Lyme (and other tick-borne) Diseases

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Written by Dr. Carly Wilbur, psi Medical Director

Welcome to a very special edition of psi’s Paradigm! Are you up to date on your Lyme disease symptoms, treatments, and preventions? With the beginning of the new school year as well as a nationwide increase in tick-illnesses, know the facts!

By all accounts, the number and extent of tick-borne illnesses are increasing annually in the United States. While Lyme disease is the most recognized of these illnesses, the Centers for Disease Control (CDC) reports that seven new tick-borne germs have been identified in the US in the last two decades.  And while not all cases get reported, the number of logged cases of Lyme disease has tripled since the early 2000’s. Several factors are to blame: new tick species have been identified, reforestation projects bring humans and wildlife in closer proximity, and climate change has altered the ecological nature and seasonal cycles that affect ticks and their hosts.


Nationwide, this has historically been an issue for the Northeast and Midwest regions of the United States, but the geographic area of concern is growing, and the number of counties that qualify for a “high risk” label for Lyme disease has increased 300% in 20 years.

In Ohio specifically, the incidence of Lyme has skyrocketed: Only 44 cases (in 28 counties) were reported in 2010, but that number was up to 270 cases (in 44 counties) by 2017 (the most recent published data for our state).

 

While not every tick encounter results in a diagnosis of Lyme disease, it’s important to recognize the symptoms that would increase one’s index of suspicion.

Erythema Migrans (EM) rash (pictured) and generalized malaise (fever, headaches, muscle pains, joint pains) within 1-2 weeks of a tick bite. If these complaints are not identified, the disease can progress within 2-4 weeks to a more disseminated form that carries the risk of central nervous system involvement (meningitis, cranial nerve palsies, eye conditions) and heart problems. Late disease, often recognized months after a tick bite, carries an even greater risk of nerve damage and prolonged arthritis.

Knowing what to look for is helpful. The Ixodes scapularis (AKA Blacklegged Tick) is tiny, and the nyph (baby) phase of the life cycle can be <3mm in size.

Certain precautions can help prevent Lyme disease:

  • When hiking, walk in the middle of the path, not the tall grass.
  • Use EPA-approved insect repellant spray with DEET.
  • Wear long sleeves and long pants. Tuck pant legs into socks.
  • Clothing and gear can be pre-treated with permethrin. After exposure, clothing can be placed in the dryer on a high heat setting.
  • Wearing light colored clothing makes ticks easier to see.
  • Shower off and check yourself (and your pet) thoroughly after being in tick-infested areas. Promptly remove any ticks discovered.
  • Continue to check for ticks 2-3 days after outdoor activities in areas known for ticks.
  • Be sure to protect your pet(s) with regular anti-tick treatments.

If a tick is discovered, immediate removal is advised.

Because NE Ohio is not currently considered an area of high endemicity for Lyme disease, the standard of care is to not start antibiotics unless certain criteria are met:

  • Tick is engorged
  • Tick has been in place >36 hrs
  • Patient has classic EM rash at tick site.

Blood tests to confirm diagnosis are not necessary if the history and  presentation are classic. EM with known exposure warrants a course of empiric antibiotic treatment.

Atypical symptoms should prompt a laboratory work-up that includes quantitative screening for serum antibodies to Lyme disease. If these are negative, no further testing is needed. Positive tests will need follow-up with Lyme immunoblot or Western blot for presence of IgM and IgG antibodies. Only with a strong response to both antibody types, can a definitive diagnosis be made.

If antibiotics are warranted, first-line agents include oral Doxycycline twice daily for 10 days or Amoxicillin three times a day for two weeks. Most clinicians will administer a single prophylactic dose of Doxycylcine if an engorged tick has been discovered.

 

For more info on Lyme disease symptoms, treatment, and prevention:

Center for Disease Control – Lyme Disease

More info on Dr. Carly Wilbur, psi Medical Director

psi’s School Health Clinic Services Program

 

Fun Summer Tips That Will Keep Your Child Learning!

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Summer is almost here… and that means your students and children will be ready for fun and excitement! Try these great tips for keeping kids focused and avoid the dreaded.. Summer Brain Drain!

1. Get involved

Kids of all ages love to know that they’re making a difference, and community service opportunities abound. Read to nursing home residents. Stock food pantries. Clean up a local park. Getting involved helps our community build a Climate of Caring.

2. A day in the park

Ohio has 83 state parks, 2 National Historic Parks, and 3 National Wildlife Refuges. There’s camping, swimming, hiking, boating, breathtaking views — even theaters and historical landmarks. Many parks offer handicapped-accessible facilities and educational programs that will foster your learners’ love of nature!

3. Get creative

Engaging the mind with reading and other creative ventures is just as vital as engaging the body. Summer is the time to read books, make videos, write stories, stage shows, make music and create works of art without the pressure of assignments, deadlines and grades.

4. Backyard adventures

You don’t need to get in the car to discover new wonders. Send kids on a backyard bug hunt, or challenge them to create art with sticks, pinecones and leaves. Hold a backyard camping trip, complete with stargazing. Plant vegetables, and make healthy meals celebrating the bounty of your garden.

5. Kitchen curiosity

Bake a cake. Make a casserole. Build a banana split. Create a new drink recipe. Kitchen adventures teach kids the basics of cooking while giving them the pride of sharing their culinary successes with family and friends.

6. Start a business

Host a lemonade stand or mow lawns. Baby-sit. Sew and sell shopping bags. Kids who earn money learn to appreciate the value of a dollar and to manage their money.

We Love Our Cleveland Cavaliers!

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Good Luck to the Cleveland Cavaliers!

Webinar: Managing Concussions in Schools

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Did you miss our informative webinar on Managing Concussions in School?   Click here to view on demand.With a focus that addresses concussions on and beyond the sports field, this webinar describes how to create and lead a school concussion management team and provides clear, non-technical information on how concussions can affect learning, mental health, and social-emotional functioning; tools for school-based concussion assessment; and guidelines for creating accommodation plans in collaboration with the family, community, and school team.  This webinar has passed but you can always review our webinars in our library.

Dr. Scott Poland gives some practical advice on grief

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In the wake of the tragic events that occurred in Orlando, many people are dealing with grief. You do not have to be directly involved with this incident, as seeing it on the news and hearing about it can bring up a person’s own life experiences, and with it, a sense of grief and despair. To help, Dr. Scott Poland,

A PSI Expert Partner and a professor in Nova Southeastern University ‘s Psychology Department, has put together some “tips” to help people deal with their grief as well as how parents should help their children understand these senseless acts.

You can read Dr. Poland’s advice online HERE .

Dr. Poland is also a nationally recognized expert on school crisis, youth violence, suicide intervention, self-injury, school safety, threat assessment, parenting and the delivery of psychological services in schools. Poland is a founding member of the National Emergency Assistance Team for the National Association of School Psychologists and serves as the Prevention Director for the American Association of Suicidology. He has led multiple national crisis teams following numerous school shootings and suicides and served as the team leader of the crisis response team sent to Jefferson County Public Schools during the aftermath of the Columbine High School shootings.

In Honor of Sister Bernadette…..

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2016-06-14_12-48-26We meet only a few very special people in our journey through life. I met such a lady close to 40 years ago when PSI was in its infancy. Sister M. Bernadette Maier, OSU, is perhaps the most remarkable woman I have met in my four decades of work with educators in Ohio. Certainly schools, and in particular the Catholic Schools, are full of wonderful people who are dedicated to their mission and give their all for the schools and the furtherance of Catholicity.

Sr. Bernadette did all that. In addition, she saw opportunity where there were obstacles, dreams where there were ‘roadblocks’ and strategies where there were almost insurmountable challenges. The non-public schools throughout Ohio but especially in the Cleveland Diocese, live her legacy every day when children benefit from services paid for by auxiliary services funds. These services didn’t just come to be by fiat. They were achieved by dint of hard work, vision, politics and endless blood, sweat and tears. Her stories and accomplishments are as voluminous as they are a study in political triumph.

She became dear to us over the years as we all strove to expand the services she wanted for ‘her kids.’ She was one of a kind, full of the vim and vigor that all movers and shakers have, changing the systems in which we live. She will live on in our hearts as an ideal to which we all should aspire, a tireless supporter of PSI and a dear, dear friend.

God Bless you Sr. Bernadette.

 

– Steve Rosenberg, President of PSI

Mandarin Language News

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PSI’s Hui-ying Lee proudly presented her students at the National Chinese Honor Society induction ceremony at Walsh Jesuit High School in April. There were eight inductees this year and they are all Chinese 3 juniors.
The National Chinese Honor Society (NCHS) was established in November 1993 to recognize those accomplished high school students who study Chinese as a world language.
The National Chinese Honor Society is a scholastic organization that promotes and recognizes students with good citizenship, leadership, and deeds of community service.Mandarin Language Services

The National Chinese Honor Society’s goal is to encourage its members to become life-long learners to gain a better understanding of Chinese language and culture, and to play an active role as constructive peace-makers in the twenty-first century. The applicant must be a full time high school student who has studied Chinese fo four semesters in high school with an average of A- or higher. A qualified candidate is someone who is willing to work with the sponsor/advisor as well as with other students as a role model to play a positive role in Chinese studies. Hui-ying has continued to develop the Mandarin Language program at Walsh over several years and her efforts are producing some exemplary students. Congratulations to all!

PSI Presented at a Conference in Amsterdam on Suicide Prevention

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PSI is proud to announce that Dr. Colleen Lorber, PSI Executive Director of Client Services and PSI partner, Dr. Scott Poland, presented at the International School Psych Association in Amsterdam, Holland this summer on suicide prevention.

Dr. Lorber holds a doctorate from Duquesne University in Pittsburgh. Her dedication to staff, professionalism and her high energy level serves the schools we partner with, extremely well. “I most enjoy helping to find and support the best possible staff to meet the many needs of the students we serve. PSI is all about providing the very best and innovative services possible to help our partner schools and their students succeed.”

Dr. Poland is a nationally recognized expert on school crisis, youth violence and suicide prevention.

Their combined presentation will focus on suicide prevention and the children served everyday by the educational community.

PSI hosted a free webinar on “Mindfulness in the School Setting”

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Our own Karen Heichel, MA  presented a free webinar entitled “Practicing Mindfulness in your School”.  This is a new and very exciting topic.  This free webinar was held on December 2nd from 3:00 PM – 4:00 PM EST. but you can watch it now in our webinar library.

Mindfulness is being used for reducing stress, increasing attention, building attitudes of compassion and kindness that lead to more productive learning environment for students and a more collaborative working place for teachers.

Karen will be talking about how studies have shown significance improvement in self-awareness and acceptance by practicing mindfulness for 15 minutes three to four times per week. These activities can be integrated into your existing curriculum.  If this topic sounds interesting to you, click here for a link to the pre-recorded webinar.

A Neurodevelopmental Approach to Autism: with Temple Grandin, Ph.D.

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PSI is pleased to share this resource with you for your own use, to share with your colleagues, or to share with the families of the students with whom you work:

We here at S.U.C.C.E.S.S. For Autism 501(c)(3) are proud to inform you that we will be hosting a winter conference this year entitled:
“A Neurodevelopmental Approach to Autism: with Temple Grandin, PhD” 
                                                                   
Thursday Dec. 3 & Friday Dec. 4th 2015
 We are pleased to welcome world-renowned author and animal scientist, Dr.Temple Grandin, to our stage this year as she presents on her experiences as an individual with autism and sensory processing issues. She will be joined by many professionals in the field of autism; you will hear from occupational therapists Lynette Scotese-Wojtila, OTR/L and Ellen Winney, MS OTR/L, speech-language   pathologist Schea Fissel, ABD, MA CCC-SLP, and developmental pediatrician, Dr. Scott Faber.

This two-day conference will be held in the Main Building of the Center for Pastoral Leadership in Wickliffe, Ohio on Thursday Dec. 3rd (2:15 – 8:15pm) & Friday Dec. 4th (8:00 am – 5:30pm).

This is a unique event you won’t want to miss! See the attached brochure for event details, registration, and continuing education opportunities! Vendor and sponsor opportunities are available for local and/or national agencies and companies who wish she share their product information while supporting this event.

FOR EASY ONLINE REGISTRATION visit www.successforautism.org.

Seats are limited to see Dr. Grandin in this intimate setting; conference registration closes on Monday Nov 23, 2015. Should you have questions or need registration or vendor/sponsorship assistance, please call Erin at 440.943.7607 or email at itcerinb@yahoo.com.