The spiral-shaped bacteria Borrelia burgdorferi, in one of its dozens of strains prevalent in the U.S., is responsible for causing the dreaded Lyme disease in hundreds of thousands of people each year.
This year could be worse than ever, experts say, especially in Pennsylvania, the leading state for reported cases of Lyme, according to the Centers for Disease Control.
Pennsylvania logged 7,351 cases of Lyme in 2015, followed by New Jersey at 3,932 and New York with 3,252. The CDC receives about 30,000 reported cases per year, but the true number may be much higher. CDC experts estimate as many as 300,000 people get Lyme each year, the majority of them in 14 states in the Northeast and Midwest.
A spokeswoman for the Pennsylvania Department of Health said the 2016 statistics for reported cases will likely be released at the end of June.
In March, two experts who have studied Lyme for the last 20 years told the NPR blog Goats and Soda that 2017 would likely be a particularly risky year for Lyme in the northeastern U.S. Their method of prediction relies on counting mice from the year before, which researchers Rick Ostlfeld and Felicia Keesing said can infect up to 95 percent of the ticks that feed on them.
The mice outbreak in the Hudson River Valley in New York was particularly alarming to Ostlfedl and Keesing, and they said other parts of the Northeast are now also primed for a possible jump in cases of Lyme.
Deer ticks have plenty of animals to parasitize in Pennsylvania. Though deer blood is often a choice meal for ticks, it is the white-footed mice that serve as the “reservoirs of infection,” according to the American Lyme Disease Foundation. A tick will feed on an infected mouse, then pass on the Lyme disease spirochete to a human.
The disease itself actually lives in the gut of the tick, not the mouth, so there is a good chance of removing the tick before becoming infected, as long as the victim of the bite acts early.
According to published studies, a tick normally cannot begin transmitting the spirochete until about 36 to 48 hours of feeding have passed.
The ratio of infected ticks can also vary wildly from region to region. In areas with lower rates of infection, such as the Pacific Northwest, infection rates can be as low as 2 percent. In areas of high infection, known as hyperendemic areas, the rate can be as high as 50 percent.
As of now, experts say a tick is the only way to get Lyme. It cannot be sexually transmitted, attempts to spread the disease among uninfected lab rats by mosquitoes have failed, and horse flies and deer flies also have not been shown to transmit the disease, even though they may carry Borrelia burgdorferi. The ALDF said those insects have not been properly tested to verify the disease, and ticks remain the real concern.
The Centers for Disease Control, as well as every health practitioner and Lyme disease group, advocates for daily tick checks. The CDC calls for showering as soon as possible when coming indoors from any activity, even if a person was not in the woods and was merely gardening in the backyard. A person should use a full-length mirror to check all parts of the body.
Clothes should be put in the dryer for 10 minutes if dry and longer if damp.
Ticks are especially attracted to dark, damp spaces like behind the ear or under the armpit.
Clothing can be pretreated with products containing 0.5 percent of permethrin, which will be effective even after several washings. Skin repellents should contain 20 percent or more DEET, picardin or IR3535.
Diagnosing Lyme is tricky, as is even identifying if a person should go in for medical treatment. Many who contract Lyme will not have the telltale bull’s-eye rash. Medical practitioners recommend seeking help if flu symptoms persist, or if a person experiences swelling and joint pain or fatigue.
Russ Rossman Jr., 64, of State College, said even with health insurance he spent $60,000 trying to figure out what was causing his debilitating fatigue.
During an interview May 23, Rossman said Lyme cost him his job at Penn State. He spent a year dealing with ongoing fatigue and was burning through sick days and vacation days as he searched for answers, and eventually had to leave his job.
He said he still is not sure when exactly he got the disease. He was active with the Boy Scouts from 2001 to 2008, and started to “really feel it” in 2006 when the fatigue started.
Rossman went to 23 different specialists, including psychologists, he said. He said the stress from not knowing what was causing the fatigue only made his symptoms worse.
“You don’t have to go hiking in the woods,” he said. “It’s all around us. It’s not limited to outdoors people. It’s in this entire area.”
He said he has pulled ticks off of himself while mowing his lawn in the Park Forest neighborhood.
Now, Rossman said he has a handle on the disease, but his current doctor in King of Prussia told him he will never recover 100 percent, and may only get 80 percent of the way there.
There are good days with Lyme, he said, and bad days.
“You’re a rollercoaster,” Rossman said. “You start feeling good and overdo it … then eventually crash.”
With some good acting on the bad days and careful watching of his activity level, he said his life is improving.
“It doesn’t mean you have to sit at home in bed, but you never know when it’s going to be a good day or bad day.”
