The Carlisle Mosquito Online

Friday, August 13, 2010

Lyme disease in Carlisle:
a hazard not to be underestimated

Lyme disease is a feature of our landscape here in Carlisle because we live in a heavily wooded area populated by, among other things, deer, mice and deer ticks (see picture at right). Nationwide, it has reached epidemic proportions greater than AIDS, and it is a very nasty little bug. A number of Carlisle residents have contracted the malady over the years with varying degrees of seriousness.

The first case of Lyme disease was identified here in town in 1999. Board of Health (BOH) Agent Linda Fantasia reports that 13 cases of Lyme disease have been identified and reported so far this year in Carlisle. In 2009 there were 29 and in 2008, 54.

Symptoms of the disease vary from person to person, but the most common early symptom is a rash, at first appearing like concentric circles around the bite site and then spreading to other areas of the body. Whether or not a person develops a rash, one can experience flu-like symptoms including headaches, fever, chills, fatigue, swollen lymph nodes and muscle and joint pain.

Left untreated for one to four months, Lyme disease can cause Bell’s palsy (temporary paralysis or loss of control of the facial muscles), rapid heartbeat and memory loss (so-called Lyme dementia), and symptoms can recur over time. At its most serious, the disease can result in chronic joint pain, inflammation and even arthritis, peripheral neuropathy (abnormal sensation of the nervous system), paralysis, and, less commonly, lupus and inflammation of the heart.

Personal stories

Gale Constable, of Lowell Street, has been taking care of her husband Peter, who is in his third year of suffering from Lyme symptoms. He was bitten in the spring but did not display symptoms right away. By fall, his illness was full-blown and he was experiencing excruciating joint pain, swelling and even paralysis and muscle atrophy. Pain medications were and still are ineffective, but he has received some benefit from acutonics, in which a tuning fork is applied to acupuncture meridians. He has also received intravenous doses of antibiotics that have helped, so far, to mitigate symptoms, and is part of a study being conducted by Massachusetts General Hospital Rheumatologist Allan Steere, M.D. The battle goes on, however, and Constable asserts that the bacterium “can change its DNA rapidly and live in muscle tissue for years, and then suddenly blow up and spread.”

Doctors, she says, are still struggling with detection and diagnosis. In addition, some doctors treat it more agressively than others. Constable has known patients to be misdiagnosed; she said that one patient even had open-heart surgery before doctors determined that Lyme disease was the cause of his heart problems. Among her friends and acquaintances and in her research, Constable has discovered people who have become chronic sufferers and have had to deal with the pain of Lyme for as much as 15 years. Two children that she is aware of were infected as three-year-olds and both developed lupus in their twenties, and one of her friends developed Lyme dementia.

“Since this is a bacteria that acts like a virus,” she says, “each patient must seek a doctor who is ‘Lyme literate’ (a so-called ‘LLMD’), advocate for himself, and do whatever works for his individual case.”

Early detection is key

Each case is different, but all seem to have a definite correlation to when the disease is diagnosed. Steve Tobin of Partridge Lane, for example, suffered his symptoms for almost a year.

John Ballantine of Fiske Street reports that his case caused flu symptoms. He was on vacation and planned to go hiking, but felt too ill to do so. He obtained a diagnosis and a course of antibiotics, which, he says, worked very quickly to eliminate his symptoms.

Selectman Peter Scavongelli of Hutchins Road says that his daughter noticed the “telltale bull’s-eye” rash on his back and he went immediately to the doctor. Because he found the tick bite rash so quickly, probably before the disease had taken hold, and took a course of doxycycline immediately, he says he never experienced the painful symptoms associated with the full-blown illness. Early detection is obviously vital: determine whether or not you have been bitten and if so, obtain treatment as soon as possible.

Pets also vulnerable

Domestic animals can also contract Lyme disease. It is found in dogs and cats and more commonly in cattle, horses and sometimes goats. Their symptoms are similar to those of human beings and can be serious. Vaccines for some animals have been approved and are in use, and it is best to protect house pets with tick prevention solutions recommended by a veterinarian.

Commonly treated with doxycycline

Although there is currently no vaccine for human beings, we, like animals, can be successfully treated for Lyme disease, with early detection. Tetracycline, doxycycline, penicillin and amoxicillin are common antibiotic treatments for animals as well as for human beings. Among those, probably the least commonly known but most commonly used is doxycycline. It is classed as a tetracycline antibiotic and is also used to treat acne and infections of skin, genital and urinary systems and anthrax, malaria and other conditions. Ballantine notes that one side effect of the antibiotics is sun sensitivity, and when he was being treated for Lyme disease, he was advised to stay out of the sun for several weeks.

Dr. Donald Craven to speak on Lyme disease on Sept. 15

The BOH is presenting Dr. Donald Craven, a specialist in infectious diseases and chair of that department at the Lahey Clinic, at the First Religious Society on September 15 at 7:30 p.m. Dr. Craven will discuss Lyme disease symptoms, diagnosis, treatment and prevention strategy, and there will be ample time for questions at the end of his presentation.

In addition, BOH Agent Linda Fantasia reports that a BOH intern from the Boston University School of Health will be mounting an exhibit on Lyme disease at Gleason Public Library in September. The exhibit will provide free handouts of information to take home.


Lyme disease prevention and detection

According to the Mayo Clinic website, “Lyme disease is the most common tick-borne illness in North America and Europe. Lyme disease is caused by the bacterium Borrelia burgdorferi. Deer ticks, which feed on the blood of animals and humans, can harbor the bacteria and spread it when feeding.” The larger and more easily recognizable dog ticks do not carry the bacterium.

Ticks are active in temperatures above freezing, so tick season is longer than one might think. Because they live in grassy and wooded areas, it is best to wear protective clothing. They like dark areas, so clothing should be light, and people should do a thorough tick check upon reaching home, including behind the ears and at the hairline. Deer ticks are about the size of the head of a pin and may be hard to spot, so check carefully. When it is not possible to wear long sleeves and long pants, people should apply insect repellent containing DEET directly to the skin before going out into the woods or grassy areas.

For more information, Carlisle’s Board of Health provides information on Lyme disease on an ongoing basis on the town website: visit See also two articles by Dr. Claudia Talland in the Mosquito online archives: (“Know the basics of Lyme disease prevention,” May 16, 2003, or “Lyme disease: When do I call my doctor?” May 31, 2002.) ∆

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