Has Climate Change Made Lyme Disease Worse?
Excerpted from the Scientific American : (9/22/2014)
Richard Gardiner had no option but to shut down his law practice in Fairfax, Va. in the summer of 2012. A fit 60 year-old, he came down with a high fever and the worst chills he had known in his life. He spent a miserable summer bedridden with aches and debilitating fatigue.
At around the same time in Bozeman, Mont., 12-year-old Noelle Freeburg – described by her mother as a “healthy-as-a-horse” tween who enjoyed dancing, swimming and skiing – became feverish, dizzy, and doubled over with stomach aches every time she tried to exert herself.
In different corners of the United States, this middle-aged man and middle school girl were embarking on the same frustrating, costly journey. It took both of them months to learn why their health was deteriorating. They were patients on the frontiers of North America’s expanding Lyme disease epidemic.
Less than four decades ago, scientists identified a spiral-shaped bacteria transmitted by the bite of a tiny hard-bodied tick as the cause of an arthritis outbreak among children in southern Connecticut. Since then, Lyme disease has emerged from obscurity to become the leading vector-borne disease in the United States. The 27,203 confirmed new cases reported to federal health authorities in 2013 marked nearly a 25 percent jump over the previous year.
While the disease is reported coast-to-coast, it is highly concentrated on the Eastern Seaboard, with a range expanding north into Canada and south through Virginia. Reasons for the spread are not fully understood but include suburbanization and the growth of suitable habitat for the black-legged tick, according to the U.S. Centers for Disease Control and Prevention. CDC believes climate change may be a factor, and this spring the U.S. Environmental Protection Agency added Lyme disease to its list of climate change indicators.
The CDC estimates that the number of infections is likely 10 times higher than reported, nearly 300,000 new cases per year based on lab test data. Yale University researchers say that 10 percent of the population of southern New England has evidence of a previous Lyme disease infection.
With so much unknown, every aspect of the disease – its spread, diagnosis, and treatment – has become steeped in controversy, with patient advocacy groups often pitted against doctors, the medical insurance industry, and public health authorities. All sides agree that prevention is key, but how to stem the disease is unclear, especially when nature appears to be tipping the balance toward spread of the evasive pathogen, at great cost to health.
“It is so pernicious in its impact on individual lives, particularly children who are undiagnosed and suffer hugely and hauntingly throughout their lives,” said Connecticut Sen. Richard Blumenthal, a Democrat who battled for better treatment guidelines as the state’s attorney general and who is leading a charge for expanded federal funding to address Lyme. “It is life-transforming in a fundamental and profound way.”
Noelle Freeburg began missing school regularly after she took ill in March of her sixth grade year. In seventh grade, she was absent for sickness for 49 days. By eighth grade, she made it to the first day of school, “and that was it,” said her mother, Danielle. “Her day was getting up, eating if she could, and then crawling back into bed.”
Doctors never could determine a cause for her symptoms, which would change often, and sometimes abate. “She had peaks and valleys,” remembers Danielle. “She’d be dizzy with a fever and that would go away in a few days, so we thought it might be viral. Then her knees hurt, and she had severe joint pain.”
One doctor said in a case like Noelle’s, with blood tests showing no underlying problem, the family should look to possible emotional issues. “I get that, but it continued not just during the school year but over summer,” said Danielle. “Stress can explain headaches and a stomachache, but it doesn’t explain a fever.”
The family took her to a holistic health practitioner who asked if Noelle’s Bozeman doctors had considered Lyme disease. “‘We don’t have Lyme disease in this area’ – that was the blanket statement from the pediatricians here,” Danielle said. “No one even asked, ‘Have you traveled?'” In fact, Danielle believes that her daughter was bitten by an infected tick in Montana; she recalls her developing a high fever after a tick bite when she was just 2 years old.