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Lyme disease in Oregon
***********************************************************************
                                                   as of 1 January 1998
Table of Contents
-----------------------------
The White House on Lyme disease in Oregon
Federal government on Lyme disease in Oregon
Oregon statutes on Lyme disease
State of Oregon on Lyme disease
Oregon State Health Division on Lyme disease
Oregon counties on Lyme disease
U.S. Army Lyme Disease Risk Assessments in Oregon 
Other information on Lyme disease in Oregon
Media articles about Lyme disease in Oregon
Medical and Scientific Abstracts on Lyme disease in Oregon
Lyme disease patient support groups in Oregon
Lyme disease patients from Oregon
Other Lyme disease resources

---------------
                          THE WHITE HOUSE
  
                    Office of the Press Secretary
  
  _______________________________________________________________
  
  For Immediate Release                              June 5, 1993
  
  
             LYME DISEASE AWARENESS WEEK, 1993 AND 1994
  
                            - - - - - - -
  
          BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
  
                           A PROCLAMATION
  
  
       Lyme disease has become the most common arthropod-borne 
  infection in the United States since it was first recognized 
  as a clinical entity in 1975.  Although most prevalent in the 
  coastal northeastern and north central States, a significant 
  number of cases have been reported in the Pacific Coast States, 
  primarily northern California and Oregon.
  
       Lyme disease is caused by a bacterium that is transmitted 
  from ticks to warm-blooded animals.  The major reservoirs 
  of infection are deer and rodents, although the ticks can be 
  carried on dogs, cats, and occasionally birds.  Persons who 
  live near or who work in wooded areas are at risk of contracting 
  Lyme disease.  Lyme disease can develop into a chronic multi-
  system disorder that can elicit a wide range of symptoms and 
  run an unpredictable course.  Clinical manifestations include 
  arthritis, neurological symptoms, heart problems, and sometimes 
  eye inflammation, hepatitis, and severe fatigue.
  
       Early symptoms may include one or more of the following:  
  a rash at the site of the tick bite, headache, fever, joint 
  pain, and fatigue.  Though the disease usually responds to 
  antibiotic treatment at this stage, in later stages it may 
  develop into a persistent chronic infection that affects joints 
  or the nervous system.  The bacteria also may be transmitted 
  from an infected pregnant woman to her fetus.
  
       Scientists at the National Institute of Allergy and 
  Infectious Diseases, along with their colleagues at the National 
  Institute of Arthritis and Musculoskeletal and Skin Diseases, 
  are supporting dozens of research projects on Lyme disease.  
  Along with several other components of the National Institutes 
  of Health and the Centers for Disease Control and Prevention, 
  they are devoting considerable effort to eradicate the disease.  
  Experts from a wide range of disciplines are focusing on 
  improving diagnostic techniques and therapeutic strategies and 
  on developing an effective human vaccine.  Animal models of the 
  disease have been developed that promise to hasten progress in 
  all of these areas.
  
       In support of these efforts, the Congress, by Senate Joint 
  Resolution 43, has designated the weeks beginning June 6, 1993, 
  and June 5, 1994, as "Lyme Disease Awareness Week" and has 
  requested the President to issue a proclamation in observance 
  of this week.
  
       NOW, THEREFORE, I, WILLIAM J. CLINTON, President of 
  the United States of America, do hereby proclaim the weeks of 
  June 6, 1993, and June 5, 1994, as Lyme Disease Awareness Week.  
  I urge all government agencies, health organizations, communi-
  cations media, and private citizens to observe this week with 
  appropriate programs and activities in order to ensure better 
  understanding of Lyme disease.
  
       IN WITNESS WHEREOF, I have hereunto set my hand this
  fourth day of June, in the year of our Lord nineteen hundred 
  and ninety-three, and of the Independence of the United States 
  of America the two hundred and seventeenth.
    
  
                                     WILLIAM J. CLINTON
  
  
                                # # #
  
http://www.pub.whitehouse.gov/uri-res/I2R?urn:pdi://oma.eop.gov.us/1993/6/9/5.text.1

---------------
Federal government on Lyme disease in Oregon:

Centers for Disease Control and Prevention (CDC) Morbidity and 
Mortality Weekly Report (MMWR) Tables (Morbidity) for Oregon:
As of week 51 of 1997, 21 case reports of Lyme disease in Oregon 
have been accepted by the CDC for 1997.  There were 19 cases for Oregon
for the same time period in 1996.

   See CDC MMWR tables at 
   http://www2.cdc.gov:81/mmwr/mmwrmorb.htm

-----
From the CDC MMWR, June 13, 1997/Vol.46/No.23:

TABLE 1. Number of reported cases of Lyme disease, by state, 1991�1996 

          1991    1992    1993    1994    1995    1996    Total   
Oregon       5      13       8       6      20      19       71

[Editorial Note: These numbers are likely "the tip of the iceberg".]

"The increase in reported LD cases in 1996 probably represents a 
combination of increased tick density, enhanced health-care provider 
awareness and reporting, and improved laboratory surveillance. In 
addition, case reporting has been enhanced through the availability of 
CDC resources for LD surveillance in eight states (Connecticut, Michigan, 
Minnesota, New Jersey, New York, Oregon, Rhode Island, and West Virginia)."

   See entire document at (requires Adobe Acrobat to view)
   ftp://ftp.cdc.gov/pub/Publications/mmwr/wk/mm4623.pdf

[Note: In Oregon, all tick-borne diseases can be reported by the 
patient.  Call your county health department and/or Dr. DeBess, 
epidemiologist who is handling tick-borne diseases at the state 
Health Division (503) 731-4024, or call Rita Stanley - see patient 
support group information below.]  

-----
More from the CDC:

Vectors of Lyme Disease

The ticks Ixodes scapularis (black-legged tick) and Ixodes pacificus 
(western black-legged tick) are the primary vectors for Lyme disease. 
I. scapularis is found in abundance in the northeastern and upper-
midwestern United States. I. pacificus is commonly found along the 
coasts of nothern California, Oregon, and Washington. 

   http://www.cdc.gov/ncidod/dvbid/tickpics.htm

---------------
Oregon statutes or other regulations on Lyme disease:

                       Oregon Administrative Rules
                             1997 Compilation
         DEPARTMENT OF HUMAN RESOURCES, OREGON HEALTH DIVISION
                                DIVISION 18 
                        REPORTABLE DISEASES AND 
                    CONDITIONS DEFINED; PROCEDURE 
                  AND FORM FOR REPORTS ESTABLISHED 
...
What is to Be Reported and to Whom 

Cases or suspected cases of the following diseases and conditions are to 
be reported to the local health department pursuant to OAR 333-018-0000: 

(1) Diseases: 
...
(w) Lyme disease; 
...
4) The remaining reportable diseases and conditions shall be reported to 
the local health department by telephone or by individual case report 
card within one week of identification of a case or a suspected case: 
The diseases and conditions to be reported within one week are: 

(a) Diseases: 
...
(I) Lyme disease; 

http://arcweb.sos.state.or.us/rules/OARS_300_1997/OAR_333_1997/333_018_1997.html

-----
                       Oregon Administrative Rules
                             1997 Compilation
         DEPARTMENT OF HUMAN RESOURCES, OREGON HEALTH DIVISION
                               DIVISION 19 
                           INVESTIGATION AND 
                          CONTROL OF DISEASES 
333-019-0000 

Responsibility of Public Health Agencies and of Licensed Physicians and 
Authority of Public Health Agencies to Investigate Reports and to 
Control Diseases 
...
(3) Every licensed physician attending a person with a reportable 
disease or condition shall report the case or suspected case to the 
local health department, instruct the person in the applicable control 
measures outlined in OAR 333-019-0010 through 333-019-0415, and 
cooperate with the local health department in its investigation and 
control procedures. 
...
333-019-0297 

Lyme Disease 

(1) Reporting. Each case or suspected case shall be reported by 
telephone to the local health department within one week from the time 
of identification. 

(2) Investigation of cases. Each report of a case shall be investigated 
by the local health department to confirm the diagnosis and determine 
the likely geographic area of exposure. If exposure in Oregon was 
likely, the Division may conduct an entomologic survey to determine the 
prevalence of Borrelia burgdorferi in the tick vector. 

http://arcweb.sos.state.or.us/rules/OARS_300_1997/OAR_333_1997/333_019_1997.html

---------------
State of Oregon on Lyme disease:

   Oregon State Government Home page (has search function)
   http://www.state.or.us/governme.htm

Oregon State Library

VIDEO LIST TABLE OF CONTENTS
Last Update April 23, 1997 
616.94 Lyme2---Lyme disease facts for kids-20 min.(English,Spanish & 
open captioned,K-adult)
616.92 Opera---Lyme Disease: Operating & participating in a self-help 
group-24 min. w/manual

   http://www.osl.state.or.us/wksmtmain/oslvideo.html

-----
April 5, 1996 
                      Oregon State Office Safety and Health Plan 
                           U.S. Fish and Wildlife Service 
                              2600 S.E. 98th Ave 
                             Portland, Oregon 97266 
...
V. GENERAL RULES

The Service prescribes mandatory protective measures for situations 
commonly encountered. 
...
I. Lyme disease. This is an infectious, seasonal disease transmitted by 
a host tick. Prevention may include employee education, tick eradication 
or population reduction, the reduction of employee field time during 
high risk periods, the use of protective clothing, and repellents.

   See entire document at
   http://164.159.11.73/safety/saf_oreg.htm

---------------
Oregon Department of Human Resources(DHR), Oregon Health Division(ODH):
http://www.ohd.hr.state.or.us/

ODH Public Health Laboratory (PHL), Virology/Immunology section:

Virology/Immunology tests for diseases of public health importance 
caused by viruses and other microorganisms by: 

Performing timely, accurate tests to detect and control infectious
diseases (e.g., hepatitis A, B, and C, HIV/AIDS; influenza and
other respiratory viruses; polio viruses; enteroviruses; syphilis,
chlamydial, fungal and rickettsial infections; hantavirus; and Lyme
disease) 

   http://www.ohd.hr.state.or.us/phl/vi/about.htm

-----
           Oregon Reportable Diseases
           Weekly Report - Week 51

The following totals represent the number of Oregon case reports 
received during week 51 ending December 20, 1997 and the cumulative 
totals through week 51 for 1997 and 1996

                              |     1997      |  1996
DISEASE                       |week 51|  1-51 |  1-51
------------------------------+-------+-------+------
LYME                          |     0 |    21 |    19
------------------------------+-------+-------+------

   See entire chart at
   http://www.ohd.hr.state.or.us/cdpe/acd/docs/weekstat.htm

---------------
Oregon counties on Lyme disease:

[Not much, but here it is for what it's worth!]

   Oregon County Health Departments
   http://www.ohd.hr.state.or.us/docs/lhd_dir.htm

Jackson County Emergency Medical Services Standing Orders 
[Jackson County is located in southwestern Oregon.]
 
INSECT STINGS AND ANIMAL/SPIDER BITES 

Tick Bites: Lyme Disease may present with distinctive Bull's eye rash 
surrounding the bite developing over a month and accompanied by flu like 
symptoms. 

   See entire Jackson County EMS Standing orders (large - 216K)
   http://www.mind.net/jcems/JCEMSstandorders.html

-----
Lyme and other Tick-Borne Diseases
by N. Looman, DCHD

"Here in Deschutes County, we don't often find evidence of the much 
dreaded Lyme disease that plagues the Northeastern U.S. or the Pacific 
Northwest (west of the Cascades). The reason is simply that the ticks 
that live East of the Cascades haven't figured out a way to carry it! 
SO, although, in the state of Oregon our Lyme numbers are increasing (52 
cases in the state of Oregon from (1993 - 1996), the High Desert remains 
fairly immune to this one particular vector borne disease."

   See Deschutes County Hot Topic of the Month at
   http://bend-or.com/~health/hottopic.htm

---------------
U.S. Army Lyme Disease Risk Assessments in Oregon :

   Camp Rilea, 1992  (Low risk) 
   ----------------------------------------
   http://www.utech.net/users/10766/080.txt

---------------
Other information on Lyme disease in Oregon:

                            College of Science
                          Oregon State University
                      1996-97 Faculty Resource Guide

ROSSIGNOL, Philippe A (541) 737-5509 
Dept. of Entomology 
rossignp@bcc.orst.edu 
Ph.D., medical entomology, University of Toronto, 1978 

Host-parasite interactions; parasitology. 
Particularly, ... epizootiology of Lyme disease and relapsing fever 
in Oregon; mosquito probing behavior and malaria epidemiology. 

   http://www.orst.edu/Dept/ncs/experts/science.htm

-----
From the County of San Diego, California Health Services:

                          COMMUNITY HEALTH SERVICES
                    Facts about LYME DISEASE in California
                          Western Black-Legged Tick 

                               LYME DISEASE

"Lyme disease is now recognized as an important tick-borne disease 
throughout the northeastern USA from Massachusetts to Delaware; in the 
midwest in Minnesota and Wisconsin; in some southeastern states; and in 
the west in California, Oregon, and Nevada, as well as in European 
countries."

See entire publication at
http://www.co.san-diego.ca.us/cnty/cntydepts/health/services/chlymedisE.html

-----
The Official Newsletter of the
MERRY CRANKSTERS Mountain Bike Club of Salem

Volume 1 Number 5, July 1997

It's not that bad, really. Lyme disease. Poison oak. Wild animals. 
Snakes. Crashes. Alien abductions. Government conspiracies.
...
We talk about Lyme disease not to scare people out of the woods, but to 
alert them to the risks so they can take some precautions and avoid 
getting a serious and potentially fatal illness.
...
Lyme disease: it's real and it's right here in Oregon

If all you know about Lyme disease is that it's something that bothers 
people back east, in places like Michigan and Massachusetts, you could 
be inviting disaster.

It's right here in Oregon, folks.

Not everywhere, and not in frightening numbers, but enough that we all 
need to be aware of it. Take the word of somebody who has caught it in 
Oregon. Twice.

I am being treated for Lyme disease for the second time in four years. 
The first time it took six months to diagnose and 18 months to recover 
completely. This time I started the treatment about 6 weeks after the 
bite and I expect to be back to normal in a lot less time, but it's 
already wrecked a lot of the plans I had for the summer.

Unfortunately, many people in the Oregon medical community still refuse 
to believe we have the disease here. I had to go through several doctors 
to find one who was willing to diagnose and treat my Lyme disease the 
first time.

Here are a few quick facts, courtesy of the CDC (Centers for Disease 
Control), that you need to know about Lyme.

Lyme is experiencing a rapid emergence in United States: 32-fold annual 
increase in reported cases since 1982, and a 41 percent increase in 1996 
over 1995. Lyme is moving into new geographic areas. Lyme disease is 
difficult to diagnose because diagnostic tests are not reliable. 
Treatment is not always effective (this pertains to chronic Lyme; caught 
early it is easier to control). Control methods are impractical (ticks 
are everywhere, and we're not going to stamp them out). Prevention tools 
are limited (short of staying indoors, and if I couldn't walk or ride my 
bike in the woods life would be pretty dull). Knowledge of geographic 
distribution is incomplete. Uninformed public and medical community 
(this is a biggie on both counts). 

Another important thing to know is that there is controversy regarding 
the treatment of Lyme disease, particularly chronic Lyme disease. 
Doctors who use treatments that are effective but still controversial 
have been banned from treating their patients. (This happened to one 
doctor here in Oregon). My admittedly biased view is that the 
controversy has more to do with money than with science. Insurance 
companies and HMOs stand to have to pay more for proper diagnosis and 
treatment of Lyme.

Because we live and ride (and hopefully, do trail work) it's in your 
best interest to do a couple of things.

First, arm yourself with as much information about symptoms as possible. 
If you are bitten by a tick in the nymph stage you may not even know you 
were bitten, so you can't rely on knowing you were bitten -- nor can you 
rely on being warned by the EM rash (that's the one that appears within 
seven to 30 days and grows slowly, often with a center that makes it 
look like a target).

Second, and this is critical, be sure your doctor is (a) aware of the 
possibility of Lyme disease in Oregon and (b) willing to treat 
appropriately. (Appropriately means a 30-day antibiotic course in the 
early stages. You don't even want to know what's appropriate for late-
stage Lyme.)

Don't wait until you are sick and are pretty sure it's Lyme disease to 
try to get treatment because, as CDC says, ignorance in the medical 
community is one of the problems. My experience, and the experience of a 
lot of other people, bears this out.

Mark Flint

Think you might have Lyme disease? Here's what symptoms to look for.

Lyme symptoms vary, and can mimic many other diseases. One of the key 
considerations in diagnosing is if the person was in an area where 
contact with ticks is possible. Obviously a tick bite and rash is a 
strong indicator. But in about half the cases of Lyme the people weren't 
aware they'd been bitten. One reason for this is that in the nymph stage 
the tick is tiny, about the size of the period at the end of this 
sentence.

The first time I had Lyme, I first noticed flu-like symptoms. The flu 
would go away, and then four weeks later come back. In the meantime I 
was having trouble with energy and stamina. I thought I had an attitude 
problem about work, and some days I could only work a few hours. Then in 
four or five weeks the flu returned, stronger. I was also having 
headaches and difficulty sleeping. I started seeing doctors, and the 
answers I was getting didn't make sense to me. The third flu episode 
came with chills and fever, a first for me. I knew it was serious, and 
began really pressing the doctors for an answer.

When I woke up in the night with aching and swollen joints I knew it was 
Lyme, and I went to a new doctor, who agreed. By this time it was six 
months since my tick bite. 

Another symptom was short-term memory loss. Fortunately that didn't last 
long.

This time around the symptoms were neurological and muscular; I had a 
facial tick, headache, difficulty sleeping, lack of energy and loss of 
stamina.

Here is a list of symptoms I picked up off the web. It's a long list, 
and you need to be able to rule out other possible causes. But as 
mountain bikers and trail workers, many of us are exposed to ticks, so 
it makes sense to include Lyme as a possibility until another positive 
cause is determined. And if it were me I'd start the antibiotics in the 
meantime, especially if I'd had a tick bite.

Remember also that the carrier is the smaller "deer tick", (known to 
biologists and entomologists like our own Alan Mudge as ixodes 
pacificus) not the larger dog tick.

OK, here are the symptoms. In general, the more serious sounding ones 
are associated with late-stage Lyme, but the disease doesn't hold to any 
particular order or progression.

          The "bull's eye rash" 
          Any other rash 
          Unexplained fevers, sweats, chills, or flushing 
          Unexplained weight change -- (loss or gain) 
          Fatigue, tiredness, poor stamina 
          Unexplained hair loss 
          Swollen glands 
          Sore throat 
          Testicular pain/pelvic pain 
          Unexplained menstrual irregularity 
          Unexplained milk production; breast pain 
          Irritable bladder or bladder dysfunction 
          Sexual dysfunction or loss of libido 
          Upset stomach 
          Change in bowel function (constipation, diarrhea) 
          Chest pain or rib soreness 
          Shortness of breath, cough 
          Heart palpitations, pulse skips, heart block 
          Any history of a heart murmur or valve prolapse? 
          Joint pain or swelling 
          Stiffness of the joints, neck, or back 
          Muscle pain or cramps 
          Twitching of the face or other muscles 
          Headache 
          Neck creaks and cracks, neck stiffness, neck pain 
          Tingling, numbness, burning or stabbing sensations, shooting
             pains 
          Facial paralysis (Bell's Palsy) 
          Eyes/Vision: double, blurry, increased floaters, light
             sensitivity 
          Ears/Hearing: buzzing, ringing, ear pain, sound sensitivity 
          Increased motion sickness, vertigo, poor balance 
          Lightheadedness, wooziness 
          Tremor 
          Confusion, difficulty in thinking 
          Difficulty with concentration, reading 
          Forgetfulness, poor short term memory 
          Disorientation: getting lost, going to wrong places 
          Difficulty with speech or writing 
          Mood swings, irritability, depression 
          Disturbed sleep-too much, too little, early awakening 
          Exaggerated symptoms or worse hangover from alcohol 

   See entire July 1997 newsletter at
   http://www.engr.orst.edu/~reed/bike/cranksters/july_97_news.html#3

[Editorial rhetorical question: Why is it that the best, and really the 
only adequate information to be found on the internet about Lyme disease 
in Oregon, comes from the newsletter of a mountain bike club in Salem 
and not from the Oregon state health authorities?]

---------------
Media articles about Lyme disease in Oregon:

STRIPE
April 18, 1997 
Protecting yourself from Lyme Disease 

By Rudi Williams 

American Forces Press Service 

"Named after Lyme, Conn., where it surfaced in 1975, Lyme disease has 
become one of the fastest-growing vector-borne diseases in the United 
States. The highest incidence occurs in the Northeast from Massachusetts 
to Maryland and in Wisconsin, Minnesota, California and Oregon. A 
vector is a host that passes the disease germ -- the tick, in this case. 
Researchers at the Armed Forces Pest Management Board note that all 
military recruit training areas are infested with ticks." 

   See entire article at
   http://www.dcmilitary.com/army/stripe/apr18/str_lyme041897.html

---------------
Medical and Scientific Abstracts on Lyme disease in Oregon:

   The Lyme Disease Network of NJ, Inc. Lyme Disease Network
   Medical / Scientific Literature Database Search Form 
   http://www2.lymenet.org/domino/abstract.nsf/$$Search 
   or
   HealthWorld Medline Search
   http://www.healthy.net/library/search/medline.htm 

Title 
  Population genetic structure of Ixodes pacificus (Acari:Ixodidae) 
  using allozymes. 
Author 
  Kain DE; Sperling FA; Lane RS 
Address 
  Department of Environmental Science, Policy and Management, University 
  of California at Berkeley 94720, USA. 
Source 
  J Med Entomol, 34(4):441-50 1997 Jul 
Abstract 
  Genetic analysis of the population structure of the western 
blacklegged tick, Ixodes pacificus Cooley & Kohls, was conducted using 
allozymes. This vector tick transmits the Lyme disease spirochete, 
Borrelia burgdorferi Johnson, Schmid, Hyde, Steigerwalt & Brenner, in 
the far-western United States. It ranges from British Columbia to Baja 
California and disjunct populations are present in Oregon, Nevada, Utah, 
and Arizona. Host-seeking adult ticks were collected from vegetation 
across the range of the species and were partially fed on rabbits prior 
to analysis. Twelve putative loci were resolved using starch gel 
electrophoresis. One locus, glucose-6-phosphate isomerase, formed an 
apparent north/south latitudinal cline and showed significant geographic 
structure. None of the remaining loci exhibited much genetic 
differentiation. Estimates of gene flow were high relative to other 
arthropods. Isolation-by-distance analysis suggests a recent and rapid 
range expansion. We conclude that the overall lack of differentiation is 
due high rates of gene flow. 

-----
Title 
  The western black-legged tick, Ixodes pacificus: a vector of Borrelia 
  burgdorferi. 
Author 
  Burgdorfer W; Lane RS; Barbour AG; Gresbrink RA; Anderson JR 
Source 
  Am J Trop Med Hyg, 34(5):925-30 1985 Sep 
Abstract 
  To determine the significance of the western black-legged tick, Ixodes 
pacificus, as a vector of the Lyme disease spirochete, Borrelia 
burgdorferi, a tick/spirochete survey was conducted in northern 
California and southwestern Oregon from 1982 to 1984. Of 1,687 adult 
ticks collected off vegetation, 25 (1.48%) contained spirochetes. Of 715 
ticks from Oregon, 14 (1.96%) were infected whereas 11 (1.13%) of 972 
ticks from California harbored spirochetes. An isolate of 1 of the 
spirochetes reacted specifically when treated with monoclonal antibodies 
to B. burgdorferi. Polyacrylamide gel electrophoresis of a lysate of the
isolate showed it to be nearly identical with 2 isolates of B. 
burgdorferi. Of the 25 infected I. pacificus, 17 had spirochetes in 
their midgut only; the remaining 8 ticks showed a generalized infection 
of all the tissues, with midgut, central ganglion and ovary or testes 
showing heavy spirochetal infections. Decreased immunofluorescent 
staining reactivity of spirochetes in tissues other than midgut in 6 of 
8 I. pacificus with generalized infection may reflect adverse 
physiologic conditions for the development of spirochetes in the 
hemocele. 

-----
Title 
  The global distribution of Lyme disease. 
Author 
  Schmid GP 
Source 
  Rev Infect Dis, 7(1):41-50 1985 Jan-Feb 
Abstract 
  Erythema chronicum migrans (ECM), the skin lesion characteristic of 
Lyme disease, was first described in Sweden in 1909; subsequently, cases 
of ECM have been reported from at least 19 countries on three 
continents. In Europe cases have occurred within the range of Ixodes 
ricinus ticks, the recognized vector of ECM in Europe, although one case 
outside this range has been ascribed to mosquito bites. In 1970 the 
first case of ECM acquired in the United States was reported, and in 
1977, the full symptom complex now called Lyme disease was described. In 
the United States three geographic areas endemic for Lyme disease are 
recognized: the coastal areas of the Northeast; Minnesota and Wisconsin 
in the Midwest; and parts of California, Oregon, and western Nevada in 
the West. These areas correspond to the recognized distribution of 
Ixodes dammini in the Northeast and Midwest and Ixodes pacificus in the 
West. Isolated cases of illness compatible with Lyme disease have, 
however, been reported from other parts of the United States; this 
suggests that cases may be more widely distributed than is currently 
recognized and that other vectors may be involved. Supporting this 
suggestion is the description in 1982 of Lyme disease in Australia, 
where none of the currently recognized vectors are known to exist, and 
the report in 1984 that Ambylomma americanum ticks can harbor the 
spirochete that causes Lyme disease. The recognition of cases acquired 
in widely separated parts of the world involving multiple vectors 
suggests that cases may in the future be diagnosed in additional areas. 

-----
Title 
  Lyme disease: additional evidence of widespread distribution. 
Recognition of a tick-borne dermatitis-encephalitis-arthritis syndrome 
in an area of known ixodes tick distribution. 
Author 
  Schrock CG 
Source 
  Am J Med, 72(4):700-6 1982 Apr 
Abstract 
  Lyme disease is a process of unknown etiology that has been linked to 
bites of ticks of the Ixodes ricinus complex. Central Minnesota is an 
area of known Ixodes dammini distribution. This case represents the first 
recognition of Lyme disease from this area. This case presented as a 
fluctuating meningoencephalitis with superimposed cranial neuropathy. The 
characteristic skin lesion, erythema chronicum migrans, was recognized by 
history, and oligoarticular arthritis subsequently developed. Physicians 
practicing in areas of known Ixodes tick distribution outside of the 
northeastern United States (coastal areas of Oregon and California, 
central Minnesota, northwestern Wisconsin, northwestern Utah, certain 
parts of Ontario) should be alert to this disease and aware of the 
variety of symptom complexes that are possible with it. 

---------------
Lyme disease patient support groups in Oregon:

   The Lyme Disease Network of NJ, Inc. lists of Lyme disease 
   support groups at 
   http://www2.lymenet.org/domino/sg.nsf/ (latest updates)
   or 
   http://www.lymenet.org/support.htm (older list - maybe out-of-date)

NW Lyme Disease Support Network
Contact:
  Rita L Stanley, Ph.D.
  (503) 413-7348
  RitaStan@worldnet.att.net
  Portland, Oregon
  Regions served by this group: Oregon, Washington and Idaho
Comments: Support and resource services are located at Good Samaritan 
Hospital, 1040 NW 22nd Ave., N300, Portland, OR 97210.

Books, tapes and other information are available. Some information is 
free or can be borrowed. Certain books can be purchased.

Meetings are held on the second Sunday every other month at the hospital. 
Telephone and e-mail support is also available. 
Call (503)413-7348 for information.

---------------
Lyme disease patients from Oregon:

   DejaNews
   http://www.dejanews.com/home_sf.shtml 

Rita Stanley - mailto:ritastan@worldnet.att.net - Portland
Dan - mailto:dwood@efn.org - Eugene
Mark Flint, Salem, Oregon, telephone: 829-9044  President of the 
   Merry Cranksters Mountain Bike Club
Kathy Davis - mailto:kdavis@pria.com
Karen - mailto:karenlee7@aol.com
Jeff Kopp - mailto:jeffkopp@aol.com - Milwaukie
Rose Mary - mailto:rsmith@sisna.com
(jhendri824) - mailto:jhendri824@aol.com
Dr. William Brown of Portland, Oregon, had Lyme disease.

Vera - mailto:vbowman@macnet.com - possible Lyme disease
Janet Josleyn - mailto:JJosl@aol.com - possible Lyme disease

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Helena Hodges has Lyme disease - Staff officer at the ESCAPE (Every 
Student Caring About Personalized Education) office at the University 
of Oregon.

The Oregon Daily Emerald student newspaper, University of Oregon, Eugene
http://darkwing.uoregon.edu/~ode/archive/v97/2/960109/960109.escape.html

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[On 23 Dec 1996, I took the following brief notes from a half hour 
program about Lyme disease in Oregon that appeared on the Outdoor 
Channel.]

     Dr. Gilmore
     Clear Point, Oregon
     Road River Park
     Jacksonville
     Medford, Oregon
     The Warren family
     Jim Blanchard

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Marsha Johnson
4307 NE Brazee
Portland, OR 97213
Oregon7@aol.com

Many friends have Lyme disease. Developing a project (1996) which will 
assess the hearing status of individuals with Lyme disease who meet 
federal standards.  

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Other Lyme disease resources:

   Lyme Disease Information Resource (LDIR)
   http://www.sky.net/~dporter/lyme1.html 

   The Lyme Disease Network
   http://www.lymenet.org/ 

   Lyme Disease Foundation (LDF)
   http://www.lyme.org/ 

   Lyme Alliance 
   http://www.lymealliance.org/ 

   Cheryl Orlowski's Lyme disease web page
   http://www.bucknell.edu/~orlowski/lymes.html

   Lyme Disease Risk Assessments - done by the U.S. Army
   http://www.utech.net/users/10766/lyme.htm 

   Lyme Disease in the United States and Canada
   http://www.geocities.com/HotSprings/Spa/6772/lyme.html

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Prepared by
Art Doherty
Lompoc, California
doherty@utech.net