WH Lyme Disease

Pennsylvania is experiencing a population explosion, but nobody’s dispatching the Welcome Wagon. Thick forests and the vast herds of deer that live within them throughout the Keystone State are an open invitation to the blacklegged tick, also known as the deer tick. The mild winter of 2017 has contributed to the exponential increase in deer ticks here — and the cases of Lyme disease they transmit.

Ironically, deer and mice are known as “hosts” that provide a food source for ticks. Lyme disease is passed from tick to human through its complex feeding process. The tick consumes the host’s blood, which it regurgitates during feeding, so whatever is in the tick’s gut has a direct route into a person’s bloodstream, including the Lyme disease bacteria.

Ticks are stealthy little arachnids, burrowing beneath clothing to find the ideal place to feast on human blood. Dr. Jeffrey Moldovan, emergency physician for Grove City Medical Center, is seeing ticks and tick bites on nearly every part of the body.

“Typically, they target arms, legs and the trunk, but lately we’re finding them on the ears, genitalia and eyelids,” he says.

A few days after spending time outdoors working on his lawnmower, 44-year-old Daniel Dennis of Grove City removed a tick from the inside of his left thigh. About 10 days later, he began experiencing vague symptoms that concerned him enough to visit Grove City Medical Center’s emergency department.

“I was having numbness and tingling in my left arm,” says Dennis.

Dr. Moldovan examined him, ran tests, and then discharged him with medication for what he believed was a pinched nerve in his neck.

Two days later, Dennis returned to the emergency department with intensifying symptoms on the other side of his body.“Along with numbness and tingling, my heart was racing and I thought I was having a stroke,” he says.

This time, Dennis was admitted to the hospital for observation, where his nurse discovered the small round rash on his inner thigh. It was this tell-tale sign that led his attending physician, Dr. Apoorva Srivastava, to a diagnosis: Lyme neuritis, a form of Lyme disease that attacks the peripheral nervous system.

Dr. Srivastava immediately started Dennis on a course of antibiotics to treat the disease, and within a day he was feeling “100 percent better.”

Pennsylvania leads the nation in cases of Lyme disease, with nearly 25 percent of all diagnosed infections originating here in the Commonwealth. Melissa Ferguson, Infection Prevention Practitioner for Grove City Medical Center, said the hospital in 2016 reported 177 cases of Lyme disease, and 30 had already been reported for January through March of this year. And the uptick is predicted to continue.

If a tick stays on a person 24 hours or more, their chances of getting Lyme disease increases because the feeding process has gone on for longer, so prompt removal is important. Dr. Moldovan says patients are coming to the emergency department with ticks still attached because they are afraid to remove them.

“Fear of decapitating the tick is unfounded,” he says. “It’s an old wive’s tale.”

He advises firmly grasping it close to the skin with tweezers and gently pulling it straight out. Using soap or finger nail polish to try to coax it out will trigger ejection of its salivary glands, forcing disease-causing microbes into the body — so don’t do it.

Even though the trademark bull’s eye rash associated with Lyme disease may be evident, it might not be. Other symptoms include extreme fatigue, headaches, fevers, chills, night sweats or neurological issues like those experienced by Dennis. However, symptoms can vary from case to case, so it can be difficult to diagnose. Long term effects of late- or untreated Lyme Disease can be especially serious, as it can attack the heart and the joints. Watchful waiting after any tick bite is unwise — it is best to seek medical attention.

Although Dennis responded positively to the antibiotics he received in the hospital, he’ll be seeing Dr. Srivastava regularly for follow-up. He’s developed facial paralysis known as Bell’s palsy, and continues to experience waves of shakiness, sweating and nausea.

“This has really knocked me for a loop,” he says.