Monday, June 13, 2005

Ticked off about Lyme disease

Marilyn Linton / London Free Press
London, Ontario Canada
2005-06-13 02:03:53

The story of Keith Poullos sounds like one of those medical mystery scripts you'd see on TV. Doctors work through medical mazes trying to identify whatever it is that, with minutes left in the show, is threatening to kill the patient.

In Poullos's case, the cause of his symptoms (fatigue, brain fog, body pain, numbness and stuttering, to name a few) was so elusive that it looked like he might have anything from multiple sclerosis to depression, from fibromyalgia to Alzheimer's.

Instead, the cause was a tiny deer tick and the final diagnosis was Lyme disease. Poullos, who lives just northwest of Toronto and works as a small engines mechanic, feels the disease has been upstaged by West Nile virus and that doctors forget it.

"My doctor knew nothing about it and didn't think it was a problem here," he told me. "They all think it's an American problem. The doctors are just not educated on this in this country." After no help at all from the medical community, Poullos was advised by a veterinarian to pressure his doctors to consider Lyme disease. He's now on antibiotics and feeling much better than a few months ago.

Lyme disease is the most often reported tick-borne illness in the U.S. The ugly little ticks, about the size of sesame seeds, attach to the skin. Infection is transferred if the ticks are also infected by a bacteria called Borrelia burgdorferi and remain on the skin feeding on your blood for 36 to 48 hours.

The classic tick bite sign is a bull's-eye type rash developing around the bite between three and 32 days later. Flu-like symptoms, fatigue, chills, fever, headache, a stiff neck and general malaise accompany the illness. But although a course of antibiotics can cure it, patients who've had it say that too few doctors diagnose it in the first place.

That may be because the test available to confirm the diagnosis (called an ELISA test) is unreliable, and a second more reliable test (called the Western blot) is used only if you test positive with ELISA, says British Columbia's Jim Wilson, a Lyme disease patient and president of the Canadian Lyme Disease Foundation (www.canlyme.com). He sazys the more sensitive Western blot should be used more often.

"A survey of 516 labs showed that they all failed to detect Lyme disease using the ELISA method," he says.

He also criticizes Canada for doing a dismal job of tracking the disease.

"In the U.S., they have a surveillance system and wherever they look they find it. The doctors also look for it. Here, doctors say, 'Don't be silly. Your symptoms aren't Lyme disease -- it's too rare.' That same patient goes across the border to a doctor and the doctor will diagnose Lyme. Here it's not even on the radar."

He says that while Canada's "medical machine continues to deny the true prevalence of this disease, more and more evidence is mounting that it may be a pandemic."

If indeed it is an enormous public health issue, we're sure to hear about it soon. But even if it isn't, more of us need to be aware of the long-term danger of the disease. Recent Finnish research indicates that nearly a third of people with Lyme disease show no immediate symptoms. Instead, the bacteria multiplies within the body -- hiding sneakily from the immune system -- and eventually wreaks havoc on the body's defences.

To prevent it, use insect repellents containing DEET and cover up with long pants and long-sleeved shirts. Even if ticks do find you, infection is unlikely to occur before 36 hours of tick attachment, so it's important to check for them daily, remove any you find with fine-tipped tweezers, then cleanse the area with an antiseptic.

Ticks prefer moist, shady places with low-lying vegetation, overgrown grass or leaf litter. They can't jump or fly, so you'll only get one on you if you happen to brush against it.

So don't get ticked: Skin cancer isn't the only reason to cover up this summer.