Dealing with Lyme Disease New tick-borne diseases creeping into Maine

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Ticks are slowly moving northward up the coast and river valleys in Maine and the dangers of their bites are growing.

Last year about 100 people in Maine, the most ever, were diagnosed with Lyme disease, which is transmitted to humans by deer ticks, according to Maine’s Bureau of Health. On top of that, countless others received preventative antibiotic treatments without complete diagnoses after being bitten by ticks. Still other cases simply went unreported.

But beyond Lyme, ticks are transmitting diseases that are new to Maine. Late last year, state epidemiologists confirmed in York County the first case of babesiosis, a parasitic disease with such symptoms as fever, headache and fatigue.

In 2000, Maine’s first case of human granulocytic ehrlichiosis was diagnosed in Franklin County and then a second case was diagnosed last year in York County. HGE is an infection from a bacterium, causing fever, chills, headache and muscular pain. As many as half of those contracting HGE require hospitalization and about 1 to 5 percent die, according to the Centers for Disease Control and Prevention in Atlanta.

And then there was the troubling news last year that since 2000, three Mainers have been infected with the Powassan encephalitis, a dangerous relative of West Nile Virus. The arbovirus is transmitted by the common woodchuck tick and is fatal in 10 to 15 percent of human cases diagnosed, according to the CDC.

“People need to be believers that they can get [these] diseases in a number of settings,” said Geoff Beckett, a state epidemiologist. He said the woodchuck tick, for instance, is found on small animals that hide under piles of junk metal, slash or other refuse in a yard. Deer ticks, which can carry the more common Lyme disease, are more often located in woodlands and places with high grass.

Beckett said that while people should take the risks from tick bites seriously, they should also maintain perspective on the problems.

“The fact of the matter is [Lyme disease] is not exploding all over the state,” Beckett said. And when Lyme disease is treated early – shortly after a rash or tick bite is discovered – antibiotics are effective in preventing serious and recurring problems, he said.

But prevention is a good idea.

“What I would say is, practice tick hygiene,” Beckett said. “You need to think about ticks and potential infection.”

That means tucking pants into socks when going through high grass, wearing an appropriate tick repellent, wearing light-colored pants so the small ticks can be spotted, and checking for ticks on the body at the end of the day.

An FDA approved vaccine had been on the market since 1998. But LYMErix was withdrawn from the market last month by drug maker GlaxoSmithKline. Though the company cited poor sales, some who had taken the vaccine had filed lawsuits seeking new government restrictions because they said they were sickened by the vaccine.

Those who have contracted Lyme disease in Maine say no one should take the risk of getting the disease lightly because if they do become infected but don’t get quick antibiotic treatment, long-term consequences will change their lives.

Take Constance “Happy” Dickey, 50, of Hampden. After a visit to Lamoine near Mount Desert Island in 1994, Dickey’s energy level began to drop. Then a nurse at Eastern Maine Medical Center, Dickey’s gait also became abnormal.

Doctors diagnosed her as having chronic fatigue syndrome and fibromyalgiam, whose symptoms are chronic pains in muscles and soft tissues surrounding joints. Despite treatment, Dickey’s problems continued. At the worst time, she estimates, her energy dropped to about 20 percent of normal. Even though she was surrounded by doctors at work and had access to specialists, none diagnosed Lyme disease.

“All of this time no one had an explanation or even offered to send me anywhere,” she said.

By 1997, Dickey’s problems had become so severe that she had to give up emergency room nursing for a more sedentary nursing position. In 1999, she had to give up a career that had spanned 25 years.

At about the same time, the wife and mother of two said she decided to do more than trust the information provided by her doctors who had dismissed the possibility of Lyme disease. After some research, she said she discovered her symptoms were similar to those described for Lyme.

“I made up my mind to go to Boston,” she said. There, at Boston University Medical Center in 1999, she was diagnosed with Lyme disease.

“The fatigue of Lyme disease is so profound, it’s what you would imagine a cancer patient on chemotherapy feels like,” she said.

Now she is at about 65 percent of her normal energy and she’s taken long-term antibiotic treatment with the guidance of her doctor in Bangor. She has also become a resource for others with Lyme disease, and serves as co-facilitator of the Lyme Support Group at EMMC, which meets the second Monday of every month. About 30 people are members, but only six or seven typically summon the energy to make a monthly meeting, she said. Dickey encourages people interested in the group to call her at home at 862-2444.

Ticks Moving North

James Dill, an entomologist and pest management specialist at the University of Maine, remembers that 20 years ago ticks were rarer in Maine. He remembers growing up in Gardiner and never having heard of a tick on a dog or a cat.

“From a historic standpoint they’ve really moved northward,” he said.

In fact, 10 years ago ticks were virtually unknown in northern Maine, said Charlene Donahue, a state entomologist.

Scientists are studying how the ticks are migrating, and they say it’s no surprise the ticks are moving primarily up the coast and major watersheds like the Androscoggin, Kennebec and Penobscot rivers.

“Ticks are animals that like to stay moist,” said Dr. Peter Rand, a researcher with Maine Medical Center Research Institute’s Lyme Disease Research Laboratory in Portland. And ticks move on birds that chase insects up rivers as they migrate, he added.

Tick populations decrease rapidly just four or five miles in from the coast, he said.

Rand said this year’s work in Maine is focused on understanding tick habitat and host populations. A better understanding of that will make it easier to identify potential risk areas, he said.

Precautions to avoid tick bites:

? Tuck your pant legs into your socks and your shirt into your pants when walking in woods, brush or tall grass. Deer ticks attach to clothing and then crawl upward.

? Wear light-colored clothing so ticks may be seen more easily.

? Use a repellent containing DEET according to label directions, particularly on shoes, socks and pant legs. Avoid applying high-concentrafion products to the skin, especially on children.

? People who must be in areas where ticks are prevalent may pretreat protective clothing with a permethrin-containing product, which both repels and kills ticks. Caution: This is not for use on skin; use only as directed on the label.

? To protect pets, consult your veterinarian about tick repellents, acaricides or, in high-risk areas, the Lyrne vaccine for dogs.

? Inspect yourself, your clothing, your children, your companion, and your pets for ticks when you get in from the field. Ticks often attach at body folds, behind the ears and in the hair. If possible, shower and wash clothes immediately. Heat drying is effecfive in killing

ticks.

? Mowing grass and cutting brush in yards may reduce tick habitats in problem areas.

? When transporting pets or game,

precautions should be taken to avoid bringing ticks to new areas.

Source: Maine Lyme Disease Task Force