Life In The Age Of Lyme

By John Skow

Guinea hens are bald, wattled and graceless. They resemble feathered footballs. Worse, they are surly, loud and unmusical, often at 3 in the morning. But they are voracious gobblers of bugs and are especially fond of the tiny deer ticks that carry the spirochetes of Lyme disease. Which is why model Christie Brinkley, SPORTS ILLUSTRATED's swimsuit sweetie some years ago, learned to love them. She has installed a flock on her estate in East Hampton, N.Y., and hands out chicks (called keets) to her neighbors.

Before she got the hens, Brinkley had taken to wearing high fishing boots when she walked to the beach. "We were really infested," she says. "It seemed as if every blade of grass had a tick hanging off it." Her hen patrol has reduced the local tick population, although that has not prevented her from contracting the tormenting ailment that she and millions of other householders routinely take elaborate pains to avoid. The tick that infected her with what was diagnosed last week as Lyme disease probably, she thinks, bit her while she was horseback riding.

Fear of Lyme disease is justified, and harboring guinea hens is reasonable, if not terribly practical for most people. The nagging affliction often shows itself first as a rash and flulike nausea, fever and aches. Lyme mimics many other illnesses, and in later stages it can escalate to arthritis, meningitis, neurological damage and sometimes physical debility and racking pain. Some 30,000 cases had been reported in the U.S. by the end of last year. From 1986 through 1989, reported cases doubled each year, and a slight drop last year (7,995 cases, from 8,551 the year before) may reflect only a change in reporting criteria.

Thus when the U.S. Centers for Disease Control advises that anyone walking through grass or brush in tick-infested areas wear long-sleeved shirts and long pants taped into sock tops, many people actually do it, though the fashion statement is irredeemably tacky. The meticulous daily body inspection that is the most effective preventive is now a normal routine, like flossing teeth. What you are looking for is the nymphal stage of an arachnid (not an insect) that is louse-size only as an adult and that as a nymph has been compared to a dark freckle. Where you are looking is behind the knees, in pubic and scalp hair, under watchbands, in armpits. Yes, you need a partner for this, and perhaps, if you are no longer 25, a stiff drink.

Old Lyme, Conn., got an undeserved reputation as a pesthole when the disease later named for it was first identified there in 1975. But it is unlikely that the disease really was newly hatched in that area. Decades earlier, on Long Island in New York, a pesky swelling called Montauk knee was causing trouble. In 1908 something indistinguishable from Lyme disease was described in Sweden. Ticks hitch rides not just on deer, mice, humans and other mammals, but also on birds, which helps explain why Lyme disease has been reported in 46 states. (Only Alaska, Arizona, Montana and Nebraska have reported no cases.)

White-tailed deer are suburban creatures, and a surge in the deer population as forests have regrown in the Northeast offers one reason that Lyme disease has hit hard in New York, New Jersey, Maryland, Pennsylvania and lower New England. Wisconsin and Minnesota have had smaller outbreaks, and so, though the ticks are a different species, has Northern California.

A fairly effective control method for a limited area is a product called Daminex, which is a tube filled with pesticide-soaked cotton. Mice take the cotton to build nests, and the pesticide kills ticks. On Martha's Vineyard and Nantucket, scientists are planning to release large numbers of a tiny wasp called Hunterellus hookeri. Success is uncertain. The wasps do kill some tick nymphs, but may in fact need a large and healthy tick population to maintain their own numbers. Other drastic preventives that householders mutter about while untaping their trousers -- region-wide burning of fields, pesticide spraying or slaughter of deer -- are just not politically or environmentally feasible.

An effective vaccine would save the day, and last year researchers at Yale were reporting some progress. But the approach has so far proved successful only in mice and has yet to be tested in humans. Some resolute citizens are said to chew garlic before venturing outdoors, hoping wistfully that what works for vampires will also drive off ticks. Ken Liegner, a Westchester County, N.Y., doctor with many Lyme disease patients, has invented a "deer gazebo" that would lure whitetails with a salt lick or apple mash and shower them with pesticide. The rumor persists that Lyme-infected veterinarians have dosed themselves with canine Lyme vaccine not tested in humans.

Antibiotic treatment usually works fairly well in the early stages, but the suffering of a few patients with advanced Lyme disease does not respond to conventional cures. So a dangerous and unconventional therapy has come into use. Dr. Henry Heimlich of Cincinnati, known for developing the Heimlich maneuver to relieve choking, observed that Lyme disease resembles syphilis in that it is caused by a corkscrew-shaped spirochete. He knew of an outdated treatment for the late stages of syphilis in which patients were deliberately infected with malaria and then cured of it. It was believed once that malarial fevers cooked away the syphilis, though now it is thought that the malaria provokes a powerful response by the immune system. Heimlich does not apply malaria therapy, which is not approved by the Food and Drug Administration. Nonetheless, he insists that the treatment, available in Mexico and Panama, is a legitimate last resort for late-stage Lyme sufferers who are "paralyzed, bedridden in a fetal position" or perhaps going blind. Results vary, and what is achieved by weeks of full-blown malaria seems at best to be a remission.

But Nancy Modiano, a 30-year-old Hamilton, N.J., resident, agrees with Heimlich. She thinks she contracted Lyme disease as a teenager. By last year she was helpless, subject to vomiting and seizures, her joints so swollen that she couldn't operate her wheelchair. She flew to Mexico City last November and was injected with malaria. For 35 days her fever would spike to 108 degrees, then drop to 95 degrees. Yet two weeks after the induced malaria was cured, she was learning to walk again. Though she still has some Lyme symptoms, her recovery continues. She sums up the experience: "I knew I was dying. I had no other choice. I would go through the malaria treatment again in a second."

For the rest of us, will summer ever be lighthearted again? Will no shirtless youth dive gallantly into the peonies to catch a Frisbee? Will no maiden swish barefoot across a dewy moonlit lawn? Eventually, yes, when poultry or medicine comes to the rescue. But not this tick-plagued summer, not just yet.

With reporting by Janice M. Horowitz and Andrew Purvis/New York