Lyme disease may linger even with treatment
Here's a terrifying concept: the battle against Lyme disease isn't progressing.
In fact, the ticks are winning, reporter Mary Beth Pfeiffer warned Monday in Scientific American.
The tick-borne disease that many denied was a factor in Western Pennsylvania throughout the 1990s is routinely diagnosed in doctor's offices, urgent care centers and emergency rooms. The PA Lyme Resources Network, which tracks the numbers in Pennsylvania, found that Lyme disease diagnoses have increased 25 percent a year over the last four years.
“Lyme treatment guidelines, which have set the standard for care in the U.S., Europe and Canada, minimize the lingering symptoms of treated Lyme disease,” wrote Pfeiffer, the author of “Lyme: The First Epidemic of Climate Change.”
The bacterium Borrelia burgdorferi, which lodges in blacklegged — or deer — ticks, causes the disease, which is transmitted to humans through tick bites. Typical symptoms include a bull's-eye skin rash, fever, headache and fatigue. Doctors have long acknowledged that, left untreated, the disease can spread to joints, the heart and the nervous system.
Last month, a national lawn care service ranked Pittsburgh ninth in the nation among cities most bothered by ticks. For the last six years, Pennsylvania has led the country with the most new cases of Lyme — more than 12,000 residents contracted the disease in 2016, according to the PA Lyme Resources Network.
While early treatment is key to attacking Lyme, Pfeiffer said it's time to acknowledge what studies suggest: even those who are diagnosed and treated promptly can continue to suffer longterm symptoms, including pain, fatigue and neurological difficulties.
Dr. Amesh Adalja, a Pittsburgh-based infectious disease specialist and senior scholar at the Johns Hopkins University Center for Health Security, said the dispute over the longterm effects of Lyme disease — whether it was a lingering infection or a post-infectious disease syndrome — was a controversial subject.
For years, Adalja said progress was stymied by what he called a cottage industry that tried to sell people suffering with long-term symptoms on costly, untested and sometimes dangerous treatments.
“Today there is a growing understanding there are some who are infected with Lyme disease and have adequate treatment but have some lingering symptoms. There have been efforts to study these patients and understand what it is about them that causes them to have persistent lingering symptoms. Studies have shown some differences genetically in the immune systems of folks who do have these symptoms,” he said.
So far, there are no simple cures for those whose symptoms stretch out over years.
“But we do know that those symptoms dissipate over time and are less destructive,” Adalja said.
The real answer, he said, lies in the development of a vaccine. Although a vaccine was developed and used widely between 1999 and 2002, it was later pulled from the market at the height of the anti-vaccine movement.
The search for answers grows more pressing as the tick, now found all over Pennsylvania, expands its reach across the country. Even now, scientists acknowledge that the affliction is underreported and that as many as 3 million Americans may have been infected over the last 10 years.
Gov. Tom Wolf has set aside $2.3 million in his 2018-19 budget to fund efforts for education and prevention on Lyme disease. Pennsylvania Department of Health spokesmsan Nate Wardle said if the money is approved during the budget process, the department will use it to foster a greater awareness of Lyme disease among the public and medical professionals.
Given the sometimes devastating impact of the disease, prevention undoubtedly is the best strategy for those out and about in the woods, wilds and backyards in Pennsylvania.
Meanwhile, the U.S. Centers for Disease Control recommends people heading outdoors wear repellent, check for ticks daily, shower soon after being outdoors and contact a doctor if a fever or rash develops.
Debra Erdley is a Tribune-Review staff writer. Reach her at 412-320-7996 or [email protected] or via Twitter @deberdley_trib.