A few feathers and a deer shank at the entrance to a den told the story of what was inside. I laced up the dogs before they managed to get in, and we moved off down field.
We try to leave fox dens alone this time of year. Fox do no harm on most farms, and quite a lot of good, as they hold down the population of white-footed deer mice which are the core sink for Lyme disease in the eastern U.S.
"Lyme disease vaccines and testing, as well as Lyme treatment of asymptomatic dogs, is a huge scam costing American dog owners hundreds of millions of dollars a year."
My tolerance for nonsense is low, and it's even lower from anonymous posters, and so I let fly, calling prattle exactly what it was, and noting that the medical literature agreed with me..
People like to be scared -- that's why there are roller coasters -- and a lot of people live their lives scared of just about everything, no matter how irrational.
Lyme Disease Is Hard to Catch and Easy to Halt, Study Finds
By Gina Kolata, New York Times (June 16, 2001)
Lyme disease is very difficult to catch, even from a deer tick in a Lyme-infested area, and can easily be stopped in its tracks with a single dose of an antibiotic, a new study shows.
And two other studies conclude that prolonged and intensive treatment with antibiotics, a course of care advocated by a small group of doctors, does nothing for people with symptoms often attributed to chronic Lyme disease.
These findings are in keeping with the assertions of researchers who say that in most cases, such symptoms have nothing at all to do with the disorder. The three studies, scheduled to be published on July 12 in The New England Journal of Medicine, were released yesterday because the journal's editors thought they were so important, with the onset of summer and the accompanying fear of Lyme disease.
"This is reassuring information for people who make decisions based on evidence," said Dr. Jeffrey M. Drazen, the journal's editor in chief.
Researchers, both those associated with the studies and others who were not, said they hoped the findings would ease what they called inflated public fear of Lyme disease, which is widely perceived as a grave illness that is easy to catch.
A total of 16,019 cases were reported to the Centers for Disease Control and Prevention in 1999; 92 percent of those cases were in nine states, most of which are in the Northeast, including New York and Connecticut.
Dr. Leonard H. Sigal, a Lyme disease expert at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical Center in New Brunswick, who was not associated with the studies, said the message from them was that "Lyme disease, although a problem, is not nearly as big a problem as most people think." "The bigger epidemic," Dr. Sigal said, "is Lyme anxiety."
The study to see whether a single dose of the antibiotic doxycycline could prevent Lyme disease was directed by Dr. Robert B. Nadelman, a professor of medicine at New York Medical College and attending physician at the Westchester Medical Center, both in Valhalla, N.Y. Dr. Nadelman said many doctors, in hopes of heading off Lyme disease infection, had been giving 10-to-21- day courses of the antibiotic to people who had found deer ticks on their bodies. "They would be treating people as if they actually had the disease," he said. He and his colleagues wondered whether one dose would be enough. They recruited 482 people in Westchester County, N.Y., where the incidence of Lyme disease is among the highest in the world. All had found deer ticks on their bodies. (The insects were identified by entomologists.) Half got a single dose of doxycycline, taken in the form of two capsules, and the others got two dummy capsules. The investigators found that the drug did prevent Lyme disease: just one person, 0.4 percent of those who took it, came down with the illness. But even among those who took the placebo, the chances of getting the disease was just 3 percent.
Dr. Eugene Shapiro of Yale University School of Medicine, who wrote an accompanying editorial, noted that the antibiotic often caused nausea, vomiting and abdominal pain and that among those who took it, there would have been very little chance of getting Lyme disease in any case.
People who are bitten can watch the site where the tick fed, Dr. Shapiro said, and if they develop a rash within a few weeks, they can take a full course of antibiotics. "Give that person 10 to 21 days of antibiotics," he said, "and they will be fine." Dr. Sigal agreed. He added that deer ticks crawl around the body for hours before settling down to feed, and during that time are easily washed off with a washcloth. And, he said, "even if you get the disease, it is easily treatable and it is curable."
But Dr. Jesse L. Goodman, a Lyme disease expert at the University of Minnesota, said some people were so horrified by the possibility of getting Lyme disease that even a 3 percent risk was too much for them. "As a physician, I could respect that," Dr. Goodman said, adding that he would offer those people doxycycline. Lyme disease researchers emphasized, however, that previous studies had shown that most people with the infection get better on their own, without antibiotics. And while a small percentage develop serious symptoms, like arthritis or heart disorders, even the vast majority of these get better, the researchers said.
Dr. Raymond Dattwyler, director of the Lyme Disease Center at the State University of New York at Stony Brook, said the typical Lyme disease patient has a rash but no other symptoms, takes an antibiotic and is cured. The two other studies released yesterday, financed by the National Institutes of Health, addressed the question of how to treat people who had Lyme disease and later developed symptoms like fatigue, aches and pains, and memory loss. Both were conducted by Dr. Mark S. Klempner of Boston University School of Medicine and his colleagues. One study enrolled patients who had antibodies to the Lyme disease microorganism, Borrelia burgdorferi, an indicator that they had been infected. The other enrolled patients who no longer had antibodies but had had a documented case of Lyme disease. Half the patients in both studies received an intravenous antibiotic, ceftriaxone, for a month, followed by oral doxycycline for 60 days; the others received dummy medications. The question was, Would this intensive antibiotic treatment make the patients better? The studies were meant to enroll 260 patients, but they ended early, after enrolling just 129 patients, because an independent committee overseeing them said it had become clear that the antibiotics were no more effective than the placebos. Dr. Shapiro said he was not surprised.
Although a small group of doctors and patients insist that symptoms like fatigue and memory loss after a bout with Lyme disease are due to chronic infection with the disease organism, those symptoms are very common among the general public, leading Dr. Shapiro and others to believe there is some other cause. "Whatever is going on with these patients," he said, "if it is unresponsive to antibiotics, it is unlikely that it is untreated Lyme disease."
In contrast, antibiotics have been shown to work extraordinarily well when, for instance, the Lyme organism has demonstrably infected the brain, Dr. Dattwyler said.
But some who have treated hundreds of patients with long-term antibiotics, like Dr. Sam L. Donta of Boston University Medical Center, were not convinced. The antibiotics in the studies were not given for a long enough time, Dr. Donta said, and he would have chosen different ones. Perhaps all that the studies show, he said, is "that this particular treatment doesn't work."
Dr. Brian Fallon, an associate professor of psychiatry at Columbia University, is directing another study of chronic Lyme disease that focuses on patients who have problems with fatigue, their memory and their ability to think. In his study, also supported by the National Institutes of Health, the patients receive intravenous antibiotics for 10 weeks, or a placebo. Dr. Fallon said he saw many such patients in his private practice and would continue to refer them to colleagues for long-term treatment with intravenous antibiotics. Dr. Sigal said, however, that in addition to the expense of long-term intravenous antibiotics - and some patients end up taking them for years - the drugs are dangerous. Some patients have died of infections caused by the catheters in their bodies, and others have experienced side effects from the drugs, including destruction of bone marrow, requiring a bone marrow transplant. "These are not benign drugs - they're all poisons," Dr. Sigal said. When they are needed to fight an infection, their risks, of course, are outweighed by their benefits. But when there are no benefits, he added, the risks are naturally unacceptable..
.IDSTEIN, Germany -- Each weekday, come rain or shine, a group of children, ages 3 to 6, walk into a forest outside Frankfurt to sing songs, build fires and roll in the mud. To relax, they kick back in a giant "sofa" made of tree stumps and twigs.
The birthplace of kindergarten is returning to its roots. While schools and parents elsewhere push young children to read, write and surf the Internet earlier in order to prepare for an increasingly cutthroat global economy, some little Germans are taking a less traveled path -- deep into the woods.
Germany has about 700 Waldkindergärten, or "forest kindergartens," in which children spend their days outdoors year-round. Blackboards surrender to the Black Forest. Erasers give way to pine cones. Hall passes aren't required, but bug repellent is a good idea.
Trees are a temptation -- and sometimes worse. Recently, "I had to rescue a girl" who had climbed too high, says Margit Kluge, a teacher at Idstein's forest kindergarten. Last year, a big tree "fell right before our noses."
The schools are a throwback to Friedrich Fröbel, the German educator who opened the world's first kindergarten, or "children's garden," more than 150 years ago. Mr. Fröbel counseled that young children should play in nature, cordoned off from too many numbers and letters.
They are also a modern-day snapshot of environmentally conscious and consumption-wary Germany, where the Green Party polls more than 10% and stores are closed on Sundays.
Only a fraction of German children attend Waldkindergärten, but their numbers have been rising since local parent groups began setting up these programs in the mid-1990s, following the lead of a Danish community. Similar schools exist in smaller numbers in Scandinavia, Switzerland and Austria. The concept is sparking interest far afield -- even in the U.S., whose first Waldkindergarten opened in Portland, Ore., last fall.
"The computer arrives early enough," adds Norbert Huppertz, a specialist in child development at the Freiburg University of Education and a Waldkindergärten booster in Germany.
Academic studies of such schools are in their infancy. Some European researchers believe Waldkindergärten kids exercise their imaginations more than their brick-and-mortar peers do and are better at concentrating and communicating. Despite dangers, from insects particularly, the children appear to get sick less often in these fresh-air settings. Studies also suggest their writing skills are less developed, though, and that they are less adept than other children at distinguishing colors, forms and sizes.
In the rolling countryside of Idstein on a recent rainy morning, parents dropped off their children at a muddy parking lot a bit after 8 as the temperature hovered around 40 degrees Fahrenheit.
Inspecting a Worm
Some of the children, wrapped in thick winter clothing, stooped over to inspect a worm. Then the five girls and four boys trudged into the neighboring woods with their two teachers before pausing to hold hands in a circle. "Good morning, sun, even though we can't see you today," said the 51-year-old Ms. Kluge, as the children joined in song and then acted out a play involving rabbits.
They hiked a few hundred feet into the forest before settling down to jump in puddles, examine a hibernating lizard and paint Easter eggs. A girl named Maxi went off to whittle a branch with a hunting knife. Another made "chocolate-vanilla-strawberry-herbal pudding" by stirring mud with a twig.
At snack time, the children sat on logs and munched on carrots and nuts while Ms. Kluge told them about the life cycle of toads. A boy named Ben wanted to know whether a North American visitor accompanying them was "a cowboy or an Indian." A bit before 1 p.m., after jumping in more puddles, playing around a makeshift tepee and singing another song involving the Easter bunny, the children emerged from the woods grinning and caked in mud to be picked up by their waiting parents.
"It's peaceful here, not like inside a room," said Ms. Kluge, who has headed the Waldkindergarten since it opened five years ago.
The children rarely venture into a trailer in the forest that's used as a shelter in extreme weather. Ms. Kluge says no child has ever asked for a toy. The children improvise instead with what the woods have to offer. And there haven't been any bad accidents beyond the occasional scrapes and bruises.
Not everyone has a feel-good experience. Frankfurt resident Donna Parssinen sent her son to a Waldkindergarten last year but says he got Lyme disease from ticks. It resulted in meningitis that temporarily paralyzed half his face. "I still like the idea" of Waldkindergärten, says Ms. Parssinen, "but once is enough." Her son now attends a four-walled kindergarten.
Still, many German indoor kindergartens take children to nearby forests once a week to tramp around. A spokesman for Germany's Ministry for Family Affairs said it welcomes the arrival of Waldkindergärten, which typically receive local government subsidies similar to those of state-run kindergartens.
Iwao Uehara, a professor at Tokyo University of Agriculture, says he has been trying to set up such a school in Japan, but the project is struggling. Until there's evidence that Waldkindergärten graduates end up attending "famous universities," it's going to be a tough sell, he says.
In Portland, though, Marsha Johnson launched Mother Earth kindergarten last fall to combat what she calls "early academic fatigue syndrome....We have 5-year-olds who are tired of going to school." The 14 children spend four hours a day at the privately run school playing in a state park forest.
How to Handle a Saw
Among the nature-based activities, children learn how to handle a real saw. "A plastic saw is no good," says Ms. Johnson. "You might as well give them a plastic life." The worst that has happened thus far to the children is the occasional bee sting, she says.
Mimi Howard, a director at the Education Commission of the States, which advises states on policy from Denver, says some U.S. teachers feel pressure "to push academics earlier and earlier." The federal No Child Left Behind law introduced standardized testing for reading and writing by third grade, but some studies recommend more "open-ended learning experiences" for young children. "We're in the debate phase," she says.
In Fife, Scotland, Cathy Bache recently took matters into her own hands and founded a private nursery school. About 20 children explore the local forests, "saw logs, make fires when cold and look at fungi," she explains. Ms. Bache admits the children fall out of trees "quite often" -- but that she doesn't let them climb higher than 6 feet, the cutoff point for her insurance policy.
