This year there have been 26 confirmed cases of Lyme disease in Tompkins County, an increase from nine confirmed cases in 2007, Carol Mohler, a community health nurse at the Tompkins County Health Department, said.
The numbers of Lyme disease cases in Tompkins County jumped to 26 this year after only two confirmed cases reported in 2006, three in 2005 and five in 2004.
New York State had 4,454 reported cases in 2006.
David Newman, director of the Hammond Health Center at Ithaca College, said he diagnoses Lyme disease one to two times a year.
“Most of them have been cases that have pretty clearly been contracted elsewhere, because our students come from elsewhere,” he said.
Theresa Lyczko, public information officer and director of the health promotion program at the Tompkins County Health Department, said there are a variety of factors that could be responsible for the recent increase in Lyme disease cases.
Lyczko said the definition for Lyme disease has changed this year, meaning what wasn’t considered Lyme disease before might be now. She said the change could account for the increase in diagnoses.
Physicians are also more aware of what to look for when there is a possible outbreak. The Tompkins County Health Department and the New York State Health Department report to physicians when they are notified of a suspected case. This lets physicians know if there is an increase of Lyme disease in the area.
There has also been an increase in the number of ticks in Tompkins County, Lyczko said. She said the number of infected ticks has increased as well, though not all ticks carry the bacterium that causes Lyme disease.
Newman said many cases of Lyme disease go unnoticed, leaving room for diagnostic error. Even though there is an increase in confirmed cases, professionals may not be able to draw real conclusions because of the variable factors.
The first stage of infection presents flu-like symptoms and often a rash that looks like a bull’s-eye, called erythema migrans, or EM. The rash is present in about 70 to 80 percent of infected people, Newman said.
Eighteen of this year’s 26 confirmed cases had the EM rash, Mohler said. The rash alone is enough physical evidence for a physician to confirm a case of Lyme disease if it is greater than or equal to five centimeters in diameter.
Some of those cases were also diagnosed by a blood test for further confirmation, Mohler said.
Mohler said sometimes a physician might not diagnose a case of Lyme disease because a patient will not have the EM rash, which means, without further testing, those cases may go uncounted.
Raymond Ghirardo, professor of art at the college, was diagnosed with Lyme disease in August after an allergic reaction to insect bites. He said he spends time outdoors in the summer, in a fairly wooded area near his home in Danby.
“I never saw a tick,” Ghirardo said. “I never had the traditional bull’s-eye rash. As far as I can tell, I didn’t have any of the other associated symptoms.”
The blood test that some physicians use is not useful in all cases to determine whether a person has Lyme disease, Newman said.
“It’s not a simple matter [to] do a test and tell if you have Lyme disease or not,” he said. “This test relies on the presence of antibodies to the Lyme organism, and using the test is complex.”
Newman said though there are several scenarios in which a person may want a blood test for Lyme disease, the test may be useless if, for example, a person displays symptoms that could also be attributed to another disease.
Newman said the majority of people with Lyme disease recover on their own, and the disease is not generally a serious, life-threatening one, though it can be. Some cases are so mild people may never know they have it. At all stages of infection, Lyme disease is treatable with an antibiotic.
To prevent Lyme disease infection, Lyczko said it’s important to take precautions before and after venturing into grassy or wooded areas where ticks might be. These include wearing long-sleeved shirts and pants and checking body surfaces thoroughly for ticks.
Mohler said the Tompkins County Health Department needs to further research all 26 cases reported this year. The complete 2008 information will not be available until after the end of the year.
“The reality is that Lyme disease has been a bit oversold,” Newman said. “It’s like a lot of other diseases, there’s the tip of the iceberg part that we’re all aware of, the stories that you hear and the cases that are the most severe.”
