Staff Writer

Kennebunk Town Manager Barry Tibbetts said he does not want to scare anyone out of their gardens this spring.

However, Tibbetts has seen firsthand how Lyme disease causes misery and pain and wants everyone enjoying the outdoors to be aware of the increased health hazard because of early spring weather.

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 50 to 300 reported cases of Lyme disease, almost exclusively in York and Cumberland counties.

“Deer ticks have clearly moved north over the last 10 years,” said Sears.

With deer ticks found in every Maine county now, the number of reported cases increased to 970 last year. The majority of reported cases still occur in York and Cumberland counties, and it is hard to determine if the increase in reported cases is a result of more infected ticks or increased awareness of the disease, Sears said.

At a lab near the Maine Mall, Susan Elias said she makes her living researching 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. It is a sign of a mild winter and early spring, and a reminder about the hazards of a disease that can be easily avoided and easily treated if detected early.

Tibbetts’ wife, Joanne, was infected years ago. Because the disease can mimic other conditions, including Parkinsons, chronic fatigue syndrome, multiple sclerosis and amyotrophic lateral sclerosis – also known as Lou Gerhig’s disease, Tibbetts said it took years to get the correct diagnosis.

Diagnosing Lyme disease is complicated by tests that either show false positives or fail to show it is present, Tibbetts said.

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 said the rash develops less than 50 percent of the time.

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 that results from infected spinal fluid.

Sears said about 14 species of ticks are common to Maine. Checking for all of them is important after being outdoors. If you find a tick, handle it with tweezers to avoid more contact with the skin, she said.

Elias said the deer tick is found mostly in wooded areas with leafy ground cover that provides a moist environment.

According to the Maine Medical Research Institute website, people and dogs and horses they own can be infected, as can small and large mammals in the wild such as mice, deer and birds.

Although the long-term effects of Lyme disease can be painful, Sears said any fatalities attributed to Lyme disease in Maine also are the result of other health complications.

Elias and Tibbetts said some very simple steps will help prevent tick bites causing Lyme disease, and 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.

When outdoors, Elias recommends wearing light colored clothing, tucking pant legs into socks, using chemical repellents such as DEET or an organic mix of lemon oil and eucalyptus.

Vigilance is critical, she said. Check for ticks when coming inside and again before bed. Ticks  can be killed with a flame or rubbing alcohol. She encourages anyone who finds ticks to send them to the lab.

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

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.

Elias said there are four stages of 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, 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 bacteria to other hosts.

The Vector-borne Disease Laboratory will test ticks sent in by patients or doctors 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 the longer treatments to be fully effective, according to www.freewebs.com/teenswithlyme.

The same vigilance needed to prevent tick bites on people is needed for dogs and horses.

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 so far, Ford said, something he attributed to more familiarity with 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.

Tibbetts said his cat stays outdoors all summer to eliminate the chance it will bring in ticks that might bite his family.

“But I absolutely would not stay indoors or be panic stricken,” he said.

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