Preventing Lyme & Other Tick-Borne Diseases

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Lyme rash ID photography by © anakopa/iStock.com, 1 t.l.; Originally printed as reference for "Diagnostic challenges of early Lyme disease: Lessons from a community case series," by John Aucott et al. BMC Infectious Diseases 9, 79 (2009). www.researchgate.net/publication/26257313. Licensed via the CC BY 2.0., 2 b.r.; © dennisjacobsen/stock.adobe.com, 1 b.r.; © imageBROKER/Alamy Stock Photo, 1 t.r.; © JerryCallaghan/iStock.com, 1 b.l.; © Jaroslav Moravcik/stock.adobe .com, 2 t.r.; Mikael Häggström/Wikimedia Commons, 2 t.l.; Originally printed as reference for "Bullous Lyme disease" by Jeffrey B. Tiger, Marshall A. Guill III, and M. Shane Champman. Journal of the American Academy of Dermatology 71, no. 4 (2014). www.sciencedirect.com/science/article/pii/S0190962214013917. Licensed via the CC BY-NC-ND 4.0., 2 b.l.; © Tramper2/stock.adobe.com, 1 m.r.

Illustrations by Beverly Duncan, except 78 by Ilona Sherratt

Range maps by Ilona Sherratt

Life cycle diagram on 30 based on an illustration created by the Centers for Disease Control and Prevention (www.cdc.gov/lyme/transmission/blacklegged.html)

Text © 2020 by Alexis Chesney

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Ebook version 1.0

March 3, 2020

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To all of my patients

Thank you for the honor of inviting me to walk with you on your healing journeys.

And to my grandmother "Nani"

Thank you for your love and inspiration. I would not be where I am today had it not been for you.

Contents

FOREWORD by Richard Horowitz, MD

Preface

Introduction

Chapter 1: Ticks

Species in North America

Tick Identification

The Tick Life Cycle

Chapter 2: Lyme and Tick-Borne Disease

Reading the Maps

Lyme Disease

Anaplasmosis

Babesiosis

Ehrlichiosis

Rickettsial Spotted Fever Group

Tularemia

Powassan Virus

Heartland Virus

Tick-Borne Relapsing Fever

Colorado Tick Fever

Southern Tick-Associated Rash Illness

Bartonellosis

Tick Paralysis

Chapter 3: Tick COntrol and Tick Bite Prevention

Reducing the Tick Population

Personal Tick Bite Prevention Strategies

Chapter 4: Herbal Prophylaxis for Lyme and Tick-Borne Disease

Why Prophylaxis?

Prophylaxis for High-Risk Populations

The Prophylactic Tick Bite Formulas

Key Herbs and an Enzyme: Profiles

Chapter 5: After a Tick Bite: What to Do

Attachment

Immediately Removeand Identify the Tick

Apply First Aid

Have the Tick Tested for Pathogens

Begin the Herbal Prophylactic Protocol

Watch for Symptoms

Get Tested (Maybe)

Chapter 6: Acute Tick-Borne Disease Treatment

What to Do If You Develop Symptoms

Beginning Treatment for Acute Tick-Borne Disease

Acute Lyme Disease Treatment

Acute Anaplasmosis Treatment

Acute Babesiosis Treatment

Acute Ehrlichiosis Treatment

Acute Rickettsial Spotted Fever Group Treatment

Acute Tularemia Treatment

Acute Powassan Virus Treatment

Acute Heartland Virus Treatment

Acute Tick-Borne Relapsing Fever Treatment

Acute Colorado Tick Fever Treatment

Acute STARI Treatment

Acute Bartonellosis Treatment

Pharmaceutical Antimicrobials

Finding a Lyme-Literate Practitioner

Looking Ahead

Acknowledgments

Appendix: Quick Reference Charts

Glossary

Notes

Resources

Index

Tick ID

Take Good Care, Naturally, with More Books from Storey

Share Your Experience!

Foreword

Why It's Important to Protect Yourself from Tick-Borne Diseases

Over the last several decades, tick-borne diseases (TBD) have been slowly spreading across the United States and the rest of the world, adversely affecting the lives of millions of people. In this country, all 50 states have reported cases of Lyme disease, and the numbers keep increasing. During the last 20 years, there has been a 320 percent increase in U.S. counties reporting ticks containing Lyme disease, as well as an alarming threefold increase in vector-borne disease cases overall. Confirming these public health reports, Quest Laboratories recently reported close to a doubling of positive Lyme testing among those being screened in 2018. These rising numbers do not account for those never screened, those who are tested but whose results show a false negative for Lyme (due to the insensitivity of the testing), or those who are never screened for associated co-infections present in the ticks.

Co-infection of ticks is now the rule, not the exception, and up to 85 percent of those with Lyme disease have been exposed to other pathogens in ticks. And transmission can happen rapidly: Powassan virus can be transmitted within 15 minutes of a tick bite, rickettsial infections can be transmitted within 10 minutes, and the relapsing fever borrelia, Borrelia hermsii, can be transmitted within just 5 minutes.

The symptoms of many of these co-infections can mimic those of Lyme. Even with early antibiotic treatment, they can have long-term disabling effects, adversely affecting the quality of your life and impairing your ability to work and be a productive member of society. Co-infections are potentially fatal in the young and elderly, especially in those with impaired immune system functioning.

Tick-borne infections can also mimic other chronic debilitating conditions, including chronic fatigue syndrome/myalgic encephalomyelitis, fibromyalgia, autoimmune diseases like rheumatoid arthritis or multiple sclerosis, and even autism or Alzheimer's disease. Tick-borne infections combined with environmental toxins have been reported in the medical literature to potentially play a role in all of these diseases. In fact, after seeing more than 13,000 chronically ill individuals with Lyme and TBD during the past 30 years, I am convinced that tick-borne infections are at the root of many unexplained symptoms and illnesses. In searching for answers for my sick and suffering patients, I have found up to 16 reasons why people may remain ill. I call this MSIDS — multiple infectious disease syndrome — and this model accounts for how tick-borne infections, along with overlapping sources of inflammation and their downstream effects, can lead to chronic illness.

Proper prevention is crucial, and the measures Dr. Chesney outlines in this book will certainly help save lives and prevent unnecessary suffering. There is no reason to tempt fate. Every time you go outside, use the tick-prevention measures discussed in this book. A small tick can cause long-lasting health issues that keep you from living life to the fullest. You will be well served to be mindful of this spreading epidemic, follow Dr. Chesney's advice, and protect yourself and your loved ones accordingly.

—Richard Horowitz, MD, New York Times bestselling author of Why Can't I Get Better? and How Can I Get Better?

Preface

My grandmother had rheumatic fever as a child and, as a result, she suffered from heart-related complications her whole life. Growing up, I spent a lot of time visiting her at the hospital. This was the same hospital where my aunt worked, where I later volunteered, and where I returned to work as a nurse extender the year after I graduated from college. This meant that I worked on a medical-surgical floor supporting the nurses as I drew blood, took vital signs, and monitored the telemetry, as well as providing comfort care to patients. At the same time, I was preparing for the MCAT (Medical College Admission Test).

I really loved the hospital but felt there was something missing. I found myself constantly thinking about what had happened to all these patients before they became so ill. What had led them to need heart surgery and chronic medications? I started reading Dr. Andrew Weil's books and learning more about natural therapies. The idea that the body had an inherent capacity to heal itself resonated strongly with me. Preventing heart disease — the leading cause of death in the United States — through diet, exercise, and lifestyle changes made sense to me. This shift in perspective led me to enter school to begin training as a naturopathic doctor in Bridgeport, Connecticut, instead of becoming a conventional allopathic doctor.

After I began practicing as a naturopath, I began to look back at my grandmother's condition differently. Her heart disease was caused by a bacterium — group A streptococcus — that she had been exposed to when she was 8 years old. Penicillin had not yet been discovered to treat her infection. She developed rheumatic fever, which caused endocarditis, an inflammation of the heart and its valves. Later, she was one of the first people to be given a replacement valve, and that saved her life. Fortunately, with the help of medication, she lived to the age of 77. I am forever grateful to the interventions of the allopathic world for this. However, I found myself wondering: If naturopathic medicine, especially herbal medicine, had been available when she was a child, could it have prevented the infection from ever affecting her heart? Perhaps my personal experience with my grandmother and my relationship to her illness planted a seed. When I began to work with people whose suffering was caused by a different bacterium — the one that causes Lyme disease — this seed would germinate into the work I do today.

In fact, my journey with Lyme disease started during my naturopathic medical education in Connecticut when a friend of mine came down with an illness that was discovered to be Lyme disease. Luckily she received treatment from a Lyme-literate medical doctor. The complexity of symptoms and the challenge to get proper treatment inspired me to learn more. In 2010, I completed an internship with Richard Horowitz, MD, a well-known expert in Lyme and tick-borne diseases (TBD). It was a gift to glean all the information I possibly could from him regarding the diagnosis and treatment of these conditions. My internship with Dr. Horowitz equipped me to answer my calling to work with those with Lyme and TBD. I had just begun practicing at Sojourns Community Health Clinic, a rural integrative clinic in Westminster, Vermont, with a new passion for detecting Lyme disease and with resources to test for and treat it. At the time, I had not realized that I arrived on the front line in the Lyme epidemic in Vermont in 2010. Patients told me stories about conventional physicians denying that there were ticks in Vermont, let alone Lyme disease. Soon after, in 2013, Vermont became the top state in the nation for Lyme disease incidence.

Currently, my patient population ranges from patients with early to late Lyme disease and from those who have one easily treated infection to others who have complex chronic illness. I see patients with the classic bull's-eye rash (known as erythema migrans) that is diagnostic for Lyme disease who do very well with prompt comprehensive treatment and go on living symptom-free. However, I mainly work with patients who have delayed proper treatment of Lyme disease because of the lack of knowledge about the disease, misdiagnosis, or confounding complex chronic illness. More frequent, more severe, and more numerous symptoms correlate with longer, more complex treatments. The longer the delay of comprehensive treatment, and the more tick-borne diseases (or coinfections) involved, the longer and more elaborate the treatment must be. I have worked with many people who have struggled on their healing journeys. I have seen people improve and many become symptom-free.

It has been an honor to witness the stories of hundreds who have been affected by the Lyme epidemic, to hold space for each patient as a whole person with an innate ability to heal, to guide the patient in testing and treatment options, and to observe the healing process. It is not unusual for someone to undergo an identity crisis and experience a range of emotions associated with the process. When people trust their bodies, their intuition, their practitioners, their treatment, and their support system, I see healing happen.

During, and especially after, treatment, I emphasize the importance of tick bite prevention. As with Lyme treatment, I individualize patients' preventive plans based on their profile for tick contact. Unfortunately, overcoming Lyme disease once does not protect you from further exposures. And if you have not had Lyme, at the rate this epidemic is progressing, it may be more accurate to say you haven't contracted it yet.

I'm writing this book to promote awareness of prevention strategies. Without an effective vaccine, accurate testing, or simple effective treatment, each of us must do our part to educate ourselves and each other in order to stop the Lyme disease epidemic. My hope is that I may empower a movement to halt the spread of Lyme and TBD through prevention. Prevention is the best cure!

Introduction

Lyme disease is the most common vector-borne illness in the United States. A vector is an organism, such as a tick, that transmits a pathogen like Borrelia burgdorferi (which causes Lyme disease) from one organism to another. There are more than 300,000 new cases of Lyme disease diagnosed each year. The number of cases has increased to about 25 times the amount reported in 1982 when surveillance of the disease began. More than half of cases occur in children. As the incidence of Lyme disease has increased in the Northeast, so has the number of patients I see. In 2015, the Centers for Disease Control and Prevention (CDC) showed a 320 percent rise in the incidence of Lyme disease in the northeastern United States and a 250 percent rise in the north-central states. This was the second year (2013 was the first) that Vermont had the highest incidence of Lyme disease in the nation. To change the tide, radical education on the prevention of Lyme disease is critical. This book will provide practical strategies that everyone — from the weekend outdoor enthusiast to the professional farmer — can use. Fortunately, you can take many steps to prevent Lyme and tick-borne disease, including managing the tick population in your yard, preventing ticks from getting on you, and treating tick bites promptly and properly if and when they happen.

Naturopathic Medicine

I am a naturopathic physician, which means I treat Lyme disease in a particular way. Principles of naturopathic medicine inform everything I do and provide a foundation for the prevention and treatment strategies I review in this book.

Naturopathic physicians are educated and trained at 4-year naturopathic medical colleges that are accredited by the Council on Naturopathic Medical Education (CNME) and have passed professional board examinations administered by the North American Board of Naturopathic Examiners (NABNE) in order to become licensed. In addition to following a standard medical curriculum, a naturopathic doctor studies clinical nutrition, homeopathic medicine, botanical medicine, psychology, hydrotherapy, and counseling. Naturopathic medicine is based on the belief that the body has an innate ability to heal. Serving as both specialists and primary care physicians, naturopaths combine conventional diagnostics and treatment with natural therapies.

As of this writing, licensure of naturopathic physicians is state by state. I am licensed in Vermont; my scope of practice includes full prescription medication rights and ordering lab work, and I am covered by Vermont insurance.

The Father of Naturopathy

Dr. Benedict Lust (1872–1945) was the father of American naturopathy. Originally from Germany, he studied with many "nature-curists" in Europe. Having received his doctor of osteopathic medicine degree from the Universal Osteopathic College of New York and his doctor of medicine degree from the New York Homeopathic Medical College, he went on to open the first naturopathic college in America (American School of Naturopathy in New York).

Principles of Naturopathic Medicine

There are six principles of naturopathic medicine that provide the foundation to the unique philosophy held by naturopaths. The principles guide a naturopathic doctor's approach to interviewing a patient, critical thinking in creating differential diagnoses, medical decision-making, and collaborating with the patient.

1. 1.Support the healing power of nature. Naturopathic medicine supports the inherent ability in each of us to heal.
2. 2.Identify and treat the cause. Investigation into the patient's complete health history is essential in discovering the cause of illness. Focus is placed on treating the cause, not just the symptoms.
3. 3.First, do no harm. Noninvasive, nontoxic methods of diagnosis and treatment are used first.
4. 4.The doctor is a teacher. For a patient, understanding how the body works, its ability to heal, and medical diagnoses and treatment is an important part of the healing process.
5. 5.Treat the whole person. Naturopathic medicine takes a holistic look at all of the physical body systems, as well as addressing mental, emotional, environmental, social, and spiritual health.
6. 6.Prevention is the best medicine. Assessing risk factors for disease and choosing a healthy lifestyle are the key to a longer, healthier life.

As you can see, naturopathic medicine takes a whole-person approach to healing acute and chronic illness. In particular, the principles above guide how I think about wellness and dis-ease in the body, and how I empower my patients through education and encourage them to trust in their body's innate wisdom. Finally, the last principle, prevention, has spurred me to learn about the preventive tools and strategies that are the focus of this book.

Roadmap

In this book, chapters 1 and 2 provide background on tick-borne diseases and ticks, the arachnids that carry and transmit these diseases. Chapter 3 describes where ticks thrive, how to decrease the tick population in your neck of the woods, and how to prevent tick bites. Chapter 4 explains how to prepare your body to be better equipped to handle a tick bite before it happens and if it happens. Chapter 5 discusses what to do if you get a tick bite, including tick removal and identification, homeopathic first aid, tick testing, immediate tick bite treatment, and symptoms to watch for. Chapter 6 explains what steps to take if you develop symptoms, what to do if you are diagnosed with acute Lyme or TBD, and how to find a Lyme-literate practitioner. The Resources section has detailed information about organizations that are referenced throughout the book, including useful services, trusted sources for herbs, educational organizations, and laboratories. These practical tools can empower each of us to help stop the spread of Lyme and tick-borne disease one person at a time.

Naturopathic medicine takes a whole-person approach to healing acute and chronic illness.

Chapter 1Ticks

Ticks are biting arachnids that are widespread globally and are problematic due to the diseases they can transmit to humans. In this chapter, we'll review the most common ticks in North America, where they are located, and the pathogens they can carry. Most importantly, we will examine how best to identify ticks, which is key to determining the risk for various tick-borne diseases, like Lyme disease.

The distribution maps will tell you which ticks are found in your state or province. However, the maps do not reflect the nuances of tick population regionality within a state or province or whether those ticks are pathogenic (carrying pathogens that may be transmitted to you from a bite). For more specific information, connect with your local department of health or USDA Cooperative Extension Office to determine the pathogenicity of ticks in your state.

Species in North America

Ticks are parasitic arachnids: they depend on a host's blood for nutrition. An ixodid (hard) tick needs three blood meals in order to grow from a larva to a nymph to an adult. To find a blood meal, a tick will sense for body heat and carbon dioxide coming from a potential host and begin "questing." Questing is the act of a tick holding on to something in its environment — a blade of grass, a bit of leaf litter, the fibers of a dog bed — with its third and/or fourth pair of legs while reaching out with its first two pairs of legs, waiting to grab hold of a passerby.