FREEPORT — After working in urgent care for almost a decade, Catherine Lockwood, a Freeport-based doctor, is taking a step back to focus on treating a problem she has seen all too frequently: Lyme disease.
Maine has the highest concentration of people with Lyme disease by population, according to the Center for Disease Control. The Maine Department of Health and Human Services reported that last year over 1,400 patients were diagnosed with the disease.
According to Griffin Dill, director of the University of Maine Cooperative Extension Tick Lab, tick season is at its height through October and November.
Lockwood’s new online clinic, treatmytickbite.com is a way for Maine patients to have a tick bite evaluated for potential risk within 48 hours of the bite and serves as a quick option to get on a round of preventative antibiotics if they are unable to get to the doctor immediately.
“We are focusing on very early prevention,” Lockwood said. “There’s evidence that says if we get antibiotics early, a blast dose early can cut Lyme disease cases down by 85%.”
The website, which uses video connection and photos to allow Lockwood to consult with a patient to hear about the event, see the bite area and possibly identify the type of tick, is not meant to help diagnose anyone with Lyme disease.
“I’m not going to be able to tell them yes, you have Lyme,” she said, “but I can say you are high risk, this is what we can offer. It’s the option of treating it early.” She can then prescribe antibiotics, which are not 100% protective, she said. If able, patients should still follow up with their primary care physician, she said.
During her time working in urgent care, 20% of cases in the fall were tick-bite related, she said, “but we’re worried about the tick bites that don’t come in.”
Her clinic aims to eliminate some of the barriers that may prevent someone from seeking treatment, whether it be cost, access or wait time. Evaluation is available seven days per week, sometimes as early as 6 a.m. or as late as 9 p.m., and costs $29 for new patients and $15 for returning patients.
Lockwood has only been running treatmytickbite.com for a few weeks, but said operations have been smooth so far. She has seen about six cases, half of which were for bites that warranted preventative antibiotics.
Lockwood said she is trying to determine what kind of market there is for such a service.
“Medically, there’s no question there’s a need,” she said, calling her website “a trial run to see if there’s an appetite for this method.”
Lyme disease is caused by bacteria transmitted to a person through the bite of an infected deer tick, according to the Maine Center for Disease Control and Prevention.
Dill said the transmission of Lyme disease is somewhat of a “chicken or the egg situation.” The bacteria is not passed from mother to offspring. Instead, a tick gets the bacteria by feeding on an infected animal, which got the disease from a tick.
Symptoms of Lyme disease include a characteristic bull’s-eye rash, fever, headache, fatigue and joint and muscle pain, among other symptoms. Later symptoms can include arthritis, Bell’s palsy and meningitis, according to the CDC.
Dill said that since April, the tick lab has tested over 1,400 ticks, about 37% of which have tested positive for the bacteria, while 8% have tested positive for anaplasmosis and 6.5% for babesiosis, both of which are increasingly common tick-borne illnesses.
The lab is not a medical laboratory and cannot diagnose someone with Lyme disease, Dill said, but will both identify and test a tick that someone is concerned about.
This winter, once tick season has passed, Dill and others at the lab will start mapping the data to help determine the risk of contracting Lyme disease across the state.
So far this year, there have been 772 people diagnosed with Lyme disease, 573 with anaplasmosis and 128 with babesiosis, according to the CDC. That number is expected to grow throughout November.
Testing for Lyme disease, according to Lockwood, can be a complicated process, because unlike testing for something like strep throat, it’s not just a question of whether the bacteria is there. Instead, it is measured by how the body responds and, aside from the distinctive bull’s-eye rash, it can be harder to tease out the reason for “feeling crummy,” she said.
Some people treated for Lyme disease can continue to experience symptoms after treatment, known as post-treatment Lyme disease syndrome or chronic Lyme; the treatment of which Lockwood called “the new frontier.”
“The idea of chronic Lyme and how to manage it is an area of medicine that is evolving,” she said, and the treatment of it “is not a settled subject in medicine.”
Lockwood follows the Infectious Disease Society of America’s guidelines for treating and diagnosing Lyme, as does the CDC, but there is a growing and passionate cohort of doctors and patients advocating for that to change.
Paula Jackson Jones, who had late-stage neurological Lyme disease and is co-founder of Midcoast Lyme Disease Support and Education, is a staunch advocate for the nonprofit International Lyme and Associated Disease Society’s guidelines.
“The basis for my group’s existence is that there’s old research and new research,” she said, and “some doctors follow the old research and some follow the new and patients are getting caught in the middle. They’re not getting proper treatment.”
The guidelines, she said, are too rigid and outdated. “Not all patients present the same way,” she said, adding that she cannot support a business like Lockwood’s because it prescribes to the Infectious Disease Society of America guidelines.
She is also wary of any business purporting to address tick-borne illness over the phone or online.
“To throw something out there and say that for the low price of $29.99 you don’t even have to come in … there is no quick fix,” Jackson Jones said. “They can look at the tick, but they can’t tell you what kind of diseases the ticks are carrying,” especially with the rise of anaplasmosis and babesiosis, she added.
“For $30 you can’t adequately assess anyone. You can’t even order a bed pillow for that,” she said.
Lockwood, though, said she is keeping updated on changes to the field and the newest Infectious Disease Society of America guidelines, which were published in June.
“Chronic Lyme disease is an unsettled area of medicine and with time and additional research, recommendations may change,” she said. “I think everyone working on Lyme disease has the same goal of helping people and decreasing cases, but there are differing opinions out there about how best to do that.”
hlaclaire@timesrecord.com
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