Lyme disease

June 13, 2010

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)