Dover, New Hampshire
Ticks prone to carrying Lyme disease have made their autumn appearance later than normal this year, and some area doctors are reporting more patients with tick bites.
Dr. Joseph Dulac, a physician at Atlantic Family Practice in Dover, said he typically treats patients with tick bites once a month, at most, during the spring and fall months.
Over the past three weeks, that number has jumped substantially, as at least three patients have come to him with fully engorged ticks attached to them. Another two or three patients have arrived with tick bites.
Officials at the state Health and Human Services Department say they haven't noticed an increase in reported Lyme disease cases, but are still tracking those figures for the season.
Dulac said he's never seen anything like this year's phenomenon.
"I'm not sure if it's all the rain we've had or just a high concentration of people coming in, but it makes me wonder if we're the only ones to see this or if it's affecting the community as a whole," Dulac said.
Black-legged ticks are the primary carriers of Lyme disease. New Hampshire's ticks most commonly are found in the southeast corner of the state.
Alan Eaton, an entomologist with the University of New Hampshire Cooperative Extension, said there hasn't been a noticeable increase in the number of ticks in the region. But he has seen a delay in the resurgence of ticks looking for hosts, like deer, dogs, or people, to feed on this fall.
"Three-host ticks," like the black-legged tick, typically feed on three hosts during their two-year life span.
Eaton said ticks usually travel in the open looking for a feeding host around the third week of September, in addition to their spring feeding time. Most are active until mid-November.
But this fall, the first ticks did not appear until mid-October. Eaton said it was unclear why the ticks are coming out later than usual, but he and other experts said warmer temperatures in September may have delayed their arrival because the ticks need a certain amount of cold before they travel into the open to look for hosts.
Preliminary symptoms of Lyme disease can include fatigue, fever, pain in muscles and joints and sometimes a rash around the bite mark. If left untreated, the rash may disappear and dizziness, irregular heartbeat, arthritis and nervous system disorders can set in, with swelling and knee pain occurring months and years later.
Doctors at the Wentworth-Douglass Hospital emergency room also have noticed an increase in cases of tick bites. Dr. Lukas Kolm, an emergency medicine physician at the hospital, said as many as a dozen patients weekly have come in with either tick bites or suspected cases of Lyme disease, compared to only half that many or less during past seasons.
"It's hard to believe it's November and people are still coming in with tick bites regularly," Kolm said.
The hospital does not have numbers on reported Lyme disease cases, but Kolm said he suspects the numbers usually are underreported anyway because the tests used to diagnose them are not always 100 percent accurate.
While nothing out of the ordinary has been reported at the state level in New Hampshire, officials in Maine say any increases this year follow a trend of more frequent tick-borne diseases over the past several years.
Maine State Epidemiologist Kathleen Gensheimer said southern Maine, particularly York and Cumberland counties, are where the most frequent findings occur, especially near the shoreline.
But recently, the state has seen reported cases of Lyme disease spread farther inland, north, and east, as is the case with other vector-borne diseases such as Eastern Equine Encephalitis and the West Nile Virus.
"We try to conduct careful surveillance of all these diseases so the medical community can provide correct diagnoses," Gensheimer said.
According to the Maine Department of Health and Human Services, the state has averaged more than 200 reported cases of Lyme disease annually from 2002 to 2004.
In New Hampshire, the state has not seen any quantitative proof that Lyme disease is on the rise or anecdotal evidence of more deer tick cases, according to Greg Moore, a spokesperson for Health and Human Services. Moore said any reports from doctors that case numbers have risen could be due to patients reporting the cases more often as Lyme disease awareness has increased.
Doctors like Dulac say they still want to encourage people to come see their health care provider if they suspect they may have Lyme disease or have been bitten by a tick.
"I just want people to know not to be alarmed," Dulac said.