One street, 3 cases of Lyme disease

Boston Globe
Region seen at high risk for tick-borne infection

By Carolyn Y. Johnson, Globe Staff | July 31, 2005

On a wooded, U-shaped street in Norwell, three neighbors have something new in common this summer: Lyme disease.

The three cases -- two boys and a 63-year-old man -- on Hemlock Drive are a timely reminder that residents in many area communities are at high risk for the tick-borne infection.

The disease usually spreads when tiny deer-tick larvae pick up the bacteria from an infected field mouse, and go on to bite humans during the summer months. Cases were once concentrated on Cape Cod, Nantucket, and Martha's Vineyard, which still boast the highest rates of infection in Massachusetts, but Plymouth County now has the fifth-highest incidence of cases in the state, and regularly racks up more than four times the national average.

Across the region last year, there were 170 cases in Plymouth County, 136 cases in Norfolk County, and 114 cases in Bristol County. The combined average of 26 cases per 100,000 people is about three times the latest available national average of 8.2 cases per 100,000 people in 2002.

''We've seen over the years an increasing number of cases . . . wherever there are deer, deer mites, and ticks," said Dr. Alfred DeMaria, head of communicable disease control for the state Department of Public Health. ''Which is pretty much everywhere, now."

The cases on Hemlock Drive exemplify the difficulty of catching and correctly diagnosing the disease, which is known as an ''imitator" because its symptoms often look like flu, arthritis, or even normal aging. If untreated, the disease can cause meningitis, chronic arthritis, or neurological problems.

Bud Sadler, 63, was lucky. He noticed a tick swollen to about half the size of a BB on his waist after mowing the lawn on a steamy day in mid-June. He later noticed a rash, and began to experience severe headaches and flu-like symptoms. His doctor put him on antibiotics, suspecting Lyme, and last week, he took his final dose.

Days earlier, Sadler's 11-year-old neighbor, Sean O'Sullivan, finished up his own antibiotics, which had to be given intravenously. O'Sullivan, too, had flu-like symptoms and aching joints in early June, but no one suspected a serious disease until, during a vacation in New Hampshire, his face became partially paralyzed with Bell's palsy.

Angela Kotlinski never saw the tick. She began to notice red circles, about the size of a half-dollar, on her 7-year-old son William's body in early June, but her doctor assured her everything was fine. When William got a sore throat and aches and was covered from head to toe with 15 red spots, she pushed a doubting nurse to get a blood test. It confirmed he had the disease.

DeMaria said the three cases on a single street -- which add to two other cases reported to the Norwell Board of Health -- aren't an ominous sign of an epidemic, but a reminder that everyone should exercise caution when they go outdoors, and stay alert for symptoms of the disease if they find a tick on their body.

Over the past two years, the number of cases reported in the state has dropped slightly, from a peak of 1,789 in 2002 to 1,437 cases last year. But DeMaria said the slight shift in numbers doesn't mean that the disease is on the decline.

Scientific studies have found that for every diagnosed case of the disease, anywhere from seven to 12 cases slip under the radar.