Lyme Disease Hits Hard in Acton

Sat, 2009-08-15

Once upon a time, Bambi could do no wrong. The elegance of deer enchanted generations, even if they did dine on crops and shrubbery. That pretty picture has been sullied of late as people increasingly see them as carriers of the notorious and increasingly troublesome deer tick, a prime transmitter of Lyme disease.

For such a tiny bug, the deer tick carries a wallop, inflicting disease carrying bites on unsuspecting residents nationwide but hitting New England states particularly hard. Acton’s Lyme disease cases continue a steady and sharp increase, so much so that the Acton Garden Club recently presented town officials with a 400-signature petition imploring the town to take more aggressive action in tick control.

As a result, the Board of Selectmen has requested that the Board of Health investigate Lyme disease in Acton to recommend an action plan. Residents and officials recently formed what Board of Health chairwoman Joanne Bissetta calls a “working group” of concerned citizens to move forward. “People are very actively interested in this,” Bissetta said. “We thought, ‘Let’s harness their energy and work together on this.”

According to Health Director Doug Halley, Acton sees about 80 or 90 diagnosed Lyme cases each year, up from 20 reported yearly cases 5 years ago. But the increase is two-fold, he said. “It is more likely now for doctors to want to test for Lyme disease,” said Halley, “but it is quite clear that the tick population is greater.”

What Can Acton Do?

While residents are clamoring for the town to do something, only so much is possible, said Halley. There is talk of controlled deer hunts to cull out some of the deer in town. Pesticide spraying is another possibility, but not something many residents want. And a lot of the burden falls on personal prevention and awareness.

“We want to choose a methodology with the most success,” Halley said. That means if a controlled deer hunt is allowed, it will only work if neighboring towns follow suit. “Deer don’t look up and say, ‘We are in Acton now,’” said Halley. “They go where the resources are. If we reduce our deer, we are only making room for more deer from other towns.

“We have to take action, but we want it to be effective,” said Halley, noting that hunting season doesn’t even begin until fall. “We can put measures in place that will make [residents] feel good, but without protecting them any more.”

Lyme disease is a tick-borne disease spread when a person is bitten by an infected tick. It is generally that it takes at least 24 hours for an attached tick to transmit the bacteria that cause disease and not all tick bites will result in Lyme disease. If caught early enough, Lyme disease is treated with a course of antibiotics and generally resolves. Unfortunately, many people are unaware they have been bitten as many deer ticks are so tiny they are not noticed. In about half the cases, people will develop a classic bulls-eye rash around the bite area, but not always. Symptoms usually develop within a month of being bitten, but the warning signs, including flu-like symptoms and muscle and joint pains, are vague and often mimic other maladies. If untreated, Lyme disease can cause chronic joint, heart, and nervous system problems and can cause co-infections including meningitis.

Long-time resident Sandy Bonzagni, an Acton Garden Club member, has had Lyme twice in the past year and realized her case was not unique. She knows Lyme has to be taken seriously. As a result, the Garden Club took on Lyme disease by gathering signatures for a petition urging the town to step up education to residents and to consider the burgeoning deer problem.

Bonzagni has been in touch with regional officials to find out what other towns are doing about deer and ticks so Acton will have some guidelines to follow when it comes time. Right now, she said, people need to write or call town and state officials with their Lyme concerns. “If the townspeople keep pushing it, then [officials] will keep pushing it,” she said.

Doctors Can’t Agree

And while towns grapple with controlling tick bites, even the medical community cannot agree if Lyme is a long-term affliction or not. State Senator Jamie Eldridge said the medical controversy surrounding Lyme disease makes it tricky to approach. Because of the disagreement, some insurance companies deny Lyme treatment by doctors. Pending state legislation mandates insurance coverage for Lyme disease treatment and eliminates liability for doctors who treat Lyme disease, said Eldridge. “We should give doctors the freedom to treat patients,” he said.

According to Senator Eldridge, who has met with many families affected by Lyme disease, the issues facing towns like Acton include addressing the burgeoning deer population and getting information to residents.

“The Department of Health is getting information to the towns and cities to be more aware of where ticks are,” said Eldridge. “But there is more action needed than just awareness because this is rising to the level of a public health hazard.”

Agitation in Acton

As the town is in the earliest stages of addressing the problem, Acton Selectwoman Terra Friedrichs said the town needs to take a broad approach to prevention and also consider that it is nearly impossible to avoid ticks. “They are in an uproar,” said Friedrichs of Acton residents. “But what do you do? Not go into the woods?” Friedrichs said a deer hunt might work in Acton if other towns follow suit, but that it should not occur without properly taking care of the killed deer and using the meat.

Spraying pesticides is another way to control ticks, but there are many residents opposed to that method. For the town to approve spraying, said Halley, it would have to determine the risk to residents from Lyme disease is greater than any risk from pesticide spraying. Years ago, the town declined to spray for mosquitoes when it decided the risk of West Nile virus was relatively low, despite media reports. To spray for ticks, the town would have to make the same determination.

Education is a big component of Acton’s strategy, including trying to get information to residents through the town web site. There have been some signs on conservation land, but more are needed said Bonzagni. And residents have to shoulder some responsibility for protecting themselves.

“There is a role for us to play and a role for individuals to play [in prevention],” said Halley. Bissetta said many residents are not taking enough precaution and need to realize the seriousness of Lyme infections.

The efforts to address Lyme disease in town are going to require the work of many boards. The result is some frustration among residents who want answers and boards that have no concrete solutions yet.

“Because this is a public health issue, it is appropriate for the Board of Health to be dealing with it,” said Halley, who thinks the town is doing enough to look into the matter. But officials will have to work together. The Board of Health can look into Lyme disease in Acton, but has no authority to implement a deer hunt. That decision is up to the Conservation Commission. Nor can the Board of Health designate funds for programs to help with Lyme; that decision belongs to the Board of Selectmen.

Protect Yourself

Despite the best efforts, people still get bitten by ticks. “When you are in the country, you have to have a degree of self-sustainability,” said Friedrichs. “A good part of this is individual responsibility. You have to look for it and if you find [a bite] you have to take care of it.”

Halley said the subcommittee will present preliminary findings to the Board of Health by the end of August. Even if more information is needed, Halley said he hopes recommendations will at least be in place by the end of September. “There is no one magic solution,” said Bissetta, noting that a regional approach to the problem is desirable.

“This is the beginning,” said Bonzagni. “The more people speak up, the more they will be listened to.”

In the meantime, Acton residents have to protect themselves from ticks. They can become more aware of where ticks are and how to avoid tick bites. Rely on the standing advice to wear protective clothing, wear DEET repellant, and stay out of tall grasses and wooded areas. It is a good idea to do daily tick checks on family members and pets to increase the likelihood of catching a tick bite at its earliest stage. Be aware of ticks and possible bites, take photos of any suspicious rash, and see your doctor if you suspect you have been bitten by a tick.

The first Lyme disease working group meeting will be held on August 18 at 6:30 pm.

http://www.acton-ma.gov/CivicAlerts.aspx?AID=26

http://www.acton-ma.gov/index.aspx?NID=143

http://www.lymediseaseassociation.org

http://www.aldf.com/

Under Our Skin video

Cure Unknown: Inside the Lyme Epidemic by Pamela Weintraub

Comments

Lyme Disease

I don’t want to take issue with this well-written article but do want to make a couple of points which I believe could be lost in the discussion and, in my view, are important to understanding solutions to the problem.
• The size of the deer population does have some effect on the movement of the ticks from place-to-place. The deer are NOT the cause of the disease. They are merely a vector.
• In the East, the deer tick is the primary carrier of the disease to both humans, dogs and to a much lesser extent cats.
• The ticks become infected from biting and feeding on RODENTS (the host). If one can reduce the number of rodents (mice, chip monks), there will be a commensu-rate reduction in the number of infected ticks (ticks bite infected rodents and themselves become infected). This can be accomplished by a number of methods including the placement of bait that will reduce the fertility of the rodents.
• Ticks are generally not found in short grassy areas but attach themselves to humans in the areas where they reside which are generally the woodsy areas, the brushy type of areas or transition areas between the grass areas and woods or bushes.
• Dogs are easily infected but are not always symptomatic. When they do become symptomatic, they often exhibit as dogs that have become arthritic. Their treat-ment is pretty much the same has human treatment—generally penicillin or cycline drugs.
• Dogs very often carry the ticks into the home where the ticks can bite humans and lay eggs as long as the home environment is not too dry. There is a great deal of suspicion that many people do become infected by being bit by a tick in their own homes.
• DEET is an effective repellant but can only protect for a few hours or even less de-pending upon the initial concentration of DEET, how much DEET is absorbed through the skin and the amount of perspiration and/or exposure to water. Stud-ies have shown that it only seems to be effective on the areas that have been treated. A tick will simply walk to an area that has not been treated to bite.
• Most experts still believe that the best defense against becoming infected with Lyme Disease is self-inspection on a daily basis. This is particularly important if one has been in an area where there ticks may have been present.
• While there is often a great deal of resistance to utilizing insecticides and arachnicides, there are some, such as Sevin® that are effective against ticks. When used during the evening hours (when most beneficial insects are not active) it has very low toxicity to bees and humans. [Sevin is extracted from chrysanthemums.] It also breaks down very soon after use and does not remain in the environment.

B. Rosen