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Identifying Tick-borne Illnesses

Fairfax County health department participates in tick survey to protect communities.

Headaches, nausea, aching joints, high fevers, chills, rashes and fatigue.

In 2003 Nick Penning of Arlington, experienced some of these symptoms three days after finding a tick on his leg. For two years, he has experienced severe symptoms and deals with joint aches, nausea and fatigue on a regular basis.

"Almost every morning I woke up moaning," said Penning about the months after his tick bite. "The pain was unbelievable."

Although Penning showed symptoms during the summer of 2003, it wasn't until April 2004 that a doctor diagnosed him with Lyme Disease, a tick-borne illness, and offered him appropriate treatment.

LAST YEAR THERE were three cases of Lyme Disease reported in Fairfax County, according to Jorge Arias, disease carrying insects supervisor, Fairfax County Department of Health.

In comparison, Loudoun County reported 70 cases of Lyme Disease in 2004, he said.

Nationally 23,000 cases of Lyme Disease were reported in 2002, according to the Center for Disease Control and Prevention (CDC).

Last month, the county health department began a program to monitor the tick population in the area.

"We want to see what ticks are out there, what the population density of ticks is and what diseases are out there," said Arias.

The Department of Health began a pilot surveillance program last month in cooperation with the state health department. Officials began gathering ticks from the county to be tested and studied.

Although only in the initial stages, Arias said the hope is the surveillance program would operate at a similar level to the county's West Nile Virus program, which tests mosquitoes from around the county to see how many are infected with the virus.

There may be more cases of Lyme disease than are being reported, and health officials suspect that Penning’s experience with a delayed diagnosis is not an isolated occurrence.

Because so few cases of Lyme Disease were reported last year in Fairfax, another hope is the program will raise awareness not only for the general population but also in the medical community about tick-borne illnesses.

"We want to get doctors to realize there is Lyme Disease out there," he said, adding some doctors are already working toward better identification and treatment.

"All of [the doctors] said I didn't have Lyme Disease and that I never had it," he said. "They said whatever I have I'll get over it."

Frustrated, Penning said he finally found a rheumatologist, an arthritis specialist, willing to treat him for the disease.

County officials are also pushing prevention awareness in the community, Arias said.

The best way to prevent infection is to avoid entering areas that are likely to be infested, particularly in the spring and summer months, according to Arias. Tick-infested areas include moist, shaded environments with leaf litter and low-lying vegetation in wooded, brushy or overgrown grassy habitats.

Because ticks are closely located to the ground, Arias said people should wear long-sleeve shirts and tuck them into pants. In addition he said people should tuck pants into socks or boot tops or wear high rubber boots.

Arias said people could also spray insect repellent containing DEET to clothing and exposed skin. Permtherin, a spray that kills ticks on contact, can also be used on clothing only. In addition, people should conduct tick checks and properly remove the tick to reduce the risk of disease.

A BACTERIAL ILLNESS transmitted by a tick bite, Lyme Disease cases have been reported in Virginia since 1982, according to the county health department. The disease is treated with antibiotics.

Found in deer ticks, the disease is transmitted after feeding for two or more days, according to the CDC.

Ticks feed by inserting their mouths in to the skin of a host and slowly taking in blood. Within two days to a few weeks after being bitten by a tick carrying Lyme Disease, 80 percent of people bitten develop a "bull's-eye" or oblong rash at the site of the bite, according to the CDC.

Other symptoms can include tiredness, headache, fever, stiff neck, muscle aches, joint pain and swollen lymph nodes. If left untreated, Lyme disease can lead to chronic arthritis or heart and nervous system complications in a small percentage of infected people that can occur several weeks to several months after exposure, according to the county health department.

In addition to looking for ticks carrying Lyme Disease, Arias said officials are also looking for Rocky Mountain spotted fever and ehrlichiosis, other tick-borne illnesses common in Virginia.

By identifying the various tick populations and any diseases they may carry, Arias said the health department would be able to step up an awareness campaign.

"It's a lot like West Nile Virus, the best resource we have is the population and the population can prevent this," he said. "Lifting the awareness of the population is so important, it will expedite the diagnosis process."

Being able to diagnose Lyme Disease early allows for proper treatment, which can result in the disease being cured, according to the CDC. But, the longer someone waits to be treated, the more severe the disease can become.

THIS WAS THE case for Penning. Because doctors said his blood tests came back negative for Lyme Disease, he was forced to wait before receiving proper treatment.

"My doctor said she was basing her diagnosis on clinical observation," he said about his symptoms. "The bacteria is very adept in hiding in your body."

In addition to nausea and headaches, Penning said he still experiences aching knees, fingers and other joints almost on a daily basis.

Now, Penning also receives treatments from a Chinese medicine specialist recommended by his doctor.

"He has me on herbal supplements and it seems to be an improvement," he said. "But, I still need to rest or stop working because of pain or double vision."

"For the last six to nine months I have been better, and my doctor said that I will be cured," he said. "But it's been a hell of the last two years."

A senior legal analyst for the American Association of School Administers, Penning, who also writes a column for the Arlington Connection, said he couldn't make it to the office for 10 months because of his symptoms. But because his job is centered around writing and because his boss has been supportive, Penning said he was able to work from home.

Today he said he is able to make it to work most days, adding he still cannot drive.

"It's been terrible," he said. "It has turned my life upside down."