Today, Explained - Little summer vampires

Episode Date: June 15, 2018

Tiny blood-sucking Lyme-disease-carrying ticks are out to ruin your summer. Since 1991, Lyme disease has doubled in the United States due to a variety of factors, including global warming and suburbanization. Vox’s Julia Belluz explains how to avoid ticks and, if worse comes to worst, deal with Lyme disease. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Thanks to Mattress Firm for supporting Today Explained this week. Mattress Firm wants to support you too with a new mattress. Check out your friendly neighborhood mattress store or go to mattressfirm.com slash podcast and use the discount code podcast10 to save 10%. So Sean, it's summer. So do you have any plans yet? Well, I hear there's lots of like beautiful wilderness D.C., the Shenandoah Valley and stuff, so I'm hoping to get out and go camping, but nothing written in stone yet, why do you ask?

Well, I have bad news for you. You might want to keep an eye out for these little tiny little vampires. They're little blood-sucking creatures. They can't fly. They can't jump. They kind of lurk in tall grass or leafy areas. And they have little heat sensors. They can smell you or sense your heat.

And then they crawl up on you. They have a little barbed mouth that they, you know, shove right through into your skin and they start to suck your blood really, really slowly. You don't even know they're there because they let off a little chemical that acts like an anesthetic. And then when they're done, they drop off of you. And shed their skins and move on through to their next stages of life and on to their next host.

You just made me miss winter. That's what we're here for. So do these little vampires have a name? We're talking about ticks. Lyme disease carrying ticks. It's exploded in America. We've basically seen the incidence double since the early 1990s. Julia Blue, senior health correspondent at Vox.

Do you know how many people, say, in the United States are walking around with Lyme disease right now? About 30,000 people are known to get Lyme every year, but they think the real number is about 10 times more. Why? Because there's all these Lyme disease zombies out there that don't even know they have it? There's Lyme disease zombies, yeah, from they get bitten by these little vampires and they don't realize they have it. Or there's an underdiagnosis problem, which that may be changing now that we have more awareness. But yeah, the Centers for Disease Control and Prevention, they think it's about 300,000 people in the U.S. every year, which would make it one of the most common infectious diseases in America now.

My name is Priscilla Rodriguez-Kishani and I live in Washington, D.C. So about three years ago, I started to feel really sick. The symptoms of my Lyme disease were, it started with honestly just like an achy, exhausted feeling, maybe like the beginning of a really bad cold or flu. But it did feel like a different level of exhaustion. My bones almost ached. My joints in particular, my finger joints, my knees, and my shin bones were really, really achy. And I would find myself falling asleep on the couch at 7 p.m. after work. I fell asleep on a few work conference calls that I took from the train. So once those things started to happen, I realized this wasn't a normal amount of tiredness. There was something different about this.

I ended up going to the doctor about two months after that achy, exhausted feeling started. And they did the standard Lyme tests and both came back negative. About a month and a half after that, I woke up one morning with these red raised nodules, not itchy, on my shin bones and on each of my elbow joints. And my elbow joints were so stiff and sore that I couldn't move my arms, essentially. A month later, I woke up with my abdomen incredibly swollen. I mean, kind of filled with liquid, squishy to the touch, and went to the ER and they ran tests and said that my liver essentially wasn't functioning correctly. And it was only eight to nine months

after first getting sick that I found my way to a private doctor in the Northern Virginia area, which is riddled with Lyme disease, who specializes in Lyme. She ordered a special test that is a lot more sensitive, a test that I think they call it bands or strains of tick-borne diseases. And that one lit up like a Christmas tree. I essentially was given kind of a cocktail of antibiotics for three to four months. And once we figured out what it was, we realized that I probably had been bitten by a tick about a year before I started to feel ill. And we think it happened when I was doing weekly horseback riding lessons in Rock Creek Park here in D.C. I never found the actual tick on my body and I never had the signature bullseye rash. And I think that's part of why it took so long to figure out what was making me as sick as I was. Julia, what exactly is Lyme disease and how do you get it?

So Lyme is a tick-borne bacterial disease. So it's spread by these nasty little vampire ticks that we've been talking about. The ticks aren't born with the bacteria. They pick it up when they're feeding on mice or deer or skunks or birds during these blood meals that we described. And then they spread it to other animals, including humans. So we can get Lyme when an infected tick chooses us as a victim. I could tell you the bacteria that mainly causes Lyme here is called Borrelia burgdorferi, and it's named after a researcher who discovered what was making children sick in a town called Lyme, Connecticut, hence Lyme disease. And his name was Willie

Burgdorfer, fun fact. And this was how long ago? Early 1980 i think like 1981 this is when we discover lyme disease or that's like when lyme disease starts happening no that's when we discover a lyme disease so basically in the late 1970s i think in 1977 in connecticut researchers found that there was this cluster of children who had arthritis but they didn't know what caused it huh and then burgdorfer comes along in the early 1980s, and he said, hey, it's this bacteria that's carried by ticks. And so he had the honor of having the bacterium named after him. How big are these ticks?

So, yeah, they're really, really small. So they're about the size of a sesame seed when they're in the adult stage. And earlier on in life, when they're in this nymphal stage, they're called nymphal ticks. They're about the size of a poppy seed. Are these the same ticks that like attack your dogs? Yes, absolutely. And you know, your dogs, cats, they can come inside the house with these Lyme carrying ticks. And eventually those ticks can make their way to you. So you really want to make sure that if you see a tick on your dog or your cat or your pet, that you're removing it

right away. So what are the symptoms of Lyme disease? Is it an itch? Is it a rash? How do you know you got it? It depends on how far the bacteria spread in the body. So one of the real telltale signs is a rash that spreads around the tick bite. The most classical presentation is a bullseye around the tick bite, so a red ring. So that's early localized disease. But if Lyme's untreated or your body isn't responding to the antibiotics that can stop it,

it can spread to other parts of the body and infect more systems in the body. And so in the weeks and months after tick bite, we're talking about severe headaches, neck stiffness, more rashes, arthritis and joint pain. You can even have facial palsy where one side of the face sort of, you lose the ability to control part of your face, brain inflammation, spinal cord inflammation, nerve pain, memory problems. So yeah, it can turn into a pretty nasty disease. Are some people more susceptible to this than others? I think it shows up mostly in young, active people because people are out and about, like you. They're planning on camping, hanging out in these forested areas. Rolling around in the grass.

Rolling around in the grass. One of the tricky things about Lyme is that in the past, I think researchers thought that everyone presented with a rash, and in particular this bullseye rash. But now we understand that it's only about 70% to 80% of people with Lyme who ever have a rash and in particular this bullseye rash. But now we understand that it's only about 70 to 80% of people with Lyme who ever have a rash. And then the other thing that makes it difficult to diagnose is that the FDA approved tests only check for antibodies of the bacteria. So that means they're looking for evidence that your immune system fought the

bacteria. And if you get the test too early, you might have a false negative because you don't have those, the antibodies aren't detectable yet. If you get the test too late, you might have a false positive, meaning you had the antibodies, your system already fought it off and it's not there anymore. One of the things that researchers working on this say is that we really need a better diagnostic test to know which stage of infection we're looking at and whether someone really has an active case. Why isn't there a vaccine yet to protect us from Lyme disease? It seems like there should be, right?

So here's another fun fact. My colleague Brian Resnick reported on the story about the ill-fated Lyme vaccine. So it was approved in 1998. And that was right around the time, if you'll remember, but there was never any data to actually suggest the vaccine was dangerous. And the FDA looked into it, found nothing, but because of all this concern and the fact that people seem to be rejecting it, the vaccine maker pulled it from the market. So we did have a vaccine that could prevent Lyme, but we don't anymore thanks to the anti-vaccine movement. So once you get Lyme disease, can you get rid of it? How do you kill the Lyme? The conventional medical idea is that, you know, if you're diagnosed,

you get a course of antibiotics two to four weeks, and you should be able to fight off the bacteria. Okay. But doctors also know a lot of people don't fully respond to antibiotics. And then there's a set of patients who they think they have what's known as chronic Lyme disease. And it's a much broader definition of Lyme. Maybe they never had a tick bite. They never tested positive for Lyme. But they think that Lyme might be to blame for their headaches and their brain fog and their fatigue. And the thing that makes it tricky is that even researchers who work

on this know that there's still so much we're learning about, for example, ticks. We're learning that they may carry many more pathogens than we even understand that might sicken people with simultaneous infections. And patient groups and some doctors have really tried to push for more awareness and research funding and attention on Lyme. Do antibiotics work for most people if you just get treated at the right time? Yes and no. So the earlier you're treated in the infection, the better you can respond. I think when you leave Lyme to linger and infect other systems of the body, it becomes more and more difficult to treat. So it can spread into

the brain, the cardiovascular system, and then it's harder and harder to kill with antibiotics. So you would want to get diagnosed and treated sooner. I feel much better than I, I mean, much better than I did before. But if I think about who I was in the year before I got sick, I'm not, I'm still not that same person. I just don't have the energy reserves that I once had. And some of that achiness can start to come back. But also because I know from my doctor that if I push myself too hard, the Lyme can flare again. And then we could find ourselves back with these weird symptoms in the body and emergency room visits and rounds of antibiotics.

So it's something that you have to manage. And it's honestly something that is always, I guess, in the back of my mind. Lyme disease has been spiking over the last two decades. The reason for that spike is after the break. This is Today Explained. A lot of people ask me, hey, it's crazy that the mattress firm rhymes with Ramos firm. That must have been some great plan to have like the host of Today Explained name rhyme with this company that supports the show so often. And the truth is it wasn't planned at all.

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Everything from how to contact your local lawmakers to protect women's rights to the meaning behind all the female characters in Star Wars. Thank you. Stuff Mom Never Told You drop every Wednesday and Friday and can be found on Apple Podcasts, Spotify, Stitcher, or wherever you get your podcasts. So tell me where the highest incidence of Lyme disease are so I can not go there. Most of the cases are, you know, the Northeast, Mid-Atlantic, Upper Midwest. And are they around in the Northeast, the Midwest all year round or just in the summer? The ticks that spread Lyme are most active in the warmer months. So in temperatures that are above 45 degrees and also in higher levels of humidity.

So most tick bites are reported in the summer. And that's also, again, when people are out and around ticks more. But you can also get tick bites in the warmer part of the fall or early spring, even late winter if it's warm enough. You said cases of Lyme disease have gone up like they've doubled since the 90s. What's up with that? So there's a few different things going on. So one is that there's just more awareness about Lyme.

So doctors know to look for it, patients know to think about it. Another thing that's happening clearly, although some still dispute it, is the warming of the climate. Climate change may have expanded the geography of where ticks can live and how quickly they reproduce. And so again, like ticks favor these warmer temperatures and more humid temperatures. So this has meant that ticks are able to live further and further north. Suburbanization, so more and more people are living near the animals that carry Lyme.

And then farmland has been reforested. That also increases the tick habitat. Okay, Julia Blues, now that you've terrified me, what do I do if I want to go camping and not get bitten by lime and not have a little tick burrow itself inside my leg and ruin my summer. Okay, so first you should never leave the house. Okay. Just kidding. That's a really short PSA. That's a short PSA.

No, in reality, I think you want to just use repellent before you go outside. Okay. Those chemicals, the DEET. Right. Get some DEET going on you and then you probably want to wear clothes that cover your body. But it's hot. I know, so maybe you can find some clothes that are like breathable but still protect you. And then you want to just be a clean person. So when you come back in from your hike and you're, you know, pretty sweaty, you want to take

a shower, look around your body, your armpits, the back of your legs, ankles, you know, get someone to check your scalp. What if I live alone? What if I'm lonely? What if you're lonely? Use a mirror. And then you want to tumble dry your clothes after, you know, 10 minutes or so. I think the CDC says you can kill those ticks. Okay. And then there are other things you can do, like walk in the center of trails. So don't go bushwhacking, like walk in the center of trails.

So don't go bushwhacking, like stick to the well-trodden trail. And what do you do if you find a tick on your body or on somebody else? One thing to keep in mind is that ticks, they take a little while to transmit their pathogens. So if you find a tick, you want to remove it sooner than later. This is like once it's burrowed, but before it's given you that little anesthetic? So they're going to be sucking your blood for, I think they take like 24 hours or more to suck your blood before they drop off of you. And the sooner you remove it, the less likely it is that the tick has transmitted, if it is carrying any pathogens, that it's transmitted those to you.

So you want to try to remove the tick pretty quickly, and you want to take a pretty sharp tweezer and kind of get it really close to the skin, and then pull upward. Today, I will today explain. So you don't want to jerk sideways, or you want to pull upward. And the reason you want to do sideways or you want to pull upward. And the reason you want to do that is you want to make sure you remove the whole tick and also remove the mouth of the tick. Because as you'll remember, they're going to burrow their mouths and heads into your skin to suck your blood. So you want to make sure you get that whole thing out.

After removing the tick, you also want to rub the bite area and your hands with rubbing alcohol, soap and water, all these things to make sure you're cleaning off the bacteria. Okay. And then the CDC suggests that disposing a tick properly involves soaking it in alcohol, placing it in a sealed bag or container. Wrapping it tightly in tape. Or flushing it down the toilet. Okay. And so you really want to kill this tick.

You want to treat the tick like, what else would you dispose of like that? Like a dead body. You want to treat this tick the way you would someone you just murdered. Right, exactly. Julia Beluz is a senior health correspondent at Vox. Thanks to Priscilla Rodriguez-Kashani for sharing her story with us. I'm Sean Ramos from Come At Me, Tix. I'm ready now. Shoutouts to Mattress Firm for supporting our podcast this week. Mattress Firm wants you to know that they're America's friendly neighborhood mattress store. Thanks.