As the summer months warm up, anticipate more ticks appearing on your skin. By now, you might have an anti-tick routine: Wearing long sleeves and tucking your pants into your socks. Applying a repellent. Checking for ticks after being outside. Removing them immediately if you find them. Clearing tall grass in your yard, where ticks are protected.
But just 15 years or so ago, ticks — and accompanying Lyme disease — were relatively rare. In 2001, there were only 8.4 cases of Lyme disease reported per 100,000 people, according to the Maine Center for Disease Control and Prevention.
By 2012, the rate increased about 10-fold, to 83.6 per 100,000 people. And 2013 set a record: 103.6 cases per 100,000 residents.
Though 1,376 confirmed and probable cases of Lyme were recorded in 2013, the actual number is likely much higher. In addition to increasing in number, cases of Lyme disease — caused by a bacteria spread by an infected tick’s bite — have emerged in every county. What started as a problem isolated in southern coastal Maine moved north.
Why exactly are ticks proliferating? How can doctors better catch and treat Lyme disease, which can result in a rash, fever, headache, muscle and joint pain, and fatigue — and affect the nervous system, joints or heart long-term?
After all, it’s a difficult disease to diagnose accurately. And how should Maine prepare for far-reaching effects of ticks, such as the harm caused to moose? How will ticks affect tourism and health care?
As the second most common reportable infectious disease in Maine, it is worrisome, to say the least, that the state knows so little about Lyme.
Sure, it’s important to talk about prevention. But more and more people know about precautionary steps, and still more and more are getting the disease. What is Maine — and the country — going to do about it?
There have been some short-term, local fixes. Islesboro residents had a special deer hunt on their island in 2012 to reduce the number of Lyme cases, for instance. And universities and research centers are doing important analysis work.
But the problem is regional, if not national, and the subject deserves a proportionate amount of attention from prominent, long-term, better-funded studies.
For Dora Anne Mills, former director of the Maine CDC and vice president for clinical affairs at the University of New England, the explosion of Lyme disease in Maine is reminiscent of the autism epidemic.
Anecdotally, public health officials heard accounts of more and more instances of autism, to the point where data about the causes, diagnosis and best response were no longer useful, and much more research was needed.
With Lyme, “I think we need a major initiative,” she said. Too many people are being harmed, and too many questions remain unanswered.
What are the specific reasons ticks are multiplying? There is some indication that the increase correlates with changing temperatures. Also, where there was once farmland, Maine now has often fragmented forest — perfect tick hideout.
Ticks like moisture — making the state’s more populated coast and riverbanks a preferred tick habitat. But what is really causing the spread of ticks, and can states curb their growth?
How can doctors better diagnose Lyme? When symptoms don’t show up until weeks after a tick bite, and ordinary lab tests often result in false-positive and false-negative findings, it can be difficult to catch.
How can doctors better treat Lyme?
“The current treatment regimen, anecdotally, is not working for a lot of people,” Mills said. “The federal government needs to more fully research the prevention strategies, diagnosis and treatment for Lyme disease.”
Happy Dickey, a registered nurse, and president and founding member of the nonprofit Maine Lyme, agrees. She also worries about the other illnesses transmitted by ticks such as Powassan virus, B. miyamotoi bacteria, anaplasmosis and babesiosis.
Lyme disease may not transmit to a human quickly — the CDC says ticks have to attach to a body for more than 24 hours — but the others can. They are far less prevalent, but they can be fatal, and much more could be known about how to test for and treat them.
So, yes, protect yourself against ticks. Apply a repellent with the right percentage of DEET or picaridin (go to http://bit.ly/pestrepellent to learn how long certain insect repellents last and whether they protect against ticks); and check yourself when you return inside.
But don’t think that the new routine is normal or acceptable. Demand more answers about how to actually fight this public health hazard.