hacked by p@3t_b@y for turks

I was attending the Moira Game Fair with the Scottish Association for Countrysports, last weekend and we were lucky enough to share our marquee with BADA-UK, for me personally, its always a pleasure meeting up with Wendy, Andy, Katrina and Craig. These 4 individuals worked tirelessley over the Moira weekend and their public awareness campaign went into overdrive  and visitors to the game fair benefitted from BADA-UK’s knowledge and help  I have to admit I shed a wee tear when I realised how successfull the trip was for the guys. I am extremely fortunate to regard BADA-UK members as friends even though I don’t suffer from a tick related illness, It’s important that sufferers and non-sufferers help get BADA’s message across  While at Moira!! I was celebrating my 50th birthday and the best present of the week-end was Wendy and Cadrina’s re-action to a few surprises that some of my friends help set up.

To every-one who made a good week-end a really fantastic one!! a great big thank you!!

Tom

Deadly tick bites haunting Turkey with summer setting in earlier

Ticks are back in Turkey, where global warming is taking its toll as well, and spreading the Crimean Congo Hemorrhagic Fever (CCHF), which might be fatal in certain cases.

The first victim this year was Nuriye Basaran, 41, from the Ortaköy district of Çorum. After she was diagnosed with the CCHF in Çorum, she was dispatched to Ankara Numune Education and Research Hospital, where she died on May 7. The tests conducted after the autopsy proved that she in fact died from this fatal hemorrhagic fever.
In the Central Anatolian town of Yozgat, indicated by the Ministry of Health among the cities where the CCHF cases are seen most often, two youngsters, an 18-year-old girl and a 14-year-old boy were bitten by ticks and hospitalized. After initial medical attention in Yozgat they were dispatched to Ankara, where the boy was diagnosed with CCHF.

Dr. Fikret Purtul, director of Health of Çorum, another Central Anatolian city, said that 26 of those who had come to hospitals after being bitten by ticks were receiving treatment for suspicious CCHF cases. Purtul said the necessary measures had been taken and that there was no need for concern. He noted that many people had started coming to hospitals daily beginning from the middle of April, suspecting they had been bitten by ticks. Çorum State Hospital’s Fever Department was cleared out for only the CCHF cases, he said and added that 10 out of 26 patients were discharged, three of them died, and the rest were still in the hospital.

Dr. Purtul stressed that the best way to combat CCHF was education. They were holding courses in various places in the city, he said. “We are educating imams, teachers and muhtars in the villages. We have so far handed out 40,000 educational brochures. We have taken the necessary measures. Our citizens can continue their lives normally,” he added.

In another Central Anatolian town, Tokat, two people suspected to have contracted CCHF were transferred to Sivas, where also eight people, six of them children, were hospitalized with suspected CCHF. The children were immediately examined in the pediatric department, where the ticks that were still in their skins were extracted under strict control. Abuzer Coskun, a doctor from the emergency services of Cumhuriyet University Research and Teaching Hospital in Sivas, said the cases of tick bites increased as the weather got warmer.

“There has been an upsurge in tick bite cases particularly since May 15 in and around our city. We receive the daily number of three to five cases of tick bites, one to two of which are diagnosed with CCHF. We will treat our patients carrying the CCHF virus in the Fever Department. We will also call back those not diagnosed with the CCHF for another examination,” Coskun stated.

He warned that those bitten by ticks should on no condition try to extract them themselves. So far, 99 people have appealed to hospitals with suspected CCHF cases. Thirty-one of them were found to have contracted the disease, whereas last year 137 people went to hospitals after being bitten by ticks, and 94 of them were diagnosed with the CCHF.

19.05.2007
Today’s Zaman Istanbul

http://tinyurl.com/2jx9ov

New research on a bacterium that can survive encounters with specific immune system cells has strengthened scientists’ belief that these plentiful white blood cells, known as neutrophils, dictate whether our immune system will permit or prevent bacterial infections. A paper describing the research was released today online in The Journal of Immunology. Frank R. DeLeo, Ph.D., of Rocky Mountain Laboratories
(RML), part of the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health, directed the work at RML, in Hamilton, MT, in collaboration with lead author Dori L. Borjesson, D.V.M., Ph.D., of the University of Minnesota in St. Paul.

Scientists analysed how neutrophils from healthy blood donors respond to Anaplasma phagocytophilum, a tick-borne bacterium that causes granulocytic anaplasmosis in people, dogs, horses and cows. A. phagocytophilum is carried by the same tick that transmits Lyme disease and was first identified in humans in 1996. Human granulocytic anaplasmosis (HGA) — formerly called human granulocytic ehrlichiosis
– is prevalent in Minnesota and along the East Coast. HGA typically causes mild symptoms that include fever, muscle aches and nausea. Some 362 U.S. cases were reported to the Centers for Disease Control and Prevention in 2003.

HGA is considered an emerging infectious disease, and Dr. Borjesson is working to understand how it affects blood cells — and neutrophils in particular. “Few people know about this pathogen, but it is important because it is transmitted by ticks and causes disease in both animals and humans,” Dr. Borjesson says.

Neutrophils, which make up about 60 percent of all white blood cells, are the largest cellular component of the human immune system — billions exist inside each human. Typically, neutrophils ingest and then kill harmful bacteria by producing molecules that are toxic to cells, including a bleach-like substance called hypochlorous acid.
Once the bacteria are killed, the involved neutrophils self-destruct in a process known as apoptosis. Recent evidence suggests that this process is vital to resolving human infections.

A. phagocytophilum is unusual in that it can delay apoptosis in human neutrophils, which presumably allows some of the bacteria to replicate and cause infection.

“This particular bacterium specifically seeks out neutrophils — possibly the most lethal of all host defense cells — and remarkably, can alter their function, multiply within them and thereby cause infection,” says NIAID Director Anthony S. Fauci, M.D.

Dr. DeLeo says the findings contrast with what is known about other bacterial pathogens, most notably Staphylococcus aureus, which is of great interest because of its increasing resistance to antibiotic treatment. S. aureus, often simply referred to as “staph,” are bacteria commonly found on the skin and in the noses of healthy people. Occasionally, staph can cause infection; most are minor, such as pimples, boils and other skin conditions. However, staph bacteria can also cause serious and sometimes fatal infections, such as bloodstream infections, surgical wound infections and pneumonia.

In their experiments, the research team compared the neutrophils response to A. phagocytophilum with that of a weak strain of S. aureus. Using microarray technology that allowed them to compare about 14,000 different human genes, the researchers discovered how the response to A. phagocytophilum deviates from that of S. aureus, and thus permits the HGA agent to survive. “This study has given us a global model of how bacteria can inhibit neutrophil apoptosis,” says Dr. DeLeo. “Our next step is to look at specific human genes or gene pathways within this model and try to determine which of these molecules help prolong cell life following infection.” Information gathered from these and similar studies, he adds, could help researchers develop therapeutics to treat or prevent bacterial infections.

Other RML collaborators included Jovanka Voyich, Ph.D., and Scott Kobayashi, Ph.D., now an assistant professor at the University of Idaho.

RML is part of the National Institutes of Health (NIH). NIH is an agency of the U.S. Department of Health and Human Services. NIAID supports basic and applied research to prevent, diagnose and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID also supports research on transplantation and immune-related illnesses, including autoimmune disorders, asthma and allergies.

http://www2.niaid.nih.gov/newsroom/Releases/bacterium.htm

by GARETH EDWARDS

A CHANCE encounter with an expert on the potentially fatal Lyme disease may have saved the life of an Edinburgh hillwalker.

Experienced walker Sylvia Miller has been put on antibiotics by her doctor and is awaiting test results to see if she has contracted the disease.

But the 60-year-old, from Dedridge, Livingston, might never have had the tests had it not been for a meeting with the head of a charity dedicated to raising awareness of Lyme’s disease.

Mrs Miller, who spends weekends walking across Scotland with other members of the St Andrews Ramblers group, was baffled when she started having bad headaches, joint pains and sickness after a recent walk in Pitlochry, Perthshire.

She went to her doctor after becoming increasingly tired and was told she had an inflamed liver. Despite several blood tests, however, doctors were at a loss to explain what the problem was.

It was not until her chance encounter with Katrina Anderson that Mrs Miller realised it was connected with a tick bite.

Mrs Anderson, 47, of South Gyle, has suffered from Lyme disease for more than 15 years, and two years ago set up Borreliosis and Associated Diseases Awareness UK (BADA-UK) to raise awareness of ticks and tick-borne disease.

While shopping at an outdoors store, she heard Mrs Miller talking about a planned walk in Arran, and advised her to wear long trousers to prevent a tick bite.

Mrs Miller said: “I told her I had recently had a tick bite and she asked if I’d been feeling all right since then. I was really surprised and then she reeled off my symptoms. I went to the doctor’s straight away and they agreed it could be Lyme disease and put me on antibiotics.”

“I really do think Mrs Anderson could have saved my life, as it seems the longer this is untreated the more dangerous it is.

“I was amazed I’d never heard about this disease. As a hillwalker, I suppose I might have been expected to know about it.”

The debilitating infection is spread by the tiny blood-sucking insects and, if left untreated, Lyme disease can affect the central nervous system and the brain and, in extreme cases, can even cause death.

The problem is on the rise in Scotland, with recent figures showing the number of cases having risen from ten a decade ago to 177 last year.

Mrs Miller has now said she will be providing as many hillwalkers as she can with information about the disease.

“If any of our walkers is bitten by a tick, I will be warning them to go to their doctor and be tested, as it’s the only way they will ever know,” she said.

Mrs Anderson, who has been campaigning for more research and treatment of the disease, as well as a greater recognition of it, said: “I’m just really glad I was in the right place at the right time - it’s very lucky, as otherwise it might not have been diagnosed for a long time.

“Hopefully with Mrs Miller they will have caught it in time.”

http://tinyurl.com/2pja5o

Hi folks

It was quite theraputic writing this - I don’t often think about it now but with recent press articles about Lyme disease it got me thinking about myself so then I decided to find out more about this website.

 What happened to me 

I was at a barbecue with my family and friends, which was organised by a local church, in 1991, in a National Park close to where we lived then in Ontario when someone noticed a tick was on my ankle. He removed it by burning the end of it using his cigarette (which I now know was a very bad idea). I didn’t think any more about it - at the time…….

Soon after I got a rash on my leg - it looked like a bull’s-eye pattern - my then GP had never seen anything similar and gave me cream to see if it helped - It didn’t seem to but the rash went away after a few weeks. I didn’t relate this to the tick at the time.

After another few weeks I got symptoms like or which possibly were meningitis – unbelievably severe headache, stiff neck - couldn’t raise my head off my pillow at all far less get out of bed. My children were very young so I got them to go and get a neighbour who was a good friend - who, by chance had invited us to that barbecue…. Sadly she has a severe mental health illness and wasn’t at all well then so wouldn’t listen to me when I asked her to get me help - she decided that she didn’t need to get me an ambulance and wouldn’t phone my husband who was doing a 12 hour shift at work. By the time he came home I was, in some ways feeling a wee bit better and just wanted to sleep so I didn’t go to hospital but did see a GP the next day - he didn’t know what was wrong.

We had already decided to come back to Scotland as my husbands employers were moving to America and we didn’t want to move with them. I was missing my family and I really wasn’t well - had no energy and felt ill all the time - I suppose a bit like M.E.

Soon after we got back we were invited to a Guy Fawkes party in the village we used to live in - I didn’t feel up to it but it was with friends we hadn’t seen for a long time so we went - I walked in but by the time we were going home I couldn’t walk without using 2 walking sticks (borrowed from the Nursing home across the road from the party - the owner was a friend who was at the party too). I was in too much pain to stand without support.

I went to my GP - he couldn’t explain what was happening to me but gave me painkillers which didn’t help and said to come back if it didn’t improve soon.

I then, a few days later, got intense pain in my jaw and my face swelled up so I got an emergency dentist appointment on a Saturday and this led to an emergency appointment at the dental hospital the next Monday. There I was told my problem was probably a rheumatology one and I was referred to a local hospital.

Other joints had started to swell up and the pain was intense and varied, for a few hours or days some joints would be very hot and swollen then often different ones would become painful too until it seemed like all were affected - I struggled to walk, my neck and shoulders were stiff and my hands were badly swollen. I had difficulty talking and eating too. There was no relief from the pain - even when I was asleep - and I had severe stiffness in my joints each morning and often all day.

I saw the rheumatologist and was admitted to the hospital - I had severe reactions to the drugs they tried. Quite often the drugs affected my liver function - I was horrified when a senior doctor told his entourage of students that he was certain I had an alcohol problem and a biopsy would prove that - this was in an open ward where everyone else could hear too - I argued with him but he was adamant - the biopsy showed that it was the anti inflammatory drug I was taking that had caused the abnormal blood test result. The biopsy caused an excruciatingly painful blood clot in my liver which was probably because this senior doctor was angry with me for arguing and was very rough doing the procedure. In fact some of the students came back to say how shocked they were that I was treated like that. This pain had me screaming in agony every time I moved for about three weeks - and I am, and was then, used to being in a lot of pain.

I felt like a guinea pig - I was diagnosed with Rheumatoid Arthritis but right from when I was told this, I was absolutely certain I didn’t have it - I knew a few people who have rheumatoid arthritis and their symptoms were quite different. At my worst I would sleep for 23 hours a day and spent my waking time in tears. I often couldn’t transfer out of my wheelchair - I used all sorts of splints, neck collar, arm sling - this might sound a bit odd but I spent a lot of time lying down on my bed - and would, because I couldn’t do anything else, not even watch tv or listen to music - count the number of individual parts of me that were painful - often more than 80! (now it can often still be 30+ on bad days). I had an anaphylactic reaction (was covered in hives and my breathing was affected) to Gold injections - and when I reported that back to the hospital was told ‘that can’t possibly happen.’ Unbelievably the Consultant insisted on giving me another one of these injections - by the time I got home I was in a really bad way, went straight to my GP - whose surgery was only 2 minutes away from my house - who sent me back to hospital very quickly. I was in hospital frequently, mostly because of drug reactions but also because I was so very ill. One particular drug caused me to be paralysed – very scary – I would get pins and needles and numbness in my feet which travelled quickly up my body and I couldn’t move at all - doctors again said ‘this can’t happen’ so it may have been to do with the Lyme disease in some way. Eventually when in hospital a physiotherapist tried traction and that was awful - too painful for words - so she said their only other option was a tens machine - within 20 mins of using it I could walk to the bathroom with only one walking stick for support - amazing.

I was soon on a waiting list to have my jaw joints replaced as I couldn’t open my mouth properly and had a lot of difficulty speaking and eating - and had constant headaches because of the jaw pain too. The rheumatology doctors and the surgeons were also discussing replacing some other joints.

I had gone from being a very fit and active person - mum, foster parent, enjoyed winter rock climbing, hillwalking and more to having very little mobility and was becoming more and more depressed - my memory and ability to cope with even the simplest of things was also affected. One day I realised that the doctors and physiotherapists just weren’t able to help and it was down to me to try to help myself so I started going to an exercise class for disabled people. I also made an effort to do some more vol. work - along with my husband and family, we had already become respite carers for children who have learning disabilities (we started doing this to help out friends - still do it now) soon after we came back from Canada. My husband would take the children out and about and I would - which was much needed - speak to the children and give them my undivided attention as much as I could.

I kept looking for answers – the hospital staff were adamant they had diagnosed me correctly and I constantly disagreed, I wasn’t sure why I felt so strongly that they were wrong - I just knew they were! I remember saying at one appointment that if I really did have rheumatoid arthritis then I had similar symptoms to someone who had this severely for more than 50 years!

One Sunday about 7 years after we came back to Scotland I was reading the Sunday Post newspaper and saw my symptoms – the ones I had had initially - and the article also said that severe chronic arthritis and affecting the heart and brain can happen if not treated properly – I was stunned – as this had all happened to me. It was about Lyme disease. I took the article to my GP and he said that I had been tested for it and the result came back negative – so I then showed him articles I had found in up to date library books which stated that it frequently didn’t show in people’s blood. He agreed then that it was worth me being referred to the infectious diseases Hospital. The Consultant there agreed I had all the symptoms but he could only be 99.9% sure I had Lyme disease - he said there was a huge difference between this and being 100% sure - and suggested he give me the treatment for it – intravenous antibiotics every day for 4 weeks and if it worked then it would be definite that this was what I had – I agreed very enthusiastically and started straight away even though it meant going to the hospital on Christmas Day.

It didn’t seem to work at first although the inflamation got a wee bit less but then I was driving my children from our home to the nearest large town and I started to feel very strange – I couldn’t work out what was wrong, other than a sort of odd feeling like butterflies in my stomach, so I stopped the car and sat for quite a while before realising that I had no pain – the strangest feeling I have ever had! I felt stunned – and on a high! The pain came back – with a vengeance after less than an hour - but I did then (and still have) short periods when I have little, or very rarely, no pain.

I was left with damaged joints and other problems, still needing a walking stick and sometimes my neck collar, wheelchair etc. but I was a lot better.

Voluntary work (and now also paid work) was and still is my coping strategy - the more I do the more energy I seem to have - when I have a break I always seem to feel a lot worse and I really don’t enjoy going away on holidays now as I get much more pain when I slow down and also I need to have my mobility aids to help  .

My mobility gradually started to get worse again – I was, though, determined that I would get a job – other than fostering I hadn’t had a paid job in 24 years.

We moved house to another village – a much smaller house I could manage more easily. I explained to my new GP that I really wanted to try to improve my health and perhaps get a job. I needed help to increase my stamina and decrease my pain. I asked for a referral to talk to a Consultant at a hospital again – so long as it wasn’t the one I had been to. I was sent to a different one fairly close by which wasn’t a good experience either as he didn’t believe I had Lyme disease and he was irritated that I told him about the difficulties I had been through at the other hospital - he said the other Consultant was one of his friends. 

My GP then organised physiotherapy and hydrotherapy at a small local hospital - I went there often twice a week for over a year - which helped a lot - I went from shuffling along very slowly using 2 walking sticks and often using my wheelchair to only needing one walking stick - and walking fairly well a lot of the time - I eventually managed to be able to raise my arms - I hadn’t been able to do this for years - my shoulders just didn’t work. The staff there did a brilliant job - coping with my emotions as much as with my mobility problems.

As I was starting to feel a lot better I realised that I could possibly, with help, do even more. I then did some research on the Internet and asked my very supportive GP for a referral to a rheumatology Professor as he seemed to be the best possible person to help me - which he did. I explained about wanting to have the stamina to do paid work so he organised some x-rays and quickly discovered that I now have ankylosing spondilitis – 2 of my brothers also have this – and he said the Lyme disease may have triggered it off – mostly people are in their teens and twenties when they get the symptoms of this. I was also referred to the Anaphylactic clinic at another hospital and was told that I had probably had a severe allergic reaction to the Lyme Disease infection, though I know other people have had similar reactions to Lyme disease as me (I have now become allergic and/or have nasty side effects to most painkillers and some food and now attend a Pain Clinic - if I am trying a different ‘painkiller’ prescription drug I have to try them out at Day Surgery in the hospital).

I still use my tens machine a lot - couldn’t cope without it. It has been the best thing I have ever bought!

My stamina improved - I still use a walking stick and quite often a wheelchair for shopping too (I hope one day supermarkets and shopping centres will have electric mobility scooters which will have shopping baskets big enough for a family shop!!!) My voluntary work led me to get a job I really enjoyed - as a Direct Payments for Community Care Support worker. The Council though ended the funding after 2 years for financial reasons. So straight away I applied for another job with a national disability led charity which I enjoyed too - I was there for about 15 months, it was only funded for a year but we managed to extend that a bit as I brought in some income. Now I work full time with an advocacy service which is perfect for me. Getting paid is  of course! Much to my surprise I have never been off work because of my impairments - just twice with my allergies - which now seem to be getting worse!

I was very surprised to read in this website that I may well still have Lyme disease – the treatment I had may only be a temporary help so I think it just might be worthwhile to look into it some more to try to find out.
Despite all this – I still enjoy Barbecues!!!!

Alison 

by SARAH HOWDEN (showden@edinburghnews.com), 18th May 2007

JANEY CARMICHAEL squeezed her eyes tightly shut as she counted slowly to ten. It was a dull cloudy day in March 2004, but the 45-year-old from Livingston was having the time of her life playing hide and seek with her young niece and nephew in the woods of Beecraigs Country Park, West Lothian.

“When I opened my eyes I could hear their giggles and knew exactly where they were, but I spent the next half an hour making a big show of checking behind every tree stump and crawling around on the forest floor calling their names before I finally ‘found’ them.”

When Janey got home that evening she found herself picking bits of bracken and pine needles out of her clothes.”

A week later Janey found a boil-like spot on her hip which quickly became inflamed. But with a holiday to New York planned with her husband Ian just a few days away she decided to wait until she got home before going to see her doctor. While on holiday, however, Janey became violently sick and spent the rest of her trip in her hotel room shivering with aching joints. But by the time she had got home she felt much better again and the boil on her hip had become a light rash. In spite of the improvement in her condition the computer consultant decided to go to see her GP.

“My doctor asked me whether I’d been anywhere where I could get Lyme disease and I told him about New York. But he said the symptoms wouldn’t have developed that quickly. There was no mention of the fact that you can get Lyme disease in Scotland though.”

Creams didn’t work, and Janey’s itchy rash on her hip persisted. Even the dermatology department of the Edinburgh Royal Infirmary, who froze the rash off in June of that year, couldn’t come up with an answer.

“I just wasn’t myself at all,” remembers Janey. “I couldn’t think straight and was irritable and forgetful. I tried to put it down to a hormonal change but deep down inside I knew something wasn’t right.”

DANGER: Milder winters and warmer summers are the perfect breeding conditions for ticks.

By January 2005, Janey, who’d recently moved house, went to see a new GP complaining of the persistent rash, plus headaches on the left side of her head. Her rash had grown again too, reaching 3cm in diameter.

Her new doctor ordered a biopsy and the rash was diagnosed as a non-specific lesion. Janey received treatment but the rash quickly regrew, before disappearing spontaneously three months later, in May 2005.

It wasn’t long before Janey’s condition deteriorated further.

“By August I started getting excruciating headaches in the evenings. I was having feelings that I wanted to urinate a lot but I wasn’t able to, and I was getting pain in my abdomen. My doctor was getting worried by that point and wanted to get me tested for lupus.

“I had started to research Lyme disease by this point and the symptoms linked up. I discovered if left untreated it can get into your central nervous system, into your brain, into all the tissues in your body and even cause death. When I mentioned my research to my doctor, however, he wasn’t convinced.”

Janey was terrified, but without a diagnosis there was nothing she could do. Lupus tests came back negative, but the abdomen pain and headaches persisted. Eventually Janey’s joints became stiff too, she struggled to get out of bed, and had terrible stomach upsets.

By October 2006 she had also developed feelings of breathlessness and her blood pressure had risen to a worrying 184/103. “I thought there was something wrong with my heart, and it was terrifying,” she says.

However, as before, just as the symptoms appeared, they then disappeared.

In January this year, however, all of her symptoms returned at once. “I had unbearable headaches for three weeks. The pain then spread from the left side of my head into my eye, and I wasn’t sleeping. I got very bad back pain, severe mouth ulcers, chest palpitations, high blood pressure and I had blue fingers with web-like blue veins. My husband Ian insisted I go back to my GP. I begged to be tested for Lyme disease.”

By this point Janey could no longer work. She was exhausted and in constant pain. Days would pass when she was physically unable to get out of bed.

“I was terrified by this point. I felt my eye was going to explode because of the terrible head pain I was having and I was frightened I was going blind.”

Finally Janey was referred to the Western General’s infectious diseases consultant. “He was brilliant. We went through all my symptoms and he admitted they were consisted with Lyme disease,” she says.

Janey was officially diagnosed with the condition in February this year and was prescribed antibiotics - 400mg doxycycline per day - twice the dose for prescribed for anthrax poisoning.

“I feel as if someone’s switched the lights back on, but I wish I’d been treated sooner. GPs should know more about these symptoms. And the public should know about the risks too. If I had been diagnosed when I had the rash initially, it would have been a short treatment and I wouldn’t have lost all this time.

“Awareness needs to raised. My consultant says that half his patients that he treats for Lyme disease have negative tests, but he treats on clinical evidence of symptoms. Many others out there are being told it’s all in their heads and often their lives are destroyed.”

I went to the doctor but they didn’t know what was wrong
DESPITE suffering from Lyme disease for seven years, Barbara Scott-Emmett has only recently received a proper diagnosis.

“Over the years I went to the doctor for all these niggling complaints but they didn’t know what was wrong with me,” says the 59-year-old from Musselburgh. “When I finally mentioned that I thought I had Lyme disease I got the impression they didn’t know a great deal about it. They thought that it was in my head, it was psychosomatic. It was only when I was referred to a specialist that I was taken seriously. At least now I can get the help I need.”
Barbara loves the countryside and regularly enjoyed walks in Roslin Glen with her husband Sandy before developing the first symptoms.

After 18 months Barbara found a ring-shaped rash on her torso.

“It disappeared as quickly as it appeared so initially I thought nothing of it,” she said. “But then when it kept coming back I Googled it and Lyme disease came up.

“I immediately mentioned it to my GP but he told me Lyme disease was unlikely as it is so rare.”

Barbara’s rash, flu-like symptoms and upset stomach kept re-occurring. And as time passed she developed other symptoms too.

“I was constantly exhausted. But I was in so much pain I could barely sleep. I developed arthritis and joint pain in my hips, ankles and wrists. It began to affect my whole life.

“I knew that something was terribly wrong with me but I felt as if no-one in the medical profession believed me.

“Eventually I started having neurological symptoms too - I couldn’t speak or think properly. I honestly thought I was getting Alzheimer’s.”

Eventually Barbara had to give up her part-time job as a secretary within a solicitor’s office and found herself practically housebound.

Desperate she returned to her GP and demanded a test for Lymes earlier this year. It came back negative in March.

Undeterred, Barbara demanded to be referred to a specialist.

“I was sent to the infectious diseases unit at the Western General and was told that despite the negative test result the most likely explanation for my symptoms was Lyme disease.

“The relief was overwhelming. Finally I had an explanation for the way I’d been feeling.”

ESSENTIAL TICK LIST MILDER winters and warmer summers are the perfect living and breeding conditions for ticks.

Not all tick bites result in Lyme disease, but for those ticks that happen to carry the bacterium borrelia, the result can be muscle pain, flu-like symptoms, paralysis, neurological problems, arthritic problems, blindness, cardiac problems - and, in certain cases, death.

The best defence is knowledge and protection. Dress appropriately when entering an area suitable for ticks - light-coloured clothes make ticks visible while drawstrings prevent them from getting inside clothing.

If you do find a tick on your body it should be removed by gripping the insect close to the skin with fine-tipped tweezers and then pulling back without jerking or twisting. Commonly held beliefs on tick removal such as covering them with Vaseline or burning them will actually increase the chance of getting an infection.

And lastly, contact your doctor if a rash or flu-like illness develops after you have been exposed to ticks.

http://edinburghnews.scotsman.com/features.cfm?id=773522007
 

Thu 17 May 2007

HOW TO AVOID TICK INFECTION
By WENDY FOX

THE majority of people in country areas take ticks for granted as a part of life. But while many know these blood-sucking parasites can carry diseases which affect livestock, few realise that they too are at risk of infection, and those risks are increasing.

Recent reports have shown that the number of cases of Lyme disease in Scotland has risen from ten a decade ago to 177 last year. But perhaps more alarming is the news that ticks are no longer confined to the countryside and have started to infringe on Scotland’s cities, including Edinburgh.

Borreliosis/Lyme disease is the most common tick-borne disease to affect humans in the UK. Recent figures published by the Scottish Centre for Infection and Environmental Health (SCIEH) have shown an increase in cases. However, in the year 2005-06, incidences increased by 90 per cent in comparison to the previous year.

Ticks are becoming more resilient and adaptable and it is vital that city-dwellers are aware of the risks.

Ticks can now live quite happily in city parks and gardens. In fact all they need to survive in these areas is good vegetation cover, which keeps humidity levels high, and animals to complete the stages of their life cycle.

Ixodes ricinus, commonly known as the sheep tick, can live without ever seeing a sheep. They are indiscriminate feeders and will choose small to medium-sized mammals and birds. The hedgehog tick (ixodes hexagonus), will also not say no to domestic pets. More importantly, both ticks are more than happy to choose us as their hosts.

But what are the reasons behind these changes? In addition to urban sprawl, another possible cause is the milder winters we’ve been having. Ticks can be active at as low as 3.5°C and the warmer temperatures would allow them to feed and breed for longer periods. People are also involved in more outdoor recreation, such as cycling, jogging and hiking, so are coming into contact with ticks.

Another probable reason for the increase of ticks in cities is general waste from restaurants and the build up of household waste from reduced refuse collections. These all support urban wildlife and therefore provide sustenance for ticks too.

Edinburgh residents should be aware that ticks may be present in their gardens or in the parks. But there is no need to panic. Risks can be minimised by not wearing shorts in the countryside or by tucking your trousers into your socks. Contrary to popular belief, if a tick does attach itself to your skin you shouldn’t burn it or smother it with Vaseline - these actually increase the risk of infection. Instead the safest method is to use tweezers or a tick removal tool to grip the insect close to the skin and then pull back without twisting or jerking. Sensible precautions can all but eliminate the risk faced by the public.

• For further information visit: www.bada-uk.org, or send an A5 1st class SAE to BADA-UK, PO Box 70, North Walsham, NR28

• Wendy Fox is director of BADA-UK (Borreliosis & Associated Diseases Awareness UK)

http://news.scotsman.com/opinion.cfm?id=767272007

Tick-borne diseases are on the rise, as the blood-sucking creatures move north. So how can we protect ourselves?
By Kate Craven
Published: 15 May 2007

WHAT IS A TICK?

A tick is an external parasite that sucks the blood of animals and humans. They live in the soil and emerge to climb tall grass, shrubs, bushes and low-level tree branches in search of a blood host. They are vectors of a number of diseases, which they transmit while feeding on the skin. They target specifically the armpit, groin and back of the knee. However, victims do not feel the bite because the tick also injects a toxin that anaesthetises the area. The public is being warned to take extra precautions, particularly while on holiday, following a huge rise in cases of Lyme disease and tick-borne encephalitis (TBE).

WHY YOU SHOULD BE WORRIED

Ticks are second only to mosquitoes for infecting humans with diseases. The two most serious are Lyme disease and TBE.

In its initial stage, Lyme disease may cause a rash and flu-like symptoms. More serious consequences in the months after infection can be facial palsy (paralysis), viral-type meningitis and nerve inflammation, which may lead to pain, disturbance of sensation or clumsiness of movement. Encephalitis (swelling of the brain) is a rare complication. Lyme disease is treated with antibiotics. Some patients still suffer months and even years after treatment from muscle and joint pain, arthritis, cognitive defects, neurological complaints or fatigue.

According to the World Health Organisation (WHO), TBE is a serious acute disease that affects the central nervous system and can lead to long-term neurological complications in 35 to 58 per cent of patients. It can result in serious meningitis, brain inflammation and even death. TBE incubation is six to 14 days and at first can cause increased temperature, headaches, fever, cough and sniffles. A second phase can lead to neck stiffness, severe headaches, photophobia (intolerance to light), delirium and paralysis. One to 2 per cent of these patients die.

No causal treatment for TBE is known at present. The incidence among children increases with age, with boys showing a higher incidence than girls in all age groups. Hospitalisation may often last up to 40 days. In worse-case scenarios, it can last up to four years.

HOW DISEASES ARE SPREADING

Between 1974 and 2003, the number of registered cases in all European countries with a TBE risk rose by an average of 400 per cent. Every year, there are more than 10,000 new cases of TBE infection. Switzerland registered a 58 per cent increase in cases (131 cases in 2004, 207 cases in 2005) and another rise of 27 per cent in 2006 (259 cases). The Czech Republic had a rise of 28 per cent from 2004 to 2005 and from 2005 to 2006 a further rise of 73 per cent (500 cases in 2004, 642 cases in 2005, 1,017 cases in 2006). In Germany, too, the changes are serious (274 cases in 2004, 431 cases in 2005, and 535 cases in 2006), as well as in Poland (174 cases in 2005, 308 cases in 2006). Lyme disease is believed to affect 2,000 people in the UK every year. A decade ago, there were just 10 cases of Lyme disease in Scotland. Last year, that figure had risen to 177. Ticks are common in woodland, heath land and where deer graze.

WHY NUMBERS ARE INCREASING

Global warming, improvements in diagnosis, and various social and economic factors may well be responsible. “The whole problem is building up. On the one hand, the risk areas are spreading; on the other, more and more people are travelling,” says Professor Jochen Süss, of the Friedrich-Loeffler-Institute in Jena, Germany.

WATCH YOURSELF WHILE ABROAD

TBE is endemic in regions of 27 European countries: Albania, Austria, Belarus, Bosnia, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Latvia, Liechtenstein, Lithuania, Norway, Poland, Romania, Russia, Serbia, Slovakia, Slovenia, Sweden, Switzerland and Ukraine.

Each year, 60 million people travel to areas where TBE is endemic. Many tourists have no experience in their home countries of TBE or of appropriate preventive measures.

“Given the continual growth in the numbers of UK tourists in endemic countries, it is only a question of time before this group too finds an increase in the number of TBE cases,” says Professor Michael Kunze of the Institute of Social Medicine, Centre of Public Health, Medical University of Vienna.

“Travellers from the UK need to be made aware that, once the disease has broken out, there is no effective treatment for sequelae - conditions that can develop in consequence. Immunisation with a TBE vaccine, in the context of preventive travel medicine, is the only method that offers lasting protection over the longer period.”

Travellers returning from an endemic area who complain of high temperature, paralysis and other symptoms associated with the central nervous system should consult a doctor immediately, especially if they have not yet been vaccinated against TBE.

WHERE YOU CAN CATCH LYME DISEASE IN THE UK

Exmoor, the New Forest, the South Downs, Wiltshire, Berkshire, Thetford Forest, the Lake District, the Yorkshire Moors and the Scottish Highlands.

TYPES OF TICKS

Around 850 species of tick have been described in the world as a whole. In Europe, eight of the group known as hard ticks have become particularly important as vectors that pass on TBE and Lyme disease. The most important and most widespread of these is Ixodes ricinus, the sheep tick. The body of the female is capable of massive stretching: it can absorb approximately 100 to 200 times its body mass in blood, which increases its volume by a factor of 120.

HOW TICKS FIND YOU

Contrary to the widely held assumption, ticks do not climb trees to drop down on to their victims. Instead, they tend to move about on the ground, in tall grass or in scrub and undergrowth, where they are brushed off on to their unsuspecting hosts: mice, hedgehogs, deer, birds or humans.

A contact time of a few fractions of a second is all it takes for the tick to attach itself to the host’s skin (animal or human). The tick uses a sensory structure, called Haller’s organ, on the last segment of its first pair of legs to orient itself to suck the blood. It can use this and other sensory organs to react to thermal, chemical and physical stimuli such as vibrations and variations in temperature caused by a passing animal or human. Ticks prefer warm, moist, dark areas of the body.

PERFECT WEATHER CONDITIONS

Humidity and warmth are ideal conditions for ticks. They are particularly active after a rainy day in summer. As long as the ground in the woodland is still damp, ticks can even survive quite long dry periods. They are less active in the cold.

“Mild winters like the one we’ve just had ensure that a large number of ticks will survive,” says Professor Süss. “Recently in Europe, the season for ticks has been significantly longer.”

In general, a slow spread of risk areas has been observed, probably due to global warming. In Finland, for example, the virus can now be found just 200km south of the Arctic Circle.

PREVENTION

Use an insect repellent that is effective against ticks; avoid wearing shorts in rural and wooded areas; be sure to tuck trousers into socks; or cover all exposed skin with protective clothing.

Inspect your skin for ticks and remove as soon as possible with fine-tipped tweezers (though TBE transmission can happen instantly). Avoid unpasteurised milk, which may also be infected with the TBE virus in endemic regions.

“Vaccination is recommended to everyone living in or travelling to areas where it is endemic - children as well as adults,” says Professor Kunze. “Another important factor leading to disease cases arises when booster doses of the vaccine are not given in time.”

The best time for the TBE vaccine to be given is in winter, to ensure that vaccine protection has been achieved before the tick season starts in the spring.

Vaccination in Austria against TBE resulted in a drastic reduction in the number of cases from 677 in 1979 to 54 cases in 2001 with a vaccination rate of 87 per cent, the best figure for the whole of Europe. The record lowest number of cases was 41, achieved in 1999.

For more information, visit www.masta-travel-health.com/tickalert and www.tick-victims.info, the first pan-European TBE network for victims, offering support and a wide range of services and information

How to remove a tick

* You need to remove the whole tick without leaving the mouth part embedded in the skin.

* Grasp the tick firmly and as close to the skin as possible.

In a steady motion, pull the tick’s body away directly outwards without jerking or twisting.

* Specialist tick-removal tools can be bought at veterinary clinics and pet shops.

* Pointed tweezers can be used to remove the tick, but you need to take care not to squeeze the tick and release infectious agents and allergens back into your body.

* Don’t try to use a flame or cigarette on the tick. And don’t squeeze the tick.

SCOTS CASES OF LYME DISEASE ARE RISING AS A RESULT OF THE EXPLOSION IN TICK NUMBERS.UNLESS DIAGNOSED EARLY, IT CAN HAVE DEVASTATING LONG-TERM CONSEQUENCES
By June Hyslop

LYME disease infections are increasing twice as fast in Scotland as the rest of the UK.

English and Welsh numbers have risen from 268 to almost 700 between 2001 and 2006.

In the same period, cases in Scotland have grown six-fold from 28 to 177 last year, according to Health Protection Agency figures.

However, it is likely that at least 5000 people in the UK have the disease caused by tick bites and causes flu-like symptoms.

Patient groups think the condition is seriously under reported and the HPA acknowledges their statistics are an underestimate.

The disease is notifiable in Scotland but not England and Wales, which makes it difficult to get reliable UK-wide data.

Bites are more common in late spring, early summer and autumn.

People involved in outdoor activities and who live and work in the countryside are most at risk. However, there have been victims in urban areas too.

Tick numbers have risen in recent years because of global warming and the abandonment of compulsory sheep dipping due to concern about the chemicals used.

Without diagnosis and early treatment it can become a chronic illness, leaving victims unable to function normally and with a bewildering range of ongoing symptoms.

Some have even had to give up work and find it impossible to lead a normal life.

Here, two sufferers tell their stories.

KATRINA ANDERSON

ALMOST 16 years after being bitten by a tick, Katrina Anderson is still in pain and suffers extreme fatigue.

Her facial nerves are damaged, she has problems with her eyesight and blood in her urine. Yet, she considers herself lucky because she can still work.

Katrina, 47, is unable to do the nursing job she loved but is now a computer-aided drafting manager for a firm of consulting engineers in Livingston.

“I can only work because I have a desk job and an understanding employer who knows about my illness,” she said.

Despite her tiredness, Katrina can’t sleep properly, as she suffers debilitating night sweats.

Her body temperature fluctuates and she has her windows open even during winter.

She said: “I have a three-tog duvet in summer and winter and my temperature is still sky high.

“Sometimes, I just don’t want to be me - I just want to lock this pain in a cupboard and walk away.”

Katrina, of Edinburgh, feels she missed out on her children growing up because of Lyme disease.

When she was bitten in 1991, her daughter Paula was six and son Blair only two.

She said: “I remember Blair saying to me, ‘Are you coming out to play British bulldog?’ and I couldn’t.

“I felt guilty because I couldn’t run around the way I wanted to. People don’t always understand because you look okay.

“Sometimes I couldn’t make it out of bed. I had no strength and couldn’t stand for any length of time.”

Katrina became depressed and thought it was all in her head.

She asked to be referred to a psychiatrist but her doctor knew there was something physically wrong - he just didn’t know what.

Eventually, after a battery of tests at the City Hospital in Edinburgh, Lyme disease was confirmed in 1993 and Katrina was treated with intravenous antibiotics.

A year later, she suffered a major setback when she was involved in a horrendous car crash. Her mum and mother-in-law were killed and Katrina smashed both her heels and broke her collarbone.

She spent 10 months in a wheelchair and had five operations.

“I’ve got bits of my hip in my feet and was told I wouldn’t walk again. At one point they were going to amputate my foot.”

Paradoxically, her Lyme disease seemed to settle down.

“I think it was because I was inactive for so long but once I got mobile again it just flared up, ” she said.

Her experience led her to become involved with BADA-UK (Borreliosis and Associated Diseases Awareness), acharity for those affected by the disease.

Katrina is vice chair while her partner Craig Coady is secretary.

On May 6 this year, son Blair, 18, took part in the Great Edinburgh Run to raise funds for BADA-UK.

TANYA EWING

NEW mum Tanya Ewing was worried sick after giving birth to son Coll in case he had Lyme disease.

She knew there was a risk she might have passed it on but breathed a sigh of relief eight days after his birth when Coll was not jaundiced and seemed well.

Tanya, 38, of Perth, had been trying to conceive for more than a year before she and 36-year-old husband, George, resorted to IVF.

Coll was born by Caesarean section in Ninewells Hospital, Dundee, on February 10 this year weighing 6lb 8oz, to the delight of step-sister Neive, aged eight.

Tanya had been carrying twins but suffered a miscarriage and lost one. It’s uncertain if this was because of her Lyme disease but it made Tanya determined not to lose Coll, too.

“There is an 80 per cent chance of miscarriage with Lyme disease, so I had acupuncture before, during and after the IVF treatment. I never felt the pregnancy was secure and got myself a foetal heart monitor so I could check up on the baby two or three times a day.”

Tanya also took antibiotics from the 37th week of pregnancy to minimise the risk.

She says: “I try not to worry about it. I still don’t know he definitely doesn’t have it but so far he is fine.

“It is much more dangerous if you catch Lyme disease while pregnant. Women who have two miscarriages are routinely checked for it.”

Tanya has suffered from Lyme disease since 1999 but wasn’t diagnosed until 2003. She doesn’t remember being bitten but has a mark on her left arm which she reckons was caused by a tick.

Her condition was worst in 2000, when she had a major deterioration after the initial flu-like infection.

“I woke up and couldn’t even get out of bed,” she recalled. “I had a palsy on my left side, slurred speech, severe long-term memory loss. I couldn’t look after myself. I slept all the time.”

Tanya had to give up her job as a sales rep.

Stuck at home and frustrated, she invented a device called Ewgeco to monitor utility bills and water usage, which is pending a patent.

It is being installed in some schools later this year and will be available in DIY stores next year.

“I wouldn’t have invented it if I hadn’t been stuck at home trying to save money on my energy bills, so something good’s come of it,” she said.

Today, Tanya still has stiff arthritic joints, sore hands and feet, suffers fatigue and walks with a limp, but stays positive: “I just get on with life.”

FACTFILE..

WHAT IS LYME DISEASE?

LYME disease is caused by a tick bite. Ticks are small blood sucking parasites which attach themselves to birds and mammals, including humans, to feed. Not all carry the disease but those that do are usually infected with borrelia bacteria.

The first sign may be a bull’s eye skin rash but this occurs in less than 50 per cent of cases. Victims may have flu-like symptoms, swollen glands, headache, muscle and/or joint pain and blurred vision.

HOW TO AVOID TICKS

Light-coloured clothing makes ticks easier to detect. Wear long sleeves and trousers tucked in to socks. Use insect repellent. Ticks tend to favour warm, moist areas like the groin, navel and armpits.

IF A TICK BITES YOU

Remove it as soon as possible. If you feel off colour, even up to six weeks or more later, see your doctor. Symptoms usually clear up with fast antibiotic treatment.

HOW TO REMOVE TICKS

Forget using a match or cigarette, this could cause the tick to pass on the disease. It is vital to remove the whole tick. The best way is using a tick removal tool, sold at pet shops and vets.

Use antiseptic to clean the wound. Store the tick in a dated plastic bag in the freezer in case you develop symptoms.

Log on to www.bada-uk.org, www.tickpreventionweek.org, www.lymediseaseaction.org.uk, www.masta-travel-health.com/tickalert

‘I felt guilty because I couldn’t run around the way I wanted to. People don’t always understand because you look okay’ - KATRINA ANDERSON

http://tinyurl.com/26pj7y

The following letters were recently sent to us by two anxious mothers whose daughters had been bitten by ticks. The first mother (Mandy) had received nothing but contradictory advice from NHS Direct and local healthcare professionals.

The second mother (Laura) took her daughter to hospital two years ago when she was bitten. Hospital staff were unaware as to exactly what a tick was, and since then the child has experienced poor health.

Regardless of whether or not these children have contracted a tick-borne infection, the lack of awareness and contradictory advice alone is extremely concerning.

We have been given permission by both mothers to publish their letters as an example of the continued lack of knowledge amongst many healthcare professionals, and why the work of BADA-UK is still essential.

Date: Sun, 22 Apr 2007
From: Mandy
To: email@bada-uk.org

I am writing to you in hope that you may be able to advise if there are any medical professions that have full knowledge of Tick bites.

My 3 year old daughter came in from the garden over a week ago and had a tick attached. I rang NHS Direct who said to try and pull the tick off myself or apply Vaseline on it to suffocate it. In the meantime I also contacted our GP who made an appointment for later that day. In the meantime I was advised the same details what NHS said.

The doctor had to try a few attempts, but the tick was very strong and after several doses of antiseptic and Vaseline the tick was still strong. It took almost an hour to release the Tick. No antibiotics were prescribed only hydrocortisone cream.

Yesterday morning, as I was getting my daughter dressed I noticed the little puncture mark was red and inflamed (1/2 inch diameter). I rang NHS again, who then contacted our out of hours GP, who then referred us to the out patients department at hospital.

The Nurse took one look and said it’s not infected and that she has had a reaction to the bite. Again did not prescribe any antibiotics and just said to give her some Piriton.

Although my daughter shows no other signs and seems well in herself, after returning from the Hospital, she was very irritable and slept for 3 hours. I rang NHS again as she was also hot and sweaty when she woke and I was told I should not have applied Vaseline. I then advised that this was what I was instructed to do by themselves and our GP. I have also since read that putting any chemicals on the tick whilst attached to the skin can make it inject its poison fluids into the skin.

The red mark is still there this morning and although not getting any worse it is looking like a bull’s eye, which is also what I have read. How can I get further help as I am getting the impression that no really knows? Every time I have spoken to anyone about this they show no concern. I am always left with the impression that I am a neurotic Mother.

I was thrilled to see your website and hope that you can advise or refer me to someone who can help further.

Many thanks

Mandy
Date: Fri, 27 Apr 2007
From: Mandy
To: email@bada-uk.org
Subject: update on my 3year old

Hi,

This is just an update to my previous email regarding my 3 year old daughter’s tick bite.

Since we went to the hospital following a rash appearing a week after the bite, I have been back twice more to see the doctor at our surgery, each time being a different one.

I made an appointment again today following episodes of my normally lively daughter complaining she was tired and being really irritable all week. I made the decision after she was sent home from nursery yesterday complaining of a tummy ache and feeling tired. Also the teacher said she was very hot although she didn’t have a temperature.

When I spoke to the doctor, they were still quite sure that you apply Vaseline to the tick prior to releasing the tick. I was made to feel silly until I produced all the written evidence I have been collecting from different sources. I also took photo’s of the rash, one in close up and another with my daughter in view. Still no real concern was shown. I said it seems the doctors I have seen show no concern and it makes me think to whether they have full knowledge about tick bites. I kept being reassured that it is not Lyme disease as it is not in this country.

When I asked again (4th time now), if she could prescribe antibiotics or even do a blood test, although it took a bit of persuading she finally agreed. When the doctor phoned the hospital to refer us, she explained to them why, etc. and there was an exchange of laughter.

Can you tell me, am I over reacting, or just concerned for one, for my daughter’s health, and for another, to what appears to be a lack of knowledge and concern within our health centre?

Many thanks
Mandy
Date: Thu, 10 May 2007
From: laura
To: email@bada-uk.org
Subject: Daughter bitten over two years ago

Hello there,

Two yrs ago I noticed a tiny bug on my, then 1 yr old, daughter’s head while in the bath. I tried to remove it and it was staying put. I assumed she had head lice. I finished getting her washed etc and we went to town and I purchased head lice lotion. When I got home around 6 hrs later, I took her hat off and looked through her hair and saw a small white thing that looked like a sesame seed, like you get on bread. I tried to brush it out and it wouldn’t budge. I looked closer and saw some tiny brown legs. I then knew it was a tick. My mum came round with the tweezers, she pulled it out.

A few days later my daughter was complaining of a sore head where the tick had been and she had a high temperature and vomiting. I took her to the hospital as it was a Sunday. At the hospital they checked her over and decided she was teething, I mentioned to them about the tick but they did not seem to know what a tick was!! I accepted there diagnosis and a few days later she improved. Since then she has suffered with dizzy spells. She’s nearly four now and she is always having random days of breathlessness and temperatures. We have been to the doctors about her wheezing and he prescribed her an inhaler, and the temperatures and dizziness I was told are just normal childhood illnesses.

It was today that I read my magazine and saw an article about Wendy Fox (Editor – who is a Lyme disease sufferer) and it just clicked about the tick. I am going to take her to the doctors today as she is off school because she keeps falling asleep at school and is not herself. This is not normal and I will mention to my doctor about the tick she had and hopefully they will send her for blood tests. I have never mentioned to the doctor (GP) about the tick before because the doctor at the hospital made it clear I had wasted his time that day and I didn’t want to sound silly again.