Field Guide to Ticks
Introduction to the Field Guide Edition
In 2001, when this book was first published, as Outwitting Ticks, the mystery of the origins of Lyme disease and the role of the deer tick, Ixodes scapularis, in its transmission were well known. Since then, deer ticks have not changed their habits, nor has the Lyme disease germ, Borrelia burgdorferi. Since 1997, Lyme disease cases have been reported in every state in the Union with the exception of Montana. In some states it is rare, such as Alaska, Hawaii, Mississippi, North Dakota, South Dakota and Colorado. In some states, particularly in the Northeast and the Midwest, reported cases generally continue to increase in number. (Centers for Disease Control, www.cdc.gov)
The standard and effective treatment for Lyme disease also has not changed much. Antibiotics administered early in the infection usually result in a total cure. Complications are rare. However, the understanding and treatment of what has been called Chronic or Persistent Lyme disease, or Post-Lyme disease Syndrome, has changed significantly. When this book first went to press, studies were underway to determine the best treatment for cases that appeared to not be cured by initial antibiotic treatment. These were usually cases not diagnosed until the second or third stage of the disease. Scientists hoped to determine whether or not extended antibiotic treatment provided cure or relief for those with persistent symptoms.
The studies, as reported by the National Institute of Allergy and Infectious Diseases (NIAID, www.nih.niaid.gov, a division of the National Institutes of Health), determined that long-term antibiotic treatment does not necessarily improve the health or well-being of persons with what is now called Post-Treatment Chronic Lyme disease (PTCLD). NIAID notes at www.niaid.gov that “it is unclear whether such symptoms are due to a long-term persistent infection or other causes.” On a more hopeful note, the web site reports on successful treatment of PTCLD pain using a neuropathic drug. It also notes that the complete genome for Borrelia burgdorferi has been sequenced by scientists at The Institute for Genomic Research (Nature 390:580, 1997) and that “the application of this information will play a significant role in increasing our understanding of the pathogenesis of Lyme disease at the molecular and cellular levels....” This knowledge should also contribute to the development of improved diagnostic tests. Currently, the observation of clinical symptoms remains the primary diagnostic tool for Lyme disease.
Now, as before, the best defense against Lyme disease is prevention and, failing that, early diagnosis and treatment. The habits and habitats of ticks are explained in this book and will help you to prevent infection. Symptoms of Lyme disease and its progress are also described. If you think you have the symptoms and have been in deer tick country, seek medical attention, and let the practitioner know that you might have been exposed to Lyme disease.