Lyme disease is one of those things you never really think about until it affects you or someone you know. The truth is – we should all be worried about it. Very much so! Personally, I know several people who’ve been diagnosed with Lyme disease and it’s a serious problem. Firstly, not only is the diagnosis challenging but also the treatment. Recently, I met a contractor from Long Island who had been diagnosed and treated for Lyme disease. He caught it while working in one of the most beautiful parts of the East Coast, the Hamptons. He described the infection as “one of the worst things I’d ever experienced in my entire life… I thought I was dying and the doctors thought I had HIV.” His experience is not an uncommon one – Lyme is a tricky disease, with various stages and presentations. But one thing is certain – if you have it, early diagnosis and treatment are essential. Prevention is best, but that can prove very difficult for the following reasons:
- The ticks that carry Lyme disease are endemic to certain areas but the ticks themselves are not always obvious. One might logically assume you can always see the ticks if they’re present. Alas, the ticks that carry Lyme may transmit the disease BEFORE they are even barely visible to the naked eye. How? During early spring and summer, tiny baby lyme disease carrying ticks called “nymphs” (what a benign sounding name!) emerge and hide in the grass, waiting for their next meal. They are so small, they’re the size of poppy seeds.
- The unsuspecting host (i.e. YOU or your dog) comes into contact with these nymphs without ever knowing it. The little nymphs although small, can still transmit Lyme disease, but you won’t see them on your skin or clothing. Now, you might spot the characteristic rash, but you might not, because…
- Erythema Migrans the so-called “bulls eye” pattern rash associated with Lyme infections is NOT always present. According to the CDC, Erythema Migrans occurs in up to 80% of patients infected with Lyme, but that means there are at least 20% of patients who lack the characteristic rash (see the CDC website on this topic for more). The CDC recommends medical evaluation for individuals who may have been exposed if they experience any of the characteristic symptoms; the range of symptoms is wide, simply perform a google search and you’ll find a myriad of presentations. But there’s another tricky aspect to Lyme disease….
- It may be asymptomatic. While this is unusual in the United States, one study from 2003 reported an incidence of asymptomatic Lyme of 10%. And I can tell you personally I met someone from Long Island years ago who had this exact thing occur, only to be diagnosed years later due to chronic fatigue. Which leads us to the another tricky aspect of Lyme…
- Treatment for Lyme disease – can be incredibly difficult. This topic has been widely discussed with personal experiences publicly shared by several celebrities. Most people have heard about the ordeal Yolanda Hadid (fashion model also on Bravo’s Real Housewife of Beverly Hills) endured, but did you also know that country singer Shania Twain lost her voice (and nearly lost her career) because of Lyme disease? Unbelievable but true. Read the articles in People magazine and Country Living where Shania Twain describes how dangerous and debilitating Lyme disease is. Why? Because of the kind of bug it is – Lyme disease (which is caused by Borrelia burgdorferi) is caused by a spirochete. Do you know what other disease is caused by a spirochete? Syphilis – caused by the spirochete Treponema pallidum. Because Lyme is a spirochete, it does not necessarily respond to treatment the same way other bacterial infections do. Frontiers in Immunology addressed this issue in an article called “Hide and Seek: How Lyme Disease Spirochetes Overcome Complement Attack.” This article describes the way the Lyme-causing spirochete evades the host’s immune system. Indeed, another article published in the Journal Infection Drug and Resistance describes the current Lyme epidemic as “a medical disaster” drawing parallels with the AIDS crisis. With over 300,000 cases of Lyme disease diagnosed in the United States, the Lyme disease epidemic certainly is an area of urgent concern. But that’s not all because …
- Individuals infected with Lyme may also be infected with other nasty tick transmitted diseases. According to Lyme Disease.Org, over 50% of patients with chronic Lyme had co-infections. Babesiosis and Bartonella were the most common ones, but there are several others and (frighteningly) they are still discovering new ones! Lyme Disease.Org publishes a list on the site at this address – https://www.lymedisease.org/lyme-basics/co-infections/about-co-infections/.
The degree of complexity and information about Lyme disease is so extensive, it’s challenging to write a simple article about it. The main takeaway point here is to be aware of Lyme disease and its seriousness. Know that the ticks that carry Lyme disease can be small and difficult to detect but are still just as dangerous. Individuals with Lyme disease are suffering with this illness every day, more needs to be done to eradicate this disease. Individuals who suffer from it should be treated with the same level of compassion as any other patient – not told they are “imagining it” or “crazy.” Lyme disease is REAL and it gets even more real when you have it! And it can happen to anyone who encounters a Lyme infected tick – even if you don’t inhabit a rural area. Lyme disease does occur in urban areas — it’s the most common tic borne illness in New York City, although the number of cases of Lyme deceased to 753 for the year 2018. Think about that, the next time you’re taking a walk in Central Park or anywhere else Lyme ticks could potentially be.