The arrival of spring brings the revival of the tick population. Ticks are known to cause many different types of infectious disease, including Lyme. The Centers for Disease Control and Prevention recently increased their estimate of new Lyme disease infections in the U.S. to 300,000 cases per year, which is 1.5 times more than new breast cancer cases and six times higher than new HIV cases per year.
At the epidemic rate of 34 new cases per hour in the U.S., health care providers in South Dakota are increasingly likely to see patients with Lyme at all stages of the disease. Symptoms during an acute Lyme infection are flu-like, including muscle and joint pain, headaches, and dizziness that start anywhere from two to 30 days after a tick bite. The appearance of a distinctive expanding bull’s-eye rash is 100 percent diagnostic for Lyme, but only occurs in a small minority of patients; no rash or an atypical rash is more common. Lyme disease is commonly transmitted by tick nymphs no larger than a poppy seed, and less than half of patients with known Lyme disease recall being bitten or having any kind of rash.
Lyme is a bacteria that can infect every system in the body, including the brain. Like its cousin syphilis, Lyme disease is a “great imitator.” People infected with Lyme are frequently misdiagnosed with diseases such as fibromyalgia, chronic fatigue, multiple sclerosis, rheumatoid arthritis and Parkinson’s disease.
When Lyme goes untreated or is under-treated, long-term illness and disability can result. Long-term consequences of Lyme disease can include fatigue, sleep impairment, joint, muscle, and nerve pain, depression, cognitive impairment, and problems with vision and hearing. These symptoms are frequently severe and impair daily functioning. About 10 percent of patients with both acute and chronic Lyme disease will experience heart problems.
The diagnosis and treatment of Lyme disease can be difficult, especially if it is not caught early. The laboratory tests currently available for Lyme are unreliable and will miss over half of the people who have been infected. A new Lyme research center at Johns Hopkins is working on developing accurate laboratory tests; in the meantime, a diagnosis must be made by an educated health care provider based on a person’s history, signs and symptoms.
My own struggle with Lyme disease began back in 2008. To the best of my knowledge, I contracted Lyme while walking the dog in a field in Rapid City. I have heard more than once that “we don’t have Lyme in South Dakota.” This is a false and dangerous assumption. Tick habitat is expanding, people are expanding into tick habitat, and people and pets travel.
I would not receive a diagnosis for nearly five years. During that time period I progressively deteriorated from a pharmacist enjoying my career choice and multiple other activities to a debilitated lump on the couch. The chronic pain and fatigue became so profound that in desperation I sought the help of a specialist in Utah, who set me on the long road to recovery that continues today.
Conquering Lyme disease will require informed patients and health care providers working together and learning from each other. Lyme-educated health care providers are few but desperately needed. There are some excellent resources available for patients and providers, including LymeCME.com and treatlyme.net. Also see ILADS.org for up-to-date treatment guidelines, and lymedisease.org for a symptom checklist.
You can prevent tick bites by avoiding tall grass and underbrush, and spraying with DEET. Another strategy is to treat clothing with permethrin, which is the most effective. Perform a post-activity inspection, and don’t forget to inspect and pre-treat your pets.
As Benjamin Franklin rightly noted, “An ounce of prevention is worth a pound of cure.”