Tick Season Renews Controversy Over Long-Term Treatments For Lyme Disease

When Brian Kelly, the owner of East End Tick Control in Southampton, routinely dragged a white sheet across a property in North Haven this spring and flipped it over, he was surprised at what he found: 49 ticks in just 15 minutes.

He explained that the process, called flagging, is used in his trade to estimate the number of ticks in an area. Mr. Kelly said he attributes the unusually high number of ticks he found that day—in prior years, he said, such a test would typically yield less than a dozen ticks—to this year’s unseasonably warm winter. He said many ticks could have survived the winter, adding to the numbers of biting arachnids that harass outdoor enthusiasts and can potentially spread Lyme disease.

JoAnn Bennett, the owner of Premier Tick and Mosquito Control in Southampton, agrees that there has been an increase in ticks this year, estimating that their numbers have gone up by about 20 percent.

Still, there is disagreement over the effect that the mild temperatures this winter had on insect populations. Carol Downing, a spokeswoman for the Suffolk County Department of Health, said there has not been a noticeable uptick in ticks this year, but that they emerged from their dormant state a month early, in March, due to the warm weather.

Tim Green, the national resource manager of Brookhaven National Laboratory’s Environmental Protection Division, said ticks spend the winter months at the base of plants for warmth, and that it takes very low temperatures to kill them off. He agreed with Ms. Downing’s observation but also stressed that most of the tick population numbers being thrown around are merely anecdotal because accurate testing would take excessive time and manpower.

The Suffolk County Department of Health advises those spending time outdoors to take such preventive measures as tucking in clothing, wearing repellent and drying clothes for 10 minutes at the highest temperature afterward to kill ticks. To address the problem of tick-borne diseases, such as Lyme disease, and make further recommendations for prevention, the county created a task force that is set to meet for the first time next Thursday, June 14, in Yaphank.

In 2010, Suffolk County recorded 609 cases of Lyme disease, the second highest number in the state behind Orange County, which reported 645 cases. More recent numbers are not yet available.

Though Lyme disease, if caught early, can be easily treated with 28 days of antibiotics, considered the medical standard, symptoms of fatigue and body aches can linger for months. That condition has been dubbed Post-Treatment Lyme Disease Syndrome and there is disagreement over the effectiveness of the often prescribed long-term intravenous antibiotic treatment, said Dr. Scott Breidbart, the chief medical officer at health insurance provider Empire Blue Cross and Blue Shield.

“The Infectious Disease Society of America, the American Academy of Neurology and the Centers for Disease Control do not recommend long-term antibiotic treatment for Lyme disease, even when everyone agreed that the patient had Lyme disease,” Dr. Breidbart wrote in an email.

Dr. Breidbart said insurance companies cover only treatments that are non-investigational, or have been proven to work, and the jury is still out on the effectiveness of the long-term treatment.

“Reasonably, people who are sick often put more credence in something they think can help them get better than a study that is showing that it doesn’t work,” he said. “Insurance coverage follows published science,” he added in an email.

Dr. Breidbart added that long-term antibiotic treatment can come with complications, like the patient developing an allergy, making it harmful to some.

“We have to be sympathetic to people that are in pain, but we have to make sure we don’t encourage the use of dangerous therapy just because we don’t have something better to offer right now,” he said.

But State Assemblyman Fred W. Thiele Jr. of Sag Harbor said he has spoken with numerous residents of Suffolk County infected with Lyme disease who said that the long-term intravenous antibiotics greatly assisted in their recoveries. “Many, many of them swear by it,” he said, of the long-term treatment. “It’s the only relief they’ve gotten.”

Their testimonials are the main reason why Mr. Thiele has sponsored legislation that would require insurance companies to cover all treatment for Lyme disease and other tick-borne pathogens, and he said he is optimistic that it will pass this session, despite the push against it from insurance companies that has prevented it from moving forward in previous years.

“I think you would be hard-pressed to find a family on the East End who hasn’t been touched by Lyme disease one way or another,” said Mr. Thiele, who noted that two of his three children have contracted the disease. “Yes, there is a division in the medical community as to how to best treat Lyme disease, but the fact of the matter is that there are a number of doctors and patients that feel that it has been very helpful to them.”

Frank Perry, the operations administrator of East End Health Plan, an insurance carrier, said his company’s patients are covered when they contract Lyme disease. He also said he does not recall a time when a patient had an issue receiving coverage for the long-term treatment.

State Senator Timothy M. Kennedy, a Democrat who represents the 58th District surrounding Buffalo, sponsored a bill identical to Mr. Thiele’s in the State Senate requiring insurance companies to cover the long-term treatment for Lyme disease. Mr. Kennedy did not return calls seeking comment this week. Both bills must be sent to the insurance committees before they will return to the floors of both houses for a vote.