My family enjoyed many summers in north-central New Hampshire.
The evening routine included body inspections on us kids for the presence of ticks. The family dog was scrutinized as well – ticks swollen to the size of small grapes were most ugly. The little we knew about ticks was that they were bad.
There were no moose in New Hampshire back then or for the previous half-century – having been hunted out. In the last 30 years, the moose are back, but apparently their population has dropped in the last several years. Our neighbors on Lake Umbagog, Maine, found a moose dead near their cabin, covered with thousands of ticks. Ticks are blamed for the recent moose mortality.
Ticks are more than a problem for just moose – they carry diseases for humans. In Colorado, where the Rocky Mountain wood tick and the American dog tick predominate, the partial list includes:
Tick fever, with flu-like symptoms, lasting one to three days. There are about 200 cases per year.
Borreliosis, including a fever for seven to 10 days, is considered very rare.
Rocky Mountain spotted fever produces a petechial (spotty) rash. It’s rare but 5 percent fatal.
Tick paralysis includes weakness of extremities and breathing and numbness. This also is rare. Symptoms typically disappear with tick removal.
Lyme disease is the number one tick-borne affliction in the United States. It was first recognized in the U.S. in 1975 amid a perplexing outbreak of juvenile rheumatoid arthritis, epicenter near Lyme, Conn. The bacterium, whose cousin causes syphilis, was identified in 1982. The cluster of headache, fatigue, joint and muscle pain and fever may follow a characteristic rash, known as erythema migrans. It is a red, annular (somewhat circular) rash that grows wider (with central clearing) and is so characteristic that diagnosis is certain. Without the rash, diagnosis is difficult, but if there is any suspicion of Lyme disease, confirmation is now possible with sequential blood serum tests.
Lyme disease is not fatal, although severely sick people might wish it were. Untreated, it often progresses to arthritis, central nervous system affliction, including meningitis, and heart problems. I know several people, even with antibiotic treatment, who were not 100 percent recovered after a year. The persistence of symptoms has been labeled “chronic Lyme disease,” and that label became the source of huge controversy – the Lyme Wars, beginning in 2006 when Connecticut Attorney General Richard Blumenthal brought anti-trust action against two groups.
The Infectious Diseases Society of America and the International Lyme and Associated Diseases Society of America endorsed differing medical practice guidelines. IDSA advocated antibiotic treatment for three to four weeks. ILADS recommended higher doses and treatment as long as six months. Health-care insurers lined up with IDSA, denying payment for longer treatment – also saving them money. Outrage followed. Lawsuits followed. Research found no additional benefit and more complications from longer treatment. Apparently, some people require more time to get better.
There is little good news in the media, but here’s some: From 2002 to 2011 the incidence of Lyme disease in Colorado was zero.
www.alanfraserhouston.com. Dr. Fraser Houston is a retired emergency-room physician who worked at area hospitals after moving to Southwest Colorado from New Hampshire in 1990.
