Tuesday 26 April 2016

A touch of Lyme

Lyme disease is named for a small town in Connecticut where the connection between ticks and feeling crappy was first noticed. It appears to be caused, not by the tick bite itself, but because that bite delivers a dose of Borrelia burgdorferi a spirochaete bacterium and cousin to Treponema pallidum the cause of syphilis. "feeling crappy" is deliberately generic because diagnosis of borreliosis is difficult as the symptoms vary widely depending on the individual and how long the bacteria have been 'on board'.  You might get a fever, chills, palpitations, tingling in the feet, rash, facial palsy / paralysis (!) joint-pain and/or arthritis [CDC, Atlanta]. The rash is classically [75% of infections] bulls-eye in shape [L on elbow joint] with a welt at the site of infection and a ring of red moving slowly out from this centre; erythema migrans in Latin.  As I said before, when I was concentrating on Ixodes ricinus the tick vector, Lyme disease is rare in Ireland.  That's good, of course but, because outside your doctor's experience, is frequently not diagnosed, which makes the discomfort last longer and lowers the chance of getting well.  That's a bummer because prompt treatment with antibiotics like doxycycline or amoxicillin will often achieve a complete cure.

Last Tuesday I was down at the Wexford Science CafĂ©, which we started up a little over a year ago to meet once a month and chat about science.  As in any such organisation it is difficult to get active participation, so I set off from home fully prepared to warn everyone to buy wellington boots against sea-level rise. When I arrive a minute late, I found that I had doubled the audience.  I guess everyone had already bought boots or boats and didn't need me to fill in the details. That was fine and I spent an enjoyable hour chatting with the other Sci-Caff stalwart, comparing notes about teaching science, which we've both spent a life-time doing. We agreed that young people were shockin' ignorant about sex - nothing new here - and then moved on to farrrrming, sheep, sheep-dogs and . . . ticks. I said that Dau.I and Dau.II and Rashers-the-dog would often come in from the fields with a tick attached. The Beloved used to dab the bug with tea-tree oil or acetone before pulling it off the skin with eye-brow tweezers.

[This is not considered best practice by the CDC.  Better to grasp the tick as close to the skin as possible and apply a steady upward pressure.  If it breaks, have another go at the attached portion and then slather with rubbing alcohol, iodine or similar. Do not, if possible, squeeze the abdomen lest you cause a regurgitation of its Borrelia rich contents. The earlier you do the removal the less blood you'll lose and the less Borrelia back-wash you'll get too.]

I shrugged and said that there were worse things that getting a tick or two. But my friend replied to the effect of "whereof one cannot speak, thereof one must be silent" [Wittgenstein] and went on to describe how her niece, a nice young woman from the Irish Midlands, had taken a tick-bite that had destroyed her life because it had developed into full-blown borreliosis. The lady was still alive but scarcely able to walk across the room and currently on four (4!) different medications to deal with the infection and its wild array of symptoms.

Borrelia is definitely on the up in Ireland, albeit from a very low base.  There is a suggestion that this rise in frequency has been helped by the influx of Poles to the Ireland, whose home country is endemic for Borrelia. I take that with a pinch of salt, because Lyme disease is on the rise all over the world for reasons that are not completely clear. Ticks are found wherever you find sheep but not all of them carry the spirochaete. I'm giving you here a heads-up for Tick Awareness Week which kicks off exactly a week from now on 2nd May 2016. Check out the new children's book about ticks The Adventures of Luna & Dips. There is a wide range of devices for tick-removal but any old fine tweezers will work effectively. Fore-warned is fore-armed!

1 comment:

  1. Thank you for the article on Lyme disease, it's great to see more awareness. For anyone interested Tick Talk has a section on Irish related science articles with regards to Lyme & co at: https://ticktalkireland.wordpress.com/irish-related-studies/