As we all take advantage of the sunny summer days, be aware it’s also tick season. And this summer could be particularly bad.
Dr. David Persse, Chief Medical Officer with the City of Houston, joined Health Reporter Haley Hernandez on KPRC 2+ at 7 to share everything we need to know about Lyme Disease, including if it’s spreading in Houston, how to spot the symptoms and more.
How many cases do you know of in our area?
This year the Houston Health Department has received reports of 3 Lyme Disease cases. The department typically reports 2 or 3 cases per year. In the last 14 years we’ve been fortunate to only have had 56 cases. We did have two atypical years: 6 cases in 2019 and 10 cases in 2013.
Most human cases occur in the northeastern and north-central regions of the United States during the spring and summer. The Lyme disease bacteria are transmitted by blacklegged ticks in the northeastern, mid-Atlantic and north-central United States, and the western blacklegged ticks on the Pacific Coast.
Is it possible that’s underreported?
The CDC has observed a huge difference in the annual total number of cases reported through monitor of cases, known as surveillance, and total number of cases documented in insurance claims data. Screening and surveillance usually reveal the tip of a disease burden iceberg. This could be improved by setting up an active surveillance, which is expensive and requires more funding in public health.
Active surveillance uses public health workers to regularly contact heath care providers or the population to seek information about health conditions. Active surveillance provides the most accurate and timely information.
In passive surveillance, a health department receives reports submitted from hospitals, clinics, public health units, or other sources. It’s a relatively inexpensive strategy to cover large areas, and it provides critical information for monitoring a community’s health. However, because passive surveillance depends on people in different institutions to provide data, data quality and timeliness are difficult to control.
What are the symptoms of Lyme?
Early symptoms may include an expanding red rash that begins at the site of a tick bite after about 7 days. The delay could be up to a month. Typically, it:
- Expands gradually over several days reaching up to 12 inches or more across
- May feel warm to the touch but is rarely itchy or painful
- Sometimes clears as it enlarges, resulting in a target or “bull’s-eye” appearance
- May appear on any area of the body
Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash.
Late symptoms are:
- Severe headaches and neck stiffness
- Additional rashes on other areas of the body
- Facial palsy (loss of muscle tone or droop on one or both sides of the face)
- Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
- Intermittent pain in tendons, muscles, joints, and bones
- Heart palpitations or an irregular heartbeat (Lyme carditis)
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
- Nerve pain
- Shooting pains, numbness, or tingling in the hands or feet
How can someone get tested to know if that have it?
People need to contact their doctor or medical home if they suspect they are infected. The doctor will evaluate the patient and consider:
- The signs and symptoms of Lyme disease
- The likelihood that the patient has been exposed to infected blacklegged ticks
- The possibility that other illnesses may cause similar symptoms
- Results of laboratory tests, when indicated.
There are important things to remember. The CDC recommends a two-step testing process. If the first test is negative, no additional test is needed. If the first test is positive or indeterminate, a second one should be performed. The overall result is positive only when the first test is positive (or unclear) and the second test is positive (or for some tests equivocal)
Most Lyme disease tests are designed to detect antibodies made by the body in response to infection. Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
Antibodies normally persist in the blood for months or even years after the infection is gone; therefore, the test cannot be used to determine cure. Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
There are OTC tests and a lab test at Lab Quest – is that recommended or does someone need to get tested through their doctor?
New tests may be developed as alternatives to one or both steps of the two-step process. Before CDC will recommend new tests, they must be cleared by the Food and Drug Administration (FDA). As always, the best thing to do is to consult with your doctor; he or she is the person that knows your medical history the best.