Colorado is an Endemic Area for Lyme Disease in Dogs, Why not Humans?
Dr. Robin J. Thomson from Naturopathic Family Medicine, LLC: Do We Have Lyme Disease in Montana?
In a nutshell, I believe we do have Lyme disease in Montana. This is a very controversial issue, and not everyone agrees with me. In my opinion Lyme tends not to be diagnosed in Montana more often because most physicians don’t test for it. (If we didn’t test for HINI flu virus, we wouldn’t have that disease in Montana, either!) Here are some points to consider:
There have been newspaper reports of a mysterious “Lyme-like illness” in Montana. The illness looks like Lyme, and has even been preceded with a bull’s-eye rash in some cases. The argument has generally been that we don’t have deer ticks in Montana, so we can’t have Lyme disease in Montana. However, there is evidence of transmission by other types of ticks and possibly other insects. See the Missoulian article for the full details at Canadian Lyme Disease Foundation.
In my clinical practice, I have seen several people with confirmed Lyme disease tests that have no significant travel history outside of Montana. I have even seen a patient who developed a bull’s-eye rash after camping east of Helena who later tested positive for Lyme disease.
According to the government, Lyme disease also doesn’t exist in humans in Colorado (although it is considered a Lyme-endemic area for dogs). But between 2005 and 2007, Dr. Martz, a Lyme doctor, conducted a study in his clinic of 40 people from Yuma County (east of Denver in a very dry area) with no significant travel history who had symptoms of a chronic “Lyme-like illness” and who improved or were cured with long-term antibiotic treatment. He presented his findings at the ILADS conference in Washington, D.C. in October 2009.
Arizona is also considered “Lyme free”. The Arizona state government has denied that Lyme disease could exist in that state both because of the lack of deer ticks and the harsh climate. But in 1991 in Mojave County (near Kingman), a survey was conducted in the mountains at 7000 feet; deer ticks were collected and later found to be culture positive for Lyme disease. See the full article at L.E.A.P. Arizona.
Both the Colorado and Arizona stories contradict another common misconception: that Montana is “too dry”, and the mountains “too high” to support Lyme-carrying ticks. There have been a few cases of Lyme disease in dogs in Montana, as well as the co-infections Ehrlichia and Anaplasma that are also tick-born diseases. See a great interactive map at Dogs and Ticks.
Even if we don’t have Lyme disease in Montana, many people (especially in the Bozeman area) have either moved here from somewhere else (i.e. the Midwest or West coast) or travel elsewhere. Also, Montanans generally like to hunt, fish, camp, and hike- often in Lyme-endemic areas in other states. It’s ludicrous not to consider a possible diagnosis of Lyme infection in someone (because “we don’t have Lyme disease in Montana”) if that person has ever traveled outside the state. Travel history is a routine part of medical history taking taught in medical schools.
There is undoubtedly congenital (mother to fetus) transmission and possibly sexual transmission of Lyme, just as for syphilis (a similar type of bacteria). This means that, potentially, infection CAN happen in Montana via means other than insects.
My main concern is properly diagnosing tick-born diseases and helping people avoid debility from a bacterial infection that is treatable. I hope that eventually we’ll have confirmed cases of Lyme disease that originated in Montana so that we can also focus on prevention.
For an in-depth explanation of the Lyme controversy and why state governments wish to ignore an emerging disease-and how it has become both a political and an economic disease at the expense of patients- I encourage you to see the documentary film “Under Our Skin”. Clips can be viewed on YouTube, and the film in its entirety can be purchased from Open Eye Productions on-line.
In a nutshell, I believe we do have Lyme disease in Montana. This is a very controversial issue, and not everyone agrees with me. In my opinion Lyme tends not to be diagnosed in Montana more often because most physicians don’t test for it. (If we didn’t test for HINI flu virus, we wouldn’t have that disease in Montana, either!)
Rebuttals: