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Move Over Lyme Disease, Here Comes Babesiosis

By: TIMOTHY KLEPPER, M.D.

Tick season is here, and we’re hearing the usual warnings about Lyme disease. But due to a mild winter and spreading tick population, there’s a new threat to watch out for: babesiosis (bah-bee-see-oh-sis).

Both Lyme disease and babesiosis are parasitic diseases carried by deer ticks, also called black-legged ticks. The CDC reports a significant increase in reported cases of both this year in the eastern U.S.

Lyme disease and babesiosis differ in their symptoms and health risks. Here’s a side-by-side comparison of the two, and what you need to look out for.

  Babesiosis Lyme disease
Likelihood of infection Low, especially if tick is attached for less than 36 hours Low, especially if tick is attached for less than 36 hours
How soon symptoms start 1-4 weeks after tick bite 3-30 days after tick bite
Symptoms Mild to severe flu-like symptoms: fever, chills, sweating, loss of appetite, nausea, tiredness

In severe infections: yellowish skin or eyes, pale skin, dark urine, shortness of breath, nausea and vomiting, abdominal pain, neck stiffness, sudden mood changes

Circular bulls-eye rash around the tick bite

Early infection: flu-like symptoms: tiredness, muscle pain, joint pain, headaches, fever, chills

Risks Can be life-threatening, especially if you have a weak immune system or don’t have a working spleen. May cause anemia, enlarged spleen, fluid buildup in your lungs, blood clotting problems, kidney or liver failure Late infection: neck stiffness, pain and swelling in your joints, numbness or pain in your limbs, memory problems, difficulty concentrating, heart problems. Usually not life-threatening
When you should see a doctor If you were bitten by a tick and have flu-like symptoms, especially if you have a weak immune system If you were bitten by a tick and have an expanding red rash around the bite or have flu-like symptoms
Usual treatment Combination of anti-parasitics and antibiotics Antibiotics Antibiotics

 

How to prevent tick bites

The best way to avoid getting sick with babesiosis and Lyme disease is to not get bitten. Remember the ABCs of prevention:

“A” stands for avoid. You want to avoid areas ticks are found, such as where there are low bushes, leaf litter and tall grass.

“B” stands for bug spray. Use it when you’re outdoors and think you’re going to be exposed to tick bites. The CDC recommends a bug spray that contains either DEET 30% or picaridin. You also could use a spray that has oil of lemon eucalyptus in it.

“C” stands for cover up. Wear protective clothing. If you have clothing over your skin, ticks won’t be able to bite you.

What to do if you’re bitten by a tick

Use tweezers to grasp the tick as close to your skin as possible, then pull the tick off with steady pressure. Then wash your hands and the area of the bite with soap and water. Sometimes, the mouthparts of the tick will break off and stay in the skin. If you can remove them easily, use the tweezers to pull them out. If you can’t remove them easily, just let the skin heal. Your body will break down the remaining mouth parts over time.

Remember, your chances of getting a tick disease are much lower if you remove the tick within 36 hours of being bitten.

 

Dr. Klepper is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. He cares for patients in the Queenstown office.

Where Are We Now With COVID-19?

By: FALANA CARTER, M.D., CO-MEDICAL DIRECTOR
August 2023

Three years after the start of the COVID-19 pandemic, daily information about the disease has receded from public view. Infection rates and deaths are down, emergency measures have ended, and people’s lives have returned to some level of normalcy.

Does that mean COVID-19 is gone?

No, daily infections still occur but the disease has changed since 2020. Mutations of the virus combined with effective vaccinations and natural immunity have reduced the illness burden and death rates.

Like many viruses, COVID-19 continues to mutate and create new strains. In the future, emerging strains could remain relatively mild or cause a serious illness. Currently, the medical community is tracking the variances and learning more about the complexity of the virus, but no clear end of infections is known.

COVID-19 has changed from a pandemic that spreads quickly and endangers large populations in a country or the world to an endemic condition. This means COVID continues to circulate within an area or community. Today, COVID -19 is currently circulating at lower levels, following the pathway to potentially become a seasonal infection flaring more in the fall and winter.

COVID-19 is still a threat

It’s important to remember that though the pandemic has receded, people still get infected with COVID-19, and 50-100 people are dying daily in the US. Those with underlying health conditions – such as obesity, diabetes, asthma or chronic lung disease, sickle cell disease or decreased immunity, and those over 65 years old — can have serious complications and become dangerously ill if infected. We should all be mindful that interactions with those who have high risk for serious complications should be limited if you have any respiratory symptoms.

As many as 16 million Americans are affected by Long COVID. Those patients with Long COVID continue to experience symptoms long after the infection ends, such as fatigue, shortness of breath, cough, headache, and difficulty thinking or concentrating. Researchers continue to explore the underlying cause of Long COVID, but we do know those who are not vaccinated have higher risk for lingering symptoms.

Where we go from here

In just three years, SARS-CoV-2 started as a limited virus overseas and developed into a major respiratory illness that affected the entire world. Increased knowledge of COVID-19 has allowed medical technology to develop various treatments that include: effective vaccines, oral medications and IV infusions that decrease serious complications. As a result of increased community immunity, treatment options and less potent mutations, COVID-19 is no longer a daily hurdle. It’s clear that COVID-19 isn’t going to disappear, so everyone needs to remain vigilant with risk management. Keep current on COVID vaccinations to new variants, continue to follow the news about the virus, and look out for others who are at high risk.

 

Falana Carter, M.D.

Dr. Falana Carter is Co-Medical Director of Maryland Primary Care Physicians. She is certified by the American Board of Family Physicians and cares for patients in the Arundel Mills office.

 

Telemedicine vs. Office Visits: Which One Do You Need?

By: STEPHANIE MCKENNEY GROFF, D.O.

Since the start of the COVID-19 pandemic, MPCP has expanded our telemedicine services to give more people access to safe, convenient healthcare. Many of our patients have come to appreciate telemedicine as an alternative to office visits, receiving care in the privacy of their homes. The American Academy of Family Physicians supports telemedicine as an appropriate means of improving health. MPCP offers virtual visits during regular office hours, evenings and weekends.

Telemedicine is ideal for many types of medical appointments, but not for all of them. So when should you schedule an online visit and when should you see your doctor in-person? Here are some helpful guidelines.

Telemedicine visits are good for:

Follow-up visits: If you’ve already seen your doctor about an illness or injury, follow-up visits using telehealth can help them monitor your progress.

Review of lab work and imaging results: If your doctor ordered blood work or imaging to assess your concerns or symptoms, a telemedicine visit can give you adequate time to review the results and have your questions answered.

Prescription refills: If you regularly take medication and your health hasn’t changed, your doctor can often refill your prescription after an online visit.

Monitoring chronic conditions: Your doctor may be able to monitor a chronic health condition, such as diabetes, heart disease or asthma, and help you manage it without seeing you in the office.

Counseling and other mental health services: Discussions about mental health, including anxiety and depression, are the top reasons people use telemedicine. Your MPCP doctor may be able to help you with these conditions and can refer you to mental health professionals if needed.

In-person visits are better for:

Your first time seeing a doctor: It’s important to meet your new doctor so you can start building a relationship and feel comfortable with them. Also, seeing you in-person gives your doctor a baseline understanding of your health and what treatments you may need going forward.

Physical exams: Are you concerned about a lump you found? Have pain in your joints? Doctors are skilled at recognizing signs and symptoms of disease and will understand what follow-up tests or treatment you need.

Need for blood tests, X-rays and other imaging scans: A visit in the office allows your doctor to perform an exam to figure out which tests will be best to help with your diagnosis.

You experience a new symptom to an existing condition: If you have a chronic condition like diabetes or heart disease, even if it is under control, your situation can change. If you notice a new symptom, you should schedule a face-to-face with your doctor.

How to schedule a telemedicine visit

To schedule an appointment during regular hours, just call your MPCP office. A medical assistant will call you before your appointment to help you connect and provide instructions on how to access the video platform that will be utilized during your visit. You may also be advised to collect your medication bottles, gather information such as your blood sugar or blood pressure logs. The medical assistant may ask you to take your temperature, weigh yourself, or provide a blood pressure reading prior to your visit.

MPCP also offers evening and weekend telemedicine visits for acute care (illness or injury) to better fit your schedule. Click here for office hours.  Call 410-729-3368 to schedule an after-hours appointment.

 

Dr. McKenney Groff holds her medical degree from Lake Erie College of Osteopathic Medicine and is certified by the American Academy of Family Physicians. She cares for patients in MPCP’s Annapolis office.

 

Telemedicine: Fast, Convenient Care

By: ARIEL WARDEN-JARRETT, M.D., FAAFP, Clinical Director, After Hours Telemedicine

At the start of the COVID-19 pandemic, MPCP expanded our telemedicine services to give more patients access to safe healthcare. Since then, many of our patients have come to appreciate telemedicine as a fast, convenient alternative to office visits.

Telemedicine allows you and your provider to see each other while you talk together. It can be scheduled during regular office hours, but after-hours and weekend appointments are also available. Telemedicine isn’t right for some appointments – such as physical exams or pre-ops – but it’s ideal for many others. Here are some reasons our patients call for telemedicine visits:

  • Cold or flu symptoms
  • Covid symptoms
  • Urinary tract infections
  • Medication refills or changes
  • Discuss test/imaging results
  • Anxiety/depression

What equipment do I need for a telemedicine visit?
You just need your smartphone, an iPad, or a home computer with a camera and microphone. MPCP uses Zoom and a few other HIPAA-safe apps to connect with patients. It also helps if you have a scale or blood pressure monitor to help provide your provider with home vital signs.

Is telemedicine really effective?
Most of our patients say it works very well for most appointments. Your doctor will listen to your symptoms and ask questions, just as if you were in one of our exam rooms. Using video, your doctor will be able to see things that will help make a diagnosis. But if there is a concern at the end of your visit that something is still unclear, your doctor will have you come into the office as safely as possible for a face-to-face evaluation.

Can I get a prescription filled from the visit?
Yes, your provider can send any necessary prescriptions to your pharmacy electronically. If you need blood tests, X-rays or other tests, your provider will arrange for you to get them safely.

How do I schedule a telemedicine visit?
You can simply call your MPCP office to schedule a telemedicine visit. If you prefer a particular video platform, just let the scheduler know when you make your appointment. Otherwise, a medical assistant will call you before your appointment to help you connect. You may also be advised to collect your medication bottles, gather information such as your blood sugar or blood pressure logs, and to take your temperature or weigh yourself prior to your visit.

What about after-hour appointments?
MPCP offers evening and weekend telemedicine visits for acute care (illness or injury) to better fit your schedule. Appointments can be scheduled Monday to Friday 5-10 pm, and Saturday and Sunday 10 am – 4 pm. Call 410-729-3368 to schedule an after-hours telemedicine appointment.

Will my insurance cover telemedicine visits?
Yes, insurance companies are encouraging doctors to connect with their patients through telemedicine. However, deductibles and co-pays may be applied. You should check with your insurance company as it relates to your specific coverage.

 

Dr. Warden-Jarrett is a Maryland Primary Care Physicians, LLC partner and is certified by the American Board of Family Medicine. She received her medical degree from the George Washington University School of Medicine and Health Sciences. She sees patients in MPCP’s Bowie office.