After years of cautioning that people were unlikely to get Lyme disease in North Carolina, state health leaders are now advising that the tick-borne illness can, in fact, be acquired here.
In at least four cases this year, Lyme was confirmed among patients who never left their home counties, ruling out the prospect that they picked up the bacterial infection while traveling.
Based on the new evidence, Dr. Megan Davies, state epidemiologist, said the state is now working to get the word to doctors, who for years were reluctant to even test patients for Lyme because it wasn't considered much of a possibility.
"What we're trying to communicate to physicians is that it's possible to acquire Lyme in North Carolina, so don't hold to an old belief," Davies said, noting that she and others are meeting with infectious disease doctors at the state's medical schools to get the word out.
And there's an entrenched view to overcome. Many patients report difficulties getting Lyme tests and diagnoses when they've been bitten by a tick, or when they come down with a rash, fever, headache, fatigue and other symptoms of Lyme.
This past summer, Angela Stott of Asheville said her son, Max, went several weeks without a diagnosis before he became so sick he could barely walk and had such excruciating headaches his eyes crossed.
More than one doctor told her Lyme disease was not a factor in North Carolina. Even when a Lyme test came back positive, Stott said, doctors still questioned the diagnosis.
"It was nightmarish," she said.
Lyme disease patients and advocates said they are pleased the state is now working to change the thinking. They said delays in treatment can have serious consequences, because the infection is harder to treat the longer it lingers.
Dr. Carl Williams, state public health veterinarian, said that's a key component of the new message.
"What we're interested in is primary prevention of acute disease," Williams said, noting that an early intervention with antibiotics is generally a cure.
Reluctance to acknowledge the presence of the infection in North Carolina stemmed from early observations of the black-legged tick, which carries the Lyme bacteria. In Southern states, the tick appeared to feed on reptiles rather than mammals. As a result, it was considered unlikely to transmit the Lyme bacteria to humans in North Carolina.
But evidence has been mounting that the ticks are spreading the disease here. Patients offered anecdotal stories, and military doctors at Camp Lejeune offered findings that Marines were coming down with Lyme after being stationed at the Onslow County base.
State health officials are working to collect their own data and will soon test 19,000 ticks for pathogens.
"It's taken a lot of investigation to uncover these cases," Davies said of the confirmed Lyme disease incidents. "We are working to try to protect [people] against this illness in North Carolina."
