Small Victories in Dutchess County, New York

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Editorial: Lyme disease needs research

May 30, 2008

Since the illness was discovered in 1975, Lyme disease has confounded the medical community and has posed a health risk to those who are active outdoors. That is particularly true in Dutchess County, which has among the highest incidence of Lyme disease in the nation. Clearly, more research is needed to halt the disease and to treat those infected.

Lyme disease is transmitted through deer ticks the size of a pinhead that live in long grass and in the woods. Most people are never even aware that they were bitten until the telltale bull's-eye rash appears around the center of the bite. But the bull's-eye rash often goes undetected. To make matters worse, the disease is often mistaken as a bad case of the flu. Lyme disease symptoms include fever, chills, headaches, neck stiffness, fatigue, muscle aches and joint pain.

No one is immune to the disease, as U.S. Sen. Charles Schumer, D-N.Y. learned last year when he needed treatment to prevent infection after a tick bite while on a trip to the mid-Hudson Valley to survey flood damage. As a U.S. senator, Schumer has access to great medical care. Many residents don't and have been given conflicting information about Lyme disease. But patients who maintain they have suffered long-term problems from the disease recently got a much sought-out concession from a national doctors group. The Infectious Diseases Society of America said it will review its guidelines that question whether people can suffer long-term effects from Lyme. It will re-evaluate the view that no evidence shows long-term antibiotics can cure chronic cases — if chronic cases do indeed exist. The society cautions that while short-term antibiotics generally are effective, long-term antibiotics are not and are potentially dangerous.

Take precautions before stepping outside

The agreement, the result of an antitrust investigation by Connecticut's attorney general, calls for the doctors group to form a panel of experts to review standards for treating Lyme disease. Lyme disease is named after the Connecticut town of Lyme, where the illness was first discovered.

With the warmer temperatures leading to more activities outdoors, people should be aware of the preventive steps to avoid contracting the disease. Wearing a long-sleeved shirt and long pants tucked into socks might look funny in the summer, but it's better than being infected with Lyme disease. Wearing lighter colored clothes also makes it easier to see ticks trying to hitch a ride.

People should check themselves, and their children and pets, after being outdoors. While people have to accept responsibility here, the medical community also must press forward with the best treatment options for those infected with Lyme.

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Tick tests to expand statewide

Dutchess, Ulster lead in Lyme cases

By Cara Matthews • Journal Albany bureau • May 29, 2008

ALBANY - As the tick population spreads north and west of its traditional Hudson Valley hub, the state Health Department is expanding testing for them to all counties in New York, Commissioner Richard Daines said Wednesday.

Until now, the Health Department has collected specimens from 12 counties throughout the Hudson Valley and Albany area and tested them for three pathogens, including Lyme disease.

Monitoring ticks across New York means the state can provide local health departments, physicians and the public with more information, said Daines, a physician.

Preparedness urged

"Every county has got to be on their toes about it," said the commissioner, who toured the state tick lab at Hudson Valley Community College in Troy Wednesday.

Already part of the program are Dutchess, Putnam, Orange and Ulster counties.

Over the last 10 years, the tick population has gradually spread northward on the east side of the Hudson River and north and west across the Hudson, Daines said.

"Our main goal is trying to figure out areas of risk," he said.

Lyme disease is a bacterial infection caused by the bite of an infected deer tick. It can cause symptoms affecting the skin, nervous system, heart and/or joints. Not all deer ticks are infected. Just four of the more than 30 tick species found in the state can create tick-borne illness.

Counties with more than 300 cases in 2007 include Dutchess and Ulster. Dutchess has had the most number of cases by far - peaking at 1,525 in 2002.

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Tick talk: Be aware of these little, disease-carrying critters

By Ralph Ferrusi • Hiking columnist • May 29, 2008

Laurie Potteiger's "Tick Season on the A.T." (May-June 2008 AT Journeys) caught my eye. Its right-on premise, that northbound AT thru-hikers "may be especially vulnerable to Lyme disease," is something I have long been aware of. I spoke at length with Laurie, and she asked me to send her my thoughts. Here's some of them:

I've maintained a 1 1/2-mile section of the AT on Stormville Mountain for 18 years. From May to October, it's Deer (more correctly, "Blacklegged") Tick Heaven, where frequent unpleasant encounters are inevitable: I've had Lyme disease twice, and been treated for it (sometimes unnecessarily) a few more times.

Years ago, a Lyme disease authority told me the only time the Lyme spirochetes could enter your body was when an attached tick regurgitated into you to detach itself. I've preached this for years. I called Dr. Richard Ostfeld at the Cary Institute of Ecosystem Studies in Millbrook and asked if this still held true. He said: "Almost."

Here's the gory story, circa 2008: Lyme spirochetes live, and replicate, in a tick's midgut. When an infected tick attaches to a host, blood moves into the midgut, activating the spirochetes. They enter the tick's circulatory system, eventually reaching the tick's salivary glands and passing into the host. This process requires 36-48 hours. The sooner you detect a tick, and remove it, the better.

Mid-May to mid-July is the worst time of year for ticks. The tiny, early-season nymphs ("poppy seeds with legs") are feeding, and are especially hard to spot. Adult ticks, especially when engorged, are much easier to spot. They do not fly, or jump on you; they hitch a ride when you brush against foliage. They survive the winter in the deep forest-floor leaf cover. The leaf-covered trails of early summer can be a real danger zone. They can become active even in mid-winter, if temperatures rise above 40 degrees.

I do daily full-body, head-to-toe, double-mirror tick checks from mid-April to mid-November - in and behind my ears, between my toes, etc. Every summer, I buzz my hair down to about a sixteenth of an inch, to make it easier to spot ticks. When I find a tick attached to me, I remove it (fine-tipped tweezers are recommended) and drop it into a small Tupperware container full of alcohol (and dead ticks), and watch it frantically swim for a second or two, then sink to the bottom.

I often wear high gaiters on longer summer hikes, and spray them with Deep Woods OFF!. Laurie mentioned permethrin: applied to clothing, it kills ticks on contact. Do NOT apply it to your skin! It's available as Ultrathon, or Bens, at local outfitters. When I do wear long pants during tick season I tuck them into my socks, dorky as this looks. Tuck your shirt into your pants; this may keep ticks from taking residence in your midsection.

When I backpack in tick season, I bring a miniature 30X Micronta microscope and a roll of Scotch Tape. Stick a suspected tick to the tape; the Micronta magnifies it for a very positive ID.

When walking behind other hikers, make it a habit to check the backs of their legs, arms, and necks for ticks.

Post edited by: savvy, at: 06/01/2008 19:51

Denise