Lyme disease in Northwest Michigan? Hikers are cautioned to check for disease-carrying deer ticks By Anne Stanton The State of Michigan has reported for the first time that deer ticks have been found in northwestern Michigan — the type of ticks that potentially carry Lyme disease. Local health officials say they have no confirmed reports of Lyme, but hikers need to respond by taking a few precautions. Lyme disease is caused by an infectious spirochete that resides in tick blood. The deer tick is red, black and very tiny. They live on deer, but occasionally crawl onto humans and dogs for a meal, at which point they burrow their barbs into the skin and release the infectious venom while they eat. Not every tick, of course, carries Lyme.
TRACKING TICKS In April’s report, the Michigan Department of Community Health showed 103 cases in the state, of which 67 were acquired in Michigan. The state also reported that Benzie and Manistee counties have known populations of black-legged ticks, with Leelanau County listed as an emerging risk for ticks. The report is drawn from the state’s 83 counties, which collect data from area doctors. The report also included findings of a Michigan State University field study, which focused its efforts along the shoreline. The report is in line with the trend of ticks marching up the Lake Michigan coast. Deer ticks were found for the first time at Orchard Beach in Manistee in the summer of 2006, according to the study’s lead researcher Jean Tsao, an MSU professor. In the summer of 2007, ticks were found in the Sleeping Bear Sand Dunes on mice, although they didn’t carry Lyme disease. Tsao told Northern Express in an earlier report that it’s only a matter of time before Lyme-infested ticks find their way north. Researchers previously believed that ticks were confined to Menominee County in the Upper Peninsula and in southwest Michigan near the Indiana border. Yet one woman believes that Lyme-carrying ticks have been at the Sleeping Bear National Lakeshore for decades, and researchers have only caught up to the reality thanks to the MSU field study. “I was personally bit at the sand dunes at the National Lakeshore, and had the bulls-eye rash; it was the size of a baseball. That was in 1989, so I’ve known it’s been there for years, and the state’s just catching up,” said Linda Lobes, whose illness inspired her to lead the Michigan Lyme Disease Association.
LEELANAU & GRAND TRAVERSE? Most significantly, the report showed two cases of Lyme disease diagnosed in Grand Traverse County and one in Leelanau County. Yet the data are questionable. A Leelanau County Health Department official said the reported Lyme case was likely acquired out of the state, and blood tests didn’t confirm the disease. The same was true of a case reported in Grand Traverse County. “One case was determined not to be a case of Lyme, while the other was a case, but strictly based on the rash and fever, not a blood test,” said Kit Mikovitz, personal health manager of the Grand Traverse County Department of Health. “The child had no known ticks, and if the child had been infected by a tick, it wasn’t necessarily acquired in Grand Traverse County,” Yet Donaldine “Dee” Bourbeau, 59, said she was diagnosed in Grand Traverse County in December of 2008 for Lyme with a blood test. She first noticed symptoms four months earlier, including crackling knuckles and a swollen knee. That was about the time she moved from Grawn to a new house in Traverse City. Her joints began swelling to the point it was too painful to get out of bed and she felt extremely tired. She went to an osteopath, who told her she had arthritis in her knee, a common symptom of Lyme. Her family doctor told her she was suffering from stress, owing to the move. He put her on Lexapro, an anti-anxiety medication, but it didn’t help. “Then I got Bell’s Palsy in my right eye (in which the eye muscles go lax—another symptom of Lyme), and I couldn’t figure out what was wrong. I had a hard time seeing, so I went into a walk-in clinic near the old osteopathic hospital and they didn’t know what was wrong,” she said. “They did a bunch of blood tests, and one of the tests came back positive for Lyme.” (During the course of reporting for this article, Bourbeau called the Health Department; she said they confirmed that it acknowledged her case in 2008 as Lyme disease and had been acquired locally. The Health Department cannot comment on individual cases due to privacy rules.)
NEVER LEFT AREA She said the doctor did another test, and again it came back positive. The case of Bourbeau makes a good argument that Lyme might be here. She has never left the area. She also spent a good deal of time outdoors, hiking, hunting for mushrooms, horseback riding, and camping, usually at Arbutus Lake and the Interlochen State Campground. Mikovitz said she doesn’t know why Bourbeau wasn’t reported to the health department, but plans to contact her. A May 2008 report in the Northern Express profiled several people who believed they were infected by Lyme disease. Most everyone suffered early symptoms of a flu-like fever, joint pain, severe forgetfulness, and overwhelming fatigue. By the time they were diagnosed, the disease had progressed to chronic Lyme disease, in which the infectious spirochete makes a hard shell or cyst around it and reproduces inside of the shell. Months or even years later, these cysts can break open to cause a whole new onset of symptoms. All of these patients came to learn that Lyme is surrounded by intense controversy within the medical community. Most doctors agree, however, that a positive or negative blood test must also be looked at in combination with symptoms. They are not always conclusive.
TRACKING TICKS The newly issued report says the MDCH is most concerned about infected deer ticks in western lower Michigan, which previously showed no evidence of Lyme disease activity. Ticks are now well established in the area, and some are infected with Lyme, the report said. The Upper Pensinusla county of Menominee, with 32 reported cases last year, showed the state’s heaviest concentration. A map showing the number of ticks sent to the State of Michigan for evaluation is more revealing; 513 came from the Upper Peninsula (a healthy majority from Menominee), compared to just 40 from the Lower Peninsula. An MDCH official said ticks were plentiful this past spring due to the unusually warm weather. Kyra Cross, who was hiking in Naubinway, along the coastline of Lake Michigan in the southern half of the Upper Peninsula said she and a group of hikers stopped at a clearing, where she found a deer tick on her white French bull dog. After she swept it off, she looked at her dark pants and found five ticks. Her friends checked their clothes, and they too found several ticks. The longer they stood there, the worse it got. “That was the end of the hike. We took off back to the cabin,” she said. “I was most worried about Lola (her dog).” The map shows very little activity on the central and northeast side of the state, but ticks are there too, Lobos said. “I had just had a guy in Grayling who told me he accidentally sat in a nest of larvae ticks. He was morel mushroom hunting, and he ended up with 56 ticks. Some were embedded, some were just crawling on him.” He took the time to capture the ticks and send them into MDCH for analysis. Not all ticks contain Lyme disease, and there is no way to tell. That’s why MDCH is asking people to send in their ticks (for directions, Google “Instructions on sending ticks and Michigan.”
PROTECT YOURSELF Although medical professionals can’t agree on much about Lyme, they do agree the disease is real and it’s wise to protect yourself. Mikovitz said anyone spending time out in the woods should check for ticks on a fairly regular basis, wear insect repellant, cover their arms and legs with clothing, and check for rashes. If you find a tick embedded on your skin, pull it straight out until it comes out — sometimes it takes several pulls because the tick clenches the skin with barbs. Dogs can also acquire Lyme disease. June Thaden, an avid hiker in Grand Traverse County, said the new report won’t keep her out of the woods, but it has certainly made her aware of the potential for Lyme. Bourbeau said that Lyme disease was the last thing she ever expected. She’s been seeing a Lyme-literate doctor near Pontiac, who put her on a heavy regimen of intravenous antibiotics, which takes about three hours each day. There are now only trace amounts of Lyme antibodies in her system. “I focus on the positive, all that I do have. I think that’s why I’m getting better,” she said.
To get more information about protecting yourself from Lyme disease, call the Michigan Lyme Disease Association at 1-888-784-LYME(5963)
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