The Smart Money: Changes to ‘the way life should be’ in the age of Lyme

Posted Wednesday, June 18, 2014 in Opinion

The Smart Money: Changes to ‘the way life should be’ in the age of Lyme

by Gina Hamilton

The annual moose lottery results were released this week, to the usual excitement and anticipation that surrounds the lucky winners getting a chance to bag Maine’s largest member of the deer population. 

But lurking behind the happy story was a sadder one.  There has been a dramatic die-off of moose population in Maine and in the rest of New England, and the blame can be laid at a very tiny door.

In January, state biologists started a five-year study involving 60 moose, who had been radio-collared, near Moosehead Lake. Half of them, 21 calves and nine adults, died between January and now.  And the biologists say they believe that ticks are killing them, specifically winter ticks.

The dead moose don’t have broken bones; there is no evidence of brainworm or other disease. They seem to be dying of anemia. It was hoped that the abnormally chilly and snowy winter would have knocked the ticks and other pests back a bit, but they didn’t. 

Maine reduced its moose permits by 25 percent because of the tick issue. But Maine still has many more moose than the rest of New England, in part because our moose range further north than other states’ populations do. New Hampshire and Vermont are calling their moose losses “catastrophic”.

The moose hunt brings millions of dollars to Maine’s economy every October, so a decrease of those dollars will be a significant hardship, especially around Moosehead Lake.

Moose aren’t the only creatures who are suffering from the effects of ticks. Three years ago, if we found a single tick on our dogs after a walk in the woods, it was a surprise. Now, they return with three or four, and those are the ones we can find early. We are finding ticks on ourselves, too. When they are engorged, you can’t tell whether they are ordinary dog ticks — about 2 percent of the tick population in Maine — or the more sinister deer ticks, which carry Lyme disease and other, more deadly infections.

Lyme disease is a bacterial infection. It is carried from host to host by ticks, which are called vectors. Other arthropods, including mosquitoes, fleas, and even lice, are also vectors for certain diseases. Other illnesses carried by the deer tick are Powassan, a viral illness which has a high mortality rate, Babesiosis, a microscopic parasite that infects red blood cells, and Anaplasmosis, which is a bacterial infection, like Lyme. While Babesiosis and Anaplasmosis can be successfully treated, there is no treatment for Powassan. Fortunately, Powassan is rare; there has only been one fatality, but that patient was a woman from the Mid-coast.

With 30,000 cases identified annually, Lyme is the most prevalent vector-borne illness in the U.S. If caught very early, and treated aggressively with a sometimes expensive form of antibiotic — doxycycline, which last year cost $3,000 for a course of 90 capsules in some areas of the country — patients are likely to recover fully, but about 13 percent of patients have residual effects from Lyme Disease.

Treating Lyme disease beyond that initial window has resulted in some controversy. There have been a few bad outcomes for patients who have had long-term antibiotic therapy, especially if delivered through a catheter or intravenously. Not all doctors accept that the residual effects, such as fatigue, body pain and arthritis-like conditions, heart disease, and difficulty concentrating, are actually part of Lyme disease at all. They point to studies in which placebos have the same effect as antibiotics. But other studies, and many patients and their doctors, believe that they are one and the same, and when the antibiotic therapy works, they say that many of the most troubling symptoms disappear.

In either case, treating the disease with antibiotics or treating the symptoms with pain management drugs and physical therapy, the cost explodes after the first month or so of Lyme disease. Patients are often hospitalized for several days. People with late stage Lyme disease find that their disease treatment can cost upwards of $20,000, according to one advocacy group. Another says that the costs could be more than $75,000.

When taking into medical costs, indirect patient costs, and loss of productivity, the conservative estimate for  annual costs for Lyme disease in the U.S. is about $3.1 billion. To put that in perspective, that is more than we spent on all our national parks last year, including a staff of 22,000 people.

In Maine, in 2012, 1,111 patients were diagnosed with Lyme disease. Last year, that number climbed to 1,376, as reporting increased. However, the Maine Centers for Disease Control says that Lyme is still underreported in Maine. They know this because the characteristic “bullseye” rash was reported by patients who tested positive for Lyme in Maine only 51 percent of the time. Nationally, about 81 percent report the rash. 

Unfortunately, there’s not much that can be done except precautionary actions, such as using an insect repellent with DEET, or, in very young children, one with lemon eucalyptus oil, wearing light colored clothing with long sleeves, tucking long pants into socks before going out into tick-infested regions, and checking one’s own body and that of one’s pets for ticks and rashes. Keeping ground cover mowed and trimming back vegetation may also help. 

There are also some sprays that can be infused into clothing and blankets that deter ticks and mosquitos.

There is no vaccine currently on the market for Lyme disease in humans. 

Mosquito-borne illnesses are also on the rise with rising temperatures. In Maine, there has been an increase in West Nile Virus, which causes flu-like symptoms and is carried by a mosquito. Maine had its first human case of WNV in 2012. Nationwide, 25 percent of people who have WNV see a doctor because of a headache. Eastern Equine Encephalitis is another virus carried by mosquitoes in Maine, with a relatively high fatality rate. Both viruses have been found in mosquito pools in Maine.

Aerial spraying is a last resort, and only when a region has been determined to have a high incidence of mosquito pools or tick habitat, because of the problems such spraying causes to the overall ecosystem, including the destruction of bees. 

It’s all part of living in Maine amid global climate change, and ticks and other vectors are only the tip of a rapidly melting iceberg.

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