part of Texas. There is another similar species of tick known as <v Speaker>the black legged tick or ixodes scapularus. <v Speaker>In the far west, running from near the California Mexican border, up along <v Speaker>the Pacific coast, all the way to northern Washington and into the southern most <v Speaker>part of British Columbia, there is another similar species of tick known as <v Speaker>the Western black legged tick or ixodes pacificus. <v Speaker>We have forty nine species of ticks all together in California, <v Speaker>but easily the most widespread tick. <v Speaker>It's exciting, specific. <v Speaker>What this says is that not only is the vector widespread in California,

<v Speaker>but the disease is widespread in California. <v Speaker>Over here, we have a tick on a piece of grass, it's a little bit high. <v Speaker>That's that's kind of unusual. But you see what. <v Speaker>What this female is doing right here. <v Speaker>She's she's got her her legs wrapped around this. <v Speaker>This piece of grass she's hanging on. <v Speaker>Now, if you happen to breathe on her or move her in some way, she'll throw out <v Speaker>those front legs like this. And she's got a little grappling hooks at the ends of her <v Speaker>legs. And if you happen to brush up against that, she swings <v Speaker>the boards and grabs hold. <v Speaker>It swings the board and starts climbing up looking for a place to feed. <v Speaker>Now, watch your breathe on her and you can see here throughout her leg. <v Speaker>It's. It's not a local problem, while <v Speaker>certainly most of the human cases have come from the north coast and the <v Speaker>western slope of the Sierra Nevada. <v Speaker>We have cases from the Mexican border to the Oregon border.

<v Speaker>The small one is the male, larger one is a female. <v Speaker>National surveillance of the disease really wasn't initiated until nineteen eighty <v Speaker>three between 1983 and present. <v Speaker>CDC kept. Statistics of reported cases from from <v Speaker>the various states and as compiled of surveillance reports, <v Speaker>over 30000 people are reported to have had Lyme disease. <v Speaker>Since the Centers for Disease Control began keeping records in 1983. <v Speaker>Yet it's clear this disease has been around for some time. <v Speaker>Scientists have shown that the spiral, Keith, was present in deer ticks collected <v Speaker>in the 1940s. <v Speaker>What that tells you is that a generation before we discovered Lyme disease, <v Speaker>the right tick had the right spider ketel genetic material <v Speaker>in it to make that disease. <v Speaker>Certainly the first example of a skin rash, erythema, chronic migraines

<v Speaker>was described in Wisconsin 1970 when it comes to the <v Speaker>published literature, the first article that we now reference <v Speaker>relating to this infection dates to 1883 three out of Central Europe. <v Speaker>We had a similar article describing the same kind of skin condition <v Speaker>in eighteen ninety nine from the United States <v Speaker>to the Lyme disease, been present on the face of the planet for well over a century. <v Speaker>For many years on the eastern tip of Long Island, New York, doctors have recognized <v Speaker>a condition which is now thought to be Lyme disease. <v Speaker>Lime has been present here for many years, both anecdotally by the patients having <v Speaker>symptoms, including a condition called Montauk Knee, which dates back many years even <v Speaker>beyond World War to. <v Speaker>The whole area is full of both ticks and Lyme disease and many victims <v Speaker>of Lyme disease. <v Speaker>Including myself.

<v Speaker>They're everywhere. <v Speaker>I know, I, uh. <v Speaker>Some people say they're not. But those in the know say that they're virtually everywhere. <v Speaker>I think I probably got it golfing as a matter of fact, I now call golf going out to chase <v Speaker>ticks. <v Speaker>We're going out to get Lyme disease innocence. <v Speaker>Years ago, when people lived in cities and decided to move <v Speaker>out in the country or into suburbia the many <v Speaker>years ago with what developers would do is they sort of clear cut a property and put <v Speaker>houses and put these little saplings in front of the houses. <v Speaker>Right. Which people didn't like. <v Speaker>So what they now do and what they've done for product fifteen years or so is instead of <v Speaker>clear cutting those sort of the sort of scoped out a little niche <v Speaker>from the woods. And so what you've now got is a beautiful set of woods just <v Speaker>beyond your backyard, a little bit of brush, low vegetation, and then your <v Speaker>lawn and then your house. And you got this nice window that looks out there.

<v Speaker>And it took a few years ago, people would say, isn't that nice? <v Speaker>The deer coming into the backyard and they're eating the communities. <v Speaker>That's that's nice. Nowadays, what people are beginning to realize is <v Speaker>that we have built the environment for Lyme disease in our backyard. <v Speaker>We've made Lyme disease a problem. <v Speaker>And in addition, we have an exploding deer population in the state of New Jersey and <v Speaker>across the northeast in general. <v Speaker>So all the factors are ripe for having Lyme disease. <v Speaker>A tick is definitely spreading, along with the spreading of a tick spiral kick. <v Speaker>It is going along with it. And so we're having Lyme disease occurring in areas where it <v Speaker>was not before. <v Speaker>And then our studies with birds, we found that migrating birds will carry ticks. <v Speaker>I was quite surprised when we first started looking at wild birds that the numbers <v Speaker>of ticks that one could find, say, on on a robin. <v Speaker>We have found a number of ticks feeding on birds to be carrying the spiral <v Speaker>feed. And we find that those parakeets that we isolate from bird feeding kids.

<v Speaker>Are infectious, birds are a natural means. <v Speaker>For moving. <v Speaker>These ticks relatively long distances. <v Speaker>Immature tics remain attached to their host, Danimal, for an average of three to <v Speaker>five days. In late summer and early fall, birds migrating <v Speaker>south. Can pick up ticks in Massachusetts or Connecticut and drop them off <v Speaker>in New Jersey and further south. <v Speaker>Birds moving north in the spring can pick up ticks in New Jersey and deposit <v Speaker>them further up the coast. <v Speaker>Now, you might say it's sort of on a roll. <v Speaker>There's a lot of ticks and there are a lot of holes that are out there. <v Speaker>And it's definitely moving into all the environments where that is suitable for the <v Speaker>lifecycle. The tick, for instance, in Minnesota is definitely moving into the Twin Cities <v Speaker>area. <v Speaker>Lyme disease now is the leading vector borne disease in the United States. <v Speaker>In nineteen ninety seven thousand nine hundred and ninety five cases of Lyme

<v Speaker>disease were reported to the Centers for Disease Control. <v Speaker>The states with the highest incidence of the disease are Connecticut, New York, <v Speaker>New Jersey, Rhode Island, Delaware, Wisconsin, Maryland and <v Speaker>Pennsylvania. <v Speaker>It's important to understand that there is tremendous regional variation in the. <v Speaker>In the distribution of Lyme disease and most of the cases occur in very specific <v Speaker>areas of the country. It is true that the disease is spreading. <v Speaker>And increasingly, we're finding cases in the Southeast, the Midwest. <v Speaker>That's may actually be more sensitive to Lyme disease than humans. <v Speaker>There is a vaccine for dogs, which is now being tested. <v Speaker>I suspect that we will find that the two juvenile stages, <v Speaker>the larva and the NIMH, will be found feeding on probably <v Speaker>every land mammal. <v Speaker>Here in the Northeast, the dog we think is an extremely important animal <v Speaker>and this person would take to new areas.

<v Speaker>We found as many as 400 one ticks on one dog and twenty seven <v Speaker>percent of these ticks were infected. <v Speaker>And this dog was then brought from a highly endemic area to a non endemic area. <v Speaker>And now that non endemic area was starting to pick up infected ticks. <v Speaker>It's suspected that this occurs because of the large number of eggs a single female <v Speaker>deer tick can lay in. <v Speaker>Adult female produces about 4000 eggs, and those eggs all hatch into <v Speaker>larvae and then they sit around a wait for an animal to go by. <v Speaker>Only one natural predator is known, a small wasp. <v Speaker>To date, this tick has been found feeding on <v Speaker>approximately 50 different kinds of birds. <v Speaker>And perhaps thirty one or thirty two different species of mammals. <v Speaker>The juvenile ticks the larval and the nymphal stage. <v Speaker>Are found frequently on white-footed mice. <v Speaker>But they're also found on other animals such as chipmunks and the white-footed

<v Speaker> mouse here in Connecticut. <v Speaker>In New York and in New Jersey. <v Speaker>I think we will find in areas where Lyme disease is endemic. <v Speaker>We will find 70 to 80 percent or more of those mice during the summer to <v Speaker>be actually infected with the spirochete that causes Lyme disease. <v Speaker> If you can somehow not allow the tick to get the organism. <v Speaker>There's no disease. End of story. <v Speaker>People try all sorts of ways to decrease the number of ticks. <v Speaker>We try to keep our grass cut short, which really does seem to make a difference in <v Speaker>keeping down the tick population. <v Speaker>I'm trying to get a controlled burn now, go through Port Republic so that because <v Speaker>all the old timers in this area say that when we had control burning, the tick problem <v Speaker>was not as bad. <v Speaker>We have everything from raccoons to possums, birds, squirrels, everything, <v Speaker>that just live all over. This is their domain, too, and all of them carry ticks

<v Speaker>which could potentially carry Lyme disease. <v Speaker>So we'd stay out of the woods. We stay out of the grass. <v Speaker>It's knee high. <v Speaker>We just try to keep everything cut as short as we can. <v Speaker>The range of these ticks is expanding. <v Speaker>Now, we have equivalent, in our force here. <v Speaker>We have almost two ticks per square meter per square <v Speaker>yard of forest. <v Speaker>Now, that's a big change. <v Speaker>We can move very, very comfortable with the fact that we know what's what's happened <v Speaker>here. Similar situations have been observed in upstate New York, Massachusetts <v Speaker>and New Jersey. And down in Maryland, Delaware <v Speaker>and into Pennsylvania, these seem to be new infestations of these ticks. <v Speaker>I'd walk through the woods all the time and maybe pull a tick off now and then. <v Speaker>Then I began to notice that even in the wintertime, in February one year, I was walking <v Speaker>through the woods and got a tick on me. They just seemed to be much more resilient. <v Speaker>Now they seem to be even worse.

<v Speaker>A lot of it has to do with the lifecycle of the tick. <v Speaker>Different stages are out at different times of the year. <v Speaker>This tick has a two year life cycle and only feeds three times <v Speaker>the adult tick is out seeking a blood meal from October of one year to May <v Speaker>of the next. These ticks are most abundant in the fall, but any <v Speaker>time that it's above 40 degrees in the winter with no snow on the ground, <v Speaker>the adult deer tick will be out. <v Speaker>After the female adult tick lays its eggs, they hatch into the tiny <v Speaker>first stage, the larval stage. <v Speaker>This small tick is out in the spring and late summer, but it doesn't necessarily <v Speaker>transmit Lyme disease. <v Speaker>The middle or nymphal stage of the tick is most abundant. <v Speaker>In May, June and July, even though it may take several hours <v Speaker>for a tick to infect a person with the spirochete that causes Lyme disease. <v Speaker>The nymph is a much more dangerous animal than the adult. <v Speaker>The adult tick is large enough that people can find it and remove it

<v Speaker>before disease transmission can occur. <v Speaker>That's not true with the nymphal stage. <v Speaker>Most people never know that they've been bitten by the nymph. <v Speaker>The nymph feeds it will be on them for four, maybe five days. <v Speaker>But these ticks are such efficient blood feeders that people never notice that they're <v Speaker>there. And the tick will drop off on its own accord and they'll never realize that <v Speaker>they've been bitten by a tick. <v Speaker>And that's the dangerous situation. <v Speaker>If you live in an area where you can find adult deer ticks in the winter, then in <v Speaker>the summer you should be looking for the nymphal tick. <v Speaker>Some people go in a park. They get bitten by a tick. <v Speaker>But it's not their environment, we live in an environment where ticks exist. <v Speaker>So we have a multifaceted problem here. <v Speaker>Important public and in many other towns in New Jersey have the same problem, just living <v Speaker>with the tick. <v Speaker>I have a home that's only twenty two miles from where the first case of actually Lyme <v Speaker>disease, erythema migrans occurred in the U.S. <v Speaker>And then only three ticks that I have found on our property in the last few years

<v Speaker>have all been infected. I enjoy going up there, but I just take proper precau- <v Speaker>precaution. <v Speaker>There's two kinds of response that I've seen from people here. <v Speaker>One is that they're they're good. <v Speaker>They accept the situation. They're not going to go out of their way to to prevent getting <v Speaker>Lyme disease. Essentially, they're still gonna go out to the yard. <v Speaker>They're gonna go hiking. They're going to have pets and they're going to do what they <v Speaker>normally do and take their chances with Lyme disease. <v Speaker>On the other end of the scale, we have people who are who are terrified to go out <v Speaker>out of doors, just the notion that there is a tick out there that could make them or <v Speaker>their children sick. <v Speaker>They don't go outside. <v Speaker>They say they're ready to move back to the city or move into another area. <v Speaker>My husband's family has lived on this property since sixteen, thirty seven. <v Speaker>We're not leaving. We're going to make things better. <v Speaker>We're going to change things. We're going to find an answer to all these questions. <v Speaker>And to me, that's one of the reasons why I'm involved with Lyme disease and with the <v Speaker>support group in South Jersey.

<v Speaker>We can't just run away and pretend it doesn't exist. <v Speaker>It does. We do have a problem here. <v Speaker>But you have to go through a lot of effort to try to protect yourself adequately <v Speaker>from Lyme disease. If you live in an area where these nymphs occur, for instance, <v Speaker>you've got to you've got to dress appropriately. <v Speaker>You know, you've got to tuck your pants into your socks. <v Speaker>You've got to wear insect repellent. You've got to wear light colored clothing so you can <v Speaker>see these ticks on them. And you have to check yourself and your children everyday, <v Speaker>everyday. You have to check for these small my new ticks. <v Speaker>Now, you're not going to do that unless you are convinced <v Speaker>that it's worth your time, that that the ticks are actually there and then you could <v Speaker>prevent Lyme disease by doing it. So you have to know that you live in endemic area. <v Speaker>Another, these ticks are around and you can determine that either by <v Speaker>contacting your local health department or collecting <v Speaker>ticks yourself. <v Speaker>May not have food.

<v Speaker>Sure, haptics in Dutchess County, New York, Gloria Wenke was able <v Speaker>to collect enough ticks to prove that an entire county has a deer tick problem. <v Speaker>Originally, Gloria was told by the health department that there were no deer ticks. <v Speaker>I got a very unsatisfactory answer. <v Speaker>I was told I was wrong and I knew I was right and I had to <v Speaker>get the proof. And that's what started. It was like Pandora's box. <v Speaker>And then I heard about Westchester's problem realized this wasn't that far from <v Speaker>Westchester. Chicks do not observe county or <v Speaker>state lines. And it got started <v Speaker>kind of that way. The handwriting was on the wall. <v Speaker>I think the more facts you have, the easier it is to deal with. <v Speaker>Facts, not fiction. <v Speaker>We don't know how to control the tip properly, Terry shall, with the State Department of <v Speaker>Health here in New Jersey, is doing some very nice work using chemicals in solid <v Speaker>form to try to diminish tick populations in various localized areas. <v Speaker>Very nice work being done by the State Department of Health.

<v Speaker>Our activities are primarily the ecology of Lyme disease, studying <v Speaker>deer ticks, how to reduce their populations, <v Speaker>identify where ticks are based on vegetation, what the principal <v Speaker>hosts or what the rates of infection are, 16 <v Speaker>mice are important in the cycle of this disease and that they provide the principal <v Speaker>source of blood for the immature ticks as well as acting as the <v Speaker>reservoir host. <v Speaker>That is the source from which the ticks acquire the spire Keats. <v Speaker>Since they are such important hosts, we use them to monitor tick populations. <v Speaker>We determine the number of ticks on mice during that particular <v Speaker>deer tick stage before we make applications and then following it. <v Speaker>And then by comparing the two, we're able to determine the effectiveness of <v Speaker>the pesticide intervention.

<v Speaker>So what we'll do is at various sites, we'll go through and monitor <v Speaker>our trapping grids two days a week. <v Speaker>We will bring them back to a vehicle. <v Speaker>Nesta ties them, count the immature deer ticks on each mouse. <v Speaker>We'll compare those data later on to what we've found at the <v Speaker>areas that were untreated. Give some relative idea of how successful we <v Speaker>are. <v Speaker>We've evaluated all these sites prior to our application and found that they had <v Speaker>the same population of deer ticks. <v Speaker>So any kind of intervention we have will be based solely on <v Speaker>the chemicals we put down. <v Speaker>We're using mice simply because the alternative <v Speaker>methods of collecting subadult ticks are even more labor intensive. <v Speaker>You have an item, Gord's larval deer tick. <v Speaker>So you can see how small the tick is. <v Speaker>The lifecycle of the deer tick is at least two years long, so that

<v Speaker>if you are trying to develop an intervention, a tick control <v Speaker>program needs to be followed through the entire lifecycle of the tick <v Speaker>so that every study that you become involved in is a minimum of two years study. <v Speaker>You're around the eyes and around the muzzle give you some idea about the relative <v Speaker>success of this study. <v Speaker>The mice from the site this morning had an average of fifty five larval ticks <v Speaker>on the site. We just looked that at one point <v Speaker>seven larvae. <v Speaker>Mouse ticks are notorious for being almost impossible to control, although <v Speaker>no attempts are being made in that direction. <v Speaker>So the best means of controlling. <v Speaker>But then the disease would do by vaccination. <v Speaker>They'll probably be at least three to five years. <v Speaker>Once a human vaccine company starts working on the development of a vaccine <v Speaker>before it's going to be available for the public because of its close links to the

<v Speaker>environment and because it is centered in in some places rather than <v Speaker>others, I think it is appropriate to view it as a public health problem, much like AIDS. <v Speaker>Lyme disease is a public health problem that came to the forefront because of the efforts <v Speaker>of people who have gotten the disease. <v Speaker>It is a personal health problem for the individual and for the individual's physician who <v Speaker>they have to treat it as they would any disease. <v Speaker>We have videos. We have one that's available for. <v Speaker>crosstream borrowing's and the videotape stores. <v Speaker>Of course, you might feel tired or have a headache, fever and stiff neck for <v Speaker>a lot of other reasons besides Lyme disease. <v Speaker>Didn't a lot of smoke, but not a whole lot of fire when it comes to properly educating <v Speaker>the population. <v Speaker>Many physicians are not adequately informed about it in early <v Speaker>disease. <v Speaker>Certainly people who come in with with the skin rash, erythema, chronic of migrants. <v Speaker>When you treat them. <v Speaker>With all antibiotics, the overwhelming majority of those patients will be treated and

<v Speaker>cured. <v Speaker>If you have any discomfort as I compress or moving joints there, there's more to <v Speaker>diagnosing Lyme disease and recognizing a rash. <v Speaker>As many as 60 percent of the people who get the disease will not recall a <v Speaker>tick bite. Nor will they get the classic identifiable rash <v Speaker>without the rash. As a major presenting symptom, Lyme disease can be <v Speaker>very hard to diagnose. <v Speaker>I see the gamut. People come into me as a tick still attached. <v Speaker>I see people coming in after the fact, having rashes, and I see people coming in much <v Speaker>later on complaining of. <v Speaker>Lyme symptoms like having a flu that doesn't go away. <v Speaker>Headaches, body aches, extreme fatigue, stiffness of the joints, sometimes heart <v Speaker>flutters, sometimes chest tightness. <v Speaker>The list goes on and on. <v Speaker>It's an important disease. It's a potentially very serious disease. <v Speaker>We're only now learning how bad it can be for some, but by no means all the people <v Speaker>who are affected. <v Speaker>One of the more disturbing things is if it affects the central nervous system as a main

<v Speaker>symptom, they can complain of dizziness and effects on the hearing and vision. <v Speaker>But confusion and forgetfulness and some people even get so <v Speaker>confused they have trouble functioning on a daily world. <v Speaker>My first test was negative. <v Speaker>And the disease just progressed and got deeper and deeper and worse. <v Speaker>Many, many people out there that have Lyme disease that are getting <v Speaker>negative tests. And because of that, the doctors say they don't <v Speaker>have life. And I think that's that's really unfortunate, <v Speaker>because the result is that that every day that goes by without <v Speaker>some kind of an antibiotic therapy. <v Speaker>It's going to progress and get more debilitating. <v Speaker>The people who are easy to treat, were easy to cure, are being treated and are being shot <v Speaker>and they're disappearing. The people, though, who are remaining are those who are the <v Speaker>difficult cases. <v Speaker>But they're also the ones who are disabled, who are losing their jobs, who are losing <v Speaker>their income and are the ones who are causing a big problem. <v Speaker>You can't believe how many people are out there lying at home disabled because of Lyme

<v Speaker>disease. And they're told, well, you had two weeks of antibiotics, you're over. <v Speaker>Laboratory tests that help physicians diagnose Lyme disease can be both <v Speaker>inaccurate and nonspecific. <v Speaker>It stated it's every medical journal. <v Speaker>Article, they will say to begin with, if it's caught early, <v Speaker>it's curable and you can go around this room and most of the people that are here <v Speaker>are victims that were patients that were not caught early. <v Speaker>And even those who were caught early may not be here because the relatively <v Speaker>new people are still not sure in the sense <v Speaker>that they're still having symptoms that the doctors ordered. <v Speaker>No. <v Speaker>There is no doubt but that patients can become symptomatically cured <v Speaker>after a period of therapy. <v Speaker>The period of therapy, I find is variable from person to person and seems <v Speaker>to be influenced by the duration of the infection and especially

<v Speaker>the duration of the illness preceding the onset of therapy. <v Speaker>My doctor thought that my positive test could be a false positive. <v Speaker>And it kept saying, well, maybe you don't have Lyme disease, even though my test was <v Speaker>positive. So we would try something for two weeks and then he'd say, well, you don't have <v Speaker>it because the two weeks is up and the antibiotic didn't work. <v Speaker>Bacterial logic cure that is getting rid of the last of the infection <v Speaker>is another story. And at this point, I don't think that we have the scientific <v Speaker>means by which to determine when a person is sterilized or this infection. <v Speaker>Polymerase chain reaction is a way of amplifying <v Speaker>genetic material. <v Speaker>Hundreds of millions of times so that you have enough to work with. <v Speaker>And we're using it both to figure out how Lyme disease <v Speaker>works and as an aid and possible aid and diagnosis, <v Speaker>we think. The Spierer key is they're driving the disease <v Speaker>throughout its course. But in order to show that, we have to find evidence

<v Speaker>that it's there and PCR is a very powerful tool <v Speaker>for developing such evidence. <v Speaker>This is a new and wonderful technique, but <v Speaker>it's a tricky one, too. And this is not a diagnostic <v Speaker>test that's available now. <v Speaker>It's been worked out. <v Speaker>There are a lot of problems. <v Speaker>We have great hopes for it, for diagnosis or for showing the perspired future there. <v Speaker>But that time hasn't come yet, and it would be cruel to present it <v Speaker>as a new breakthrough. <v Speaker>So just sending off some specimen now and say PCR, it <v Speaker>is probably a fruitless procedure. <v Speaker>Nobody should underestimate the importance of the clinical disease. <v Speaker>It is an infection. It is a serious infection with potentially very serious <v Speaker>later manifestations later. <v Speaker>Manifestations of Lyme disease may be a bigger problem and may be less amenable to

<v Speaker>therapy. <v Speaker>What is there about? This is a display against Embar. <v Speaker>Why did you need chronic fatigue? Or and this is cause there are <v Speaker>identifiable clustering of symptoms. <v Speaker>That's the phrase. Clustering the symptoms. <v Speaker>You know, certainly are not affiliated with any <v Speaker>long term or as some call it, third stage or tertiary Lyme <v Speaker>disease. Like its cousin, syphilis can be hard to treat. <v Speaker>The one thing with Lyme disease is by the time you find out that you have Lyme disease, <v Speaker>it has devastated your entire life. <v Speaker>I've seen patients have a few weeks of antibiotics and Beacom to the over the illness <v Speaker>called Lyme and never have come back yet. <v Speaker>I've seen people on antibiotics for sometimes as long as two years and I object to <v Speaker>testing showed that spark is still present in their body. <v Speaker>There is no way for them to know whether you're cured. <v Speaker>There's no test to ever know. <v Speaker>So no doctor has ever known cure. <v Speaker>Yet they continually tell patients that they could set them off.

<v Speaker>I mean, sometimes treatment can fail. <v Speaker>Antibiotics are the main tools. <v Speaker>And when you no longer can use antibiotics. <v Speaker>There's not much that they can do for. <v Speaker>At this time. <v Speaker>Mandy Schmidt was a 10 year old, a student from Sayreville, New Jersey. <v Speaker>She died in 1990 after two years battling complications <v Speaker>that resulted from Lyme disease. <v Speaker>You never expect such an impact. <v Speaker>From something like Lyme disease, Mandy presented with a rash in October. <v Speaker>So I suspected it could have been we were on a pumpkin farm picking pumpkins. <v Speaker>We'd go every year. And that was a couple of weeks before <v Speaker>Mandy got the rash, some assuming it's from there. <v Speaker>I never saw take on needing. <v Speaker>I saw the rash. But then you take I took her to the pediatrician and she diagnosed a <v Speaker>staph. She didn't culture it as such, though. <v Speaker>And you believe the pediatrician in April, it came to a full head.

<v Speaker>She went to school just like every other day. <v Speaker>That day, she went to religion classes. <v Speaker>She came home. She developed an instant high fever. <v Speaker>She had a grand mal seizure. <v Speaker>And by the time the paramedics came, she was already in a coma in my house. <v Speaker>And that started the whole row to. <v Speaker>Treating Mandy and trying to save her when she came out <v Speaker>of the coma. She was never the same again. <v Speaker>There was evidence of brain damage. <v Speaker>Right at that time. And if anything, she just got progressively <v Speaker>worse. I didn't think Lyme disease at the time. <v Speaker>I started putting all the symptoms together and then I brought it to the doctor's <v Speaker>attention. You know, wait a minute. Why don't you check for line? <v Speaker>I had to bring it up. It's not like we were blaming everything on Lyme disease. <v Speaker>We did make sure, Mandy, we weren't missing anything, that Mandy had nothing else <v Speaker>when she died. <v Speaker>There was controversy over what caused her death. <v Speaker>Mandy had severe brain damage due to the Lyme disease.

<v Speaker>I would like to invite all them skeptics so they could sit with me and my <v Speaker>husband. And watch what she went through. <v Speaker>Her swelling of her joints, the recurrent Lyme rashes. <v Speaker>Which was documented by doctors as DCM Rash. <v Speaker>Mandy Ross, the use of her arms, her legs. <v Speaker>She stopped eating this. All her muscles were affected. <v Speaker>Her swallowing muscles. <v Speaker>At the end, Mandy was totally blind. <v Speaker>Mandy's mother vowed that she would speak out to make sure that this would never <v Speaker>happen to anyone else. <v Speaker>She should have been allowed to grow up and have a normal life like I did, you know, roll <v Speaker>around in the grass playing leaves. <v Speaker>Can't do that today. Ken, not that every night that you're being paranoid, <v Speaker>you're protecting what's so precious to you. <v Speaker>When antibiotic treatment fails, people may do desperate things, including contracting <v Speaker>malaria to fight Lyme disease. <v Speaker>Sally Tim polling shows that path was a complete antibiotic treatment

<v Speaker>failure and that's what led me <v Speaker>to the malaria therapy. <v Speaker>Malaria was used to fight syphilis infections before the advent of antibiotics. <v Speaker>Sally traveled out of the country to infect herself. <v Speaker>It's not the treatment of choice. <v Speaker>I was very desperate. I was very sick. <v Speaker>I contracted malaria. I came back. <v Speaker>I waited two weeks. Where to start? I got very, very sick. <v Speaker>I almost died. I when I recovered from the antidote, <v Speaker>I was symptom free. <v Speaker>There is a rationale for thinking about <v Speaker>induction of fever as a mechanism of curing Lyme <v Speaker>disease. <v Speaker>A lot of doctors are angry at downright angry at me for <v Speaker>doing this. They said it was a terrible thing to do. <v Speaker>I do not feel that any kind of any any patient <v Speaker>should be advised to receive this therapy in

<v Speaker>an uncontrolled non investigative environment, <v Speaker>because this clearly is experimental therapy with significant <v Speaker>potential hazard for the patient. <v Speaker>Something happened in my body to make my wife's symptoms go away. <v Speaker>I think it's the job of every doctor, every researcher out there to find out exactly what <v Speaker>happened. <v Speaker>We all see patients. <v Speaker>Physicians running Lyme disease centers throughout endemic areas for this illness <v Speaker>see patients in whom the diagnosis is in question and we'll see many individuals who have <v Speaker>received unconventional forms of therapy. <v Speaker>We do our best to perform objective evaluations <v Speaker>of what might be going on in those patients and in making <v Speaker>recommendations to them regarding what we feel would be the <v Speaker>best approach to treatment for any continuing symptoms. <v Speaker>They haven't even looked at me and maybe they'll call me an anecdotal case and say,

<v Speaker>you can't go by one case. You've got to start somewhere. <v Speaker>After a number of months, Sallie's symptoms began to return. <v Speaker>Many researchers believe that when they find the best treatment for the average case <v Speaker>of Lyme disease, the small number of people who are now difficult to treat <v Speaker>will also be cured. <v Speaker>There's a very big fringe that's growing the <v Speaker>Gaussian distribution that they use, that the level of distribution <v Speaker>is miscued because the statistics in the papers. <v Speaker>It's obvious as more and more states form support groups, that <v Speaker>the number of people who are caught are the fringe seems to be the majority <v Speaker>rather than the minority. <v Speaker>We don't know. They don't know how long it's going to take to cure this thing. <v Speaker>But at least I got better. I'm now able to walk and function as a human being. <v Speaker>A lot of unknowns in many of the questions that come up. <v Speaker>We really don't know the answers to.

<v Speaker>And there's a rigidity in the medical profession. <v Speaker>Then again, it is there people going <v Speaker>untreated and that is criminal. <v Speaker>Medical research can't predict the chances of getting Lyme disease. <v Speaker>What is known is that not every deer tick carries the spirochete. <v Speaker>But even if the tick is infected, it would have to be attached to your body for several <v Speaker>hours before you could get the disease. <v Speaker>The best precaution is to avoid being bitten by a tick. <v Speaker>If you are outside in an area where you think there could be ticks, where proper clothing <v Speaker>checked for ticks. Remove them if you are bitten. <v Speaker>Senior doctor, you have to treat the patient as an individual. <v Speaker>Really, really do. And if you have the patient improving to the point, you say maybe you <v Speaker>can stop the antibiotics. So stop them. <v Speaker>The patient stays. Well, that's fine if they relapse. <v Speaker>Don't start saying that. Having a psychiatric disorder. <v Speaker>Some of the symptoms of Lyme disease may sound like depression. <v Speaker>And as people go from doctor to doctor, some in the medical profession discount

<v Speaker>their symptoms. <v Speaker>It's only the courageous doctors who will stick their neck out <v Speaker>and treat these suffering patients. <v Speaker>We have to function within the limits of our technology, within the limits of <v Speaker>our technology. We take patients very seriously. <v Speaker>We look for evidence of Lyme disease, both by history and physical and by laboratory <v Speaker>testing, and occasionally a patient will arrive who we <v Speaker>just can not make the diagnosis of Lyme disease. <v Speaker>I'm not. I will tell people that I don't think they had Lyme disease. <v Speaker>I have a physician that I'd say he is a brave man. <v Speaker>He's willing to try all forms of treatment, whatever, just to <v Speaker>try to get something that works. <v Speaker>And it's been a long haul to finally find a man, a doctor <v Speaker>that would be willing to try some some new things. <v Speaker>He also is under a lot of pressure from his peers.

<v Speaker>A lot of physicians are in disagreement about current forms of treatment <v Speaker>and he's willing to stick his neck out and actually try to help me. <v Speaker>Many physicians are concerned that some of these long term symptoms may not be <v Speaker>Lyme disease and may indicate something else. <v Speaker>Does the scientific approach to diagnosing Lyme disease miss patients who <v Speaker>in fact have Lyme disease but can't be diagnosed using that scientific approach? <v Speaker>And I think the answer is possibly. <v Speaker>I'm really glad that we've got the doctors out there right now that are trying to become <v Speaker>knowledgeable about Lyme disease and they're willing to just stick with us <v Speaker>no matter if we don't get well right away. <v Speaker>But they don't abandon us. <v Speaker>We need to get a better sense of what the optimum therapy is. <v Speaker>We really don't know there are lots of antibiotics that are being used. <v Speaker>There are lots of antibiotics being used for different at different dosages, for

<v Speaker>different durations, in different dosing schedules. <v Speaker>And there's a lot of information out there, but it's not well-organized and it's not done <v Speaker>in prospective studies so that you can say, aha, the best form of therapy <v Speaker>for Lyme disease is such and such. <v Speaker>Taken this way and done that way. <v Speaker>It'll be a very nice thing to know. We don't know that as of yet. <v Speaker>We don't know the full clinical spectrum of the disease. <v Speaker>I think it's very important to tell everybody again to be very, very strong <v Speaker>and to know exactly your body and what you're going through. <v Speaker>And to tell your doctors that you really know what your body is doing <v Speaker>and how it reacts and to understand the treatment that you think you <v Speaker>have to have and not force, but to be strong enough to tell your doctor. <v Speaker>Doctor, this is what we have to try. <v Speaker>If it's working, it's going to make me better. <v Speaker>If it's not working. Why isn't it working? <v Speaker>The best doctors in Lyme will tell you that they still are fumbling <v Speaker>around in the dark.

<v Speaker>Polly Murray's mystery disease remains a mystery and consequently presents <v Speaker>all of us with a major problem. <v Speaker>It's a disease that is not yet fully understood or defined. <v Speaker>It's a disease for which treatment is known to fail. <v Speaker>It's a disease that for many is hard to diagnose. <v Speaker>Its symptoms may be vague, mimicking many other diseases. <v Speaker>It's transmitted by a tick that is easily missed. <v Speaker>Lyme disease is a public health problem that requires significant funds for education, <v Speaker>surveillance and control at a time when our country's public health system is <v Speaker>already stressed. It's a disease that pushes the limits of current science. <v Speaker>And it's a disease we can get in our own backyard.