Forget Covid -- Lyme is Worse

[Paul J Hetzler]

Ticked Off Again

It seems the price we pay for warm weather is the onset of bug bites. Clouds of mosquitoes suck the fun out of outdoor activities, but one bite from a deer (black-legged) tick can put you out of commission for the whole season – maybe longer.

As recently as a decade ago in northern NY State it was unusual to find deer ticks on you even after a long day outdoors. Technically an invasive species, the deer tick (Ixodes scapularis) is another gift from down south, having gradually moved north from the Mid-Atlantic and lower New England states. Generally speaking, they are now widespread in the northeastern US and southeastern Canada.

Deer ticks are arachnids, in the same family as spiders – smaller, but far more dangerous. They are known to vector Lyme disease and a slew of appetizing scourges, including babesiosis, erlichiosis, anaplasmosis, Powassan virus and more. It’s fairly common for a tick to transmit multiple diseases at the same time.

Our understanding of tick-borne illness has changed drastically in the past few years. If you have literature older than 2015, throw it out (tick literature – save your other books). As an example, Dr. Ninevah Zubcevic, a tick specialist who teaches at Harvard Medical School, contends that the red expanding “bull’s-eye” rash or erythema migrans, once considered the hallmark of Lyme, is actually rare, occurring in fewer than 20% of Lyme cases. Other credible sources put it even lower.

In 2014, the New York State Department of Health commissioned a tick study in four northern NYS counties. It concluded that about 50% of ticks were infected with Borrelia burgdorferi, the spirochete bacterium that causes Lyme (not Lyme’s – those are for mojitos and margaritas). This conflicts with older material suggesting a 20% deer-tick infection rate.

In addition, by 2016, researchers had identified two more deer tick-borne microbes in the genus Borrelia. These newbies, B. miyamotoi and B. mayonii, can give you a so-called “Lyme variant.” Sadly, blood tests don’t recognize these recently identified pathogens.

This isn’t to say we need to panic, though feel free if you like. Avoiding ticks would be the most effective course of action, but if you work or play out in the real world, that’s not always an option. The US Centers for Disease Control and Prevention (CDC) recommends using products with 20-30% DEET on exposed skin.

Clothing and footwear can be treated with 0.5% permethrin. Although I am not a fan of pesticides in general, I can’t say enough about how effective permethrin is. It not only repels ticks, it kills them within minutes. Another great thing is that it’s a once or twice per season application – it is reported to stay effective through at least 20 wash cycles. Always follow label instructions – permethrin is 2,250 times more toxic to ticks than to mammals, but it’s still a pesticide.

Out in the woods, never follow a deer trail. Treat your pets regularly with a systemic anti-tick product and/or tick collar so they don’t bring deer ticks into the home. Talk to your vet about getting your pets vaccinated against Lyme (sadly there is no human vaccine at the moment).

Check for ticks every evening after showering. They prefer hard-to-see places such as the armpits, groin, scalp, and the backs of the knees. Also look closely at the beltline and sock hem – they like to tuck into the edge of clothing.

If you find a tick has latched onto you, the CDC recommends grasping it with tweezers as close to the skin as possible and pulling straight up until it releases. You may have to pull hard if it has been feeding for some time. Use steady pressure – no sudden motions.

Do not use heat, petroleum jelly, essential oils or other home remedies – please! These treatments may get a tick to release, but they will also make it disgorge the entire contents of its gut into your bloodstream. Unless you want a disease injection, remove ticks the proper way.

Please note that mouthpart fragments usually remain in your skin afterward. This is not a problem, and will not increase the risk of illness. Apply a topical antibiotic – your body will expel the fragments.

While it was once thought ticks did not transmit Lyme until they had been attached for 36 to 48 hours, experts now say that while you definitely have 24 hours, beyond that you are at risk. But other illnesses can be transmitted within minutes. Hooray, right?

Early symptoms of Lyme disease vary widely – wildly – from person to person. Early Lyme effects may include severe headache, chills, fever, extreme fatigue, joint pain, night sweats, or dizziness. But the first signs could be heart palpitations. Lyme may present with sudden and marked confusion as its first symptom. Too many times it has been mistaken for dementia, and has also been misdiagnosed as depression, and even schizophrenia.

If you’ve been bitten by a deer tick and have any such symptoms, call a doctor right away. Prompt treatment is critical – Lyme can cause irreversible arthritis, and cardiac impairment, or neurological damage. Most people respond well to treatment, but a few may take months, sometimes more than a year, to recover. It’s a shame how little is known about “Post-Lyme Syndrome” or “Chronic Lyme” beyond that they may involve autoimmune responses, and they devastate the lives of those afflicted.

An important point is that the Lyme titer or Western blot test is NOT a yes-or-no assay. Each lab chooses how sensitive – i.e., effective – to make its Western blot. Of the 36 immunoglobulin “bands” identified by the CDC for a complete Lyme test, labs typically check for seven to twelve bands.

Individual labs also decide how to interpret the tests. One lab might count two positive bands as a yes-result, while the next may require three bands. Follow this logic: Two bands present – “Stop whining and get back to work.” Three bands – “OMG you poor sick puppy! Take these pills and rest a few weeks.” You get the yes-or-no call, sure. But you don’t get to see your score card unless you insist.

Also, the Western blot is known to have at least a 36% false-negative rate (Journal of Clinical Infectious Diseases, 07/2008). And according to lymedisease.org, “56% of patients with Lyme disease test negative using the two-tiered testing system recommended by the CDC. (Stricker 2007)”

To recap, deer ticks can mess up your life in a big way. Use permethrin on clothes and shoes, check for ticks daily and remove them promptly. Very few Lyme cases involve a rash, and symptoms can be all over the map. Find a doctor who will treat you based on clinical presentation, because testing is unreliable, to put it nicely. For lots more great information, peruse the Canadian Lyme Disease Foundation website at https://canlyme.com/

Now, get ticked off and stay that way!

Paul Hetzler is a naturalist and an ISA-Certified Arborist. He lives with his wife in Val-des-Monts, Québec.

[Joanne Vaughn]

FYI  Besides permethrin, one can use a recently approved repellant such as Spalding Labs Bye Bye Insects Fly spray. It is a mixture of plant oils, including gerranium I believe,  that repel flys. It has also been found and approved for use against ticks. I have used this product for 2 years for flys on my donkeys.  Pro: effectively repels flys, smells great, non toxic.  Cons: must be sprayed every day, stains their fur yellow, washes off.   I am not employed by Spalding labs.