By Richard Telford
In the fall of 2013, our five-year-old daughter complained of soreness in one of her wrists. We asked if she had banged it or taken a fall. She said no. Comparing the wrist in question to her other one, we realized that the swelling was bilateral. The lack of an obvious cause of injury, in conjunction with an observable sense of malaise in an otherwise energetic child, raised alarm bells for us. We promptly asked her pediatrician to order a test for Lyme disease; several days later, the test came back positive.
Lyme disease is caused by Borrelia burgdorferi, a bacterium transmitted through the bite and subsequent engorgement of its primary vector, the blacklegged tick (Ixodes scapularis), also known as the deer tick. Immediate symptoms include fever, headache, fatigue, and, sometimes, what is commonly called a “bull’s-eye rash” at the site of the bite. Untreated, the disease can infect the joints, heart, and central nervous system, causing an array of serious and debilitating symptoms. Early treatment with doxycycline is effective in most cases, but in 10- 20% of treated cases, serious symptoms can persist in affected individuals for several years or more. Commonly called Chronic Lyme, the Centers for Disease Control terms this condition Post-Treatment Lyme Disease Syndrome, or PTLDS. The existence of PTLDS, which is largely attributed to residual tissue and immune system damage, has been the subject of great controversy, and I plan to write about this controversy in a later post on The Ecotone Exchange.
According to the CDC, in 2012, the most recent year for which statistics are available, our home state of Connecticut had 1653 confirmed cases of Lyme disease and an additional 1004 probable cases, with an incidence rate of 46 cases per 100,000 population. The CDC further reports that Lyme disease is “the most commonly reported vectorborne illness in the United States,” which is striking in that 95% of Lyme disease cases were reported in only 13 states in 2012. Even more striking is the fact that the earliest cases of Lyme disease, 51 in total, were first reported in 1975, only 39 years ago. In a 1976 letter to Connecticut’s regional and local directors of health, State Department of Health Commissioner Douglas S. Lloyd noted that 51 residents of Old Lyme, Lyme, and East Haddam Connecticut had been diagnosed with a form of arthritis characterized by “short and mild but often recurrent attacks of pain and swelling in a few large joints,” as well as “fever, headaches, weakness and a skin rash […].”
The Commissioner went on to note that “seasonal and geographic distribution of cases and the association with a skin lesion suggest that a virus carried by a biting insect may be responsible for this disease.” However, until researchers could “isolate an infectious agent,” Lloyd cautioned, “Any other action taken now to prevent contact with an unknown virus carried by an unknown insect would disrupt the community far more than is warranted by the facts.” There could be no sense at that time that the occurrence of this mysterious disease would rise meteorically in the coming decades, spiking to a high of 29,959 confirmed cases in the United States in 2009. It is important to note, too, that these statistics almost certainly represent a significant underreporting of actual cases in the United States for a variety of reasons, which the CDC itself acknowledges.
In the spring of 2012, the Connecticut Audubon Society held a series of four public panel discussions in which they asked panel experts and audience members to answer the following question: Where is the next generation of conservationists coming from? As a professional educator and CAS volunteer, I was invited to sit on one of these panels. At the center of the discussion was the fact that children today spend considerably less time directly interacting with the natural world, especially in unsupervised exploration. Reasons posited for this included the influence of personal communications devices and social media platforms, over-programming of extra-curricular activities in children’s lives, the lack of well developed environmental science curricula in many schools, and fear in various forms—fear of abduction, fear of animal attack, fear of injury, and, most pertinent here, fear of Lyme disease.
The proliferation of Lyme disease has serious long-term implications for the conservation movement that mirror its serious long-term implications for public health. This is especially true in the northeastern and upper midwestern states, where it is not hyperbole to characterize the proliferation of Lyme disease in these regions as epidemic. In the 72 hours leading up to the submission of this essay, I removed one imbedded blacklegged tick from our two-year-old son’s ear, two from my leg, one from my stomach, and a number of others from our and our children’s clothing. Blacklegged ticks are ubiquitous and can often imbed themselves and transmit the Borrelia burgdorferi spirochete undetected. In spring, summer, and fall, thorough nightly tick checks are a necessity in our family, yet we fear we are instilling in our children the notion that the natural world is a hostile place rather than a welcoming one, a place of danger rather than a place of solace and rejuvenation. Children who grow up fearing the natural world have little incentive to help conserve it.
Eight months after my daughter’s treatment for Lyme disease, she shows no signs of being in that 10-20% of the Lyme-affected population with persistent, recurring symptoms. Her initial test results suggested an early diagnosis, and we are hopeful that this was the case. Along with that hope, though, we are plagued with a persistent fear—that, in the act of immersing our children in the natural world that we ourselves love so much, we must also subject them to the onerous and potentially long-lasting symptoms of an unseen and virulent disease carried by a likewise unseen host. This is a fear with which the conservation movement needs to come to grips. It cannot be dismissed or minimized. It must instead be openly acknowledged and addressed through increased, proactive education on prevention, identification of signs and symptoms, and treatment of Lyme disease. This must be done both for the benefit of public health and for the benefit of the natural world itself.