Hispanic workers falling ill to Lyme disease

By Susan Abram
Staff Writer

STAMFORD - The red rash across Pedro's shoulder should
have been a warning sign. So should have the rashes on his
legs.

But it was the sudden fatigue, blurred vision and stiff muscles
in his neck that forced the 33-year-old landscaper to see a
doctor.

Pedro, a Guatemalan who has been a day laborer in the
Stamford area for 11 years, did not wish to give his real name.
He believes his illness is contagious and is afraid he will be
stigmatized.

Pedro said he heard about Lyme disease from the contractor
who hired him. He was even given a brochure about it, written
in English. From what he understood, Lyme disease is
transmitted from an infected deer tick.

Almost one year after he was diagnosed with Lyme disease,
Pedro doesn't know much about it.

"I heard my boss tell me about it a long time ago, but I didn't
pay attention," Pedro said in Spanish. "I didn't think it would
affect me."

State and local health officials acknowledge there is little
information about Lyme disease available in Spanish. But
many of those who work in landscaping and construction - day
laborers and migrant workers from Central and South America
who move to the area for seasonal work - are at high risk.

"We've always said people who work and play outdoors need
to take extra precautions," said Pat Mshar, epidemiologist for
the state Department of Public Health. Information is available
on the health department's Web site, but not in Spanish,
Mshar said.

"If a population has been identified to show high rates of the
infection, we will work with them to get the word out," she said.

Health officials at some clinics in Stamford and Norwalk
acknowledge the disease is affecting men such as Pedro, who
work six days a week, usually outdoors.

The men "are not too aware about it," said Julie Geiser, nurse
practitioner for the Stamford Community Health Center on
Henry Street.

"I tell them to tell their friends" about taking precautions such
as daily tick checks, vaccinations and insect repellent, Geiser
said.

But the vaccine is expensive, especially for the uninsured.

"I believe publicity about it will get the word out," Geiser said.

In the past two years, Geiser has tested 12 men who
described themselves as day laborers. Ten of them tested
positive for Lyme disease.

Among those who didn't have the disease is 51-year-old
Ramon Garcon, a gardener who said his wife found a tick in
his head.

He said the bite forced him to go to the doctor, but he tested
negative. He was urged to try the controversial vaccine.

"I knew nothing about Lyme disease," he said in Spanish. "I
don't know anyone who has it."

Though Lyme disease is not contagious, infected ticks can
jump from one person to another. Many day laborers live in
small dwellings, several to a room. Infected ticks on one man's
clothing can jump to another's. Some of the men have families,
so women and children are at risk, health officials said.

Enriqueta Stavert of Wilton has started a crusade to bring
information about the disease to the Hispanic community. She
began translating pamphlets about Lyme disease into Spanish
two years ago. She passes them out in churches, hardware
stores, nurseries and to people she sees working outdoors in
Wilton, Norwalk and Danbury. She also is trying to spread the
word in Stamford.

Stavert said that when she approaches Spanish-speaking
gardeners with her fliers, she gets mixed reactions, especially
after she describes the symptoms - fatigue and fever and joint
pain that can persist for weeks.

Signs may include rash - sometimes shaped like a bull's-eye -
and flulike symptoms.

"They tell me, 'I've heard of something like this. My friend has
it,' " Stavert said. "They all know someone who has Lyme
disease. There are a lot of people getting it and they don't
know what it is. Many don't want to go to the clinics to be
tested because they are afraid they will be deported."

Many day laborers are in the country illegally.

The Centers for Disease Control and Prevention released new
data last week that found the number of Lyme disease cases
soared in the late 1990s.

The CDC recorded about 17,000 cases of Lyme in 1998 and
more than 16,000 in 1999, mostly in the Northeast - especially
in Connecticut - and the Midwest.

The United States averaged about 11,000 cases a year in the
first eight years of the decade. Increased awareness of Lyme
disease may account for some of the rise, according to the
CDC.

But the agency attributed the jump mostly to cities sprawling
into rural areas, new homes being built in wooded spots and a
booming population of deer, which carry ticks that spread the
disease.

"We know the risks of Lyme disease are higher among those
who work outdoors," said Dr. Michael Parry, director of
infectious diseases at Stamford Hospital.

Parry said he hasn't seen much information on the disease
published in Spanish.

"I think they've heard about it, but they don't know exactly what
it is," he said of the migrant workers.

The reason could be that Lyme disease hasn't been
researched as well in minority communities, said Tom
Forschner, executive director of the Hartford-based Lyme
Disease Foundation, which provides information worldwide.

"This has been a 'white' disease for the last few decades,"
Forschner said.

Red rashes such as those described by the CDC do not
appear on all types of skin, Forschner said. There's a general
assumption that minorities, who are more likely to live in urban
settings, are not at risk for Lyme disease.

The foundation has received requests for Spanish-language
pamphlets from California, but not from Connecticut, he said.

"We're readying our (Spanish) brochures now," Forschner said.

One of the problems has been figuring out the proper
translation for "la enfermedad de Lyme," he said.

For Pedro, the Stamford landscaper who became ill last year,
the struggle continues. He has taken the antibiotics and feels
better, but each time he feels sick, he doesn't know whether
it's the Lyme disease or a cold.

"This is a very ugly disease," Pedro said. "I had terrible
headaches and I've fainted. I was in bed for nine days. For
those of us who have to work each day, an illness like this
means we lose money. Information in Spanish would be very
good. I wouldn't wish this illness on anyone."

Hispanic workers falling ill to Lyme disease, Greenwich Time, 19 Mar 01
http://www.***.com/

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How to Apply Repellants [in Spanish] - Westchester County
http://www.westchestergov.com/health/TickborneSpanishHowtoapplyRepell...

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Rita

January - June
This year the ALDF will initiate two new programs, "Safe Camping for
Children" and an "Hispanic Educational Campaign on Lyme Disease and other
Tick borne Infections" for the Latino Community. Whereas both of these
projects will focus on areas of the northeast initially, we anticipate their
institution around the country within 3-5 years. We intend to divide the
country into bio-regions which will reflect tick-borne diseases indigenous
to that area.

Safe Camping for Children
This six point program is being designed to significantly reduce camper
exposure to ticks by instituting habitat modification to reduce tick
populations, educating staff and volunteers about a variety of methods they
can employ to increase camper safety, educating campers about the importance
of daily tick checks, proper tick removal, and early disease symptoms to
reduce late stage sequalae, to educate parents and children's physicians.

We have established an alliance with the Boy Scouts of America (we've helped
the Girl Scouts develop a tickbuster badge program), the National Camp
Association, Outward Bound, and are working to establish an alliance with
the Archdiocese of New York. In addition, we will begin to work with day
camps throughout the tri-state New York-New Jersey-Connecticut area. As 30%
of all reported cases of Lyme disease occur in residents under the age of
17, we are convinced that this program will have an impact in reducing
reported cases in this age group.

Hispanic Education Program

The main objective of this program is to educate members of the Hispanic
population in the tri-state area about Lyme disease and other tick-borne
infections. Many in this primarily immigrant group work outdoors and face
the threat of tick-bites on a daily basis. As such, the ALDF is developing a
multi-faceted educational program designed to increase awareness of
tick-borne diseases and, expect to have measurable results indicating a
reduction in reported cases of serious late-stage Lyme disease and other
tick-borne infections within a 2-3 year period.

Schoen- "There are no diagnostic guidelines anyone is wedded to."
Evans- "I am the managed care liaison for Yale Independent Phys."
Rahn- "I help BC create managed care dictum"
Sigal- "I am the Center of the Universe."
Steere- "Only experts like me know anything."
Shapiro- "Ho-Ho-Ho, You'd think there were two different diseases..."
Anyone at Stony Brook
  Dattwyler- "I don't need to comment, everyone
               knows I am God's gift to New York Biotech."
Haperin- "What I know and what I do for patients is two different
          things. At your service."
Parry- "Get the vaccine.  Then I can be in the next trial !$!$!$!"
Feder- "We know what is is, but no Commoner actually deserves treatment"
Zemel- "Shut up and listen.  You need to come to CCMC.  I
        need a yacht."
Gerber- "What Schoen says."
Wormser- "We don't know what it is, but we know how to treat it."
Nadelman- "What Wormser said."
Nowalkowski- "I think I better shut up now."
Sood- "Where's my scipt?  I didn't get a script."
Caldwell- "I love God and My Country.  I am secure in
             my retirement plan. I am going fishing now."    
Sikand- "Ha-ha-ha.  We're all getting old.  There's
         no place in the form for that symptom".
Molloy- "Your are wasting my time. I do not speak with commoners."
Malawista- "Nevermind!!!  It goes away!!! I solved the
         problem.  And just don't worry about neuroborreliosis.  
         I can retire a famous scientist now."

This is not possible, Ticks know better than to go across the border.

Chicci