Don’t Take Lyme Disease Lightly

The tick-borne illness remains a serious threat, experts caution

The mention of West Nile virus can send some people into an unwarranted panic.

But did you know that Lyme disease infected more than 23,000 Americans in 2002, more than double the number of those infected by West Nile?

Both are insect-borne diseases, both can have a debilitating effect on the human body, and both are continuing their relentless spread into new areas of the country.

So why do headlines seem to scream every new case of West Nile virus, while Lyme disease is met with a "ho-hum" shrug?

Doctors believe the explanation lies in the fact that West Nile virus can kill — taking 264 lives in 2003 — while Lyme disease is considered potentially debilitating but not fatal.

"The whole thing with Lyme disease really is diagnosis and treatment," said David Weld, executive director of the American Lyme Disease Foundation. "If caught early, you can prevent later-stage problems."

Lyme disease is caused by the bacterium Borrelia burgdorferi. These bacteria are transmitted to humans through the bite of infected deer ticks, and caused 23,763 infections in the United States in 2002, according to the U.S. Centers for Disease Control and Prevention.

Lyme disease was discovered in 1977 when arthritis was observed in children in Lyme, Conn.

People with Lyme disease generally have a rash in the shape of a bulls-eye at the site of infection, and also can suffer from such symptoms as fever, malaise, fatigue, headache, muscle aches and joint aches. The incubation period from infection to the onset of the rash is typically seven to 14 days but may be as short as three days and as long as 30 days.

If left untreated, more dire symptoms can arise: arthritis, mainly in the large joints; neurologic abnormalities, such as aseptic meningitis, facial palsy, motor and sensory nerve inflammation and inflammation of the brain; and cardiac problems, such as an enlarged heart or acute inflammation of the tissues surrounding the heart.

Doctors treat Lyme disease using oral antibiotics, or intravenous antibiotics if the disease has progressed to its later stages, said Dr. Peter Welch, an infectious disease doctor at Northern Westchester Hospital Center in Mount Kisco, N.Y.

"The most common reason for intravenous treatment is if the disease has invaded the nervous system," Welch said. "The pills don’t penetrate into the nervous system as well."

There is some debate among doctors over whether Lyme disease is completely curable.

"There’s one school of medical thought that antibiotics should be given for months or years, and that the disease is not curable," Welch said. "I’m not in that camp."

Welch believes the human body can be rid of the bacteria with proper weeks-long treatment using antibiotics.

In 2002, the latest year for available statistics, 95 percent of Lyme disease cases were from the states of Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Wisconsin.

However, the disease continues to crop up in new areas, mainly where both deer and human populations are growing, Weld said.

"In the last two years, five or six counties just north of San Francisco have been identified as a real hot spot," he said. "There are a lot of deer there, and a lot of people.

People likely to catch Lyme disease are those who enjoy outdoor activities, such as hiking, camping or fishing, or live or work in residential areas surrounded by tick-infested woods or overgrown brush. Individuals engaged in outdoor occupations, including landscaping, forestry, and wildlife and parks management in endemic areas, may also be at risk, health officials said.

To protect yourself against Lyme disease, doctors recommend, first, that you avoid places likely to be infested with ticks, particularly in the spring and summer. Deer ticks favor a moist, shaded environment, especially areas with leaf litter and low-lying vegetation in wooded, brushy or overgrown grassy locales, according to the CDC.

People who do venture into tick habitats should wear light-colored clothing to help spot ticks. Wearing long-sleeved shirts and tucking pants into socks or boot tops can help keep ticks from reaching your skin.

Welch also recommends the use of insect repellents containing DEET, although he added that the best way to prevent Lyme disease is to perform frequent tick checks.

"Remember that if ticks are removed before they’ve been attached for 48 hours, they usually do not transmit the disease," he said. "If you find a tick on you and remove it, only about 2 percent of those bites result in Lyme disease."

One of the newer advances in the fight against Lyme disease has been technology to help eliminate ticks, Weld said.

The Lyme foundation promotes the use of a bait station that lures deer in with corn, then coats their ears and neck with insecticide while they feed. Two studies have found that a station can eliminate up to 98 percent of the ticks in a given area, he said.

"It’s the ultimate answer, from my viewpoint," Weld said.

More information

American Lyme Disease Foundation

To learn more about Lyme disease, visit the U.S. Centers for Disease Control and Prevention.