Friday, September 24, 2010
Specialist calls Lyme disease “an epidemic”
“Lyme disease is really an epidemic in this area now, and it is way underreported,” according to Dr. Donald Craven, M.D., who presented a lecture sponsored by the Carlisle Board of Health on the dangers of tick-borne diseases to a crowd of 40 to 50 people in Union Hall on September 15. Craven, a professor at Tufts University School of Medicine, founded and is chair of the Center for Infectious Diseases and Prevention at Lahey Clinic Medical Center.
Tick-borne diseases begin as a “summer flu,” difficult to diagnose. Blood tests are unreliable, according to Craven. Rather, doctors should look for a variety of signs and symptoms and should treat as Lyme upon clinical suspicion, according to Craven. Twenty percent of people with an infected tick bite do not get the typical bull’s-eye rash. Craven advises that if you suspect you have symptoms of early-onset Lyme disease, seek immediate treatment.
The same tick bite that transmits Lyme disease bacteria can transmit co-infections Anaplasmosis (Ehrlichiosis)and Babesiosis. Initial symptoms of tick-borne disease can appear three to 30 days after the bite. “Mono, HIV/AIDS, Lyme, Anaplasmosis, Babesiosis, swine flu and non-infectious diseases all present the same way, with headache, malaise and muscle pain,” he said. If Lyme disease or Anaplasmosis are not treated early with antibiotics, later symptoms resembling arthritis and premature old age – memory-loss, chronic fatigue, or even organ failure – may occur at any time in the future. People who go untreated may develop serious nervous system problems. The relative incidence of different types of symptoms is: arthritis: 30%, neurologic problems: 15% and cardiac problems: 1%, according to the study “Surveillance for Lyme Disease – United States, 1992 - 2006.” The study is available on the U.S. Centers for Disease Control web site at: www.cdc.gov/mmwr/preview/mmwrhtml/ss5710a1.htm.
Babesiosis is a parasitic protozoa that looks like malaria under a microscope. Treatment for Babesiosis includes antibiotics and anti-malarial medicines. Tick-borne diseases can become chronic and debilitating. For Lyme disease and Anaplasmosis, antibiotics may be administered orally or via injections. If the case is advanced, a month of injections may be recommended. In some advanced cases treatment proves ineffectual and has to be abandoned.
Craven did mention some good news. “The tick must be attached to your skin for more than 36 hours for it to actually transmit the disease. If it is a tiny little tick, not engorged, the chances it transmitted the disease are practically nil.”
Dog ticks do not carry Lyme disease – only deer ticks can. Deer tick nymphs are agressive biters and are very small – approximately the size of the “D” on a dime. Craven guesses that ten to 15% of deer ticks in Carlisle are infected with one or more disease.
Bug repellent with DEET prevents ticks from attaching to or climbing clothing. Wearing white, tucking pants into socks and avoiding the woods from spring to winter also reduce the risk of tick bites.
“Education and prevention are key. There has to be a lot more media and education, starting with the kids in schools.” Always be wary of flu-like symptoms – if the fall and winter are warm, tick season can extend into December. Ticks are active any time temperatures are above freezing.
If bitten by a tick, carefully remove the head and area attached to your skin with tweezers. Craven does not recommend saving the tick to send to a lab for testing, since ticks are so small that blood tests are impractical. Remember that if the tick is not round and full of blood, it has probably not been on long enough to transmit disease. Craven hopes that a vaccine will curb this epidemic some time in the future. ∆
Lyme Disease Statistics
According to the Mass. Department of Public Health (online at: www.mass.gov/Eeohhs2/docs/dph/cdc/lyme/lyme_disease_surveillance_2009.pdf):
• “Lyme disease is considered endemic in all of Massachusetts.”
• There were roughly 4,000 confirmed cases of Lyme disease in the state in 2009.
• The majority of symptoms first appear during June, July and August.
• The populations most at risk of contracting the disease are children aged five to 14 and adults aged 55 to 69. ∆
© 2010 The