Lyme Disease – Let’s separate fact from fiction
MUNCY – The Centers for Disease Control and Prevention and the Pennsylvania Department of Health have reported an increasing prevalence of Lyme Disease in Pennsylvania. Although geographic distribution is still much higher in the East Coast, more tick colonization is taking place as it moves further inland. This fact was pointed out on a map during an informational program held Wednesday, August 28 at the Life Center in Muncy Township by Dr. Russell Gombosi from Susquehanna Health’s Internal Medicine & Pediatrics.
The program was given in partnership with Blue Cross of Northeastern Pennsylvania to further explain the cause, symptoms and stages of Lyme Disease. According to Dr. Gombosi the increase has been ten fold in Central PA from 1990 to 2010, with an especially dramatic rise since 2003. Part of this, he explains, could be from an increased awareness and an over-diagnosis. It is also increasing worldwide, throughout Asia, Europe, Russia, China and Japan.
Gombossi held his residency in Springfield, Massachusetts, not far from where the disease inherited its namesake, Lyme, Conn. and “arthritis-like symptoms” were determined. He feels that the increased cases are due probably to a warming climate. “Temperatures are rising and ticks are moving into warmer climates.”
Lycoming County reported up to 50 cases in 2011. “This is based on an average of 5 per 1,000,” said Dr. Gombossi.
The medical term for the infected nymphal tick is the Borrelia which feeds on the white-footed mouse in the spring. From there the tick feeds on animal hosts including humans and white tailed deer. The adult tick produces larvae which then feed on Borrelia infected mouse in the fall, and the infected larvae become the infected tick. “The scapularis tick is the one that infects,” Gombossi explained.
Ticks are most active in late spring to early and mid fall.
Often symptoms can appear 3 to 34 days after a tick attack. A bright red outer circle can appear at the site of the bite which indicates stage one of the disease. “It is a classic bulls eye. It may be necrotic (dead tissue showing blue at the center),” added Dr. Gombossi. Common sites could be the groin area, the thigh or underneath the arms (axilla).
Flu-like symptoms can appear such as fever, nausea, fatigue, chills, headache, muscle and joint pain which indicates stage 2 of the disease. According to the doctor, it could possibly take up to 4 weeks before these symptoms appear. “Multiple spots can develop that could lead to hepatitis,” he said. A rash occurs in approximately 70 to 80 percent of infected persons which usually feels warm to the touch but is rarely itchy or painful. If untreated, the infection may spread to other areas of the body. Bells Palsy could show up as well and lack of treatment could result in further complications. “We treat the manifestations.”
Stage 3 of the disease is rare. Many symptoms will resolve over a period of weeks to months, even without treatment, but complications can result if untreated. “Nerves can get inflamed from this virus, and about 60 percent infected will get arthritis. Eventually your body will clear the infection,” he assured. 95 percent clear in one year. Note that if there is an immediate reaction to a tick bite, then it will not be Lyme. “It takes 2 to 3 days to incubate.”
A simple blood test (ELISA) is used to detect Lyme. “A screening test takes 4-8 weeks to be positive. This is when you look for the organism.” If still experiencing joint pain after 3 weeks of antibodies, then the organism might still be there. To treat the disease use ibuprofen, or naprosyn can be used for joint pain.
The disease is now highly endemic, over the 10 percent mark according to Dr. Goombosi. The best way to treat Lyme is through prevention. DEET is effective. “Wear pants and tuck your pant legs inside your sock and boot,” he warns if going outdoors into the woods. “Take tick checks every time you are in the woods. Repeated exposures will make you more susceptible,” cautions Dr. Gombossi. “It can reoccur, but it depends on your body’s immune response. Potentially, you could get another case.” Keep in mind that treatment is effective and prognosis for full recovery is very high.