The Battle Against Lyme Disease Continues In Connecticut

By Jan Howard

Lyme disease is epidemic in Connecticut, and considered a major health problem. It is the most common vector-borne disease in the United States.

There are no vaccines available to provide immunity to Lyme disease or other tick-borne illnesses, such as ehrlichiosis and babesiosis. However, tick-borne infections usually respond well to treatment, particularly when diagnosed early, accurately, and treated promptly. Antibiotics are very effective in its treatment. Six weeks of antibiotic treatment are usually recommended.

“It’s an important issue, and it’s not going to go away,” Newtown Director of Health Donna McCarthy said recently. “People are going to get Lyme disease.”

However, she said, personal protection practices and property management to control ticks can be helpful in preventing tick bites and risk of disease.

Brochures about Lyme disease, personal protection, and property management are available at the Newtown District Department of Health at Canaan House on the Fairfield Hills campus.

Ms McCarthy said she is currently contacting local landscapers to give out brochures about Lyme disease and property management to homeowners. Brochures are also distributed at meets she attends and through the schools.

She said more emphasis has been given to the West Nile virus than to Lyme disease because people have died as a result of West Nile.

“The risk is more passive with West Nile,” she said. “An unsuspecting person bit by a mosquito can get West Nile. You have to do something to expose yourself to Lyme disease.”

Lyme can be very serious, she said, and she urges residents to learn what they can about it. “Look at potential exposures and take precautions,” she advises.

The good news, she said, is that people are doing tick checks. More and more ticks are being submitted to the Health District, she said. Of the ones turned in, about 22 to 25 percent are positive for Lyme disease.

If the ticks are not engorged, people will not be infected, she said. If they are not engorged, it means that people are getting them off quicker.

Ms McCarthy said Lyme disease is underreported. Mandatory reporting by laboratories was previously required as part of a program of the Center for Disease Control and the Department of Health in support of a Lyme vaccine. When the program ended, the requirement for labs to report cases of Lyme disease also ended.

Doctors are required to report the diagnosis of Lyme disease, and Ms McCarthy said she has receive more physician reports since the lab reporting requirement ended.

Ms McCarthy said requiring mandatory reporting by labs came up during a public hearing sponsored by Attorney General Richard Blumenthal in January. She believes that he will try to champion the cause.

She said people are more aware of Lyme disease from media stories and medical journals. She said Dr Thomas Draper, the Health District’s medical advisor, is working with a task force at Danbury Hospital to provide information about the disease for doctors and their patients.

Ms McCarthy knows all about Lyme disease, having had it three times and has undergone the six weeks of antibiotic treatment.

“I was lucky the first time,” she said. “I had a rash, the classic bull’s-eye. I felt horrible and could barely walk.” She also had severe headaches and stiffness in the neck.

The other times she was aware of the symptoms and what they meant.

Ms McCarthy knows that Lyme disease is sometimes difficult to diagnose. She also knows how frustrated people get when they are ill and are not successful in obtaining treatment.

“You have to be persistent with your doctor or get another doctor,” she said. “Don’t give up.”

She explained that some people suffer from long-term effects from chronic Lyme disease, which is difficult to treat. She emphasized that raising awareness about Lyme and other tick-borne diseases, taking protective measures, and, if bitten, having diagnosis and treatment early are key to defeating chronic Lyme.

Having a good relationship with your doctor is very important, she said.

She said Lyme disease is underdiagnosed. “I want to think that is decreasing because doctors are more aware of the disease,” she said. “It’s a bigger problem than what they thought it was.”

 

A Personal Experience

Dominick Posca, buildings and grounds supervisor for Newtown schools, knows first-hand the effects of Lyme disease. This has led to his enthusiastic support for tick prevention programs at the schools and local parks.

Mr Posca first experienced symptoms in 1986. He said he was not feeling well and felt dizzy all the time. After a month, he went to the doctor, but the symptoms persisted for seven to eight months. He had no rash, and three blood tests came back negative.

Knowledge about Lyme disease was in the early stages in 1986. “Today, we’re really educated on it. We’re more aware today,” he said. “I don’t want to see anybody get it.”

His symptoms, he said, were varied. “I had nausea. I felt like my equilibrium was off, that it was an inner ear problem.” He also suffered from light sensitivity.

“The fatigue was the worse thing,” he said. “I couldn’t make it past 10:30 or 11 am. I was not myself.

“I got to a point where I thought, is this every going to leave me? Will I be able to function?”

His work at the schools was affected, he said. “I worked, but for seven or eight months my performance was not there.” He said his wife of 40 years, Velva, and his two sons were very supportive and concerned throughout his long ordeal as well as former Superintendent of Schools John Reed.

“They were right behind me,” he said.

Mr Posca credits his primary physician, Dr Robert Winech of Bethel, for the successful treatment he received. “He’s the one who led me to places to go,” he said. “You have to have faith in your doctor.”

Lyme disease finally was diagnosed through a spinal tap by a neurologist. For a period of seven or eight months, Mr Posca went to Danbury Hospital every day for intravenous treatments. “I felt like a pin cushion,” he said. He required intravenous treatment for so long that his veins began to collapse.

Following that treatment phase, a permanent IV was inserted that treated him with an antibiotic 24 hours a day for 48 days. Following that, after a consultation at Yale, he was treated with an oral medication for a year.

His symptoms were confined mostly to his upper extremities, Mr Posca said.

“To this day, I have some relapse from it,” he said. These flashbacks can last a week to ten days, he added. “I was told I had Lyme disease of the brain. I fought it, and I’m here today.

“That’s why I do so much at the schools so the kids won’t get it,” he said. Spraying, woodchip barriers between woods and playgrounds, and bait boxes are all part of the campaign to reduce the incidence of Lyme disease among Newtown school children.

Mr Posca said he has to keep a positive attitude. He suffers from periodic arthritic pain in the back of his neck but takes medication to relax the muscles. Another periodic problem is fatigue. “If I get tired, I just stop. I have it every now and then.”

Because of his experience and knowledge and the work he does, Mr Posca checks himself daily for ticks. He praised Newtown’s Lyme Disease Task Force for doing a “fantastic job” in educating the community about Lyme disease.

Lyme disease was first recognized in Lyme in 1977. During 2002, 4,631 cases were identified by the Connecticut Department of Public Health.

Infection is caused by the spirochete bacterium Borrelia burgdorferi and is transmitted by the bite of the black-legged or deer tick. Most cases occur in the late spring and early summer when the nymphal stage of the tick is active. Nymphal ticks are the primary source for transmitting the bacteria and because they are so tiny (less than 2mm) they go unnoticed and are not removed.

The highest incidence of Lyme disease in Connecticut is in young children, as their play activities often place them at risk. Certain occupational and recreational activities increase the risk in adults as well.

The infection can cause a characteristic rash, called erytheme migrans (EM0) within three to 21 days of a tick bite. The painless rash gradually expands, often measuring five centimeters or more in diameter, and disappears without treatment. The presence of an EM rash larger than a quarter in diameter usually confirms a diagnosis of Lyme disease. Other common symptoms are flulike, including fatigue, muscle and joint pain, low-grade fever, headache, chills, and stiff neck.