Lyme Disease Delays Carpenter's Move Back to Brazil

Carlos Vieira shows his back where a tick bit him, leaving a reddish circular "bull's eye target" mark. (photo: Eduardo A. de Oliveira)

After living in the US for eight years, Carlos Vieira Jr., 28, planned to move back to Brazil. But the bite of a minuscule deer tick last month forced the carpenter to change plans.

Vieira was infected with Lyme disease, an infection spread from ticks that carry the B. burgdorferi bacteria. An infected tick had bit Vieira while he was working on a house in Wellesley, Mass.

Symptoms of Lyme disease can show up within three to 30 days of getting bit by an infected tick. Symptoms include nausea, head ache, pain of the bones, and physical weakness.

Vieira felt these symptoms almost two days after the estimated time of the tick bite. He also noticed a growing reddish rash, or erythema migrans to doctors, on his back where the tick had attached itself.

"One day after the doctor [suspected] I contracted the disease, I...was exhausted, didn't want to do anything," Vieira says.

Instead of reuniting with his wife and daughter in Brazil, Vieira was told by a doctor at Cambridge Hospital, in Massachusetts, that he would have to undergo a treatment that could take as long as two years.

"It's not the disease that worries me, but my condition in America," says Vieira. "Who will pay my bills here and in Brazil?"

Untreated, Lyme disease can affect the joints, provoke nervous system problems, or even slow down the heart rate, according to the Massachusetts Department of Public Health (MDPH).

People who are diagnosed with Lyme disease can be treated with antibiotics. Prompt treatment during the early stage of the disease prevents later, more serious problems.

The disease can occur any time of the year, and it is most often in the Northeast, mid-Atlantic and upper Midwest regions in the U.S. In Massachusetts, the illness occurs throughout the state.

The disease is not contagious by air or touch - that is, persons cannot get Lyme disease simply by being close to or touching someone who has the illness.

The B. burgdorferi bacteria are especially present in young ticks, or nymphs, that live on deer. The ticks are most active during the warm months of May to July.

Adult ticks are most active during the fall and spring, but they can search for a host, such as deer, any time that winter temperatures are above freezing.

The tick must be attached to a person for at least 24 hours before it can spread the bacteria.

As Vieira's symptoms persisted, he turned down a $60,000 carpentry project.

"I waited for this project for 60 days. That would be my last job here. I could complete it in three months and pocket about $40,000," he says.

After waking up one day with back and neck pain and the worst headache of his life, Vieira was treated at the emergency room of Cambridge Hospital by Dr. Gaylen McCann, who prescribed him an antibiotic and a painkiller. He also gave Vieira medical material about Lyme disease in his native Portuguese.

Several attempts to reach Dr. McCann were unsuccessful. But Dr. Pieter A. Cohen, another physician affiliated with Cambridge Hospital who attends to many immigrant patients, said that people who suffer from late complications of Lyme disease "might require 30 days of antibiotics because the bacteria has spread to many parts of the body."

However, says Dr. Cohen, "the true late stage of Lyme [disease] in the U.S. generally only involves infection of the joints, usually large ones such as the knees."

According to the MDPH, about 60 percent of people with untreated Lyme disease get arthritis in their knees, elbows or wrists. The arthritis can move from joint to joint and become chronic.

However, six persons, teaming with the nonprofit Ad Hoc International Lyme Disease Group, published an article in the New England Journal of Medicine in October of 2007, criticizing the very existence of chronic Lyme disease.

The six persons are Henry M. Feder Jr., MD, Barbara J.B. Johnson, PhD, Susan O'Connell, MD, Eugene D. Shapiro, MD, Allen C. Steere, MD, and Gary P. Wormser, MD.

The article concluded: "'[T]he assumption that chronic, subjective symptoms are caused by the persistent infection with B. burgdorferi is not supported by laboratory studies or controlled treatment trials."

In other words, Lyme disease disappears after a few months - the existence of chronic, or long-term, Lyme disease is not supported by scientific study.

The Journal recommended, as advice to clinicians in a review article, that Lyme disease patients should be thoroughly evaluated for medical conditions unrelated to Lyme disease that could explain the symptoms.

"If a diagnosis for which there is a specific treatment cannot be made, the goal should be to provide emotional support and management of pain, fatigue, or other symptoms, as required," explained the Journal's article.

While the Journal, one of the most respected publications for physicians, acknowledged that "explaining to the patient that there is no medication, such as an antibiotic, [to treat Lyme disease]" is difficult to do, "the failure to do so will leave the patient susceptible to those who would offer unproven and potentially dangerous therapies."

The MDPH warns that you don't have to be a hiker on Cape Cod to worry about ticks. A tick can bite you in your own backyard, but you can take measures to prevent getting bitten.

To see the MDPH's full list of preventive measures, which include using a repellent and wearing long-sleeved shirts and light-colored pants tucked into your socks or boots, visit www.mass.gov/dph/cdc/epii/lyme/lymehp.htm.

As for Carlos Vieira, he has finished a month-long treatment of daily antibiotic pills.

But he has another doctor's visit to make soon because doctors suspect the bacteria has spread to his liver.

source: EthnicNEWz.org

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