Post-Pandemic, Remember Lyme Disease: Patch Q&A

HUDSON VALLEY, NY — For more than 30 years, New York Medical College's Lyme Disease Diagnostic Center has operated every summer at the height of tick season.

Don't let the name fool you. The center has provided the region's residents with diagnosis and treatment not only for early and acute Lyme disease but also Anaplasmosis (Ehrlichiosis), Babesiosis, Deer Tick Virus (Powassan) and Borrelia Miyamotoi.

“Lyme disease, if not recognized and treated in its early stages, can have extremely detrimental effects," the founder of the center, Dr. Gary P. Wormser, told Patch. "As the summer months begin and people spend more time outside, increasing their exposure to ticks, we recognize the necessity of opening the Center so those who need to be treated and diagnosed for Lyme disease have the means to do so."

Tick-watchers have predicted in 2021 tick populations may be larger and around longer than usual. So with the center open as of June 1, Patch sat down with Dr. Wormser with a few questions.

Patch: How did the coronavirus pandemic complicate the work of the center?

Dr. Wormser: Last year and now also this year the LDDC is by appointment only rather than as a walk-in clinic. However, appointments are readily available without the need to wait. The Clinic sees patients at night on Tuesday, Wednesday, and Thursday every week during the period from June 1 through the end of August.

We have implemented additional measures in our Center to ensure the safety and wellbeing of our patients and staff as concerns of COVID-19 still remain.

All patients will be required to wear masks and additional safety measures regarding COVID-19 will be discussed by telephone when the appointment is made.

Patch: Was there a difference in 2020 from 2019 in terms of the disease or treatment?

Dr. Wormser: The main issue was the potential delay in the diagnosis and treatment because of the thought that the patient’s tick-borne illness was instead COVID.

Patch: How common are long-term effects from Lyme?

Dr. Wormser: In terms of the frequency of persistent subjective symptoms after antibiotic treatment of patients with erythema migrans (the round red patch, often bullseye-pattern), such as fatigue, muscle or joint pains, or memory/concentration symptoms, about 10-20 percent of adult patients can be expected to experience such symptoms for at least 6 months post-treatment. It is referred to as Post-Treatment Lyme Disease Symptoms or PTLDS. The erythema migrans is the most common manifestation of Lyme disease. Other manifestations may involve the nervous system such as facial palsy or the heart potentially leading to heart block. If you are talking about the late complications of untreated Borrelia burgdorferi infection, the one we see is Lyme arthritis.

Patch: Is anyone working on a vaccine?

Dr. Wormser: Very much so: Pfizer. The vaccine that is likely to enter into clinical trials fairly soon is a multivalent vaccine designed to prevent Lyme disease in both North America and Europe, but it's not based on RNA.

Patch: Are you considering expanding the center's focus to include other tick-borne diseases?

Dr. Wormser: We have been focused on the 5 deer tick-transmitted infections in our geographic area for years, both in terms of offering accurate diagnostic testing at the LDDC and in conducting research on all of them.

Dr. Wormser warns: early symptoms of Lyme disease may be mild and easily missed. They include:

• An expanding circular rash at least two inches in size—that may or may not look like a bull’s eye — that usually occurs at the site of the tick bite
• Headache
• Fever/chills
• Stiff neck
• Pain in joints or muscles
• Paralysis of facial muscles
• Palpitations
• Multiple rashes

If you experience any of these symptoms or would like to learn more about the Lyme Disease Diagnostic Center, please visit www.nymc.edu/lddc or call (914) 493-TICK [8425]. The Lyme Disease Diagnostic Center is open to patients 18 years of age and older who are either acutely ill or who have recently been bitten by a tick. Most insurances are accepted. Children under the age of 18 may be evaluated by the Department of Pediatrics Division of Immunology and Infectious Diseases at NYMC by calling (914) 493-8333.

At New York Medical College, Gary Wormser, M.D. is chief of the Division of Infectious Diseases and vice-chair for research and development in the Department of Medicine and professor of medicine, microbiology and immunology and of pharmacology.

At New York Medical College, the School of Medicine, Graduate School of Basic Medical Sciences, and School of Health Sciences and Practice, the Touro College of Dental Medicine at NYMC, and the Touro College School of Health Sciences’ nursing program are all on the Valhalla campus in Westchester County, New York.