Lyme Disease Symptom: Fear : Medical Experts in County Say There’s Little to Worry About Here

Summer brings the fear of contracting Lyme disease, a highly publicized illness caused by a form of corkscrew-shaped bacterium called Borrelia burgdorferi . The disease, which is spread by ticks primarily in the summer months, is a real danger in most states, particularly those in the Northeast. But Orange County medical professionals say the threat here has been exaggerated.

“There are two diseases here--Lyme disease and mass hysteria,” said Dr. Mark Catalanello, one of 13 doctors in the UC Irvine-based Fifth Pathway program, which recently completed a year of collecting data on the illness and presented its findings to pediatricians and pathologists at UCI and Long Beach Memorial Hospital. “You always hear about the poor debilitated kid, and there’s a lot of shock value in those stories, but it’s not as bad as it’s said to be. The facts are blown out of proportion.

“The good news is that despite all the hysteria and the established bad side effects if undetected, it’s very treatable,” said Catalanello. “The bad news is if you don’t treat it, it can pound you.”

There had not been a documented case of a person contracting the disease in Orange County, according to public health officials, despite the presence of the carrier tick here. There are, however, about seven Orange County residents who contracted the disease outside the area.

But in Northern California and all other states except Alaska, Arizona, Hawaii, Montana, Nebraska, New Mexico and Wyoming, more than 14,000 indigenous cases have been reported since 1982, with the vast majority occuring in the Northeast.

“It’s really an East Coast phenomena,” said Catalanello. “There are areas there where 70% to 100% of ticks are infected. How it got out here is a total mystery, but in California, the state average (of infected ticks) is about 1.3%. It’s probably in Orange County, but no one is making a big stink about it here so no one is doing a whole lot of research on it in this area.”

Dr. Tom Prendergast, deputy health officer/epidemiologist for Orange County Public Health in Santa Ana, said about 100 ticks have been tested in Orange County. Thus far, the bacteria has not been found.

“But it is entirely possible that it is here,” he said. “We just don’t yet have a reliable case.”

Lyme disease was named after an epidemic of the disease broke out about 15 years ago in Lyme, Conn.

About two to six weeks after the bite of an infected tick, an expanding rash develops at the bite site in about half of patients, according to Catalanello.

“After that, they may appear normal,” he said. “If, and I stress if, a person is going to get chronic manifestations, it will most likely be weeks to months later.”

Those symptoms may include fever, fatigue, musculoskeletal discomfort, headaches, chills and lymph node enlargement. Symptoms may wane, and if left untreated, may become chronic, with flare-ups persisting for years.

In children, arthritis in the knee is a common and dramatic symptom, Catalanello said.

“When a child gets Lyme disease, he or she will say, ‘Mommy, my knee hurts,’ and the child won’t be able to walk. It’s that debilitating.”

Catalanello said those exposed to the illness usually don’t contract it.

“Like any major disease, those who test positive don’t necessarily have symptoms,” he said. “If you’ve been to an area where it is and you’re sick, treat it.”

In the Northeast, Lyme disease is carried by the deer tick. On the West Coast, it’s carried by the Western black-legged tick. Both are about the size of a pinhead and difficult to see, like a “moving freckle,” the Fifth Pathway report said.

The ticks position themselves on grass, low-lying tree branches or shrubs and grasp onto people or animals as they brush against that vegetation. “What is interesting is that Orange County has just at least as dense a population and as favorable a habitat for the tick as other places,” said Catalanello. “The tick is here, and I bet we have the disease, but we don’t yet have the proof.”

Catalanello said researchers think the reason no one has been reported contracting the disease in Orange County is because of the “humongous local population of the Western fence lizard, or blue-belly.”

Reptiles sampled in other California counties do have the tick in their bodies, he said. But unlike other species that act as tick hosts, or “reservoirs,” such as humans, deer or mice, the lizard does not contract the disease. Therefore, when the lizard is bitten by another tick, that tick does not become infected and later spread the bacteria.

“The lizard is a dead end and the buck stops there,” Catalanello said. “And if a tick had to be stuck somewhere, the lizard is the best place to be. It’s a huge population that the tick loves because it’s easy. Ticks don’t fly or jump, and the lizards are down on their level. It’s a lot less hassle for the tick than humans.”

Another possible explanation, but a less likely one, is that the Western tick in the baby stage is less aggressive than the baby East Coast tick, he said.

Because of the variable and confusing clinical symptoms, Lyme disease is often undiagnosed, misdiagnosed or overdiagnosed, doctors said. And without the rash or memory of a tick bite, it can mimic a variety of other disorders.

“It’s called the ‘great imitator,’ just like syphilis,” said Catalanello. “And the hysteria over it is similar because of the dramatic symptoms.” Adding to the problem is the unreliability of current blood tests that can give both false positives and false negatives.

“Your doctor does not require a positive lab test to diagnose Lyme disease if his level of suspicion warrants that diagnosis,” said Catalanello. “If you just got back from New York or your dog just got back from New York, that’s an indication. You have to trust and depend on your physician. It’s a clinical diagnosis, not a laboratory test diagnosis.”

Prendergast agreed that tests are unreliable.

“There are certainly people who have been missed,” he said. “On the other hand, it’s a relatively rare condition. The whole medical community suffered when the intense publicity about Lyme disease started. Lots of people went to their physicians and wanted to be tested, creating unmeetable expectations.”

A 35-year-old woman in Mission Viejo who asked not to be identified was tested, and she said it helped determine a diagnosis that meant relief after four years of suffering from severe arthritis.

“One day I was feeling fantastic and planting flowers,” said the woman, one of the people here who contracted the disease outside the area. “The next day, I could barely walk. I literally came down with it overnight.”

She lived in Marshfield, Mass., and went to six different New England doctors, none of whom suggested the possibility of Lyme disease. After moving to California two years ago, the first rheumatologist she consulted tested her for the illness and found positive results.

“Once he said it, it clicked,” she said. “We had lived behind 900-acre forest (in Massachusetts) and every night we had tick checks because we had had them on us. It was weird. Here it was, an East Coast disease, and no one there thought to look for it.”

Since she was in the late, severe stage of the disease, oral antibiotics were not sufficient, she said. She spent two weeks in a hospital receiving penicillin intravenously. When that failed, she was given a different drug. The symptoms have subsided, but she is still taking medication.

“I’m still not going to be able to run or ride a bike,” said the once-athletic woman. “It hurts for me not to be able to do these things because no one thought to look (for Lyme disease). But I feel that everything has a purpose and a meaning, and for some reason this is my crutch to carry. Gradually, I’m getting better.”

Catalanello said the hysteria surrounding the disease is tremendous.

“Everybody is putting out all this stuff to fight this disease that we’ve had around all along,” he said. “You have your tests, tick removal kits, insecticides and pesticides. And there’s no indication that any of this works to detect or prevent the disease.

“The best bet is simply to check the body thoroughly for ticks when you get back from being outside.”

THE CARRIER

Common name:

Western

black-legged tick

Latin name:

Ixodes pacificus Size: About 1/8

inch

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