This summer could be the worst ever for Lyme disease. Experts predict as much as a 20 percent jump in new cases compared with last summer, when there were an estimated 300,000 infections in the U.S. "We've never seen anything like it before," says Lyme expert Richard Ostfeld. Why? A small acorn crop last fall caused up to an 80 percent decline in the mouse population, which is the preferred blood source of the parasites – deer ticks – that spread Lyme disease. Since there were plenty of mice last year, there were also plenty of deer ticks. But a lot fewer mice this summer means that all those ticks will need a new host. That host will be you.
The name "deer tick" is misleading, as the nymphal tick that carries Lyme is mostly hosted by mice – and by pet dogs and cats – though deer and birds can carry it, too. Deer ticks are the size of poppy seeds and much smaller than wood ticks – the kind big enough that you can easily find them and pick them off your dog. You can get Lyme in any state, although it's more prevalent in the Northeast and Midwest. While the disease is usually curable if you take antibiotics within a few weeks of infection, late-stage Lyme can cause severe fatigue, joint pain, and heart problems. There is still no accurate way to test for Lyme, especially in its early stages. For 20 years, doctors have used a two-step blood test, but experts now say it doesn't catch the disease in everyone, pointing to a Johns Hopkins study that found the test failed to detect Lyme in up to 55 percent of early-stage patients. "The standard two-step test is very insensitive in diagnosing the early disease," says Dr. Benjamin Luft, an infectious disease doctor in New York. "Unfortunately, the earlier the disease is diagnosed, the easier it is treated."
Symptoms of Lyme are also subtler than commonly believed. Most people associate Lyme with a sore knee or a bull's-eye rash, but researchers say early-stage Lyme is more likely to manifest as a mild flulike illness accompanied by a stiff neck, a headache, or a rash so pale or oddly positioned that it's barely noticeable. "The symptoms of Lyme disease are highly variable and diverse and, to a large extent, not specific to the disease," says Luft. This, combined with the lack of a surefire test, has caused many people to slip through the cracks and into the later stages of the disease.
So how do you know if you have Lyme? Anyone with flulike symptoms in the summer or fall should suspect Lyme, especially if you live in or have visited an endemic area. "If your symptoms last more than 10 days, you have to consider the possibility that it's more than a transient virus or cold," says Lyme specialist Dr. Brian Fallon. Don't wait for a rash or rely on early testing. Instead, find a doctor who will prescribe antibiotics without a positive blood test, says Luft. "The earlier you treat, the likelier it is you'll be cured." Ask your doc to also test for babesiosis and anaplasmosis, two other tick-borne illnesses.
If you're diagnosed late, most experts say to take antibiotics for one to two months. And if you still have symptoms after treatment, find an autoimmune or neurological disease specialist. You could have something like walking pneumonia, a thyroid problem, or anemia. But "if there's no other explanation, your physician should consider the real possibility that you're still infected [with Lyme] and seek another course of antibiotic treatment," says Luft.
There is a small ray of hope in treating the disease, however: the possibility of a vaccine against deer ticks, which is "under development but probably years away from marketing," says Ostfeld. While there's already a vaccine for use in dogs, a similar inoculation developed for people in the late 1990s ended in patients with adverse side effects and a subsequent lawsuit.
How to Prevent Lyme Disease
1. Don't sit in the grass. Or lean against trees or fences. Though it's more difficult for ticks to attach when you're moving, try to walk, run, and bike in the middle of trails.
2. Cover all exposed areas. If you venture into the woods or do lawn work in a high-risk area, wear a long-sleeved shirt, and tuck your pants into your socks. Spray exposed skin with deet of at least a 20 percent concentration – research shows deet can be harmful to your health and the environment, but scientists say the risks of Lyme outweigh the possible harm. Treat clothing with permethrin (an insect repellent). Also spray your shoes with it – a treatment lasts up to one month and repels up to 90 percent of ticks.
3. Do tick checks. After a prolonged time outside in a high-risk area, throw your clothes in a dryer at high heat. Feel your entire body for unusual bumps that could be ticks. Take a shower, and wash your hair. Do a tick check again in three days, as they can remain attached.
4. Tweeze carefully. If you find a tick, remove it with tweezers as close to the skin as possible by pulling firmly without squeezing its body. Save it in a jar with a blade of grass to keep it alive for testing. Disinfect the bite with alcohol. See a doctor. (We're not overreacting, as most ticks carry infections.)
5. Protect your pets. Use Frontline on your dog, and talk to your vet about a vaccine against deer ticks. (There is no vaccine for cats.) Keep pets off furniture, and vacuum frequently.