The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Workforce
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Rheuminations: How Tiny Ticks Have Fueled Outrage and Acrimony in Some Communities

Rheuminations: How Tiny Ticks Have Fueled Outrage and Acrimony in Some Communities

August 1, 2013 • By Simon M. Helfgott, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

You Might Also Like
  • Letters: Detecting Lyme Disease May Require Thorough Testing
  • Diagnosis, Treatment Updates for Lyme Arthritis
  • Lyme Disease
Explore This Issue
August 2013
Also By This Author
  • Patient Access to Electronic Health Records Yields Unexpected Results
Ticked Off

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE
Simon M. Helfgott, MD
Simon M. Helfgott, MD

Lyme disease has been a difficult journey.

—Allen Steere MD

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

In 1975, Polly Murray, an artist residing in the idyllic town of Old Lyme, Conn., was clearly worried about the health of her four young children.1 Recently they had all developed skin rashes and flu-like illnesses. One son, Todd, had been diagnosed with juvenile rheumatoid arthritis (JRA) and another son, Alex, had developed an unexplained stiff and swollen knee. Murray was not reassured by the pediatrician’s assessment that there was absolutely no link between their illnesses. Nor were her fears allayed by the discovery that twelve children in Lyme had recently been diagnosed with JRA. There were no obvious explanations for this outbreak. Some people speculated that a nearby nuclear power plant was to blame. Others ascribed it to contaminants present in the town’s drinking water supply.

I have heard from reliable sources that Murray contacted several Boston-area teaching hospitals seeking their help, but to no avail. She found a more receptive audience in Connecticut, where an epidemiologist working in the State Department of Health put her in contact with Allen Steere, MD, then a first-year rheumatology fellow at the Yale School of Medicine in New Haven, Conn. Dr. Steere, whose previous training had been in the field of epidemiology, paid a visit to Lyme, a wooded hamlet of 5,000 residents nestled at the mouth of the Connecticut River. He was intrigued. A preliminary surveillance study of three contiguous towns—Lyme, Old Lyme, and East Haddam—identified 39 children and 12 adults with some form of inflammatory arthritis.2 Most of the patients resided in heavily wooded, sparsely settled areas and there appeared to be a peak occurrence of the illness in the summer months. What might be responsible for this outbreak? The patients’ physical examination findings and laboratory test results did not point to a specific cause. The breakthrough clue came after a meticulous review of the patients’ histories, when Dr. Steere discovered that one-quarter of them had noticed a rash in the shape of a bull’s-eye pattern develop a few weeks before the onset of the arthritis. Olé!

Bull’s Eye

The history of the bull’s-eye rash brings us back to the early years of the twentieth century when a Swedish dermatologist, Dr. Arvid Afzelius, presented a paper to the Dermatologic Society of Stockholm that described a patient with an expanding skin lesion, which he termed erythema migrans. Paradoxically, this rash, which faded within a matter of weeks, was renamed erythema chronicum migrans. A dozen years later, Dr. Afzelius, who studied under the famed Hungarian physician and dermatologist Moritz Kaposi, presented a second report on a series of six patients with this rash:3

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Pages: 1 2 3 4 5 | Single Page

Filed Under: Rheuminations Tagged With: Borrelia burgdorferi, CDC, Centers for Disease Control and Prevention, diagnose, IDSA, Infectious Diseases Society of America, Lyme Disease, rheumatologist, Tick-Borne Disease, Tick-Borne Illness, ticksIssue: August 2013

You Might Also Like:
  • Letters: Detecting Lyme Disease May Require Thorough Testing
  • Diagnosis, Treatment Updates for Lyme Arthritis
  • Lyme Disease
  • Lyme Arthritis Treatment Protocols Critical as Lyme Disease Spreads

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

Simple Tasks

Learn more about the ACR’s public awareness campaign and how you can get involved. Help increase visibility of rheumatic diseases and decrease the number of people left untreated.

Visit the Simple Tasks site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.