Pilot program to fight Lyme disease:
DEC offers field employees new vaccine

TAKING HIS MEDICINE - PEF DEC geologist Kent Johnson receives a free lyme disease vaccination from PEF DEC Health Services Nurse Jaquelyne Harte. - Photo by Jonathan Rosen

By Heath Fradkoff
Acting on a suggestion from PEF, the state Department of Environmental Conservation is moving to protect its "high-risk" employees against tick-borne Lyme disease which has infected more than 36,000 New Yorkers since 1986.

The DEC program, which uses a new vaccine, is thought to be the first of its kind in the U.S. And it's seen as a pilot program for New York State. If it's successful, said PEF Health and Safety Director Jonathan Rosen, it may spread to other state agencies whose employees face high risk of Lyme disease exposure, such as the departments of Transportation and Agriculture and Markets.

Last month, the DEC began a voluntary program for vaccinating eligible employees with "LYMErix." By providing the free vaccinations, the DEC hopes to ensure its workers will remain healthy and on the job.

Not for everyone
DEC is offering the free vaccinations only to employees considered at significant occupational risk of getting Lyme disease. The National Centers for Disease Control considers you at high risk for getting Lyme disease if you spend a significant amount of time in tick-infested areas.

Vaccination 78% effective
LYMErix was engineered to induce in humans the production of antibodies that can combat the Lyme-disease bacterium. When a vaccinated person is bitten by an infected tick, these antibodies enter the tick and attempt to kill the bacteria before they have a chance to enter the person's body.

Some PEF members at DEC participated in a 10-state blind-trial study which showed the vaccine was effective in 78 percent of definite Lyme disease cases. So, even employees who have completed the three-injection vaccination series will still have to take precautions to prevent and treat tick bites.

Vaccination series takes a year
The vaccination process currently takes a year, with a second injection one month after the first and a third injection 11 months after that.
"In the future, after they have more data, I think they hope to shorten the process to six months," said Jonah Triebwasser, a PEF steward and member of the Joint Health and Safety Committee at DEC. It is still not known, he said, if those who are vaccinated will need booster shots in future years to maintain protection.

Taking the bite out of Lyme disease
Tick not to scale.

By HEATH FRADKOFF
Lyme disease is a debilitating affliction which has the potential to cause arthritis, and abnormalities of the cardiac and nervous system.
The disease is caused by a bacterium that is transmitted through the bloodstream by the deer tick.

Tell-tale signs
Early signs may include:
- Fatigue, chills, fever and headache;
- Muscle and joint pain, and swollen lymph nodes; and
- A characteristic bulls-eye skin rash.
Advanced symptoms may include:
- Arthritis, pain and swelling
of joints;
- Nervous-system abnormalities such as numbness, pain, Bell's Palsy and Meningitis; and
- In rare instances, irregular heart rhythm occurs.

In some cases, no rash is apparent and the first signs of Lyme disease are arthritis or nervous-system problems.
Antibiotic treatments are very effective against Lyme disease. If it is caught in the early stages, recovery is most often quick and complete, although there have been a few reports of death.

Prevent infection
- Receive the three-injection vaccinations available now;
- Avoid tick-infested areas, especially during the high-risk months of May, June and July.
When walking through wooded areas:
- Remain on paths and avoid high grasses or shrubbery;
- Wear a hat, boots and light-colored long pants and long-sleeved shirt with both tucked in;
- Use insect repellent containing DEET or treat your clothing with permethrin which kills ticks on contact; and
- After walking outdoors, check your clothes and body thoroughly for ticks and wash your clothes at high temperatures.
- Keep ticks away from your home by keeping grass and heavy shrubbery cut and cleared. Protect and regularly inspect your pets for ticks.

Fight the bite
- If you are bitten, remove the tick as soon as it is discovered, using tweezers, tissue paper or a rubber glove to grasp the tick's mouth as near your skin as possible and pull upward and out with a firm and steady pressure. Do not squeeze, crush or puncture the body of the tick. After removal, thoroughly disinfect the wound and wash your hands;
- See a doctor if you believe part of the tick remains attached or under the skin, or if you develop symptoms of infection.

Many HMOs will cover LYMErix
By Lorraine Simpkins
If you are looking for protection from Lyme Disease, vaccinations are available for the first time this year. They are given in a three-part series and provide nearly 80 percent protection.

The cost of the vaccinations (approximately $130 for the LYMErix vaccine) is not covered by the Empire Plan. However, many of the HMOs available to state employees are covering it.

Each HMO uses its own criteria for determining whether benefits will be provided for the vaccine. In general, HMOs are only providing the benefit to members living in a county that is endemic as defined by the state Department of Health and the national Centers for Disease Control.

The vaccine is FDA-approved for use only in people 15 to 70 years of age.
HMOs that are providing at least limited coverage include: Aetna U.S. Healthcare; Empire BCBS BlueChoice HMO; HIP of NY; HMO-CNY; Healthsource HMO; Independent Health, Hudson Valley; Independent Health, Western NY; Kaiser Permanente; MVP; PHP; United HealthCare; Vytra; and WellCare.

For specific information, please contact your HMO.

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