PRAISE FOR LYME
‘A powerful wakeup call’
In October 2016, author and investigative journalist Mary Beth Pfeiffer was visiting New York’s Metropolitan Museum of Modern Art when she found herself standing before one of Claude Monet’s masterpieces: Poppy Fields near Argenteuil. In its classic pastoral scene, a young boy makes his way through a field tinted with orange poppies and green thrush. A woman, perhaps his mother, walks beside him in a beige bonnet and flowing blue gown, dangling a turquoise umbrella over her shoulder. The two, at ease beneath a patchy blue sky, seem to nearly disappear into the tall, wild grasses all around them.
For Pfeiffer the scene triggers not admiration but anxiety.
“I can no longer look at such pastoral loveliness without seeing what lurks within,” she writes in her new book, Lyme: The First Epidemic of Climate Change (Island Press, April 2018). “I know what’s there.”
Since 2012, Pfeiffer has been investigating the explosive growth of tick populations in the United States and around the world, and with it, the rising incidence of Lyme and other tick-borne diseases. What she has discovered, both about the disease itself and the woefully flawed methods with which it is tested, diagnosed, and treated, is enough to give anyone lacing up their shoes for a leisurely stroll in the outback some serious pause.
“Blacklegged ticks have taken up residence in half of continental America’s counties, spreading west, north, and south from the Connecticut town from which Lyme disease was named in the late 1970s, like some unchecked algal bloom,” she writes. “These eight-legged arachnids have turned childhood from a time to explore nature to a time to fear it.”
'Superbly written and researched'
Spread by a few species of almost invisibly small ticks and frustratingly difficult to treat, Lyme disease has reached epidemic proportions across the globe during the last few decades, afflicting upwards of half-a-million people. This in-depth report on the illness, which veteran journalist Pfeiffer calls the first true epidemic of climate change, reveals the full scope of Lyme’s devastating reach both currently and potentially as temperatures warm in places where ticks didn’t previously exist. Pfeiffer begins by tracing Lyme’s spread from as far back as 20-million years ago, when the responsible bacterium, Borrelia burdorferi, made its first appearance, to its more recent explosive outbreak in Lyme, Connecticut. In addition to describing Lyme’s insidious symptom progression, she takes the medical profession to task for following inadequate Center for Disease Control (CDC) guidelines and thereby underestimating the disease’s true deadly impact. Superbly written and researched, Pfeiffer’s work should go a long way toward convincing the public to take this modern-day scourge more seriously.
'A work of breadth and depth, impressively documented, elegant'
By Ron Meador
Ticks can, and sometimes do, deliver two, three, or four diseases in one bite. So resourceful are infected ticks that two feeding side by side on the same animal may pass pathogens one to the other and never infect the host. So clever is the Lyme pathogen that infected ticks are more efficient at finding prey than uninfected ticks. These ticks may not be able to fly or jump or trek more than a couple of human steps. But they have changed many lives, cost billions in medical care, and colored a walk in the woods or a child’s romp in the grass, our very relationship with nature, with angst. This is all the more disturbing when we realize, ultimately, that it is we who unleashed them.
— Mary Beth Pfeiffer in “Lyme: The First Epidemic of Climate Change.”
Hers is a work of both breadth and depth, impressively documented and often elegant. It began as a string of newspaper pieces that Pfeiffer wrote for the Poughkeepsie Journal in upstate New York, where she specialized in investigations. I mention this at the outset because her topic is obviously and deservedly controversial, and I want you to know that she treats it with a traditional journalistic rigor sometimes lacking in modern nonfiction books, where the needs of narrative can dominate.
However, it is also a book that makes a political point — transparently and persistently — that the shocking and still-accelerating spread of Lyme infection, and the suffering of victims left with chronic illness and disability, have been amplified needlessly by official indifference to prudent, practical, science-based remedies. Also, by policy decisions in which self-interest, ethical lapses and conflicts of financial interest played a role.
The result, she says, is a rapidly spreading tick-borne illness “that has been minimized, underestimated and politicized to the point that doctors fear treating it aggressively with a cheap, common drug: antibiotics.” (She might have added — highly safe, easily obtainable, unlikely to be abused.)
So Pfeiffer’s discussion goes well beyond the familiar, messy disagreements over attributing this symptom or that syndrome to a long-lasting Lyme infection that can’t be proved with lab testing, or to corollary damage that some but not all experts have sourced to the Lyme spirochete, Borrelia burgdorferi, whose capability for evading antibiotics and other medical intervention is established.
'Engrossing, even-handed, urgent'
After reading Mary Beth Pfeiffer’s engrossing new book, Lyme (out April 17), you will probably want to kill any tick you can find, donate to Lyme research, and find out if you are at risk for tick-borne diseases.
Spoiler alert: your risk is likely increasing. Ticks, some of whom carry the pathogenic bacteria that causes Lyme, can now survive in environments where they would have frozen to death 30 years ago. The good news is that there’s a lot of new research coming out about stopping and treating tick-borne illnesses, and a good new book that connects the dots between climate change, ticks, sick people, and policy.
Pfeiffer takes a comprehensive, even-handed look at the “Lyme wars” – on one side, there are doctors who strictly follow the Infectious Disease Society of America guidelines on Lyme, which have been criticized as biased and were subjected to an antitrust investigation. On the other side are the patients and doctors who have experience with chronic or late-stage Lyme disease, which causes joint pain, cognitive impairment, and is sometimes treated with long courses of antibiotics (which the guidelines do not support). Pfeiffer carefully presents both perspectives, while also showcasing individual patients’ stories.
'Builds a strong case'
An alert about the dangers of Lyme disease and other tick-borne infections.
Veteran investigative reporter Pfeiffer (Crazy in America: The Hidden Tragedy of our Criminalized Mentally Ill, 2007) lives in New York state, not far from the Connecticut town that gave its name to a bacterial infection a generation ago. Not only is there scant government research on Lyme disease, but the Centers for Disease Control and Prevention and the National Institutes of Health assert that the disease is easy to diagnose and cured with a course of antibiotics. They deny the existence of chronic Lyme disease, in which some patients experience painful joints and even heart disease or neurological problems, including cognitive declines. The agencies also inveigh against treating such patients with further courses of antibiotics.
In page after page of data and interviews with patients, advocates, and researchers around the world, Pfeiffer builds a strong case: Diagnosis is not easy, many patients do not have the bull's-eye rash associated with the tick bite, and the CDC's diagnostic criteria are problematic. Worse, the prevalence of Lyme is rapidly growing worldwide. Thanks to global warming, tick species are spreading farther and finding ample numbers of small mammals to infect. The species that carry Lyme often carry other pathogens, a condition that seems to increase their vigor, while their saliva contains anti-coagulants, anesthetics, and immunosuppressive agents that enable the fiendishly small blood-suckers to hang on. Indeed, the author suggests that an anti-saliva agent might be more effective than an anti-Lyme vaccine. One difficulty with a vaccine is that the Lyme bacterium is a spirochete (like the agent for syphilis), a bug able to lie low and hide from the immune system in tissues as a persister.
Pfeiffer's indignation and constant lacing of the text with tick names and numbers, disease counts, and tragic cases create a high emotional pitch that can be exhausting, but the basic facts she sets forth are credible, and they deserve immediate attention.
"This is an illness that has been minimized, underestimated, and politicized.” Thus says investigative reporter Mary Beth Pfeiffer on Lyme, the tick-borne disease now on the march in North America, Europe and Asia. As Pfeiffer’s hard-hitting study reminds us, non-specific symptoms and other complexities make tackling Lyme a formidable challenge. She nimbly interweaves numerous strands of research — into the influence of climate change on the Lyme invasion, the disease, the pathogen, the vectors and the harrowing impacts borne by some sufferers.
'A meticulous researcher with a gift for story'
Does anyone else remember life before Lyme disease, when we could roll down grassy slopes, meander through meadows, and frolic in leaf piles without fear? When every outdoor excursion didn’t call for a strip search of every family member, and finding a tick was as simple as saying “yuck,” removing it and going on about your business?
That day is long gone. Most everyone you meet in the Rondout Valley, Hudson Valley and beyond has a Lyme disease story; just about everyone has been infected at some point. The lucky ones among us experienced acute symptoms like the famous bullseye rash or something that felt like a bad flu, went immediately to the doctor, were treated with antibiotics, and got on with our lives. For far too many people, though, something as insignificant-seeming as a tick bite that may not even have been noticed at the time has led to horrid and life-changing consequences, made far worse by the fact that they’re suffering from a disease that very few doctors fully comprehend and even fewer dare to treat against the guidelines handed down by the Centers for Disease Control and National Institute of Health.
How did we get here? How exactly did ticks become so dangerous and this illness so widespread, and why are the health care politics involved so utterly insane? In “Lyme: The First Epidemic of Climate Change,” local author Mary Beth Pfeiffer lays out the big picture. It’s not a pretty one. It’s scary, as a matter of fact, and gives one a feeling of being caught up in an almost irreversible slide toward dystopia, but the truths she is telling are ones we need to know.