TIME: Almanac 1993/TIME Almanac 1993.iso/time/062491/0624130.000

Text File | 1992-08-28 | 7.3 KB | 154 lines

                                                                                HEALTH, Page 45

Life in The Age Of Lyme


As the disease spreads, many scared Americans have declared war
on ticks. Summer may never be the same.

By JOHN SKOW -- Reported by Janice M. Horowitz and Andrew Purvis/
New York


    Guinea hens are bald, wattled and graceless. They
resemble feathered footballs. Worse, they are surly, loud and
unmusical, often at 3 in the morning. But they are voracious
gobblers of bugs and are especially fond of the tiny deer ticks
that carry the spirochetes of Lyme disease. Which is why model
Christie Brinkley, SPORTS ILLUSTRATED's swimsuit sweetie some
years ago, learned to love them. She has installed a flock on
her estate in East Hampton, N.Y., and hands out chicks (called
keets) to her neighbors.

    Before she got the hens, Brinkley had taken to wearing
high fishing boots when she walked to the beach. "We were
really infested," she says. "It seemed as if every blade of
grass had a tick hanging off it." Her hen patrol has reduced the
local tick population, although that has not prevented her from
contracting the tormenting ailment that she and millions of
other householders routinely take elaborate pains to avoid. The
tick that infected her with what was diagnosed last week as Lyme
disease probably, she thinks, bit her while she was horseback
riding.

    Fear of Lyme disease is justified, and harboring guinea
hens is reasonable, if not terribly practical for most people.
The nagging affliction often shows itself first as a rash and
flulike nausea, fever and aches. Lyme mimics many other
illnesses, and in later stages it can escalate to arthritis,
meningitis, neurological damage and sometimes physical debility
and racking pain. Some 30,000 cases had been reported in the
U.S. by the end of last year. From 1986 through 1989, reported
cases doubled each year, and a slight drop last year (7,995
cases, from 8,551 the year before) may reflect only a change in
reporting criteria.

    Thus when the U.S. Centers for Disease Control advises
that anyone walking through grass or brush in tick-infested
areas wear long-sleeved shirts and long pants taped into sock
tops, many people actually do it, though the fashion statement
is irredeemably tacky. The meticulous daily body inspection
that is the most effective preventive is now a normal routine,
like flossing teeth. What you are looking for is the nymphal
stage of an arachnid (not an insect) that is louse-size only as
an adult and that as a nymph has been compared to a dark
freckle. Where you are looking is behind the knees, in pubic and
scalp hair, under watchbands, in armpits. Yes, you need a
partner for this, and perhaps, if you are no longer 25, a stiff
drink.

    Old Lyme, Conn., got an undeserved reputation as a
pesthole when the disease later named for it was first
identified there in 1975. But it is unlikely that the disease
really was newly hatched in that area. Dec ades earlier, on Long
Island in New York, a pesky swelling called Montauk knee was
causing trouble. In 1908 something indistinguishable from Lyme
disease was described in Sweden. Ticks hitch rides not just on
deer, mice, humans and other mammals, but also on birds, which
helps explain why Lyme disease has been reported in 46 states.
(Only Alaska, Arizona, Montana and Nebraska have reported no
cases.)

    White-tailed deer are suburban creatures, and a surge in
the deer population as forests have regrown in the Northeast
offers one reason that Lyme disease has hit hard in New York,
New Jersey, Maryland, Pennsylvania and lower New England.
Wisconsin and Minnesota have had smaller outbreaks, and so,
though the ticks are a different species, has Northern
California.

    A fairly effective control method for a limited area is a
product called Daminex, which is a tube filled with
pesticide-soaked cotton. Mice take the cotton to build nests,
and the pesticide kills ticks. On Martha's Vineyard and
Nantucket, scientists are planning to release large numbers of
a tiny wasp called Hunterellus hookeri. Success is uncertain.
The wasps do kill some tick nymphs, but may in fact need a large
and healthy tick population to maintain their own numbers. Other
drastic preventives that householders mutter about while
untaping their trousers -- region-wide burning of fields,
pesticide spraying or slaughter of deer -- are just not
politically or environmentally feasible.

    An effective vaccine would save the day, and last year
researchers at Yale were reporting some progress. But the
approach has so far proved successful only in mice and has yet
to be tested in humans. Some resolute citizens are said to chew
garlic before venturing outdoors, hoping wistfully that what
works for vampires will also drive off ticks. Ken Liegner, a
Westchester County, N.Y., doctor with many Lyme disease
patients, has invented a "deer gazebo" that would lure
whitetails with a salt lick or apple mash and shower them with
pesticide. The rumor persists that Lyme-infected veterinarians
have dosed themselves with canine Lyme vaccine not tested in
humans.

    Antibiotic treatment usually works fairly well in the
early stages, but the suffering of a few patients with advanced
Lyme disease does not respond to conventional cures. So a
dangerous and unconventional therapy has come into use. Dr.
Henry Heimlich of Cincinnati, known for developing the Heimlich
maneuver to relieve choking, observed that Lyme disease
resembles syphilis in that it is caused by a corkscrew-shaped
spirochete. He knew of an outdated treatment for the late stages
of syphilis in which patients were deliberately infected with
malaria and then cured of it. It was believed once that malarial
fevers cooked away the syphilis, though now it is thought that
the malaria provokes a powerful response by the immune system.
Heimlich does not apply malaria therapy, which is not approved
by the Food and Drug Administration. Nonetheless, he insists
that the treatment, available in Mexico and Panama, is a
legitimate last resort for late-stage Lyme sufferers who are
"paralyzed, bedridden in a fetal position" or perhaps going
blind. Results vary, and what is achieved by weeks of full-blown
malaria seems at best to be a remission.

    But Nancy Modiano, a 30-year-old Hamilton, N.J., resident,
agrees with Heimlich. She thinks she contracted Lyme disease as
a teenager. By last year she was helpless, subject to vomiting
and seizures, her joints so swollen that she couldn't operate
her wheelchair. She flew to Mexico City last November and was
injected with malaria. For 35 days her fever would spike to 108
degrees, then drop to 95 degrees. Yet two weeks after the
induced malaria was cured, she was learning to walk again.
Though she still has some Lyme symptoms, her recovery continues.
She sums up the experience: "I knew I was dying. I had no other
choice. I would go through the malaria treatment again in a
second."

    For the rest of us, will summer ever be lighthearted
again? Will no shirtless youth dive gallantly into the peonies
to catch a Frisbee? Will no maiden swish barefoot across a dewy
moonlit lawn? Eventually, yes, when poultry or medicine comes
to the rescue. But not this tick-plagued summer, not just yet.