The number of Lyme disease cases in Berks County has dropped significantly for the first time in three years, but area medical experts say the number of cases will likely increase for the 2018 report.
In its 2017 report, the Pennsylvania Department of Health ranked Berks County as the third lowest in the average annual number of cases per 100,000 in population. In total, the county had 142 recorded cases.
That is a significant decrease from the 463 cases and 585 cases reported in 2016 and 2015, respectively. In 2014, Berks County reported 150 cases.
The department plans to release its 2018 Lyme disease data in June. But during the past 12 months, Reading Hospital recorded more than 1,000 cases of the tick-borne disease, said Dr. Debra Powell, medical director for infection prevention for Tower Health.
The winter months of 2018 were at its highest peak, with Reading Hospital averaging about 50 to 70 cases per month. Powell said its next highest month was in July with 164 cases. This data is based on laboratory identification.
“It’s an endemic disease in our area, so expect that we are going to see more Lyme diagnoses because we have more deer in the area and more ticks,” she said. “If we have a mild winter, we’ll probably see even more of it.”
Dr. David Gasperack, regional medical director for WellSpan Medical Group, said though he believes there will be an increase in the number of ticks in the area, he is uncertain if a milder winter will be a factor.
“Where we live, we are going to get a freeze regardless of whether the winter is mild or not,” he said. “It’s really based on geography and how much time you spend outside.”
Geographically, a majority of the Lyme disease cases lie in the Middle Atlantic and New England states. The CDC reported that the number of positive cases increased by 78 percent just in Pennsylvania, which led the nation with about 11,900 cases in 2017.
One reason that Pennsylvania has been the top-ranked state may be that all Lyme disease cases have been documented by local physicians and then sent to the state’s Department of Health.
To combat Pennsylvania’s potent health problem, Gov. Tom Wolf added $2.5 million in his 2018-19 budget to hire staff at the Department of Health to implement the Lyme Disease Task Force’s 18 recommendations. These recommendations include more surveillance, prevention and education programs and a statewide environmental survey.
Lyme disease is usually spread via a bite from an infected black-legged tick or a deer tick, generating early symptoms including fatigue, headache and muscle aches.
People with Lyme disease often develop circular rashes called erythema migrans, which resembles a Target-logo-like bullseye with a red dot in the middle, a white ring around that and then another red ring and white ring.
It is rare for a person to die of Lyme disease, but if symptoms are left untreated, they can worsen to conditions like severe rashes, arthritis, severe joint pain, facial palsy and heart problems. When used correctly, antibiotics are the common treatments.
“The CDC does recommend the one-time dose of antibiotics, a one-time dose of doxycycline to prevent Lyme,” Gasperack said.
Powell said that if a patient’s symptoms last for a couple weeks, he or she must get an antibody test done. For symptoms located in the knees and hips, the health provider can tap the knee, pull fluid out and test that fluid for Lyme.
“You have to do the right test in order to diagnose it,” she said. “It depends on who the patient is seeing to do the right test.”
Anybody can be at risk for Lyme disease.
In one case, a man in his 50s passed out in his shower. His heart rate was so slow that a pacemaker was initially supposed to be implanted in him. After more questioning, it was discovered that the man had gotten some tick bites. Powell said she performed an antibody test to determine if he had Lyme disease. The result came back positive, and the man was treated with antibiotics.
“His white blood cell count was elevated, and the concern was whether he had an infection,” said Powell.
Two years ago, a school nurse found a tick in the hip of Gasperack’s son Carter. She removed the tick at school and sent it to the then 8-year-old’s home in a plastic bag. Carter was monitored but was not treated with antibiotics immediately.
“We never saw the rash,”Gasperack said. “Then, three to four months later, out of nowhere, he just developed right-knee pain. His right knee got very swollen and red, and he got a fever.”
A preliminary antibody test, called the enzyme-linked immunosorbent assay, or ELISA, came back positive, and Carter was treated with antibiotics and recovered.
The CDC says ticks hide and bite inconspicuous areas of the body. So it is important for people, who have spent a considerable amount of time in wooded or grassy tick-infested areas, to check under their arms, in and around their ears, inside their belly button, behind the knees, in and around the hair, between the legs and around the waist. For a more effective body inspection, use a hand-held or a full-length mirror.
Parents should inspect their children for ticks after they have been outside. Adults and children should also change their clothes and take a shower within two hours of coming indoors. It is also important to check your pets on a monthly basis.
If people are going to be in a wooded or grassy damp area, it is best to wear boots, long pants and long-sleeved shirts. Check your clothing for ticks. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after coming indoors.
The CDC recommends wearing insect repellents containing NN-Diethyl-meta-Toluamide, or DEET, which is the most common ingredient.
“Repellents that contain 98 percent DEET will last about 10 hours, but most only contain 7 percent DEET and only last about two hours,” Gasperack said.
The best prevention for Lyme disease is to simply avoid tick-infested habitats, experts say.
Contact Rosalba Ugliuzza: specialsections@readingeagle.com.
