DermHelpCentral

Bedbug Invasion 2010

"Cimex lectularius, the notorious bedbug, is an international arthropod of mystery.  In comparison to other insects that bite man, or even only walk across man’s food, nibble man’s crops or bite man’s farm animals, very little is known about the creature whose Latin name means — go figure — “bug of the bed.” Only a handful of entomologists specialize in it, and until recently it has been low on the government’s research agenda because it does not transmit disease. Most study grants come from the pesticide industry and ask only one question: What kills it?"

Donald McNeil's article in the September 1, 2010 NY Times, "They Crawl, They Bite, They Baffle Scientists" is a fine introduction to this important pest.

This Bedbug's Life

an Op-Ed piece in the August 8, 2010 NY TImes by entomologist May Berenbaum

Bedbugs (Cimex lectularius), once a rarity, over the past decade have become ubiquitous pests. "Global travelers now bring in a steady supply from around the world, inconspicuously undeclared in checked bags and carry-on luggage. Today, bedbugs have been found in all 50 states, as well as Guam, Puerto Rico and American Samoa, and bedbug-related calls to pest control operators are escalating at a fantastic rate. From June 2009 to June 2010, there were more than 31,000 calls in New York City alone."

Dr. Berenbaum's chatty, informative editorial, This Bedbug's Life,  is a must-read for anyone interested in or bothered by these unlovable vermin.

.

Preventing Lyme Disease

Prophylaxis with Single-Dose Doxycycline for the Prevention of Lyme Disease after an Ixodes scapularis Tick Bite
The Tick Bite Study Group

ABSTRACT

Background It is unclear whether antimicrobial treatment after an Ixodes scapularis tick bite will prevent Lyme disease.

Methods In an area of New York where Lyme disease is hyperendemic, we conducted a randomized, double-blind, placebo-controlled trial of treatment with a single 200-mg dose of doxycycline in 482 subjects who had removed attached I. scapularis ticks from their bodies within the previous 72 hours. At base line, three weeks, and six weeks, subjects were interviewed and examined, and serum antibody tests were performed, along with blood cultures for Borrelia burgdorferi.

Results Erythema migrans developed at the site of the tick bite in a significantly smaller proportion of the subjects in the doxycycline group than of those in the placebo group (1 of 235 subjects [0.4 percent] vs. 8 of 247 subjects [3.2 percent], P<0.04). The efficacy of treatment was 87 percent (95 percent confidence interval, 25 to 98 percent). Objective extracutaneous signs of Lyme disease did not develop in any subject, and there were no asymptomatic seroconversions. Treatment with doxycycline was associated with more frequent adverse effects (in 30.1 percent of subjects, as compared with 11.1 percent of those assigned to placebo; P<0.001), primarily nausea (15.4 percent vs. 2.6 percent) and vomiting (5.8 percent vs. 1.3 percent). Erythema migrans developed more frequently after untreated bites from nymphal ticks than after bites from adult female ticks (8 of 142 bites [5.6 percent] vs. 0 of 97 bites [0 percent], P=0.02).

Conclusions A single 200-mg dose of doxycycline given within 72 hours after an I. scapularis tick bite can prevent the development of Lyme disease.

Lyme Disease - Jane Brody

Lyme Disease is becoming more wide-spread and common.  There have been many articles and even books on the subject.  Jane Brody devoted her column this week to Lyme.  It's a fine introduction and a good source of references.  She writes:
"The disease can be maddeningly difficult to diagnose. Only 50 to 70 percent of patients recall being bitten by a tick. Ordinary laboratory tests are rarely helpful. Tests for antibodies to the bacterium or for its genetic footprints result in many false-negative and false-positive findings."

To access her article, go to:  Lyme Permalink.

Ms. Brody also cites a recent Mayo Clinic Proceedings article: Diagnosis and Treatment of Lyme Disease which can be accessed at MCP Lyme or this pdf:   Download lyme_mayo.pdf

Lyme Disease

Lyme Disease is a concern to many people who enjoy the great outdoors in New England and other parts of the U.S. You can find a nice chapter on eMedicine or here's a more user friendly article by medical reporter, Christie Aschwanden, that appeared in Backpacker magazine In June 2006.  This article can also be accessed at: Aschwanden Lyme

 

 

Dr. Austin's Head Lice Treatment

Dr. Melanie Austin’s Homeopathic Lice Treatment

This is a picture of eggs (called "nits") on the hair.

For background material go to: DermNet

Don’t Panic!
You or your child did not get head lice because of your hygiene or anyone else’s. You got unlucky, that’s all!

Here’s a simple treatment that works.

1. Go to your local supermarket or pharmacy and get a long metal hair pick called a lice or nit comb.
2. Combine a 50:50 mixture of baking soda and thick crème rinse
3. Divide hair into 6ths
4. Pull nit comb through crème rinse mixture then through a small section of hair starting at the scalp…..repeat until entire head is done
5. Wash hair out thoroughly
6. Apply small amount of Cetaphil cleanser to hair and comb through
7. Then blow Cetaphil dry – this works to suffocate the lice (you hair will feel as if you have a light styling gel dried in it)
8. Wash nit comb daily by pouring boiling water over it….if you boil the comb, the teeth will loosen and fall out
9. At night rub small amount of extra virgin olive oil into scalp – if there are active lice this will prevent them from adhering to the hair shaft and getting a nightly “blood meal.”

Repeat this process daily until no further lice or nits are present
Continue this process then every other day for 7 days
If nits are present...continue process until all nits are gone then every other day for 7 days

Check all family members for nits – treat everyone who is infested

Check in your local community if there is a “Nit Picker” a professional who removes lice. If you can see the “nit picker” its well worth the money in the time and effort spent.  But if you’re fastidious about the plan you can manage yourself. Keep in mind, it is labor intensive, but WORKS!

Other Management:
So you know what to do with your head…..
Now we have to prevent re-infestation
1.    Wash all sheets, blankets comforters and pillowcases in hot water and dry in dryer
2.    For those items that can’t be washed, toss in the dryer for 20 minutes
3.    For those items which can’t be washed or dried, seal in plastic bag for 2 weeks
4. Pillowcases, sheets and towels should be washed daily until no nits are   
    present
5. Carpeted areas should be vacuumed
6. Upholstered furniture should be steam cleaned once you’ve see a “nit
    picker” or as soon as no further nits are present

Your pets can not carry lice and thus should not be treated!

A Poem – attribution unknown

Share a thought
Share a ride
Share a feeling …deep inside
But never share a hat or comb
Or lice will make your head their home!

Melanie Austin is a native New Yorker. She is a graduate of Smith College, Suny Downstate in Brooklyn (M.D.)  and a well-respected mid-western pediatric residency program.  After residency Dr. Austin indulged her wanderlust and worked for year as a locum tenens in places like Dodge City, Kansas.  She now understands the true meaning of "Git outta Dodge!" She also volunteered with the Maryland Militia and went to New Orleans during the aftermath of Hurricane Katrina.  The armed forces put up with Major
Dr. Austin for two weeks, and then gratefully accepted her letter resignation. She was HONORABLY discharged. In June 2006 Dr. Austin finally married her fiancée, Greg. They are both living happily in the Boston area with their cat Brooklyn and their rescue doggy Katrina.