Special Report: Lyme Disease, A Suburban Menace


Is It a Panic Attack or Is It Lyme Disease?

Panic attacks might be an indication of Lyme disease.

During a 10-week period in 1999, Dr. Virginia T. Sherr, a nurses who complained of racing pulse, breathlessness, overwhelming anxiety, impending doom, sweating, unique pains, headaches, chills, and confusion.

The nurses did not know one another. Their personal physicians eliminated other possible causes and concluded that the three had typical panic disorders.

Subsequent tests by the psychiatrist found the presence of tickborne diseases, specifically deoxyribonucleic acid (DNA) of Lyme spirochetes in the blood (two cases) or urine (one case), and positive single photon emission computed tomography (SPECT) brain scans found brain abnormalities compatible with Lyme disease in all three cases.

Since the diagnosis of Lyme borreliosis, and treatment with high oral doses of antimicrobial medications, all three nurses have been free of panic attacks. Antianxiety medication became unnecessary in one case and was greatly reduced in the others. Two of the patients required pain medications for other symptoms of persistent Lyme disease.

Lyme disease is an infection caused by the corkscrew-shaped bacterium Borrelia burgdorferi (see Lyme disease: Questions and Answers) that is transmitted by the bite of deer ticks and western black-legged ticks, according to the Centers for Disease Control and Prevention, Atlanta.

Since this diagnosis, other cases from the same geographic area have also been diagnosed via SPECT scans as Lyme encephalitis/vasculitis, including one man who tested negative and who experienced horrific rage, panic attacks, and headaches. He is recovering with antimicrobial treatment for previously unsuspected tick-borne diseases.

Lyme Disease: Questions and Answers Q. How is Lyme disease transmitted?
A. By ticks (deer ticks and western black-legged ticks) that become infected with bacteria that cause Lyme disease.

Q. How do people get Lyme disease?
A. By the bite of ticks infected with Lyme disease bacteria.

Q. What is the basic transmission cycle?
A. Immature ticks become infected by feeding on small rodents, such as the white-footed mouse, and other mammals that are infected with the bacterium Borrelia burgdorferi. In later stages, these ticks then transmit the Lyme disease bacterium to humans and other mammals during the feeding process. These bacteria are maintained in the blood systems of small rodents.

Q. Can you get Lyme disease from another person?
A. No, Lyme disease bacteria are not transmitted from person to person. For example, you cannot get infected from touching or kissing a person who has Lyme disease or from a health care worker who has treated someone with the disease.

Q. What are the signs and symptoms of Lyme disease?
A. Within days to weeks following a tick bite, 80 per cent of patients have a red, slowly expanding “bull's-eye” rash (called erythema migrans), accompanied by general tiredness, fever, headache, stiff neck, muscle aches, and joint pain. If symptoms remain untreated, weeks to months later some patients may develop arthritis, including intermittent episodes of swelling and pain in the large joints; neurologic abnormalities, such as aseptic meningitis, facial palsy, motor and sensory nerve inflammation (radiculoneuritis), and inflammation of the brain (encephalitis); and, rarely, cardiac problems, such as atrioventricular block, acute inflammation of the tissues surrounding the heart (myopericarditis), or an enlarged heart (cardiomegaly).

Q. What is the incubation period for Lyme disease?
A. For the red “bull's-eye” rash, usually 7 to 14 days following tick exposure. Some patients experience later manifestations without having had early signs of disease.

Q. Can a person be reinfected with Lyme disease?
A. Yes. Having had Lyme disease does not protect against reinfection. Some people have had Lyme disease more than once after reexposure to infective tick bites. This stresses the need for continued tick bite prevention activities, such as wearing appropriate clothing when in tick-infested areas, checking daily for ticks, and quickly removing any attached ticks.

Q. How is Lyme disease treated?
A. According to treatment experts, antibiotic treatment for 3 to 4 weeks with doxycycline or amoxicillin is generally effective in early disease. Cefuroxime axetil or erythromycin can be used for persons who are allergic to penicillin or who cannot take tetracyclines. Later the patient, particularly with objective neurologic manifestations, may require treatment with intravenous ceftriaxone or penicillin for 4 weeks or more, depending on disease severity. In later disease, treatment failures may occur and re-treatment may be necessary.

(From the Centers for Disease Control and Prevention, National Center for Infectious Diseases, Division of Vector-Borne Infectious Diseases, Fort Collins, Colorado, 2000.) Lyme Disease in the United States
During the past 10 years, the states listed below reported 90% of the cases of Lyme disease in the U.S.

Legend for Chart:

A - State
B - Cases Reported: 1989–1998
C - Annual Incidence per State 100,000 persons



New York

39,370 21.6

17,728 54.2


14,870 12.3

New Jersey
13,428 16.9


4,760 9.3

Rhode Island

3,717 37.5


3,410 6.8


2,712 4.5


1,745 3.8


1,003 14.0
From the Centers for Disease Control and Prevention.

Lyme Disease: Prevention and Control

Whenever possible, avoid entering areas that are likely to be infested with ticks, particularly in spring and summer, when nymphal ticks feed. Ticks favor a moist, shaded environment, especially leaf litter and low-lying vegetation in wooded, brushy, or overgrown grassy habitat. Both deer and rodent hosts must be abundant to maintain the enzootic cycle of Borrelia burgdorferi.

Wear light-colored clothing so that ticks can be spotted more easily and removed before becoming attached. Wearing long-sleeved shirts and tucking pants into socks or boot tops may help keep ticks from reaching the skin. Because ticks are usually located close to the ground, wearing high rubber boots may provide additional protection.
Applications of insect repellents containing DEET (diethyl toluamide) to clothes and exposed skin and permethrin (which kill ticks on contact) to clothes should also help reduce the risk of tick attachment.

Daily checks for ticks and their prompt removal help to prevent infection, since transmission of B. burgdorferi from an infected tick is unlikely to occur before 36 hours of tick attachment. Embedded ticks should be removed using fine-tipped tweezers. Do not use petroleum jelly, a hot match, nail polish, or other products. Grasp the tick firmly and as closely to the skin as possible. With a steady motion, pull the tick's body away from the skin. The tick's mouth parts may remain in the skin, but do not be alarmed. The bacteria that cause Lyme disease are contained in the tick's midgut. Clean the area with an antiseptic.

The number of ticks in endemic residential areas may be reduced by removing leaf litter, brush piles, and wood piles around houses and at the edges of yards and by clearing trees and brush to admit more sunlight and reduce the amount of suitable habitat for deer, rodents, and ticks.

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