Lyme disease on the rise?

Every summer brings an increased threat of diseases spread by ticks, and other insects. As the mercury climbs and people spend more time outdoors, we are more exposed to bug bites and the illnesses they can bring. “The numbers on some of these diseases have gone to astronomical levels,” says Lyle Petersen, MD, director of the division of vector-borne diseases at the Centers for Disease Control and Prevention (CDC).

According to the latest CDC figures, the number of so-called vector-borne diseases transmitted by bug bites more than tripled between 2004 and 2016. Reported cases surged from 27,388 to nearly 100,000 annually for a total of 642,602 cases — and those numbers may be vastly under reported. (1)

Tick-borne Lyme disease (Lyme disease and anaplasmosis are the most common diseases spread by tick) , is a prime example: About 30,000 cases are reported each year, but the CDC estimates that the actual number could be 10 times greater. (2)

The surge in insect-borne diseases is driven by a combination of a number of factors, including the absence of effective vaccines to prevent, lack of the promotion of information for the public on how to protect themselves, and patients seeking qualified practitioners to diagnose and control. “A lot of trends are driving the upsurge, all of these things working together: climate change, humans interacting differently with our environment, and some of the things we do in our households,” says Heidi Brown, PhD, an expert in vector-borne disease transmission at the University of Arizona in Tucson. Furthermore, regarding changes in deer populations, which carry the tick that spreads Lyme, or the distribution of the pathogens, she says that “teasing these apart is a challenge.”

Hotter, wetter weather due to possible climate changes fuels the spread of infectious diseases like Lyme, dengue, West Nile, and Rocky Mountain spotted fever, as mosquitoes and ticks move into newly warmer habitats.

“As environmental conditions change, it is likely that certain diseases will occur in areas where they previously had not occurred,” says Dr.Petersen. “Climate is only one of several very important factors that influence the distribution and occurrence of vector-borne diseases.”

Urban sprawl is upending natural habitats for animals that carry these vectors, like deer or mice, as humans increasingly move into once heavily forested regions.

“We are creating the ideal living conditions for white-footed mice and other small mammals that are responsible for spreading infected ticks, and driving away predatory species, like foxes and owls, that feed on these small mammals,” says Dr. Richard Ostfeld, Phd. “As a result, Lyme disease is now found in places that it never occurred in recorded history.”

Improvements in surveillance and diagnosis have also contributed to the increase in reported cases of infectious diseases, even though much work remains to be done. “We’ve become much more adept at the molecular diagnostics that lead to pathogen discovery and securing a diagnosis faster,” says Dr. Paul Auwaerter, M.D.

However, the CDC believes that current surveillance data still substantially underestimates actual vector-borne disease occurrences. For example, “recent data from clinical and laboratory diagnoses estimate that Lyme disease infects approximately 300,000 Americans yearly, eight- to tenfold more than the number reported,” according to the CDC.

Part of the reason for the discrepancy is that people infected with these diseases who experience mild symptoms may not seek medical attention. Another factor is that many cases are misdiagnosed or simply never reported to the CDC in the National Notifiable Diseases Surveillance System. Some cases are clinically diagnosed based on symptoms and a history of possible exposure to ticks, but not verified with bloods tests.

“More than half of U.S. counties are now home to the blacklegged tick that spreads Lyme disease — double the number of counties in 1994.”

Does climate play a role?

More than half of U.S. counties are now home to the blacklegged tick that spreads Lyme disease — double the number of counties in 1994.The hardy ticks that spread Lyme-causing bacteria have taken up residence as far north as Canada.

Meanwhile, lone star ticks, southern natives that transmit diseases like tularemia and human granulocytic anaplasmosis, have been spotted as far north as Maine. (3)

Lyme disease is so closely linked to climate change that in 2014 the Environmental Protection Agency (EPA) added the disease to its list of indicators to track where the country is warming. (4)

So What’s Being Done?

Public health agencies face increasing demands as well as limitations in tackling the onslaught of vector-borne diseases. Budget cuts at the local and national levels have hit prevention campaigns, as well as the ability to detect outbreaks and swiftly respond as needed.

As part of this effort, however, four universities — the University of Florida, the University of Texas Medical Branch at Galveston, the University of Wisconsin in Madison, and Cornell University — were awarded $10 million each to establish regional centers that respond to vector-borne infections.

Congress established the Tick-Borne Disease Working Group to review federal efforts related to all tick-borne diseases and to better coordinate the federal response to outbreaks. Still, Auwaerter says, “Public health agencies are woefully underfunded, even though they have great potential for keeping us safe.”

Perhaps complicating matters further it that there is disagreement over the diagnosis and treatment of diseases like Lyme.

“Some physicians and infectious disease scientists don’t accept the term chronic Lyme disease, and the term now generally being used is post treatment Lyme disease syndrome for people who still show symptoms after a course of antibiotics,” says Ostfeld.

“There is some opposition to extended treatment with antibiotics, especially intravenous treatment, but the opposition is by no means universal,” he says. “Two professional groups, the Infectious Diseases Society of America and the International Lyme and Associated Diseases Society, are at odds over diagnostic and treatment guidelines.”

Are There Any Vaccines or Treatments?

Currently, there is no Lyme disease vaccine; a previously available vaccine was discontinued in 2002. Treatment can vary from oral antibiotics, antibiotic and/or nutritional I.V.'s , as well as, prescription medications and/or natural supplements. See your physician for their available treatment options.

How Can I Protect Myself?

Bug bites are a fact of life, and they usually do not lead to serious illness. However, preventing insect and tick bites is vital to stopping the spread of vector-borne diseases.

Here are some steps that you can take to protect yourself and your family. Treat clothing and gear with an insecticide. You can spray boots, pants, socks, and tent gear. Wear long-sleeved shirts and long pants. These give you an extra layer of protection. Ticks live in grassy wooded areas. They can also travel on animals, like deer, mice, or the family pet. Any time spent outdoors — whether it’s gardening, walking the dog, or camping — can bring you in contact with ticks. If you’re walking outdoors, avoid wooded and brush areas with high grasses and piles of leaves. Do a careful tick check when you come indoors. Check under the arms, around the ears, inside the belly button, between the legs, behind the knees, and in and around the hair on your head — all places where ticks like to hide. Tumble dry clothing on high heat for 10 minutes to kill any ticks. Shower within two hours of coming indoors.

If you spot a tick, be careful how you remove it. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. After removing the tick, place it in a ziplock baggy with a moist cotton ball. Thoroughly clean the bite area and your hands with rubbing alcohol or soap and water. Never crush a tick with your fingers. Testing: You can visit www.igenix.com, or www.tickreport.com to read more about where to send your ticks and how much it costs. Results typically come back within a few days to a week.

If you have been diagnosed with Lyme or may have been bitten by a tick consult with your preferred physician. If you have any questions and would like a consultation for testing, diagnosis and treatment. Please feel free to give Integrative Medical Associates a call or visit our website for more information on the practice.