Case Is a First in Southland : Lyme Disease Contracted by Laguna Beach Woman

A Laguna Beach woman has contracted Lyme disease, apparently becoming the first person in Southern California to come down with the debilitating ailment since reporting it became mandatory this spring.

State and local health officials on Tuesday called the case unusual, but said that although Lyme has become epidemic on the East Coast and coastal areas of Northern California, it is not a significant threat in Southern California.

“It’s a relatively low-risk problem” locally, said Dr. Robert Murray, an epidemiologist with the California Department of Health Services. In areas that are hot and dry, the tick that carries the disease “can virtually disappear,” he said.

Rick Greenwood, an Orange County health official in charge of communicable disease treatment, added that there may be some small area of infection in Orange County, “but generally speaking, we haven’t seen it.” Greenwood said he is waiting for the U.S. Centers for Disease Control in Atlanta to confirm the Lyme diagnosis before adding it to county health records.

First identified 14 years ago in Old Lyme, Conn., Lyme disease has swept the Northeast as well as Wisconsin, Minnesota and Northern California. The Centers for Disease Control, which recorded 526 cases in 1982, tracked more than 5,000 cases in 1988. The “little bitty” deer tick that causes the disease is “spreading,” explained CDC spokeswoman Gail Lloyd.

In a survey of Lyme disease in California, epidemiologist Murray studied 400 cases from 1983 to 1987, 59% of those in Humboldt and Mendocino counties.

Lyme-infected ticks seem to thrive in the moist, cool environment of coastal Northern California, Murray explained. “It requires just the right combination of events, a climate bathed by moist coastal breezes with dells and valleys and brush-covered hills where the ticks can survive for long periods of time and small rodent populations can act as a reservoir for the spirochete (the spiral-shaped bacteria that cause Lyme),” he said.

Murray said he found only two of the 400 cases in Orange County, six in Los Angeles County and three in San Diego County. Murray said he did not have statistics for 1988 and was now gathering data for 1989. Physicians have only been required to report the disease to state health officials since March 30. Murray confirmed that the Laguna Beach case appears to be the first report of Lyme from Southern California since reporting became required.

Sometimes dubbed “the great imitator,” Lyme disease is characterized by flulike illness--fatigue, headache, joint pains--and frequently, a rash. Later symptoms, which can appear months after the initial infection, include inflammation of the heart, numbness and muscle weakness, meningitis and arthritis. Antibiotics can successfully treat the disease, although in a few patients permanent joint damage may occur, CDC officials said.

In the Laguna Beach case, a woman in her early 40s--she has asked that officials not identify her publicly--visited her doctor in May complaining of fatigue, headaches and a low-grade fever. She also had a rash below her arm pit and, according to physical medicine specialist F. P. Meyer, might have received a tick bite several weeks earlier.

At the woman’s request, Meyer conducted a blood test to see if her serum contained the spiral-shaped organism that causes Lyme. “Nobody was more surprised than I was when the test came back positive,” Meyer said. “The health department has been telling us there hasn’t been any in this region.”

He and county vector control officials theorize that the woman may have received a tick bite in her back yard, which borders one of Laguna Beach’s brush-covered canyons. Deer, mice and rabbits, all of which carry the Western black-legged tick, inhabit the canyon, according to James Webb, county vector control biologist.

Webb urged residents not to be “alarmists” about Lyme. But he suggested that anyone entering a brush-covered area should wear long trousers, not shorts, apply a good insect repellent such as DEET, and after leaving the brush conduct a thorough “tick check.”

In Southern California, the incidence of Lyme-infected ticks was less than in Central and Northern California, he said, “But I’ve walked through brush and picked up three or four ticks. . . . It only takes one.”

The Carrier

Common name: Western black legged tick Latin name: Ixodes pacificus Color: Females, red-brown with black legs. Males, brownish black all around. Lifespan: 2 years Food: Blood Hosts: In early life cycle stages, the tick feeds off small rodents, lizards and birds. Adult ticks feed off large mammals such as deer, dogs and humans.