Preventive measures for Lyme remain low despite risk in Ohio

9/2/2013

COLUMBUS — Health leaders are encouraging more attention to Lyme disease and have bolstered efforts to stop it, but some say Ohio is ill-prepared to alert residents to the threat.

Last month, the Centers for Disease Control and Prevention confirmed what experts had long suspected — that its historically reported incidence of the disease in the United States (about 30,000 cases a year) was really about 10 times that.

The CDC’s top Lyme disease expert called it a “tremendous public-health problem” and urged prevention.

The Ohio Department of Health ended the statewide tick and mosquito surveillance program this year because of federal funding cuts.

State officials say they will help guide local health departments that want do their own surveillance. Columbus Public Health is trapping and testing mosquitoes but not identifying ticks.

Glen Needham, a retired entomology professor from Ohio State University, said most local health departments don’t have the resources to focus on ticks, and surveillance efforts are grinding to a halt.

“The [Lyme-carrying] tick hasn’t been here that long. We found the first established population just in 2010,” he said. “We’ve been watching the emergence from two counties to 26 counties to now maybe 56 counties that may have the tick.

“This kind of information alerts people in those areas that they should be more vigilant.”

The Ohio Department of Health is working to prevent tick-borne illness by educating health-care workers and reaching out to the public in a variety of ways, including through lawmakers and at the Ohio State Fair, spokesman Tessie Pollock said.

But monitoring is the best way to keep Ohioans alert, said Lois Hall, the executive director of the Ohio Public Health Association.

Some have argued that once a disease-carrying insect is here, surveillance shouldn’t make a difference, because prevention should be ongoing.

But Ms. Hall said that human nature doesn’t work that way; a possible threat and a real one are different.

A meteorologist on television “can tell us that the weather conditions are right today for tornadoes, and I’m not going to change a thing,” she said. “People don’t pay attention to generic warnings.”

Ms. Hall said doctors won’t put Lyme disease on their list of things to rule out if they don’t know of threats specific to their communities.

Lyme diagnoses can be difficult. There’s a test for it, but it’s not perfect. And because the disease hasn’t been as prominent in Ohio as in some other states — there were 59 known cases in the state last year — it’s not on doctors’ radar.

Josh Neptune, who lives on 30 partially wooded acres in Coshocton County, suffered for months with severe symptoms of Lyme disease before he finally met an infectious-disease expert who diagnosed it.

His family doctor initially told him Lyme disease was impossible in Ohio, Mr. Neptune said.

His wife, Joy, and 15-year-old daughter, Makala, also have the disease.

Mr. Neptune, 40, struggles with ongoing problems, including balance problems, severe headaches, and vision problems.

The initial, vague flulike symptoms of Lyme disease can sometimes throw off doctors, said Dr. Kurt Stevenson, an infectious-disease specialist at OSU’s Wexner Medical Center.

Once a diagnosis is made, antibiotics are the primary treatment. Early identification and treatment are best because the problem is still localized, Dr. Stevenson said.

“If they develop arthritis or nerve problems, even if you treat the infection, some of the residual damage may persist,” he said. “Usually more antibiotics aren’t going to fix that.”