Groups combat rise of Lyme
With the number of cases of Lyme disease dramatically increasing on the island this year, members of the Deer Task Force (DTF) joined the Block Island Health Services (BIHS) board at its Aug. 26 meeting to plan for what all agreed was a serious public health problem.
BIHS board president Bob Fallon said the DTF had asked to be present at the health services board meeting because of what the DTF feels is a growing and urgent public health issue.
Fallon agreed that BIHS was “better suited to support the notion of a public health issue.” He said he also received a request from Dr. Peter Baute for the BIHS board to develop a policy to address the rise of Lyme disease on the island.
“We’re asking for a support letter from you — if you will tell us what we can do to elicit the media to facilitate something with the Rhode Island Department of Health,” said DTF Chair Ruth Perfido.
Perfido has been leading the talks between the DTF and the R.I. Department of Environmental Management (DEM). But there have been recent calls, as indicated by Perfido’s remark, to get the state Department of Health (DOH) more directly involved in the discussions about what is happening with deer and Lyme disease on the island.
There has been progress with the DOH. “We’ve had a doctor assigned to us from the [state] Department of Health and we are asking the doctor to come out [to the island],” Perfido said. The DTF was asking the BIHS board to support the idea that Block Island has more of a health issue because of the deer, rather than a nuisance issue because of the number of deer on the island.
“The DEM’s constituency is not health; it’s hunters. But it is the health center’s mission to complement and come up with a statement supporting the DTF and go further and support the elimination of the deer herd,” said Baute.
Board member Dr. Al Casazza agreed with Baute and thought the board was in a position to advance educational activities. BIHS Board member Bill McCombe said, “If we can only get the DEM on board for the eradication of the herd. We are stopped in our tracks if herd management is only based [on maintaining a sufficient herd for hunters]. It should be based on the health issue.” But McCombe added that the DTF had made considerable progress. “They’ve made some really good headway on this issue,” he said.
According to Becky Ballard, vice-president of the DTF and liaison between the town and the DEM, educating the public is the primary goal. Ticks can be found in unexpected places and can attach to people who are out hiking or even searching for the glass floats on the island. Ballard said she felt the public’s general knowledge of the Lyme threat is negligible and she also felt people — visitors and residents alike — needed more education about the deer tick and its potential repercussions.
Linda Closter, a registered nurse on the medical center staff, reported that by the end of July, there were 66 cases diagnosed by local medical center staff. Last year’s total was 48 cases.
Nurse practitioner Liz Dyer said the numbers of Lyme cases referred to only “those we have confirmed as tested,” but noted that the testing was expensive and that many on island “don’t have insurance, so that the number of cases is ultimately under-reported.”
Closter added, “Last year only half had a rash. This year 56 cases were identified by a rash.” The rash is a characteristic symptom of Lyme that often appears as a bulls-eye inflammation surrounding the tick-bite; however, it is not present in all cases of diagnosed Lyme.
Fallon also cited a report from the Centers for Disease Control (CDC) of a ten-fold increase in the number of cases of Lyme disease in the United States. These cases were “predominantly in the northeast indicating an important health problem in the US,” according to the report. Fallon added that although the issue had not been placed specifically on the agenda, it was important enough for the board to consider.
“I feel the town has an obligation to do something about it,” he said. Board member Kay Lewis reminded the group that at their last meeting “we agreed that if the numbers continued to be elevated, we’d send a letter to the Town Council.”
The CDC report Fallon referred to announced that cases of the disease had been grossly under-reported across the United States. The CDC found there were approximately 300,000 persons diagnosed with Lyme across the country annually, rather than the previously reported of some 20,000 to 30,000. This new estimate derives from a survey of 17 national laboratories, a national patient survey and a review of insurance data.
BIHS Secretary Sue Hagedorn wondered whether it should be “just the Town Council, or should we include Dr. [Michael] Fine [Director of the Rhode Island Department of Health]?”
Fallon asked whether the group should also “try to get some public health funds,” given that the CDC’s goals were to identify, treat and educate the public on Lyme disease.
Board member Cookie Lenocci said, “We’ve had a huge bump-up of the disease; shouldn’t we go directly to the CDC?”
Dr. Janice Miller, of the Block Island Health Center, and Dyer agreed that in general people do not know how to recognize a deer tick and that the public needs to be educated to do so and also to know what the symptoms of Lyme are. In addition to the rash, onset of the disease may be indicated by a fever, headache and fatigue, as well as the often present tell-tale rash.
Agreeing, audience member Richard Weisbroat said that at the BIRA meeting it was generally agreed to classify the issue as a public health problem.