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Tiny predators
NH is the nation's hotbed of ticks and Lyme disease

05/29/14
By Rebecca Fishow rfishow@hippopress.com



 Think you’re picking more ticks off your dog, your kids or yourself than you were at this time last year? You’re not wrong. Data collected by state authorities and local experts show the numbers are up. 

“I’ve been collecting high numbers myself,” said Alan Eaton, who has been studying black-legged ticks and other species for about 25 years through the UNH Cooperative Extension. 
The greatest cause of mortality for ticks is drying out, so a snowy season that started relatively early, paired with a fair amount of rain in early spring, means ticks are thriving. 
 
Up-tick
The weather can’t explain the long-term trend of a larger tick population. While ticks used to be somewhat restricted to the southeastern part of the state, they’ve been spreading to more western and northern parts of New Hampshire. 
One indicator is a study conducted by the Department of Fish and Game that counts ticks on deer. Results from 2013 showed that 77.3 percent of deer carried ticks that year, up from only 2.4 percent in 1991. That includes deer in counties like Carroll and Cheshire, which had no ticks in 1991 but in 2013 reported 100 percent and 74 percent, respectively. 
The increase is at least partially the fault of humans, Eaton said. Back in the day (way back in the day, around the 1890s), most of southern New Hampshire was open pastures, an environment in which ticks do poorly. Then, slowly, the forest grew in. Then people started building houses in the forest. 
“We have forest areas and a little opening, and then more forest area, and another little opening, each with a house,” Eaton said. 
That pattern has created “edge habitats,”  areas that are leafy and damp like the forest but attract large populations of birds and mice, on which ticks depend to live.
“We made it much better for these ticks, and they are re-invading the territory and taking advantage of a good thing,” Eaton said. 
 
Lyme disease on the rise 
According to a study conducted by the state Department of Health and Human Services, from 2007 to 2012 about 60 percent of the state’s black-legged ticks (also called deer ticks) were infected with the bacteria Borrelia Burgdorferi, which causes Lyme disease. It is treatable if caught early but potentially life-threatening if not. 
New Hampshire now has the highest rate of Lyme disease per capita, said Beth Daly, chief of Infectious Disease Surveillance for DHHS.  
“Back in the 1990s we had fewer than 100 cases each year,” she said. “In the early 2000s we counted a couple hundred cases each year. In 2006 and 2007 it increased dramatically.” 
Since 2008, the number of New Hampshire Lyme disease cases had essentially plateaued, but in 2013 the number reached the highest on record at 127.6 cases per 100,000 people. That’s 1,689 confirmed and probable infections. While the stats indicate an increase in the number of cases, Daly suggested that the increase could also be a result of additional personnel and federal funding. 
Lyme disease is caused by the bite of an infected black-legged tick. When the tick bites,  it imbeds itself in the  skin. It needs to be attached for from 24 to 36 hours to pass the bacteria. 
A tick attached for only a short period of time may leave a small red mark, but it’s usually not dangerous, experts say. If it’s been there longer, people should speak to their physicians or healthcare provider about receiving an antibiotic to help prevent infection or illness, Daly said. 
If illness does develop, it will usually occur within three to 30 days after the bite. Some, but not all, victims will develop a bull’s-eye rash around the site of the bite, or multiple bull’s-eye rashes anywhere on the body. 
Additional symptoms can be non-specific, such as fatigue, body aches, and, further along, arthritis, neurological problems like Bells Palsy and heart block, Daly said.
 
The “chronic” debate 
If the infection is detected early enough, patients will likely recover without complication. But once the disease reaches chronic stages it can be difficult to diagnose — and many in the medical community maintain that chronic Lyme disease doesn’t exist.The Infectious Disease Society of America doesn’t recognize it and  discourages healthcare companies from paying for long-term antibiotic treatment. 
“The controversy is really around whether you can be chronically infected, meaning the bacteria is still in the body and causing illness,” Daly said. “There is a recognized syndrome called post-treatment Lyme disease, which is when patients have been treated but continued to have symptoms. It does not mean bacteria is alive in you; it can be damage to the body from the original infection, so additional antibiotic treatment is not going to help.”
Despite that, some sufferers seek out Lyme-literate doctors, who do treat the disease with long-term antibiotics. The method is legal in New Hampshire. In 2010 and 2011, New Hampshire passed two bills that allow physicians to prescribe long-term antibiotics as therapy for patients diagnosed with Lyme disease. 
Nancy Bourassa, who runs Lyme 411, a support group for sufferers based in the Lakes Region, is one of those patients. She was diagnosed with Lyme disease seven years ago after experiencing and trying to treat a number of seemingly unrelated symptoms including hearing loss, extreme exhaustion that caused her to fall asleep mid-sentence and while standing, and severe twitching that spread down the left side of her face. 
“I also had joint aches that were coming and going,” she said. “I was going to physical therapy for those and my therapist said, ‘Have you ever been tested for Lyme disease?’ ... So I went to go see a Lyme specialist. and he said, ‘We are 100 percent sure you do have Lyme disease.’”
She worked with a team of doctors and was put on a rotating schedule of antibiotics. She also took supplements for the allergies caused by the disease and was given a special diet. For the last two and a half years, Bourassa has been free of most symptoms. 
“I attribute it to the team of four doctors that I was seeing who all worked together,” she said. 
Tick checks 
As with many diseases, prevention is key.
“There’s one thing you and everybody else can do,” Eaton said. “It’s easy and it doesn’t cost money and would tremendously reduce risk of Lyme disease. Basically, a daily tick check during tick season. Brad Paisley had a song that said, ‘I’d like to check you for ticks.’ So let Brad Paisley check you.”
Other effective preventative measures include using repellents that contain DEET on skin and clothes, wearing light colors and long pants and sleeves if going hiking, walking in the middle of trails and using products that contain permethrin on clothing. 
Homeowners can take measures to help keep their yards tick-free. They can cut their lawns short, and if they live along a forest border, put a 3-foot or wider barrier of mulch or rock between the woods and yards, which will prevent ticks from coming into the grass. 
If you do find yourself carrying a tick, or think you may be infected, “the number-one thing is to not be scared,” said Bourassa. “Just be informed.” 





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