Mysterious Lyme

Calgary Sun Media - Canada
The story of Keith Poullos sounds like one of those medical mystery scripts you'd see on something like TV's House, where Dr. House works through a series of theoretical medical mazes in an attempt to track down whatever it is that, within 10 minutes of the show's end, is threatening to kill the patient.

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

Instead, the cause was a tiny critter called the 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 overshadowed by the awareness of West Nile Virus and that doctors just don't get it.

"My doctor knew nothing about it and didn't think it was a problem here," he said.

"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 feels greatly improved over a few months back.

Lyme disease is actually the most commonly reported tick-borne illness in the U.S., having been identified in 1975 after a clustering of cases around Lyme, Conn.

The ugly miniscule creatures, about the size of a sesame seed, attach to the skin and, if they themselves are infected by a bacteria called Borrelia burgdorferi and remain on the skin feeding on your blood for between 36 and 48 hours, you will also become infected.

The classic tick bite sign is a bulls-eye type rash that develops around the initial bite site between three and 32 days. Flu-like symptoms, fatigue, chills, fever, headache, a stiff neck and a general malaise, accompany the illness.

And although a course of antibiotics can cure it, patients who've struggled with the illness say 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 the ELISA, says B.C.'s Jim Wilson, president of the Canadian Lyme Disease Foundation (www.canlyme.com), and a Lyme disease patient.

He believes 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 said.

Wilson also criticizes Canada for doing a dismal job of tracking the disease: "The confirmed cases in Ontario are 23 a year. Across the border, however, they have 5,000 cases a year. Yet we share the same fauna and flora as our neighbours to the south. The migratory birds transplant these ticks everywhere, they are like airplanes for the ticks.

"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."

Wilson further charges 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."

He says there were over 23,000 cases confirmed in 2003 in the U.S. and Lyme is underestimated "six to 12 fold."

However, others argue fewer than 15,000 North Americans annually are affected.

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 nearly one-third of people with Lyme disease do not show immediate symptoms. Instead, the bacteria multiplies within the body — hiding sneakily from the immune system, and eventually wreaking havoc on the body's defences.

Wilson says it was months after he was bitten in 1991 that he experienced drooling, numbness in his legs, and foggy thinking.

Part of the frustration felt by Keith Poullos is he could have been bitten decades ago. Later stages of Lyme disease can include nervous system disorders, abnormal pulse, enlarged lymph glands, facial palsy and arthritis.

Prevention is key. Use insect repellents containing DEET and cover up with long pants and long-sleeved shirts.

If you do see a tick, don't panic; infection is unlikely to occur before 36 hours of tick attachment. It's important to check daily for ticks.

If you find a tick the Canadian Lyme Disease Foundation says to promptly remove it with fine-tipped tweezers, getting as close to the skin as possible, then cleanse the area with an antiseptic.

Ticks prefer moist, shady places with low-lying vegetation, overgrown grass or leaf litter: Think woods and the edges of rural golf courses.

But these creatures cannot 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.