Nature Bites!

Having recently moved to a new house near the State Game Lands I was excited to take my nephews and niece out to explore. Being that it was somewhat chilly I had a long sleeves and long pants. I felt I was pretty protected as we were not going deep into the woods, but instead were staying on a trail that we only followed for a couple hundred yards.  When we got back, I sat down saw a tick run across my leg. Yes, I screamed.  I quickly grabbed a paper towel and scooped it up off my pants leg and promptly disposed of it.  At that point I made sure that everybody that went for the walk (including myself) was thoroughly checked for ticks. Luckily we did not find any more ticks, at least not then.

The next afternoon I happened to look down at my leg and noticed an unusual mark. Upon closer inspection I saw that there were little legs sticking out of it and yes they were squirming. I had a tick attached to me- ewwww!!  I used to be a lab tech so not much throws me but this little bloodsucker actively burrowed in my leg did and I needed to get it out ASAP as I couldn't tolerate the thought of it being attached a minute longer! I quickly got tweezers and extracted the entire tick, head and all, from my leg.  Just in case it was needed, I saved the tick in a container.  I then went and washed to bite wound and my hands thoroughly, just as the instructions I found on the internet said.

Having two friends with Lyme disease really made me concerned about my risk. I knew to look for a bull’s eye rash but didn't really know much else. My first thought was that first thing Monday morning I needed to call my primary care physician to see what they would recommend.  From the primary care standpoint I was grateful that I have a relationship with a primary care office and knew that if I called they would be able to help me, which they did.

On Monday morning I called my primary care office, PinnacleHealth Medical Group, Heritage Family Medicine, not really sure what to expect. After explaining the situation the office wanted me to come in evaluate the tick bite and see if there was any follow-up necessary. I was so fortunate in that they were literally able to get me in within a half an hour.

Dr. Metropoulos at Heritage Medical Group in Lemoyne was wonderful and explained the risks of Lyme Disease based on my case and our options for treatment. We both agreed that a prophylactic course of antibiotics would be the best route for me.

I typically spend a lot of time outdoors and thought I was pretty knowledgeable about healthcare. But this tick bite was definitely a learning experience for me.

I had some pretty big questions throughout this experience. Luckily, within PinnacleHealth we have a number of experts including those in the primary care field and infectious diseases. And consulting with Dr. John Goldman with infectious disease he was able to provide me with some great information answers to my questions.

Dr. Goldman recommends the following safety tips for tick bite prevention.

• Wear long sleeves and long pants
• Use insect repellent with DEET
• Change clothes immediately after coming inside your house
• Wash clothes promptly

Since all the boxes are unpacked and I am certainly not moving anytime soon, I'm going to have to learn how to live in an area where ticks are prevalent.  I've since stocked up on insect repellent, have made a habit of checking myself frequently for ticks and am looking forward to spending time going for more long walks this summer.

Want your questions regarding tick bites and Lyme Disease answered? Join Dr. Goldman on August 20^th at the Camp Hill Giant for a free seminar titled Lyme Disease: What You Should Know. There is no cost to attend but registration is required.  Please call 231-8900 to register. 

Ebola Virus – What You Need to Know

 Blog contributed by
Dr. Joseph Cincotta,
primary care physician

The African Ebola Virus outbreak has been one story that has been a prominent part of recent health-related news.  Although not a new problem for the African continent the most recent outbreak has gotten much more attention as concern has grown about the spread of this virus from rural and more isolated communities to more urban settings, and the concern of its spread to even further places across the globe.

The Ebola virus was first recognized in 1976 in Zaire and since that time there have been a number of outbreaks across different African regions.  The infection currently has a very high mortality rate – 57 to 88%, and there is no vaccination to prevent the infection.  In addition, there is currently no specific anti-viral medication treatment program available to combat the infection once it occurs.  Treatment today is focused on what we call ‘supportive measures’ in an effort to give the patient’s own immune system time to overcome the infection.  Unfortunately, these ‘supportive measures’ are not always successful and patients still succumb to the infection.

The virus is spread by direct person-to-person contact.  This may involve direct contact with an infected patient or direct contact with infected body fluids from that patient.  If exposed, it generally takes about 5 to 7 days to develop symptoms but there are cases where it has taken longer than 2 weeks for symptoms to develop.  This raises the concern of the spread of this virus from one geographic area to another, as patients who are infected but who have no symptoms may travel out of a known area of infection and spread the virus.  As populations become more mobile and less isolated the possibility of spread of the infection is higher and requires more attention to efforts to contain the spread of the virus.

Symptoms of the disease usually start with a rather abrupt onset of fever, chills and tiredness.  These are followed by headache and muscle ache, nausea, vomiting, diarrhea, and abdominal pain.  As you will notice, these are very common symptoms for many other infections, and there is nothing specific to indicate an Ebola infection during the early phase.  Thus, the medical team needs to have a high degree of suspicion particularly when working in areas known to be at risk for this infection.  And, for health care workers not in those regions, getting a travel history from patients as part of the routine history when a patient has these symptoms is very important.

Over a period of several days the symptoms often worsen and may involve bleeding from different sites, problems with bruising, and very low blood pressure.

Work is going on to develop a vaccine as well as find medications to treat the infection.  However, efforts to date have been unsuccessful.  For now we need to rely on supportive measures such as IV fluids and nutrition and treating the complications of the disease when they occur.  These measures allow the body time to develop its own antibodies to fight off the infection.

Efforts at prevention involve avoiding travel to areas of known infection , doing your best to avoid sick individuals, and paying attention to good hygiene practices of regular hand-washing.