By Roxanne Carfora, D.O.
As America grapples with the worst pandemic in generations, there is another frightening contagion that is sweeping our country. It is one far from the spotlight, ignored in great part by the media and not fully recognized by many of our nation’s practicing healthcare professionals. But it is, nonetheless, an epidemic within the pandemic.
The issue is Lyme disease, the most-commonly reported vector-born illness in the United States. From 2016-2019 the number of Lyme cases in the country rose to nearly 450,000, making Lyme the third most prevalent infectious disease behind Chlamydia and gonorrhea. No one is safe from this, with victims commonly including hikers, campers, hunters, fishermen and other outdoor enthusiasts. Golfers, gardeners, landscapers and children playing field sports are particularly at risk and should thus have their guard up year-round, and especially in summertime which is “Lyme time.”
No longer can Lyme disease lurk in the shadows of our nation’s healthcare agenda. According to the U.S. Centers for Disease Control, tick-borne diseases range from subclinical to fatal infections with disproportionate incidence in children or the elderly. It is no wonder then that a 2019 study conducted by Columbia University’s Mailman School of Public Health called tick-borne diseases “a worldwide threat to public health,” and, in doing so, joined with experts in the medical and scientific communities who have proclaimed Lyme disease an epidemic, a national public health crisis and a growing threat.
In addition to Lyme disease being one of the fastest growing infectious diseases in the country it is also, unfortunately, one of the most arduous to diagnose. Unlike a mosquito bite where people know immediately if they have been bitten, Lyme disease symptoms often do not appear for 2-6 weeks and only about 25 percent of patients even recall getting a tick bite. In addition, Lyme disease presents differently from person to person and often present with other co-infections. Particularly complicating matters today is the fact that Lyme shares many symptoms of COVID-19 including fever, achiness, exhaustion, chills and cough.
Despite these hurdles, early diagnosis is critical. If left untreated, Lyme disease can lead to unintended consequences including neurological defects, heart problems (such as an irregular heartbeat), eye inflammation, liver inflammation, bell’s palsy, meningitis and severe fatigue. Simply put, late diagnosis should not be an option to any clinician and, fortunately, it doesn’t need to be.
My ally in early diagnosis is the Sofia® 2 Lyme FIA test by Quidel Corporation. While other Lyme tests require being sent out for centrifuging and a delay of days to receive results, the Sofia 2 test produces positive or negative results within minutes from a single finger prick. The blood sample is placed on a cassette and inserted into the Sofia 2 analyzer to provide both myself and my patients accurate indicative results right on the spot. This simple and rapid in-office test has become essential to my practice as accelerating detection allows us to know how to proceed in treating the patient, whether the results come back positive or negative.
Winning the battle against any disease has always necessitated igniting a partnership between medical science and the patient, each doing their part and understanding their responsibility. Lyme disease is no different. That means that clinicians have a responsibility to educate their patients that Lyme disease is an epidemic on the rise. Just as we’ve educated the population about COVID-19 and the need to social distance, wash hands frequently and wear a mask, the public needs to be educated on what they can do to minimize the chance of getting a tick bite that could cause Lyme disease. Hikers, for example, should be advised stay on path, spray shoes and ankles with repellent, wear long pants sleeves and check themselves often for ticks or tick bites. In short, be smart and be on guard.
At the same time, clinicians need to do their part in creating an atmosphere wherein curiosity about Lyme disease becomes a normal part of any patient visit. They need to ask a patient “where have you been?” and “what were you doing?” They need to make Lyme a consideration for any patient of any age who complains about fatigue and exhaustion, or who presents with a rash or ongoing headache. Later stages of Lyme disease should never happen. But that is only possible if physicians and other clinicians remember to “think Lyme.”
Roxanne Carfora, D.O. is founder of New York-based Ageless MD which combines family medicine, antiaging medicine & aesthetics in one patient-friendly environment. She is also host of the radio program “Getting You Healthy, Naturally” and co-author of “Ageless Adventures” which provides tips on how to live a more active, healthy lifestyle.