By David Harry

Staff Writer

The plastic planters on the porch of the Tibbetts home in Scarborough mean Joanne Tibbetts is ready to get back into her garden.

When she gets to work this year it will be without the aches and pains from Lyme disease, now alleviated by antibiotics she’s taken since diagnosed with the disease last year.

Reported cases of Lyme disease, spread by bacteria from deer ticks, are increasing, said Dr. Stephen Sears, state epidemiologist at the Maine Center for Disease Control and Prevention. 

Five years ago, Sears said Maine had 250 to 300 reported cases of Lyme disease, almost exclusively in York and Cumberland counties. Last year, that total increased to 970 reported cases.

The majority of reported cases still occur in York and Cumberland counties. Sears said it’s hard to determine if the increase in reported cases is a result of more infected deer ticks or increased awareness of the disease.

At a lab near the Maine Mall, Susan Elias researches ticks she receives in the mail.

Elias, a clinical research associate at the Vector-borne Disease Laboratory operated by the Maine Medical Research Institute, said the packages are coming in earlier and more frequently this year, a sign of the mild winter and early spring. 

Lyme disease can be easily avoided and treated if detected early, but can be a source of misery if not discovered and diagnosed.

“Time is of the essence if you think you have gotten a bite. Don’t expect to see a rash and (you should) insist on six weeks of antibiotics,” Tibbetts said.

Tibbetts said she may have been infected 20 years ago. “It took about 15 years to really take me down,” she said. Her symptoms were back pains, migrating arthritis pain and “overwhelming fatigue.”

Tibbetts said she was not diagnosed with Lyme disease until a year ago, when she visited a specialist in Connecticut who took 16 blood samples and performed multiple tests.

Elias said Lyme disease may first manifest itself as a skin rash in the shape of a bull’s eye, but data cited at www.freewebs.com/teenswithlyme reports rashes develop less than 50 percent of the time. Tibbetts said she never saw a rash develop.

Lyme disease can mimic other conditions, including Parkinson’s disease, chronic fatigue syndrome, multiple sclerosis and amyotrophic lateral sclerosis – also known as Lou Gerhig’s disease. 

Diagnosing Lyme disease is complicated by tests that either show false positives or fail to show it is present. Tibbetts was tested over the years but never matched all the factors to result in a positive diagnosis.

Flu-like symptoms may occur at the same time or precede the rash, Elias said. If untreated, Lyme disease can cause arthritis and possibly a form of meningitis from infected spinal fluid.

Sears said about 14 species of ticks are common to Maine. They can spread a variety of diseases and infections, although the research institute website lists human granulocytic ehrlichiosis and babesiosis as the most common diseases transmitted in Maine. Both resemble Lyme disease with flu-like symptoms and body aches caused.

Elias said deer ticks are common to wooded areas with leafy ground cover, but everyone spending time outdoors should check for ticks.

According to the institute website, Lyme disease strikes, people, dogs, horses and small and large mammals in the wild.

Elias and Tibbetts said some very simple steps will help prevent tick bites that cause Lyme disease. Sears and Elias said a tick has to be engorged on its host animal for 24 to 36 hours for the bacteria to be transmitted.

“If a tick is just crawling, it hasn’t bitten yet,” Elias said.

Elias recommends wearing light-colored clothing when outdoors, tucking pant legs into socks, using chemical repellents such as DEET or an organic mix of lemon oil and eucalyptus. Clothing also can be sprayed with permethrine, which repels and kills ticks.

Vigilance is critical, she said. Check for ticks when coming inside and again before bed. 

Removing attached ticks takes patience, especially when removing a lip called the hypostome, which penetrates the skin. Elias said people should not worry if the hypostome remains when the tick is removed – it will fall out of the bite area on its own. 

Inexpensive tick removal kits are available at the Lyme Disease Foundation website, www.lyme.org.

Barry Tibbetts, the Kennebunk town manager who has watched his wife, Joanne, endure Lyme disease, said they do not always send in ticks they find.

“There is an immense amount of satisfaction in destroying a tick,” he said.

Elias said there are four stages of tick engorgement: not engorged, slightly engorged, moderately engorged and very engorged. The last two stages indicate possible transmission of Lyme disease, but the disease is easily treated with antibiotics within 72 hours of detecting symptoms.

Deer ticks have a two-year lifespan from hatching from eggs to adulthood, Elias said, and feed once as they pass through the larvae, nymph and adult stages. They survive winters by going into a sleep stage known as diapause.

Elias said the nymph stage, where ticks may first pick up the bacteria and cause Lyme disease when they feed on smaller mammals, can be especially dangerous because they are harder to see and still may pass on bacteria to other hosts.

The Vector-borne Disease Laboratory tests ticks to determine the species and level of engorgement, Elias said tick samples should be preserved in rubbing alcohol and can be mailed to the Vector-borne Disease Laboratory, Maine Medical Center Research Institute, 75 John Roberts Road, Suite 9B, South Portland, ME 04106.

A submission form to accompany the sample is available at www.mmcri.org/lyme.

Sears said cases discovered after 72 hours can be treated with antibiotics over several weeks, but no study has established longer treatments to be fully effective, according to www.freewebs.com/teenswithlyme.

Dr. Matt Ford, a veterinarian at Scarborough Animal Hospital said he is already seeing patients with ticks.

“It is already starting, fleas as well,” Ford said.

More ticks has not meant more disease this spring, which Ford attributed to more awareness of the disease by veterinarians and dog owners. Dogs can be protected with an annual vaccine and the topical treatments such as Frontline that are applied monthly.

Ford said symptoms and effects are similar in canine infections – a dog will endure aching joints that can be evident as it shifts from leg to leg, and show a loss of appetite and thirst.

Ford recommends both vaccine and topical treatment and said the topical treatments used to repel or kill fleas and ticks should be applied in months when the ground is not frozen. 

Lyme disease is not found in cats, Ford said, but Barry Tibbetts said his cat stays outdoors all summer to eliminate the chance it will bring in ticks.

“But I absolutely would not stay indoors or be panic stricken,” he said. He and his family will enjoy the spring.

Staff writer David Harry can be reached at 282-4337, ext. 219