[elfdoctors]

Lyme testing has come a long way. However, it is still an inexact science. Results are very iffy for the first month after infection. You can diagnose Lyme this way but there will be many false negatives. If someone has a flu-like illness or an unexplained rash during the summer months with a history of tick exposure, treatment should begin without waiting for the lab test.

If someone has had symptoms for six weeks or more and has a negative Lyme test, I have been told that the false negative rate for the test in this situation is less than 1%.

The false positive rate has been dramatically reduced with the use of Western Blot confirmation of Elisa positives. However, while people can clearly get Lyme more than once, their blood tests will often remain positive. This tends to be the most common way that false positives will occur. False positives can also occur in certain diseases such as Lupus in which many abnormal antibodies have developed. The state requires people to have appropriate symptoms as Lyme can no longer be diagnosed based solely on a positive blood test.

[elfdoctors]

With early detection, and appropriate treatment, Lyme disease has a very good cure rate. Here is a summary of the new guidelines from the Infectious Disease Society of America which were only released last fall: http://www.medscape.com/viewarticle/545601

You should check with your doctor, but it seems reasonable for geocachers to have a lil doxycycline on hand so you can take a dose when ya get a deer tick bite, if ya expect to be out in the woods a lot.

The guidelines do not support this. Here is a quote from the guidelines: “To prevent LD after a recognized tick bite, routine use of antimicrobial prophylaxis or serologic testing is not recommended. A single dose of doxycycline (200 mg) may be given to adults and to children at least 8 years of age (4 mg/kg up to a maximum dose of 200 mg) if all of the following circumstances exist: (1) the attached tick can be reliably identified as an adult or nymphal I. scapularis estimated to have been attached for at least 36 hours; (2) prophylaxis can be started within 72 hours of tick removal; (3) ecologic information indicates that the local rate of infection of these ticks with B. burgdorferi is at least 20%; and (4) doxycycline is not contraindicated.”

For geocachers or anyone else with high risk occupations or hobbies, I have a very low threshold for using antibiotics, but I always wait for symptoms except for the relatively rare situation in which someone presents with a tick bite which has been reliably present for more than 36 hours. Alternatively, if another condition also exists which could also be treated (e.g. acne or rosacea in which doxycycline taken once daily is one of the appropriate treatments) I will occasionally prescribe doxycycline to do double duty here. The only prevalence data that I am aware of showed that 70% of ticks in Fort McCoy were infected with Lyme. Areas of the state such as Burnett (where I live) and Washburn counties which have been consistently either #1 or #2 in Lyme disease risk for the last several years probably have higher rates. Fortunately, even if the tick is infected, the disease is not easily transmitted as most estimates only put the risk of Lyme at 3% after a bite from an infected tick.

Here is a link which even includes a map with relative risks in each county of Wisconsin. http://dhfs.wisconsin.gov/communicable/LymeDisease/pdffiles/Lyme2006summary.pdf

My question for the medical folks is, does it have to be doxycycline or will any antibiotic work?

It is very easy to use chemoprophylaxis with doxycycline in a single dose as zuma described. This is inexpensive and usually well tolerated. Here’s another quote from the first link:
The guidelines do not recommend substituting amoxicillin for doxycycline in persons for whom doxycycline prophylaxis is contraindicated unless a higher infection rate was documented in specific local areas.

Some people are unable to tolerate doxycycyline. In my experience true allergies to doxycycline are rare as most are only sensitivities (nausea or diarrhea). Many people with “allergies” are still often able to tolerate doxycycline when needed for other more serious tick borne illnesses such as ehrlichiosis/anaplasmosis (for which we know that most other antibiotics will NOT work). If another antibiotic has to be substituted, single dose treatments cannot be done.

Sorry for the technical lingo. 😳 I know different opinions are very common from different groups, but IMO these guidelines are the best.

[elfdoctors]

Thanks for the kind words! 😀 Crex Meadows is the real attraction. It has 3 State Natural Areas and a wildlife refuge area within its 30,000 acres. Cachers will drive through some of the protected areas which didn’t allow caches. At least two species of birds nesting here cannot be found anywhere else in the state.

Contact me if any of you are planning a visit. There are very few cachers in this neck of the woods.

[elfdoctors]

Thanks to BNB for helping me find the CVB caches around Lake Menomin. I had a great day caching – more than doubling my prior high for caches in a day (35 GC.com approved caches, and 4 more CVB event caches). I’ll have to try to get back to this area again.

[elfdoctors]

IMO, that rash is not the Erythema migrans rash characteristic of Lyme disease. It is difficult to tell from that picture, but it appears that the worst of the redness is in the epidermal layer of the skin. This would be more suggestive of a simple cellulitis (skin infection which could be caused by ANY bite or break in the skin) rather than Lyme (which tends to have more of the redness slightly deeper in the dermal of the skin. The history of a wood (rather than deer) tick bite makes this more likely also.

Either way, that rash needed antibiotics. I would probably have used something that covered Lyme just to be safe (as you may have missed another smaller Lyme tick).

[elfdoctors]

Tactical Squirrel just completed the work on his end. I have now adopted all of his Burnett County geocaches and changed most of the containers as the old coffee can styled containers were beginning to leak. I found all the caches that I had not found including replacing a deactivated cache GCM87P which will be able to activated again.

There are some beautiful spots up here. All you downstaters are welcome to come up here and do some caching. 😀

[elfdoctors]

How about an exception for people who own property in Wisconsin?

Around here, the majority of the cachers are Minnesota residents (many of whom own lake homes in the area). These people are also paying property taxes. Out of state residents own about as much property in Burnett County as Wisconsin residents (1/3 of Burnett County land is publicly owned, 1/3 is owned by Wisconsin residents and 1/3 is owned by people who live out of state (primarily Minnesota)).
I would hope that our organization could be more inclusive. This would also give increased representation for some of the more rural areas (particularly the lakes districts).

[elfdoctors]

…. and to you too!

Our family actually went out and found a few caches today. The kids wanted to try some cheap walkie talkies that the Easter Bunny left for them. It actually turned out to be a nice day after a chilly start.

[elfdoctors]

Here’s another clever indoors one (which doesn’t require you to talk to anyone): GCQJ43

[elfdoctors]

Beadelake Crew’s series of caches on the Gandy Dancer trail is particularly good and has a COTM winner. The trail starts in St. Croix Falls and goes north to the Duluth area.

[elfdoctors]

I also agree. I certainly would not be offended if a mistake was pointed out to me.

Some of us will mention if a site is of historical significance to increase a cache’s appeal to get people to come find it. However, most of us are not true historians and may not do the actual research to check for accuracy. Also, if I was particularly busy, I might not update the cache listing immediately unless I knew the e-mail contained accurate information.

I personally know very little about the history of northwestern Wisconsin despite living here for over 15 years. 😳

[elfdoctors]

Northwestern Wisconsin is a hotbed of Lyme disease (particularly compared to eastern Wisconsin which has very few cases) so I have learned a lot about ticks.

Up here we see a large seasonal variation in tick numbers. As a general rule, ticks will become active in the springtime whenever the air temperature is above ~60 degrees. There are tremendous numbers of ticks in late April into June – peaking around the third week of May (my record is picking off 61 in 1 day). After ~July 4th, tick populations plummet. Ticks can actually become quite hard to find in August. After Labor Day, we start to see more ticks again on the warmer days until the snow flies (but to a much lesser extent than in the spring).

Start those tick checks now!

[elfdoctors]

We found 3 this weekend also – all deer ticks. The deer ticks seem to get active sooner than the wood ticks.

[elfdoctors]

Thanks for the suggestions. I was able to find four more of his caches on Saturday (and even had some spare caches ready so I’ve already replaced two of his neglected caches).

I wasn’t able to find Swiss Pines either. However, the concept is different enough for the county that I will probably just replace the cache.

I also did realize that there are 3 caches in River Falls which will need to be adopted by someone else (although Tactical Squirrel may keep those as he is moving to Trempaleau County and I believe he has relatives in this area).

[elfdoctors]

Thanks for the suggestion. I will probably adopt most of them but I was hoping that there was someone else in the area who might take a few.

Unfortunately, except for some Minnesota natives who have lake cabins, I am not aware of any other cachers in this county. 🙁

I am planning on trying to find as many of these that I can to begin the adoption process.

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