Environmental Engineering Reference
In-Depth Information
CHAPTER
13
Eco
logy of Lyme Dise
ase
Richard S. Ostfeld
Cary Institute of Ecosystem Studies, Millbrook, New York
DISCOVERY
When two residents of Lyme, Connecticut, reported to the Connecticut State Health
Department in 1975 that a number of children in their town were suffering from a recur-
rent, inflammatory disease of the knees and other joints, public health officials responded
quickly. The local rate of this arthritic syndrome was 100 times greater than that of juve-
nile rheumatoid arthritis in the general population, suggesting a local cause. Some of the
children had experienced a skin lesion about a month before the onset of joint pain and
swelling.
Researchers from Yale University began to monitor the health of patients following the
appearance of similar lesions, finding that many of them later developed arthritis as well
as nervous system and heart disorders. These researchers were aware of previously
described co-occurrences of similar skin lesions (called erythema migrans, or EM) with
joint pain and neuritis in the European medical literature from the late nineteenth century.
This European syndrome was associated with tick bites, and although the causative agent
had never been identified, many patients responded well to treatment with penicillin, sug-
gesting a bacterial etiology (reviewed by
Stanek et al. 2002
). The search for ticks in forested
habitats near Lyme revealed abundant populations of what was then presented as a new
species of ixodid tick, named
Ixodes dammini
(
Spielman et al. 1979
). Shortly thereafter it
was discovered that cases of this new disease, named Lyme disease, were widespread in
coastal New England and the upper Midwest of the United States, and in both regions
were spatially correlated with abundant populations of this tick (
Steere and Malawista
1979
). The disease also occurred in California and Oregon associated with a closely related
tick species,
I. pacificus
. Evidence was pointing toward a widespread, tick-borne bacterial
agent as the cause of a newly named, but probably ancient disease characterized by multi-
ple symptoms varying over time.
