Lyme Disease: Fear Itself

When it comes to Lyme disease, as it unfortunately does every season, the accepted wisdom always has been to treat early, the earlier the better.

The sooner antibiotics are administered following the appearance of the characteristic "bull's-eye" rash surrounding a tick bite, or other significant symptoms, runs the theory, the greater the patient's chance of escaping serious aftereffects, up to and including, in rare instances, death.

Stories have long circulated of visitors to the East End, or Nantucket or the Connecticut shore, who were bitten by a deer tick and went home to unwitting doctors in the Midwest or California complaining of chills, fever, pain in the joints, or exhaustion; being diagnosed with the flu, and later experiencing cardiac arrhythmia or arthritis.

In recent years, however, awareness of how to recognize Lyme disease and how to treat it has soared, both among the general public and in the medical profession.

That, according to a report released this week by the Yale University Lyme Disease Clinic, is both good and bad. It seems that many patients who undergo treatment for Lyme are so afraid of the illness that they press their physicians for a course of treatment they may not really need.

Of 209 persons in the Yale study, 125 turned out not to have Lyme disease at all, although they visited their doctors an average of seven times and took antibiotics for an average of 42 days. Fifty-two of the 125 suffered from apprehension, so certain were they that they had the disease. More than half reported adverse side effects from the antibiotics.

Pressured by fearful patients, concluded the study, some doctors are prescribing too quickly, without consideration of the possible ramifications.

There will be those who say it is better to take unnecessary antibiotics and contend with their side effects than to wind up with an irregular heartbeat or painful arthritis, and maybe they're right. On the other hand, if ever there was a shining example of an instance in which an ounce of prevention was worth a pound of cure, this must be it.

Spring is coming. Wear long pants and stay away from the tall grass.