Epidemic of Lyme found to be worse

Pittsburgh — When hunters head to the woods this fall they’ll want to double up on protection against black-legged ticks, since a new federal study confirms that Lyme disease is far more prevalent than previously reported.

The U.S. Centers for Disease Control and Prevention estimates about 300,000 people are diagnosed with the debilitating tick-borne illness each year – or 10 times the number reported to the CDC.

“This new preliminary estimate confirms that Lyme disease is a tremendous public health problem in the United States, and clearly highlights the urgent need for prevention,” said Dr. Paul Mead, chief of epidemiology and surveillance for the CDC’s Lyme disease program.

Pennsylvania often has more cases than any other state. In 2011, it reported one-fifth of all known Lyme cases.

And the disease remains on the rise.

“The change in Pennsylvania has been very dramatic,” said Mead. “We’ve watched it move westward across the state over the years, because of the growing number of deer and good habitat for ticks.”

Ticks have always been around, but were less of a problem centuries ago, when Pennsylvania’s forests and deer herds were overharvested, said Steve Jacobs, a Penn State University entomologist. “Now ticks are repopulating, moving to new areas and setting up.”

The recent evolution of agricultural fields to new-growth forests has attracted development; at the same time, deer are proliferating in urban areas, all of which put more folks at risk of developing Lyme disease, Mead said.

Although ticks will feed on the blood of various mammals, from white-footed field mice to squirrels, deer are their preferred host, said Mead, indicating one in three or four ticks is likely to be infected with the Borrelia burgdorferi bacteria that cause Lyme disease.

Ticks can transmit the disease in any season, but most actively seek blood meals as nymphs in spring; there’s a small secondary spike in fall, Mead said. “The vast majority of cases are in June and July, but activity bumps up again in October and November.”

With no vaccine against Lyme disease, hunters and other outdoors folks need to protect themselves in other ways, advised Dr. Kristin Waller, a physician who heads the surveillance section in the division of infectious diseases for the Pennsylvania Department of Health.

“If you’re spending time outside, you need to take your health into your own hands to prevent tick bites,” said Waller, who recommends spraying with DEET repellent, wearing long sleeves, and tucking long pants into socks.

Folks who don’t want to spray their skin with DEET can instead spray their clothes or buy clothes manufactured with Permethrin, said Mead.

Showering within two hours of coming back indoors can wash away ticks, and provides an opportunity to check for ticks that have embedded themselves in the skin.

Nymphal ticks are so tiny they may be hard to detect, but finding and removing them with sharp tweezers is critical, he said. It takes 24 to 36 hours for a tick to infect its host.

The infection starts in the skin, and then enters the blood stream and disseminates throughout the body.

Early stage symptoms can include a bull’s-eye rash, headache, fever and fatigue. If left untreated, Lyme disease eventually can cause inflammation of the joints, the heart and nerves in the face, as well as confusion and other cognitive problems, Mead said.

Because a diagnostic blood test for infection isn’t reliable until the disease has been in the body for several months, doctors initially must base their diagnosis on symptoms, said Mead.

Early treatment – with antibiotics – helps ensure the best prospects for curing the disease, he said, although antibiotics can work in the later stage, too.

Some victims claim that even after treatment, Lyme symptoms linger and become chronic, said Jacobs, who performs public outreach through Penn State Extension.

So-called Post-Treatment Lyme Disease Syndrome isn’t fully understood, even by medical professionals.

“There’s a belief among some that the body’s own immune system starts fighting Lyme disease and never shuts down, that all sorts of chronic things are triggered by the bacteria,” Jacobs said.

Bob Stibitz, of York, said his wife, Wanda, is still treating today for the effects of Lyme disease she contracted 11 years ago while camping. Although a doctor removed a tick from her leg, she did not receive antibiotics immediately, he said.

Bob Stibitz said he contracted the disease two years later.

“We both got really sick, but our symptoms were different,” said Bob Stibitz, who now is 65. “Mine were more cognitive. I had brain fog. I worked as a computer programmer and I’d look at code and not understand it. I couldn’t remember what I’d read as soon as I turned a page.”

He said his personality changed. “I was always laid-back, really easy to get along with, but I became a real bear,” he said. “I’d never found a tick on my body, but when my wife convinced me to get tested for Lyme disease, that’s what it was.”

Stibitz co-chairs the York Lyme Disease Support Group to raise awareness among medical professionals and the general public.

“Awareness is it,” he said. “Know how to protect yourself, and talk with your doctor about treatment as soon as you find a tick or think you may have been bitten.”

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