Requires health insurers to cover long-term antibiotic therapy for tick-borne illness.
Lyme disease is a bacterial infection transferred to humans through tick bites. Only a certain type of tick carries Lyme: the blacklegged tick, which was formerly called the deer tick. Lyme disease causes a range of both immediate and long-term symptoms. Those symptoms can be very serious if the disease is left untreated.
Lyme disease in NH
New Hampshire currently has the highest rate of Lyme disease in the United States, with over 1,300 reported cases per year for the last several years.
Roughly 60% of blacklegged ticks in New Hampshire carry the Lyme bacteria. Lyme infections are reported most frequently during June and July.
Lyme disease is one of four tickborne diseases that can be found in New Hampshire. The others are anaplasmosis, babesiosis, and Powassan virus infection. All of these are spread by blacklegged ticks.
Symptoms of Lyme disease
Ticks can’t transfer Lyme disease to humans quickly. A tick must be attached to your skin for 36 hours or so. However, blacklegged tick nymphs – which most commonly bite humans – are extremely small, which can make it easy to overlook them.
Symptoms of Lyme disease include a red “bulls-eye” shaped rash. Those infected might also get a fever, headache, muscle aches, joint pain or fatigue. There can be more serious long-term symptoms if Lyme is untreated. Those can include nerve issues, heart problems, and swelling in the joints.
Many of the symptoms of Lyme also appear in other illnesses. This can make diagnosing Lyme disease challenging. There are tests that look for your natural antibodies to the Lyme disease bacteria. It takes your body several weeks to develop those antibodies, so testing too early can result in a false negative. They also stick around long after the disease itself is gone, so tests can’t reliably tell you whether the infection has cleared up. You can also get a false positive for Lyme if you’re infected with a range of other diseases.
Some services offer to test ticks for Lyme bacteria. However, the CDC does not recommend these tests, noting that just because a tick contains Lyme bacteria doesn’t mean you were infected. Also a tick might test negative, but you might have Lyme from a bite by a different tick.
Preventing Lyme disease
There are many things you can do to minimize your risk of getting Lyme disease.
- You can avoid long grasses, brush and wooded areas where ticks congregate.
- You can use barriers such as wood chips or rocks to create ‘tick free zones’ in your yard.
- You can wear tick-repellant clothing or spray yourself with insect repellant when outdoors.
- Check your clothing and your body daily for ticks after spending time outdoors.
- Use tick-prevention products on your pets or prevent them from exploring potentially tick-infested areas.
If you are bitten by a tick, remove the tick as quickly as possible. Do this with tweezers and then clean the bite area.
A vaccine for Lyme?
There is currently no vaccine for Lyme available. One was on the market in the late 1990s but was discontinued due to lack of consumer demand after a controversy over unsubstantiated claims the vaccine caused arthritis. Two new Lyme vaccines are in development but are years away from potential public release.
Treating Lyme disease
If Lyme disease is identified early, it is usually treated with a simple course of antibiotics. Cases where the disease is more established may require longer courses of antibiotics.
There is some controversy over “chronic Lyme disease”, where Lyme disease patients report continuing symptoms such as fatigue and aches after regular treatment. Some physicians support using prolonged courses of antibiotics to treat these cases. The National Institute of Allergy and Infectious Diseases argues there is no evidence those longer treatments benefit patients and they may even be harmful.
Lyme disease in NH state policy
The treatment debate has played out at the policy level with bills that require insurance companies to cover long-term antibiotic treatment for Lyme or that require doctors to tell patients about the potential for false negatives in test results. So far, the only bill like this to pass in New Hampshire prohibits the state’s Board of Medicine from penalizing doctors for prescribing long-term antibiotics for Lyme disease patients.
Establishes a commission to develop a statewide strategy on tick management.
Requires insurance coverage for further blood testing for persons who are still symptomatic after a first blood test for tick-borne illness.
Requires licensed health care providers to provide detailed test results to patients being tested for Lyme disease.
Proclaims the month of May to be Lyme disease awareness month, and requires the Department of Health and Human Services to make information about Lyme disease available on its website.
Allowing doctors to prescribe long-term antibiotic treatments for Lyme disease
Creating a committee to study alternative medical treatments for Lyme disease
Should NH continue to allow doctors to prescribe long-term antibiotics for the treatment of Lyme disease?
This year, a state commission is studying the issue of testing for Lyme and other tick-borne diseases. They'll look at the issue of the reliability of these tests and what sort of information should be provided about them to patients. Have an opinion? Contact your elected officials and share your thoughts.
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