Update 2022: Lyme Disease

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By Mary Carpenter

In this entry to MyLittleBird’s Summer Update Series, Mary addresses tick-borne illnesses, notably the most common—Lyme disease. Others also on the rise in the U.S., as the tick vectors move northward with climate change, include Rocky Mountain spotted fever, which causes a rash and if untreated can lead to death; and Alpha gal syndrome, spread by the Lone Star tick and causing a potentially deadly allergic reaction to meat. 

LYME DISEASE, according to a 2022 meta-study, has afflicted more than 14% of the world’s population—more than 9% of U.S. residents, with the highest rates in Central Europe—reported by NBC news in June. The study assessed the seroprevalence, levels of antibodies in the blood, of the disease in more than 158,000 people around the world.

Lyme disease, though, has benefited from the Covid pandemic with better attention and new research on long-lasting symptoms common to both diseases: disabling fatigue, cognitive problems that include difficulty focusing and pain. Posted last May on the Johns Hopkins Lyme Disease Research Center site: “We are hopeful that the tremendous resources for long-haul Covid research could help accelerate Lyme disease knowledge and treatments as well.”

Long-lasting Lyme symptoms may be more likely when treatment is delayed, according to a Johns Hopkins study —important information for anyone who thinks they might have been bitten by a tick, have a rash that could be the result of a tick bite or have flu-like symptoms including painful muscle aches. They should insist their doctor prescribe at least three weeks of doxycycline —or otherwise find a more Lyme-savvy doctor who will.

From Mary’s earlier post on Lyme disease:

As of July, 2019, Lyme disease had moved into all 50 states, with a 20% rise in incidence compared with 2016.  Data from New Jersey-based Quest Dynamics show “positive results for Lyme are both increasing in number and occurring in geographic areas not historically associated with the disease,” according to CBS news.

To reiterate our advice, it’s time to ratchet up anti-tick measures. Wear light-colored clothing to make ticks easier to spot—and long pants tucked into socks. Spray the insecticide (as opposed to insect repellent) permethrin heavily on clothing and repeat after every one or two washes.  What might be easier over time is purchasing pants pre-treated with permethrin, on which effects last through dozens of washings.

In addition, apply insect repellents containing DEET, picaridin and lemon eucalyptus oil directly on the body. Within two hours of walking in grass or any vegetation not closely trimmed, take a hot shower and check your clothes and body. Ticks love warm, moist areas like armpits, hair and especially groin areas—although the nymph or juvenile tick that most often transmits Lyme disease can be hard to spot, “with bodies as small as a freckle or the tip of a pencil.” Wash clothes in hot water; and before or instead of washing, dry for 10 minutes at a high temp in a dryer.

In addition, protect predators of the white-footed mice, because mice are crucial to the larval stage of the life cycle of Lyme-carrying ticks and considered primary vectors of Lyme disease. An individual mouse can carry up to 100 ticks at a time. At the next stages, nymphs are most dangerous to humans, and adult ticks live and mate on deer—responsible for spreading the larvae. Be especially kind to neighborhood foxes, which can intimidate prey animals like mice to hide and become less likely to end up as tick food, according to Arlington Patch.

If you find a tick attached to your skin, remove it as soon as possible—within 24 to 36 hours, before the tick has the time to inject the Lyme bacteria—and save the tick. Even without the characteristic bull’s-eye shaped rash—which occurs in only around half of Lyme cases—showing the tick to medical professionals can help persuade them to begin antibiotic treatment. Blood tests that confirm Lyme disease rely on the development of a measurable immune response, sometimes requiring weeks to show a clear result.

Because some doctors underestimate Lyme risks and dismiss reports of symptoms, a physician familiar with tick-borne diseases may provide the best treatment, advises Kris Newby, producer of the Lyme disease documentary Under Our Skin. “Don’t waste valuable treatment time trying to convince an inexperienced physician that you’re really sick.”

Lyme-savvy doctors are also more likely to be aware of updated treatment protocols, notably prescribing doxycycline for three or four weeks rather than the two weeks initially deemed sufficient. Newby advises contacting the International Lyme and Associated Diseases Society for a list of local practitioners. Locally, the Johns Hopkins Lyme Disease Research Center is a resource for treatment of Lyme, in particular “Post Treatment Lyme Disease Syndrome.”

When I had Lyme disease in 2008, it took almost two weeks to persuade my doctor to prescribe doxycycline, after which intense muscle aches and fatigue lasted for several months. Among symptoms that persist almost 15 years later, two have well-documented connections to Lyme disease: difficulty sleeping and peripheral neuropathy that causes numbness in the feet and legs resulting in difficulties with balance and walking. And a third, clearly linked to Lyme only recently: my cholesterol levels shot up 150 points during the acute stage and remain about 100 points higher today.

Which is why I tell anyone who thinks they might have been bitten by a tick, have a rash that could be caused by a tick or have flu-like symptoms, including muscle aches, to waste no time insisting their doctor prescribe doxycycline; otherwise look for one who will, as soon as possible.

—Mary Carpenter regularly reports on need-to-know topics in health and medicine.