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Raj Patel, MD. Education: MS-Rutgers University MD – Robert Wood Johnson Medical School Residency-Family Medicine Post Graduate studies in Autism Spectrum Disorders & Lyme Disease Research: Ampligen-CFIDS (Hemispherx Pharmaceutical) Clinical: 18+ years clinical experience

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raj patel md
Raj Patel, MD


MS-Rutgers University

MD – Robert Wood Johnson Medical School

Residency-Family Medicine

Post Graduate studies in Autism Spectrum Disorders & Lyme Disease


Ampligen-CFIDS (Hemispherx Pharmaceutical)


18+ years clinical experience

Active member of Defeat Autism Now (DAN)

Active member of International Lyme and Associated Diseases Society (ILADS)

Active member of California Lyme Disease Association (CALDA)

Raj Patel, MD

Medical Options for Wellness

5050 El Camino Real, #110

Los Altos, CA 94022



Raj Patel, MD


Lyme Disease


Fastest growing vector borne infection

CDC estimated 24,000 cases in 2002 with the CDC itself admitting reported cases represent less than 10% of all cases.

Tick bites frequently transmit multiple infections:



Babesia and other piroplasms

Bartonella like organisms

Raj Patel, M.D.


Reported Cases of Lyme Disease, United States, 1995-2009

National Surveillance case definition revised in 2008 to include probable cases;

details at http://www.cdc.gov/ncphi/disss/nndss/casedef/lyme_disease_2008.htm

Raj Patel, M.D.


Vector Life Cycle


Raj Patel, M.D.


Lyme Disease

Lyme Disease Symptoms

Symptom presentation typically mixed depending on mix of infections present

Classic Symptoms Associated with Borrelia

Starts gradually with flu-like symptoms

Multi system involvement when disseminated

Migratory arthralgias that evolve into arthritis

Occipital headaches with neck stiffness


Four week cycle of symptom flare-ups

EM rash (bulls-eye)

Raj Patel, M.D.


Lyme Disease

Classic Symptoms Associated with Babesia

Rapid onset of symptoms (cyclic high fevers, severe headaches, & sweats esp. at night)

Air hunger

Dull global headaches

Prominent fatigue with exercise intolerance

Symptoms cycle every 4-7 days

Hypercoagulable states

Raj Patel, M.D.


Lyme Disease

Classic Symptoms Associated with Bartonella like organisms

CNS symptoms prominent (anxiety, agitation, insommnia, seizures, outbursts and anti-social behavior)


Soles tender esp. in morning

Striae (hyperpigmented stretch marks)

Elevated VEGF (vascular endothelial growth factor) useful marker to follow response to treatment.

Raj Patel, M.D.

protecting yourself


Year round threat with Spring and Summer being prime time

Carried by deer as well as other animals to your yard

Mice become carriers when infected ticks feed on them. Subsequently, when non-infected ticks feed they

become infected

Found in cool moist areas, around shrubs and woody areas, tall grass, and around the edge of yards

Ticks prefer moist skin folds:

Back of neck

Inside part of elbows and knees


In and around ears

Protecting Yourself

Raj Patel, M.D.

protecting yourself1

Minimize Exposure:

Yard Prevention

Yard prevention very important

Keep lawn mowed, cut down brushy areas, & clear away leaves

Trim trees to ensure adequate sunshine

Creating a 3 ft. wide wood chip or gravel border and stone wall can reduce ticks by 50%

Hiking Precautions

Walk in middle of trails

Wear light colored clothing

Wear gloves, hat, long sleeves

Use Deet type repellent on exposed skin

Use Permethrin tick repellent on clothing

Check yourself thoroughly afterwards

After possible exposure take clothing and place in dryer at high heat for 15 minutes to kill ticks left behind

Protecting Yourself

Raj Patel, M.D.

protecting yourself2

Keep your pets protected:

Particularly susceptible, frequently bringing deer ticks into your house

Use Frontline or K9 Advantix monthly for cats and dog

Use Damminix tubes to reduce deer ticks by more than 90%

(tubes filled with cottton treated with Permethrin)

Protecting Yourself

Raj Patel, M.D.


What To Do If You Get A Tick Bite

  • See a doctor immediately. The sooner treatment is started the better the results.
  • Go to www.lymediseaseassociation.org for a list of lyme literate MDs (LLMD). Otherwise, take a copy of the ILADS treatment guidelines with you for your doctor http://www.ilads.org/files/ILADS_Guidelines.pdf
  • Save the tick. Laboratories can test the tick for the presence of lyme and associated coinfections.
  • If a rash develops take photographs. It may help your doctor in the diagnosis.
  • Laboratories vary in terms of the depth of lyme testing provided. Dr. Patel prefers to use the following:
  • Igenex www.Igenex.com
  • 1-800-832-3200
  • Stony Brook Laboratory www.path.sunysb.edu/labsvs/tickpics/TICKpic.htm
  • 1-631-444-3824
  • Clongen Laboratories www.Clongen.com
  • 1-301-916-0173

Raj Patel, M.D.


Testing and Treatment After Tick Bite

  • Testing
  • PCR (blood and Serum) for Lyme, Ehrlichia, Bartonella, Babesia, Mycoplasma
  • FISH for Babesia and Bartonella
  • Western-Blot not useful. Take 2-6 weeks to turn positive
  • Treatment:

IDSA: Rx within 72 hours with Doxycycline 200 mg (4mg/kg) one time dose

if age >8 years. No treatment recommended for < 8 years unless symptoms warrant it.

ILADS: No specific Rx. Use clinical judgement based on geographical

location, type of tick, if engorged, and method of removal.

Burrascano Guidelines: Treat 28 days regardless of age.

Note: Make sure to treat for coinfections if the tick tests positive.

Raj Patel, M.D.


Lyme Western Blot Testing

Raj Patel, M.D.

Grier, T. Laboratory Tests. Lyme Times. Summer 2004:21-25

useful resources

ILADS (International Lyme and Associated Diseases Society)


Turn The Corner


CALDA (California Lyme Disease Association)


“Coping with Lyme Disease, A Practical Guide to Dealing with Diagnosis and Treatment” by Denise Lang and Kenneth Liegner, MD

“Prevention Tips” LymeTimes. Summer 2004, p.5-8.

Other Useful Websites/Articles







Useful Resources

Raj Patel, M.D.