TICKS GATHERED TO DO LYME DISEASE STUDY

Despite a Cape Girardeau physician's belief that Lyme disease exists in Missouri and state health officials confirming 300 cases of it federal researchers have collected ticks in an effort to determine its existence.

The researchers believe the ticks collected in Southeast Missouri hold the answer to the question.

The researchers, who are with the federal Centers for Disease Control, are working in conjunction with the Missouri Department of Health to conduct the study. They have collected about 3,000 of the arthropods in hopes of studying them.

The Cape Girardeau physician, Dr. Ed Masters, said there is no doubt in his mind that Lyme disease exists here. He said he has a great deal of evidence of the disease's existence, including serum samples and 25 positive skin biopsies from patients.

But Roy Campbell, a CDC medical epidemiologist working on the project, said: "In a rigorous scientific sense we don't know if Lyme disease occurs here. But at the same time there are (medical) cases that are highly suggestive of Lyme disease. So there's a lot of frustration and confusion in the medical community and well founded," said Campbell.

The state department of health invited the CDC to help in an investigation of reported Lyme disease cases in Missouri, said Campbell.

Sue Tippen, communicable disease coordinator with the state health department, said the study was prompted, at least in part, by a 90 percent increase in reported cases from 1989 to 1990.

Physicians in Missouri disagree over whether Lyme disease actually exists here, Campbell said. Some say they have seen cases of it while others say they haven't.

"Either way, a true Lyme disease case can be confused with a number of other diseases, and a number of other diseases can be confused with Lyme disease," he said. "So there's confusion in both directions."

Yet Masters said: "There are well over 300 cases confirmed by the health department and the CDC in Missouri. Basically if I am wrong, the entire world's literature is wrong.

"My opinion to the people who are doubters is, `Have they seen the evidence?' If they've seen the evidence the evidence stands for itself."

Masters said he and some colleagues, both from Missouri and out of state, have tried to maintain a Lyme disease culture for a couple of years but have failed.

"The fact that we don't have one yet is not anything to be embarrassed about," he said. "It's one of the most difficult things to grow. Spirochetes can be tough. In fact it's so difficult that very few people even attempt it."

Lyme disease cultures have only been carried out with success in five states, Masters said.

Campbell said he and two CDC biologists have worked in the region about a week. The ticks were sent this week to Fort Collins, Colo., home of the CDC division that studies most diseases transmitted by arthropods, which includes ticks and mosquitoes.

Researchers are also carrying out case studies of people infected with the disease, Campbell said, to determine whether patterns exist with certain risk factors or activities, such as hunting, swimming or hiking.

"We're trying to find out which people are getting sick and if they have something in common, basically." Sixty patients were surveyed, along with an equal number of people in a random control group, he said.

The study's third and final part, he said, is to set up a network of physicians here who will attempt to culture, from humans, the bacteria that causes Lyme disease. In turn, the physicians will send the cultures made from skin and blood samples to Fort Collins. A few physicians in northern Missouri have also agreed to take part, said Campbell.

The bacteria that causes Lyme disease needs to be grown in a test tube either from ticks, humans or rodents in order for adequate proof to exist of the disease, said Campbell. Clinical tests can be difficult and blood tests are notoriously unreliable, he said.

Results of the studies' first two parts won't be completed for several months, he said. The third part will be ongoing.

Campbell said biologists collected what appear to be two types of tick: the dog tick and what is commonly called the lone star tick. But that won't be known for sure until the ticks can be studied under a microscope at Fort Collins.

Most of the ticks collected were the lone star tick, he said, and that's the tick most people are interested in. "People here think that if Lyme disease is transmitted, it's mostly by that tick."

Tippen said researchers collected the ticks by pulling a piece of corduroy attached to a pole through the woods. The ticks would fall on the fabric. Tippen said the researchers would then place the ticks in vials labeled with the exact location where they were found.

"If the ticks test positive for the disease, we will know exactly where they came from," she said.

The ticks came from 25 sites determined through reported cases of Lyme disease in Southeast Missouri, she said. Researchers, Tippen said, gathered the ticks from the counties of Cape Girardeau, Perry, Bollinger, Stoddard, Wayne and Ste. Genevieve.

"We asked patients where they think they got the tick bite," she said. "Some said working around their own home; others said at a friend's farm."

Campbell said two teams of biologists carried out the collection effort eight hours a day for a week. The effort, though concentrated near the Cape Girardeau area, included the Mingo Wildlife Refuge near Puxico, he said.