Zelis: 8 things Vermonters should know about Lyme disease

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Many Vermonters are not aware that Vermont is No. 2 in the U.S. for incidence of Lyme disease. According to the the Vermont Department of Health, cases of other tick-borne diseases such as babesiosis and anaplasmosis are also steadily increasing in Vermont.

VTLyme.org is a new, non-profit organization focused on providing equitable information and support to Vermonters affected by Lyme and tick-borne diseases.

Eight things to Know About Lyme disease in Vermont:

1 Not everyone gets a rash.

According to the National Institutes of Health, "The most distinct symptom of Lyme disease — the circular red rash known as erythema migrans (EM) — does not appear in at least one quarter of people who are actually infected with Lyme bacteria." In Vermont, recent data shows the incidence of EM rashes has been decreasing in Vermonters with confirmed Lyme disease.

2 It's not just Lyme disease.

According to the Vermont Department of Health, anaplasmosis, babesiosis, ehrlichiosis, Borrelia miyamotoi and Powassan virus are all present in Vermont. Some of these tick-borne diseases may require a different test or treatment than Lyme disease.

3 Lyme disease can be diagnosed 12 months of the year.

Vermont Department of Health data shows confirmed cases of Lyme disease are diagnosed all 12 months in Vermont. The majority of cases are diagnosed May through September.

4 Blood tests might not work.

Because it may take weeks for antibodies to develop The CDC notes, "testing an infected person too early can produce a negative result." According to The Vermont Department of Health, "Even the best available Lyme testing is imperfect and should be interpreted in the context of the patient's clinical presentation."

5 A person may have symptoms weeks, months, or years after being bitten.

Treatment failure does occur, even with early diagnosis, so follow up visits for patients diagnosed with Lyme disease are essential. Vermonters with disseminated Lyme disease may need a different treatment than those in an early stage of the disease.

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Other tick-borne infections, such as babesia, may require a different approach than Lyme disease, or have different symptoms. It is possible for a person to be infected with a tick-borne disease and not experience any symptoms for months to years after a tick bite.

6 Not all ticks carry Lyme disease.

Only four of thirteen tick species in Vermont are known to carry pathogens. One of these four is responsible for 99 percent of all tick-borne diseases reported in Vermont — the blacklegged tick.

The Vermont Department of Agriculture 2018 tick report showed over 60 percent of the ticks tested positive for at least one disease; 56.7 percent were positive for Borrelia burgdorferi, which causes Lyme disease; 8.25 percent were positive for anaplasma phagocytophilum (anaplasmosis), 1.03 percent for babesia microti (babesiosis), 1.03 percent for Borrelia miyamotoi, and 1 percent for Powassan virus. Approximately 5 percent of the ticks tested positive for two or more pathogens.

Remember, just because you have been bitten doesn't mean you have contracted a tick-borne disease, and correctly identifying the type of tick that bit you will help you understand your risk for infection.

7 Vermont has a lot of Lyme disease.

Vermont regularly tops U.S. states for incidence of Lyme disease. The most recent CDC surveillance numbers show Vermont's incidence per 1 million people is 103.6. For comparison, the incidence rate in Connecticut was 38.5, New York's was 17.6, and Massachusetts rate was 4.7.

The CDC designates a state a "high incidence state" when there is an average incidence of at least 10 confirmed cases per 100,000 persons for previous three reporting years. Vermont's three-year incidence rate is 86.7 per 100,000 people.

8 Lyme can affect mood, cognitive performance, and mental health.

According to the Global Mental Health Program at Columbia University "significant cognitive and psychological symptoms are being recognized as part of the symptom pattern associated with untreated and/or chronic Lyme Disease."

Depression can be a component of Lyme disease. Case studies show symptoms of Lyme disease can be similar to symptoms of schizophrenia or bi-polar disorder. Research has also shown a possible connection between Lyme disease and suicidality.

In children, Lyme disease may appear as a learning disability, difficulty with memory or processing, self-harming behavior, vision changes, or ADHD. Learn more about Lyme and mental health at VTLyme.org.

May is Lyme Disease Awareness Month. VTLyme.org, an all-volunteer non profit organization, is currently raising funds to offer free presentations, information and resources to Vermonters about Lyme and tick-borne diseases. More information is available at www.VTLyme.org or at https://www.gofundme.com/vermont-lyme-nonprofit-may-2019-vtlymeorg.

Rebecca Zelis is a mental health professional and the founder of VTLyme.org. She lives in Brandon.


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