Do you feel carefree in Central Park, safely isolated from the famous Lyme disease locations upstate in Long Island, Connecticut and New Jersey?
After all, Lyme spreads from deer ticks, and there are no deer in Central Park. But deer ticks are also carried by rodents, such as mice and birds that are spreading Lyme into new areas. What about all those squirrels?
University of California studies have found squirrels in California to be infected with the Lyme bacteria (Borrelia burgdorferi). University of Oxford research states that squirrels carry the ticks that spread Lyme disease in the U.K.
Ticks are Mobile and Spreading
Yet there is a bigger animal that can carry numerous deer ticks, right into the city, into apartments and houses. That's right, I am talking about man's best friends: dogs. Now, I am a big dog lover, and our family has always had a dog. But dogs carry ticks, including deer ticks that carry Lyme disease (Borrelia burgdorferi) and other tick-borne diseases.
Speaking of dogs and ticks, the U.S. Centers for Disease Control and Prevention (CDC) explains the American dog tick is a common transmitter of Rocky Mountain spotted fever. The CDC states:
Rocky Mountain spotted fever (RMSF) is a tickborne disease caused by the bacterium Rickettsia rickettsii. This organism is a cause of potentially fatal human illness in North and South America, and is transmitted to humans by the bite of infected tick species.
Dog ticks are found "in abundance" in all five boroughs of New York City.
Deer Ticks in New York City Parks
According to The NYC Department of Health and Mental Hygiene: "The black-legged tick (deer tick) has been found in some park areas of the Bronx, Staten Island, Queens and Brooklyn." About half of the deer ticks collected in the study tested positive for Borrelia burgdorferi, so they could transmit Lyme disease.
Yet this could be the tip of the iceberg when it comes to deer tick presence in New York City. The report cited above explains that information on tick populations in NYC "is limited" and based on just a few studies by Fordham University and the The NYC Department of Health and Mental Hygiene.
In scientific literature it has been noted that many cases of Lyme disease go undiagnosed. When you look at the reported numbers, keep in mind the actual figures could be much higher.
Lyme Disease Cases Grow
In New York City in 2001, there were 228 confirmed Lyme disease cases diagnosed. This number grew to 643 by 2009. Looking at the United States as a whole, the CDC notes that confirmed cases of Lyme disease went from 19,804 in 2004 to 29,959 in 2009.
Lyme Disease -- Not in My Backyard
It is time we rethink the supposed geographic barriers to Lyme disease. People often tell me that "there is no Lyme disease in my town" when they come from Northwestern Connecticut, or Vermont, or even Long Island. This type of "not in my backyard" thinking is not going to help in the challenging fight to prevent, test for, treat and cure Lyme disease.
Not on the East Coast or California? Research proves that Lyme disease is spreading to the Midwest and into Canada. Lyme disease has been reported in more than 70 countries and is one of the most common tick-borne diseases in China.
So let me illustrate how Lyme can occur in the city.
Michael, an avid softball player, developed muscle aches, fatigue, fever and chills last May. When he went to the doctor, he told Michael that he had the flu and sent him home, but he continued to get worse. Michael hadn't left New York City in a year, and the doctor who saw him never suspected Lyme disease.
His symptoms continued, so he came to my office. When I suggested that he could have urban Lyme disease -- a typical Lyme infection acquired in cities rather than the suburbs or countryside, he was initially surprised.
Then he recalled that he had seen a deer tick in his apartment on the Upper East Side a week before his symptoms started. He didn't notice a tick bite, but that is a common experience among people who get Lyme.
A blood test confirmed the presence of antibodies to the Lyme bacteria, Borrelia burgodrferi, and revealed a pattern of recent infection. A few weeks taking the antibiotic, doxycycline, cleared his symptoms, and a year later he's totally fine.
So, how did Michael catch Lyme disease in Manhattan?
Well, every weekend he'd play ball on the grass in Central Park. Think about the grass in city parks. Dogs walk on it. Many of these same dogs spend weekends with their owners in the Hamptons, upstate, or in Connecticut, all hotbeds for Lyme disease, where they can easily pick up deer ticks and bring them back to their city homes.
Although the ticks that spread Lyme disease, Ixodes scapularis, are popularly known as deer ticks, they also live comfortably on small rodents and birds, so they can easily hitch rides to urban parks.
Get to Know about Lyme Disease
Deer ticks are so tiny that you may not see them biting you. While the classic rash caused by a deer tick bite looks like a target ("bull's eye" rash), many people see no rash.
Lyme disease symptoms can occur within days or weeks after infection. Timely treatment improves the cure rate, but chronic infection can persist and lead to a wide variety of serious symptoms in any part of your body such as joints, muscles, nervous system, and heart.
People with unexplained fatigue, fever or muscle pain, or acute change in emotional or cognitive function, or with a diagnosis of autoimmune or degenerative neurological disease, should be evaluated for Lyme.
So where could you get Lyme disease? Anywhere a dog goes, and these days our dogs travel -- a lot. Our favorite pets travel around the country with us, and could bring along an uninvited guest: the deer tick.
Learn how to combat Lyme disease, a persistent and challenging foe, in "Fighting Back Against Lyme Disease."
Now I'd like to hear from you: Do you have unexplained symptoms? Have your been tested for Lyme disease or other tick-borne diseases? How do you think you may have gotten Lyme?
Please let me know your thoughts by posting a comment below.
Leo Galland, M.D.
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Leo Galland, M.D. is a board-certified internist, author and internationally recognized leader in integrated medicine. Dr. Galland is the founder of Pill Advised, a web application for learning about medications, supplements and food. Sign up for FREE to discover how your medications and vitamins interact. Watch his videos on YouTube and join the Pill Advised Facebook page.
References and Further Reading:
- See how Lyme disease spreads in Midwest
- More: Risk of Lyme Disease Expands
- Read: "Spring Surge in Lyme Disease"
- Learn how Lyme disease hides in lymph nodes
Am J Trop Med Hyg. 2008 Oct;79(4):535-40. "Identifying the reservoir hosts of the Lyme disease spirochete Borrelia burgdorferi in California: the role of the western gray squirrel (Sciurus griseus)." Salkeld DJ, Leonhard S, Girard YA, Hahn N, Mun J, Padgett KA, Lane RS. Department of Environmental Science, Policy and Management, and Office of Laboratory Animal Care, University of California, Berkeley, California
J Wildl Dis. 2010 Jan;46(1):291-6. "Coinfection of western gray squirrel (Sciurus griseus) and other sciurid rodents with Borrelia burgdorferi sensu stricto and Anaplasma phagocytophilum in California." Nieto NC, Leonhard S, Foley JE, Lane RS. Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, California
Folia Parasitol (Praha). 1997;44(2):155-60. "Role of grey squirrels and pheasants in the transmission of Borrelia burgdorferi sensu lato, the Lyme disease spirochaete, in the U.K." Craine NG, Nuttall PA, Marriott AC, Randolph SE. Department of Zoology, University of Oxford, UK.
N Engl J Med. 1988 Dec 1;319(22):1441-6. "Seronegative Lyme disease. Dissociation of specific T- and B-lymphocyte responses to Borrelia burgdorferi." Dattwyler RJ, Volkman DJ, Luft BJ, Halperin JJ, Thomas J, Golightly MG.
Am J Clin Pathol. 1996 May;105(5):647-54. "Polymerase chain reaction detection of Lyme disease: correlation with clinical manifestations and serologic responses." Mouritsen CL, Wittwer CT, Litwin CM, Yang L, Weis JJ, Martins TB, Jaskowski TD, Hill HR.
New York City Department of Health and Mental Hygiene. "DOHMH Advisory #10: Tick-borne Disease Advisory." June 16, 2011
Vector Borne Zoonotic Dis. 2011 Oct;11(10):1351-8. Epub 2011 Jun 20. "Ixodes scapularis and Borrelia burgdorferi among diverse habitats within a natural area in east-central Illinois." Rydzewski J, Mateus-Pinilla N, Warner RE, Hamer S, Weng HY. Department of Natural Resources and Environmental Sciences, University of Illinois at Urbana-Champaign, 1816 S. Oak Street, Urbana, IL 61820, Researchers from the University of Illinois department of pathobiology and Michigan State University also contributed to this study.
Leighton, P. A., Koffi, J. K., Pelcat, Y., Lindsay, L. R. and Ogden, N. H. (2012), "Predicting the speed of tick invasion: an empirical model of range expansion for the Lyme disease vector Ixodes scapularis in Canada" Journal of Applied Ecology, 49: 457-464. doi: 10.1111/j.1365-2664.2012.02112.x published by the British Ecological Society, Faculty of Veterinary Medicine, University of Montréal, 3200 Sicotte, C.P. 5000, Saint-Hyacinthe, QC J2S 7C6, Canada
N Engl J Med. 2013 Jan 17;368(3):291-3. doi: 10.1056/NEJMc1215469. "Human Borrelia miyamotoi infection in the United States." Krause PJ, Narasimhan S, Wormser GP, Rollend L, Fikrig E, Lepore T, Barbour A, Fish D.
This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine or the provision of health care diagnosis or treatment, (iii) or the creation of a physician-patient relationship. If you have or suspect that you have a medical problem, contact your doctor promptly.
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