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Lyme disease spikes
Sunday News
Published: Aug 03, 2008
00:13 EST
Lancaster
By PAULA WOLF, Staff
One day at work, Lisa McElroy suddenly came down with fever and body aches.
 
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Chris Harnish, who was recently diagnosed with Lyme disease, poses in her backyard with dog Sydney.
 
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"I thought I had the flu," said the Landisville mother of three.

Her symptoms only intensified, as she started suffering severe spine and pelvic pain, and hallucinations from the fever.

When she went to the doctor, McElroy mentioned that she had recently gone hiking, possibly exposing her to ticks that carry Lyme disease. He ordered a test.

McElroy learned the next day that the test was positive, and she was prescribed antibiotics.

"It took me two weeks to feel really good again," she said.

This summer, McElroy has plenty of company, as local physicians are reporting an uptick in Lyme disease cases. It appears that the number of infections is rising, perhaps in part because of more residential development invading tick habitat. But the public also is more aware of Lyme disease symptoms and seeking medical help for them.

Cases up this year

Humans get Lyme disease from the bite of blacklegged ticks (formerly known as deer ticks) which thrive in humidity and are often found in wooded or leafy areas. The bacterial infection is usually cured in its early stages with oral antibiotics. However, if left untreated or treated inadequately, Lyme disease can produce complications, including nervous system problems, that require more intensive therapy.

"I've had several patients [with Lyme disease] over the last few months," said Dr. Stephen Diamontoni of Stephen G. Diamontoni, M.D., & Associates Family Practice.
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"It seems like a few more this year" than last, he said.

That increase could be a reflection of more people seeking treatment than anything else, Diamontoni said.

"Public sensitivity to the symptoms of Lyme disease is higher than it's ever been," he said.

Those symptoms include a bull's-eye-shaped rash — known as erythema migrans — at the site of the tick bite, along with fever, muscle aches, joint pain, headaches, malaise and fatigue.

The rash, which often shows up seven to 14 days after the infection, is evident in the majority of Lyme disease cases he sees, Diamontoni said, though sometimes people don't recognize it for what it is. "They'll come in for fatigue," he said.

Lancaster city resident Susan Walker said her 11-year-old daughter, Adelaide, exhibited a fever and "general malaise" before noticing a large bull's-eye rash on her back.

At the time, Walker feared it was the result of a poisonous spider bite.

Occasionally, the disease manifests itself in other ways, Diamontoni said. One of his patients, a teen, developed arthritis in the knee from Lyme disease. The problem was remedied with antibiotics, he said.

Bell's palsy and cardiac symptoms also can result from the infection, Diamontoni said. One patient came in with carditis, a heart problem that caused fainting episodes. The cause, Lyme disease, was treated with intravenous antibiotics.

"I had five people in one week" with Lyme disease, said Dr. Gayle Sisbarro of Crooked Oak Family Health Center. "That was amazing."

Typically, "I may get a couple [of cases] a year."

Sisbarro said her Lyme disease patients range from children to older adults. "One was a young girl who just came back from a trip to Mexico," she said.

The symptoms vary widely, Sisbarro said. While the bull's-eye rash is common, some people develop "weird" rashes that also turn out to be indicators of Lyme disease, she said.

Sisbarro said she prescribes a three-week dosage of the antibiotic doxycycline, a common treatment for the infection.

"Anybody with any kind of rash" or viral-type symptoms should be checked out, she said.

"People just have to be really aware if they're outdoors," she advised.

Chris Harnish, who found out last month she was suffering from Lyme disease, said she developed an odd-shaped rash that resembled poison ivy, but experienced no other symptoms.

"I thought I had a staph infection," the city resident said.

She soon learned her real diagnosis. "I've talked to so many people who've said, 'Yeah, I've had it,' " Harnish said. Lyme disease "is pretty much all over the place."

Gail Sheffer, who heads the York Lyme Disease Support Group, said her membership of about 120 covers at least six counties, including Lancaster.

"For a long, long time," she said, the number of members from Lancaster County was two. But in recent months, it's risen to 10, Sheffer said.

County a hotbed

Holli Senior, a spokeswoman for the state Health Department, said the reporting of Lyme disease cases is now more accurate than it used to be.

But it's also clear that infections appear to be rising, Senior said, and one reason may be the growth in development, "the fact we're cutting down more trees."

And while Lyme disease continues to be more prevalent in the eastern and southcentral regions of the state, "it's gradually migrating to the west" of the Commonwealth, she said.

In 2007, Lancaster County ranked fifth in Pennsylvania in Lyme disease cases with 249, trailing only Chester, Montgomery, York and Berks counties.

Dr. Christopher Hager of Lincoln Family Medicine in Ephrata wrote an article on Lyme disease that was just published in Lancaster County Woman magazine. He noted that Pennsylvania has the second-highest volume of Lyme disease in the country, after New York.

The incidence is greatest in the summer "because that's when the ticks are out and the people are out," Hager said.

"We see a lot of it" at the practice, he said. Lancaster County "is what we call an endemic area" for Lyme disease.

About 80 percent of the patients exhibit the bull's-eye rash, Hager said. He also emphasized that "if the tick is attached for less than 48 hours, you won't get Lyme disease."

Dr. Randy Kochel of County Line Medical Center in Gap said that the illness is still misdiagnosed. "Many things wind up being called Lyme disease," he said.

Kochel, chairman of the family medicine department at Lancaster General Hospital, said he follows a defined procedure in diagnosing it.

First, there's a screening test, and if that comes back positive, a second, confirmatory test is done, he said. If the screening test is negative (possibly a false negative), a confirmatory test may still be tried, Kochel said. A positive confirmatory test means a diagnosis of Lyme disease.

He also tries to counter common Lyme disease myths, such as the widespread belief "that once you have it, you always have it," Kochel said.

"That's not true."



Paula Wolf is a staff writer for the Sunday News. She can be reached by e-mail at pwolf@lnpnews.com.

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Paula, keep up the good work, this was a great article, and I wish I could have READ MORE on the subject. I found Dr. Sisbarro's comments astounding that she had 5 patients in one week that she diagnosed and/ or treated with lyme disease. Although it doens't surprise me as I am a lyme patient, and my whole family of 4 has had since 2004. We have been on and off treatment since then. It is harder to get well after not being diagnosed in a timely manner.
I'd like to correct the good dr. who said PA was BEHIND New York. That may have been the case a few years ago, but not for 2007. Currently PA is the #1 state in reported cases to CDC as of this week. In fact PA has been in the top 5 for the past 10 years.
Also, what world does Dr. Kochel live in?? Having lyme disease is the hardest thing in the world to get diagnosed with. I found his remarks quite flippant and quite the contrary. Lots of things do LOOK like lyme disease BUT, lyme patients will tell you it took many months if not years to get a lyme diagnosis.....they just aren't given out......mostly because of the ingorance of our doctors and specialists. They just rely too much on the inaccurate screening test (ELISA) which is the least sensitive screening test ever!!! The western blot is hardly a CONFIRMATORY test either. At best it catches 50%......Lyme is a clinical diagnosis, even Johns Hopkins says so along with CDC. Perhaps Dr. Kochel needs to learn some more about Lyme disease.
It would be good to remind readers that ticks don't wear wristwatches either. .....the magical 48 hours or less of tick attachment does not preclude one from getting infected with lyme or any other tick borne disease. That was a very irresponsible comment.
Also to Dr. Kochel, since there is no test available to confirm when all bacteria are killed, how do you tell someone WHEN IT IS GONE?? I would like to know how he knows when ITIS GONE.
[color="#000099"]Wake up, there are too many sick people in Lancaster!!!!

Phantomskiss
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