Saturday, 26 April 2014

Tick tubes

Springtime is the season of cute fluffy lambs, ickle yellow chicks and tits in me box (nesting box, you filthy animals!). It's also the season of evil shitbag ticks roaming about waving their vile little legs, waiting for some poor creature to brush on past whilst doing the gardening or foraging for a tasty morsel.

Then I saw this cute little fella (wood mouse??) in our garden, I thought, mmm..adorable as you are, you're probably carrying ticks and you could well be infected with Borrelia burgdorferi (see this study in the netherlands). Wood mice can infect larval ticks with Borrelia burgdorferi s.l. according to this swedish study and  this german study.

There are some things you can do to stop these demon ticks embedding themselves in your flesh and sucking the life force out of you- see this excellent easter blog post by tick talk Ireland on preventative measures and this page by BADA-UK. My personal weapons of choice are pictured below. DEET is normally recommended as the most effective repellent but I don't like using it and it's not suitable for young children. BADA-UK say that Mosiguard natural (which contains the natural product citridiol) is as effective as DEET, and I know on midges it is very effective. I also like Autan (which contains Icaridin).I should add that it's important to put repellents on where ticks are likely to get access to your skin. I put it on hands, wrists, lower legs, waist and neck, plus my daughters hairline.

When I am well enough to start hillwalking again, I will impregnate some clothing with permethrin (the lifesystems product pictured), as permethrin impregnated clothing has been shown to be very effective in preventing tick bites.

I keep this arsenal handy from April-October and even use repellent on a warm winters day if I'm doing something tick-risky.

This year though, I have added a new and excitingly home-made tool to my 'nuke the buggers' toolbox. Tick tubes are cardboard tubes filled with permethrin-impregnated cotton wool or other natural nesting material. The idea is that mice take the cotton wool into their nests and in doing so, kill all their fleas and ticks and thus help to reduce the number of ticks milling about locally. There are commercially available tick tubes from a company called Damminix and these have been shown to be very effective in one recent study. A friend has used these in their garden and they say that after they started using them they saw no ticks at all in their garden whereas before they'd had quite a few and family members had been bitten in the garden. Damminix tick tubes are not available in the UK,  to my knowledge, and so I thought I'd make my own (plus I'm a skinflint!).

So here's how I did it:

Toilet roll inners, cotton wool balls, Lifesystems permethrin spray, some disposible gloves, a bit of cardboard to spray the balls on and acrylic paint to attempt to waterproof the tubes a bit. Sorry can't seem to rotate the photo!

I thought painting the tubes in acrylic paint first would help to stop the cotton going soggy and might stop the tubes disintegrating too fast. I wore disposible gloves when handling the permethrin or permethrin soaked balls. BTW I'm not paid by lifesystems or anything, I just bought that because it was in a handy spray, available from a UK seller, contained only permethrin (I didn't want to use other, potentially more toxic insecticides) and wasn't a huge volume of product that I'd have to later dispose of.

I used cardboard to spray the cotton balls on and dry them on as this can be binned rather than having to wipe down a surface with a cloth which would potentially allow permethrin to get into a water course if I rinsed out the cloth. Permethrin has very low toxicity to most mammals but it highly toxic to aquatic organisms so please take precautions to avoid swilling any of it down the sink. It is also highly toxic to cats, so if you have cats, perhaps best to not impregnate clothing with it. This is the reason I put only four balls per tube as I didn't want any cotton sticking out of the end where cats could get to it. I don't have cats but my neigbours do.

Stuffing me tubes

It took a whole day for the permethrin soaked balls to dry, you don't want to put them wet into the tubes- not very attractive as a mouse duvet!

Place the tubes where mice are likely to stumble upon them. Mice don't generally like being out in the open, so behind pots and containers, near walls with crevices, alongside fences and at the backs of borders. Also perhaps under a bird feeder as mice do love a bit of discarded bird seed.

Worth a shot I reckon, and pretty cheap. I haven't noticed ticks in my garden, but we do have deer and sheep just across the road, and I have plenty of birds which are competant hosts for Borrelia. We've even had a pheasant on our lawn before, also a competent host.

I has been pointed out to me that permethrin is listed here as banned in the European Union. However, I think it might have been banned just as a plant protection product due to it's affects on aquatic organisms should it get into water courses (see this bafflingly opaque EU directive). As far as I can make out, it's still allowed as a human and veterinary medicine (e.g. head lice treatment and tick and flea treatment for dogs), wood preservative, a spot treatment as an insecticide/acaricide and on some textiles (see this document). I reckon it's use in tick tubes would fall within these allowed applications. If someone else knows differently, let me know!

Just to reiterate, don't throw it in watercourses or down the sink as it will kill aquatic organisms and don't let cats come into contact with it.

Friday, 11 April 2014

A trio of fantabulous European Lyme conferences!

Well, it's all going on! April, May and June are busy busy busy- three fanastic European Lyme meetings are happening - one in good old blighty!

Very brilliantly, a private sponsor has arranged for a panel of seven US tick borne disease doctors and researchers to come on over to London to speak to our doctors for a day symposium on June 7th.

In the words of the sponsor/organiser (from the blog of Joanne Drayson, UK Lyme patient)

The Speakers will be seven USA TBD Specialists, all of whom have over 20 years experience in dealing with these insidious infections. The purpose of this meeting is to discuss, with interested UK Doctors, Vets and their Researchers, testing, diagnosis, treatment, and the consequences to patients and healthcare providers of missing or not recognising the symptoms early.

A situation that is fairly unique and very important, is that in most specialties, the treating doctor will have had no personal health experience of the illness he/she  is treating, whereas in the case of TBD infections  the visiting  American doctors have either had a personal brush with Lyme Disease etc or, have family members who have been afflicted. 

There is a lot of interest in this symposium from Senior Doctors etc, possibly due to the fact that many patients whose symptoms have been missed or misdiagnosed are encroaching on clinics for Neurology, Cardiology, Ophthalmology, Endocrinology, Rheumatology and Chronic Pain.

The warnings have been around for many years regarding long term damage to human and animal health with regards to Tick-Borne Diseases. Can our health authorities really afford to continue with the misconception that Ticks and the diseases they harbour are a 'rare and regional' problem, I think not. 

Education is the key to the most difficult of situations, and it certainly is to this one.

It will not be open for patients to attend, as the aim is to get doctors talking to each other.The exciting news is, Dr Matthew Dryden and Dr Tim Brooks are going to be attending the symposium and the NORVECT conference (see below). In case you weren't aware of who these people are, Dr Dryden is in charge of the newly opened (and sadly soon to be closed) national Lyme referral 'clinic' at Royal Hampshire County Hospital in Winchester. Dr Tim Brooks is head of the Rare and Imported Pathogens Laboratory (RIPL), Porton Down, which does the NHS Lyme disease testing for England and Wales.  

Thier attendance at the London Symposium was facilitated by the wonderful Lady Mar.

WOW!! Thank-you so so much to the person who sponsoring this and absolutely great that Drs Dryden and Brooks are attending. If you have any names of genuinely Lyme-interested NHS doctors who would like to attend, please do email them to Joanne Drayson for her to pass onto the organiser. Joanne's email is Please include a bit of info about that doctor. We don't want valuable spaces taken up by die-hard IDSA ers, so they sould be open minded and interested in learning. Consultants would be great!

I'm feeling happy!
There is also the ILADS (International Lyme and Associated Diseases Society) conference in Augsberg, Germany on April 25th and 26th. Click here for the programme. Dr Armin Schwarzbach, of Infectolab/BCA, is talking on laboratory testing and Dr Daniel J. Cameron, is speaking on building an evidence-based laboratory practice, which should be interesting.

Then there is a star-studded line-up for the NORVECT conference on 26th-27th May, in Oslo, Norway. "Who are NORVECT?" I hear you ask- this is what they say:

About NorVect – The Nordic Network for Vector-borne Diseases

NorVect is a Nordic interest group, dedicated to building and sharing vital knowledge about vector-borne diseases – particularly in the fields of diagnostics and treatment – across our countries.
In cooperation with authorities and other interest groups, we arrange knowledge-leading seminars, conferences, and events covering leading international research and insights on vector-borne diseases.
In doing so, we strive to create a platform for continuous improvement, and for an open and constructive dialogue between patients, their families, health practitioners, authorities, and politicians alike.
NorVect is founded and run solely by patients with the desire to make a difference.
Focus on research, focus on dialogue, and focus on the patients are the cornerstones of our organization.

Think that sounds good? You wait till you see the speakers they have arranged, they are:

Joseph J. Burrascano Jr., MD
Richard I. Horowitz, MD
Edward B. Breitschwerdt, DVM
Alan MacDonald, MD
Eva Sapi Ph.D.
Christian Perronne, Ph.D, MD
Jyotsna Shah, Ph.D, CCLD, MBA
Judith Miklossy, Ph.D, MD, DSc
Carl-Morten Motzfeld Laane, Ph.D
Randi Eikeland, Ph.D, MD
Bela Bozsik, MD

Fantastic work, guys!! This is the programme. What an amazingly exciting event this is going to be. Before you start rushing to book your flights and get your skis out of the loft, please take note that this conference is primarily aimed at Medical professionals. They say :

Due to limited space, we will not be able to open up for patient registration before one month prior to the conference. They also say: The Norwegian Medical Association (NMA) is currently reviewing our application for doctors’ specialization credits. Information will follow within the next few weeks.

I think that's the equivalent of continuing professional development (CPD) credits, so doctors should be able to attend and claim back expenses and add it to their CV as training (if the NMA approve it).

I am very encouraged that Dr's Brooks and Dryden are willing to attend and hear what these highly experienced Lyme doctors and researchers have to say. I hope they listen and learn, for there is soooooo much to learn. I think, (I hope) it will open their minds as to the complexity of it all. I also hope the speakers provide citations or other scientific evidence for their claims. This is difficult to do in a talk, I know, but it will really help the IDSA supporters see that what we as patients have been saying is not just plucked out of thin air. Fingers crossed that the coffee time chat will be fruitful and not antagonistic.

Why not write to your doctors to tell them about it? I have! I've not had a reply and don't expect them to actually go, but if they don't know about it they don't have the opportunity of going, and I hear Oslo is a lovely place for a weekend city break ;-)