If a tick attaches to a mouse, deer, or other animal that is carrying the bacteria called Borrelia, and the tick becomes infected. It may then spread the disease when it attaches itself to you. Tick populations tend to be higher in elevations, in wooded and grassy areas where the creatures they feed on live and roam; including deer, rabbits, birds, lizards, squirrels, mice, and other rodents. They can also be found in urban areas as well as on beaches and coastal areas of the country.

One of the major issues in Saddle River is the large populations of deer and the deer tick that spreads Lyme disease. Every summer we have a few people in the borough that are infected with Lyme disease. These are usually people that walk through the woods and come back home with an embedded tick.

What are the stages of Lyme disease?

There are several phases of Lyme Disease that are important. The first phase is the early localized disease. A characteristic flat red ringed bull’s-eye rash develops in 75% of the people who have been bitten by a tick infected with Lyme. The rash appears days to weeks after the bite and spreads outward. The bull’s-eye rash is called erythema migrans. Some people don’t notice or even remember being bitten by a tick because the tick is too small, or a rash never appeared. Someone with newly acquired Lyme disease can suffer from fatigue, headache, joint and muscle stiffness, and swollen glands.

The second stage of Lyme disease is called early disseminated disease, which means that when you’re not treated and you ignore the skin redness associated with the early localized Lyme disease, the second stage occurs weeks or months after the appearance of the red rash. During this time bacteria affect other parts of the body including the heart, joints, and nervous system.

The third phase is what is called the late disease. Late stage Lyme disease can inflame the heart and lead to heart rhythm disorders and even heart failure. Nervous system problems associated with late disease can include facial paralysis known as Bell’s palsy, meningitis, confusion, and abnormal function of the nerves outside of the spinal cord. We call that peripheral neuropathy. Joint inflammation can certainly occur in just one or a few joints; most often the knees, resulting in pain, stiffness, and swelling. The arthritis associated with Lyme disease can become chronic and may mimic other forms of inflammatory arthritis.

How is the disease diagnosed?

The doctor uses a variety of methods to diagnose Lyme disease. If the doctor sees the red bull’s-eye rash the diagnosis must be considered. The patient is then asked if they been in a wooded area known to have ticks that harbor the bacteria. In Saddle River everywhere the deer are can be considered areas of high risk. Even if the diagnosis is not clear-cut, the doctor can perform a physical exam and tests to exclude other potential problems. There are antibody tests available for Lyme disease but they’re not useful in the early stages, because the immune system has to have some time to react. Many doctors prefer to treat the patient for Lyme disease before a solid diagnosis is made because of the danger of having the disease present in the body months and years after the acute illness has resolved.

Can pets get Lyme disease?

Yes. Your pet can develop Lyme disease from the bite of a black dog tick, which may transmit the bacteria known as Borrelia. A dog is a favorite target for an infected tick. When your dog gets sick the dog becomes feverish and lame in one or more joints and can exhibit sluggishness and swollen lymph nodes. Many years ago, a vaccine for Lyme disease was developed for humans, but because of poor demand it was not continued. A vaccine is available for dogs, however. There is testing, treatment, and a prevention program which applies to dogs. This is very important to understand because the dog can develop kidney failure from Lyme disease which can be fatal. Serious cardiac and neurological effects can also occur in the dog, just like one sees in humans.

Pandemic Corner

I try not to discuss too much about COVID- 19 in Ask Dr. Bob. However, each month I try to have something to say which will enlighten the readers of the Saddle River magazine. This month I’d like to focus on the different kinds of vaccines in development.

There are several different kinds of vaccines in development against COVID-19. Let me summarize the different types. Previously I said many of the vaccine companies are approaching phase 3. Phase 3 are efficacy trials where scientists give the vaccine to thousands of people and wait to see how many become infected compared with volunteers who receive what is called a placebo or sugar injection. These trials determine if the vaccine protects against the coronavirus. The different kinds of vaccines are: whole virus vaccines, which uses a weakened or inactivated version of the coronavirus to provoke an immune response; genetic vaccines, which are those that use one or more of the coronavirus’s own genes to provoke an immune response; viral vector vaccines that use a virus to deliver the coronavirus genes into cells and provoke an immune response; and lastly, protein-based vaccines. The protein-based vaccines are those that use the coronavirus protein or protein fragment to produce an immune response.
All in all, there are over 30 corporations developing vaccines around the world. By the time I write this column in December, I would hope we would have an efficacious vaccine for the control of COVID-19.