How Big of an Issue is Lyme Disease Today on the AT

[tdoczi]

If a hiker were to start taking Doxy just because of a tick bite and nothing else they would be acting foolishly. I also agree with Muddy.

a close friend of mine, who is not a hiker, was bitten by a tick once. he went to the dr (or maybe it was the hospital even) to have it removed. the dr sent it out to be tested, and pending test results, started him on doxy. it happens. i bet if i just walk into a dr's office without even a tick attached and tell them ive been bitten by a tick they might give it to me. if i were also throw in ive been feeling sluggish and achey, they almost certainly would. and maybe ive been feeing that way for a whole host of other reasons, or maybe its all just in my head because of the tick bite. in either case, a small contribution towards creating a potentially new disease that actually is fatal and life threatening has been made, and why? fear.

[squeezebox]

The accuracy of the testing just isn't perfect yet. Therefore the just in case happens. Overuse of antibiotics? Probably. Dangerous? less than a bad case of Lyme. Misunderstanding or lack of understanding? plenty. Look at Ebola 25 yrs ago and now.
The Dr. is covering his ass, his lawyer's ass, and the patient's ass.
Creating a new disease? I wouldn't go there.

[tdoczi]

The accuracy of the testing just isn't perfect yet. Therefore the just in case happens. Overuse of antibiotics? Probably. Dangerous? less than a bad case of Lyme. Misunderstanding or lack of understanding? plenty. Look at Ebola 25 yrs ago and now.
The Dr. is covering his ass, his lawyer's ass, and the patient's ass.
Creating a new disease? I wouldn't go there.

not dangerous for the person taking the antibiotics, no.

i posed the question not to you, but i'll pose it again. do you know what MRSA is? do you know why it is so dangerous, and unlike lyme, actually can kill you or seriously and permanently mess you up? no, it is not directly related to the antibiotics used in treating lyme, i dont think, but conceptually the overuse of doxy can certainly contribute to the rise of other superbugs.

[tdoczi]

http://www.tufts.edu/med/apua/about_...ioticres.shtml

[Sarcasm the elf]

a close friend of mine, who is not a hiker, was bitten by a tick once. he went to the dr (or maybe it was the hospital even) to have it removed. the dr sent it out to be tested, and pending test results, started him on doxy. it happens. i bet if i just walk into a dr's office without even a tick attached and tell them ive been bitten by a tick they might give it to me. if i were also throw in ive been feeling sluggish and achey, they almost certainly would. and maybe ive been feeing that way for a whole host of other reasons, or maybe its all just in my head because of the tick bite. in either case, a small contribution towards creating a potentially new disease that actually is fatal and life threatening has been made, and why? fear.

I do not doubt anything you have said in the quote above, however I have been fortunate enough to have two different doctors over the past 15 years who have both pushed back when I came in with a probable case of Lyme. Both times I tested positive and one of those times I had full blown symptoms so I ended up getting put on a full course of Doxy, however I was glad to know that I had found myself MD's that weren't just going to write a scrip every time I came in just to get me out of their office.

On a side note since, being on Doxycycline is miserable and some of the side effects can be potentially harmful. A lot of people including myself find that we are nauseous throughout nearly the entire course of the antibiotic. It also drastically increases your sensitivity to the sun so you can get a sunburn from very minimal exposure, it got so bad for me last time that I ended up walking around Manhattan on a hot day wearing long pants, sunglasses, and my rain shell just to avoid getting burned. I think that people who take it "just in case" are nuts.

[imscotty]

a close friend of mine, who is not a hiker, was bitten by a tick once. he went to the dr (or maybe it was the hospital even) to have it removed. the dr sent it out to be tested, and pending test results, started him on doxy. it happens. i bet if i just walk into a dr's office without even a tick attached and tell them ive been bitten by a tick they might give it to me. if i were also throw in ive been feeling sluggish and achey, they almost certainly would. and maybe ive been feeing that way for a whole host of other reasons, or maybe its all just in my head because of the tick bite. in either case, a small contribution towards creating a potentially new disease that actually is fatal and life threatening has been made, and why? fear.

A single dose of Doxy after a tick bite for prophylaxis is actually the procedure recommended by the CDC (in most cases). The following is from the CDC website...

TICK BITE PROPHYLAXIS
The Infectious Disease Society of America (IDSA) does not generally recommend antimicrobial prophylaxis for prevention of Lyme disease after a recognized tick bite. However, in areas that are highly endemic for Lyme disease, a single dose of doxycycline may be offered to adult patients (200 mg) who are not pregnant and to children older than 8 years of age (4 mg/kg up to a maximum dose of 200 mg) when all of the following circumstances exist:

1. Doxycycline is not contraindicated.
2. The attached tick can be identified as an adult or nymphal I. scapularis tick.
3. The estimated time of attachment is ≥36 h based on the degree of engorgement of the tick with blood or likely time of exposure to the tick.
4. Prophylaxis can be started within 72 h of tick removal.
5. Lyme disease is common in the county or state where the patient lives or has recently traveled, (i.e., CT, DE, MA, MD, ME, MN, NH, NJ, NY, PA, RI, VA, VT, WI).

Lyme is no fun. If you discover a deer tick imbedded in you, see your Dr. and try to nip it in the bud.

[tdoczi]

A single dose of Doxy after a tick bite for prophylaxis is actually the procedure recommended by the CDC (in most cases). The following is from the CDC website...

TICK BITE PROPHYLAXIS
The Infectious Disease Society of America (IDSA) does not generally recommend antimicrobial prophylaxis for prevention of Lyme disease after a recognized tick bite. However, in areas that are highly endemic for Lyme disease, a single dose of doxycycline may be offered to adult patients (200 mg) who are not pregnant and to children older than 8 years of age (4 mg/kg up to a maximum dose of 200 mg) when all of the following circumstances exist:

1. Doxycycline is not contraindicated.
2. The attached tick can be identified as an adult or nymphal I. scapularis tick.
3. The estimated time of attachment is ≥36 h based on the degree of engorgement of the tick with blood or likely time of exposure to the tick.
4. Prophylaxis can be started within 72 h of tick removal.
5. Lyme disease is common in the county or state where the patient lives or has recently traveled, (i.e., CT, DE, MA, MD, ME, MN, NH, NJ, NY, PA, RI, VA, VT, WI).

Lyme is no fun. If you discover a deer tick imbedded in you, see your Dr. and try to nip it in the bud.

leaving aside how i personally feel about that recommendation, my friend was not given a single dose, he was put on a course.

[tdoczi]

I do not doubt anything you have said in the quote above, however I have been fortunate enough to have two different doctors over the past 15 years who have both pushed back when I came in with a probable case of Lyme. Both times I tested positive and one of those times I had full blown symptoms

were the symptoms the first time or the second time?

i know its not entirely equivalent, but i dont think its entirely irrelevant either- my dog is permanently positive for lyme, on CERTAIN tests. after about the 5th positive i finally convinced my vet to stop telling me to give my dog doxy and to only rely on the test that never shows him positive. depending on what else they were testing for they were using different tests, one always was, and i assume always will be, positive. the other has always been negative.

[MN Star]

if i get lyme disease? i will chalk it up to bad luck and much like i did with giardia, i will get it treated and go back to what i was doing. no biggie.

i'm not sure what attitude you're referring to. you seem to almost be comparing me to people who recklessly get lost because of their own carelessness and need to be rescued as a result. if so, my response to that is something not fit to say in public.

My ex-boyfriend was on a weekend motorcycle trip in WI and a month later was in the ICU from Lyme after it began affecting his major organs. He also thought taking tick precautions was silly.

I'm happy for you that you aren't afraid. I really am hoping you end up right in the end thinking we are just scared sheeple idiots. I really do. No one deserves to find out that they should have been more careful after a week in the ICU.

Good luck!

[tdoczi]

My ex-boyfriend was on a weekend motorcycle trip in WI and a month later was in the ICU from Lyme after it began affecting his major organs. He also thought taking tick precautions was silly.

I'm happy for you that you aren't afraid. I really am hoping you end up right in the end thinking we are just scared sheeple idiots. I really do. No one deserves to find out that they should have been more careful after a week in the ICU.

Good luck!

sorry for your bf and for anyone who goes through that, but there are probably 25 other things with way better odds of landing me in the ICU. and the fact that he wasnt even hiking (or maybe they were camping while riding?) tells me that if you are going to be struck with lyme it can happen at a random, seemingly inexplicable time and place just as well as it can while out hiking. one cant protect themselves against it 24/7/365 can they? i mean i suppose you could, but no thanks.

[Traveler]

I have a question... about the ticks that carry Lyme (deer ticks only I presume?)... are they just out in the summer time or are they a year round issue? Same question for RMSF. Usually a good frost or two kills most summer bugs, but not so sure about these.

The short answer is, deer ticks can be active year round, with a bit of a caveat. "Tick Season" for these pests is typically considered early spring into late fall, however they can be active anytime the temperature around them is above freezing. Even ticks that appear dormant or dead will quickly liven up once the temperature goes above 32 degrees and can get rambunctious when its over 40. I will usually check my pants after being out on trails in winter, even in temperatures well below freezing and will find a tick here and there on them.

[Don H]

When your only other option is to stay home, you just go , be prudent, and deal with it if it happens. Thats all anyone can do. Its all anyone does.

Good advice. I would add do your own research, learn the signs and symptoms and talk with your doctor.

Some of the information posted has been just flat out wrong.

I had a physical just before leaving on my thru. My doctor asked what my greatest concerns were, my answer was plantar fasciitis (I have a history of this) and Lyme disease. My doctor discussed the Lyme issue and gave me a 7 day prescription for Doxycycline to take with me.

I ended up getting Lyme disease in Massachusetts. I called my doctor and he called in a prescription for another 21 days. Testing after I got home showed I had indeed contracted Lyme. I believe that recognizing the symptoms and starting Doxy immediately was key in a quick recovery.

[Offshore]

so you have no data of any kind to share then?

I can't think of any better data source than the CDC. Proper interpretation is what makes data useful information, and that's what's sorely lacking in your series of posts. The purpose of my reply was not to try to convince you to change your outdoor health and safety protocol - so check the ego. It is a heads up to others that you are taking raw data and drawing conclusions that are unsubstantiable on even an empirical level.

[Connie]

you need to review this thread i think. it went something like this-

OP- is lyme disease a real concern or is trumped up and exaggerated?

me- trumped up and exaggerated. i dont worry about it.

everyone else- what!?!?!?! are you crazy!?!?!? thats nonsense!!!!! how can you say such a thing!?!?!?!?

me- well here, let me tell you...

have i told anyone what to do? have i tried to convince anyone not to take precautions? no, you want to walk around in long pants and sleeves in august thats all you. but as much as you dont like me trying to convince others not to do it, i dont particularly like others trying to convince people to do it.

moving beyond that, to a more serious extension of this (that you question if it exists, but it does, people on this very board have said they do it, though thankfully, not many) if a hiker is walking around with a prescription antibiotic and starts taking it because he/she has been bitten by a tick, sorry, that person is acting foolishly and selfishly and is, frankly, dangerous. another thing hikers get is MRSA. do you know why MRSA exists and is the concern that it is?

Did you get giardia, with your "why bother taking precautions" attitude?

If you are in the USA, the only treatment alters human DNA. I think that is unacceptable.

If you are in Canada, there is less risk from the treatment for giardia. At least, that is available in Canada.

I am not in Canada. I always used "good practice" in getting water, in prefiltering, in backflushing the filter, and, in using chemical treatment or I carried water, even if it meant having a pack horse for spending weeks at a time out where the water sources were not acceptable. But, that's "just me" according to you.

[FlyPaper]

Really? I am a vet.

There is "no way" I could get the VA to hand out antibiotics, and my private MD would never do it either.

The fact is, hikers are atypical for the amount of exposure to ticks and thru-hikers more atypical.

I would say that increases your chance of getting an infected tick and that statistic would be more than a random chance of death by car accident, much more so, of injury by car accident, because of the sample size: nearly every adult drives a car but hikers are a smaller sample and hikers have more exposure than the general public.

Indeed. I would guess that for one single day on the trail, you are 1000+ times more likely to get a tick bite than in one single day as an office worker in a big city. Presumably that means you're 1000+ times more likely to get Lyme's disease. The overall number of cases is low for the whole population, but I think we all need to take the threat very seriously when hiking, especially in the north east.

[tdoczi]

Did you get giardia, with your "why bother taking precautions" attitude?

If you are in the USA, the only treatment alters human DNA. I think that is unacceptable.

If you are in Canada, there is less risk from the treatment for giardia. At least, that is available in Canada.

I am not in Canada. I always used "good practice" in getting water, in prefiltering, in backflushing the filter, and, in using chemical treatment or I carried water, even if it meant having a pack horse for spending weeks at a time out where the water sources were not acceptable. But, that's "just me" according to you.

the story of my own ideas on why i got giardia is in a prior post in this thread.

alters human DNA? the standard medical treatment is a course of metronidizale (sp?) it can also be treated, i later found out, by large doses of bismuth, but also, most people just clear it from their systems naturally.

[tdoczi]

Indeed. I would guess that for one single day on the trail, you are 1000+ times more likely to get a tick bite than in one single day as an office worker in a big city. Presumably that means you're 1000+ times more likely to get Lyme's disease. The overall number of cases is low for the whole population, but I think we all need to take the threat very seriously when hiking, especially in the north east.

i'm reminded of one of my favorites simpsons lines- "whats a billion times zero!?!?! AND DON"T SAY ZERO!." (i suppose in this case its probably more like 1000 x .000000000000000000002167, but, it still reminded me of the quote).

[Lnj]

The short answer is, deer ticks can be active year round, with a bit of a caveat. "Tick Season" for these pests is typically considered early spring into late fall, however they can be active anytime the temperature around them is above freezing. Even ticks that appear dormant or dead will quickly liven up once the temperature goes above 32 degrees and can get rambunctious when its over 40. I will usually check my pants after being out on trails in winter, even in temperatures well below freezing and will find a tick here and there on them.

Thanks ATT. That is very surprising to me. Glad to know it. I will be sure to take the necessary precautions. We did Grandfather Mountain a couple of weekends ago and took zero precaution, as I thought it was too cold for them now.

[squeezebox]

No reason to be paranoid, no reason to be careless. Find the happy middle.

[Koozy]

During my 2014 thru hike, I knew just about as many people that got Lyme disease and those that didn't. VA through MA generally, but not restricted to that area by any means. Talking with other hikes from 2014 we estimated that approximately 50% of thru hikers came down with Lyme disease. Luckily I was not one of them.