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To catch a disease.

TO CATCH A DISEASE

"Always set a thief to catch a thief," wrote 17th-century theologian Thomas Fuller. What about a disease to eradicate another disease? Is it possible, or even ethical, to treat Lyme disease--now reported in 45 states (particularly the Northeast, the upper Midwest, the deep South, and the West Coast)--by inflicting patients with malaria, one of humanity's earliest known scourges and currently one of the world's most prevalent infectious diseases?

Dr. Henry Heimlich thinks so. In a recent New England Journal of Medicine article, the developer and namesake of the famous lifesaving maneuver writes that advanced cases of Lyme disease can be treated if patients are first given a mild form of malaria. After three weeks, doctors can then cure the resulting fever with quinine or other drugs.

The act of giving a disease to cure or prevent another is not that unusual. Cowpox has been used as a vaccination against smallpox; likewise, the Sabin live oral vaccine for polio contains a mild form of the poliovirus itself. As late as 1975, when neurosyphilis had become almost extinct, doctors were treating neurosyphilis patients by injecting them with small doses of benign malaria before treating the resulting fever with drugs. Lyme disease, like neurosyphilis, starts with the acute symptoms of a bacterial infection that may later produce insidious and long-lasting aftereffects.

In our March issue, we reported new developments regarding a possible Lyme disease vaccine. Until such a remedy is developed, nature lovers should avoid ticks that carry the Borrelia burgdorferi bacterium by exposing as little skin as possible (certainly no bare feet or sandals) while walking in the woods. Check your skin and clothing (especially in the groin and armpit areas) from time to time for the very tiny Ixodes dammini ticks. If you do find one lodged in your skin, don't panic; grab a pair of tweezers and, grasping the tick as close to your skin as possible, gently pull it outward. The trick is to do it as quickly as possible; infected ticks won't infect you even if you're already bitten, provided you spot the offender in time. Forget the time-honored methods of removal--cigarettes, matches, alcohol, etc.--which rarely work and may be harmful.

Look for a new product called Permanone that should be applied to clothing only, not skin. Not only does permethrin, its active ingredient, repel infected ticks, but it kills them as well. Avoid repellents that contain R-11 (recently rated as environmentally unsound by the Environmental Protection Agency) or 100 percent deet; 50 percent deet, found in such repellents as Repel or Off, is just as effective and is less likely to produce skin reactions. There's even a line of clothing now, manufactured by a Wisconsin firm, that is designed to repel all biting insects, including (and especially) Lyme-disease-causing ticks. Called the Creative Comforts clothing system, it involves applying small amounts of deet and Permanone to a lightweight jacket and leggings for up to 48 hours of outdoor protection per treatment.

Even if you have been bitten, seek immediate medical attention only if you are pregnant. Otherwise, wait until symptoms appear--headache, fever, chills, or other aches. Lyme disease readily responds to antibiotics in the early stages, and most people do well even when treated later. If these early symptoms are left untreated, however, neurological and other symptoms may appear weeks, months, or up to two years later in the form of transient arthritis attacks in the larger joints. Headaches, stiff neck and partial facial paralysis may then occur--symptoms that also occur in patients with advanced cases of syphilis. There have even been isolated reports of persons who have developed otherwise unexplainable strokes as the result of Lyme disease contracted in Europe. Neurologists now recommend that U.S. doctors consider this option in selected individuals who have had strokes, such as military personnel stationed overseas.

Obviously, tracing such symptoms to a tick bite is difficult, but laboratory tests may rule out that possibility. Meanwhile, unless Dr. Heimlich's proposal catches on, or someone develops a Lyme disease vaccine, avoidance and prudence (without panic) are the best recourses.
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Title Annotation:treatment of Lyme disease with mild form of malaria
Publication:Medical Update
Date:Sep 1, 1990
Words:683
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