CHICAGO — Dr. Leeber Cohen was the active sort when he lived back in Mt. Kisco, N.Y., always pedaling his bicycle, jogging down the streets, practicing the piano or puttering in his back-yard flower beds in the posh Westchester County suburb.
But about two years ago, the obstetrician, then 32, suddenly experienced a mysterious weakness in his right arm. First, medical colleagues said he must have suffered nerve damage while cycling. Then came terrible migraine headaches, which the experts blamed on stress. And when dizzy spells came on, an internist gave Cohen medication for vertigo.
After two months of feeling lousy, Cohen came up with his own theory--that he had Lyme disease, a sometimes hard-to-recognize, potentially crippling malady borne largely by deer ticks that he may have picked up in the garden.
'Very Serious Complaints'
Several blood tests, spinal taps, CAT scans and intravenous antibiotic treatments later, Cohen thinks he has shaken the illness, though he still has a ringing in his ears that may never go away.
"I had never really been on the other side of the bed before," said Cohen, who has since moved his practice to Chicago. "This was a very frustrating experience for me because I had very serious complaints that weren't taken seriously for a long time."
Unfortunately, Cohen's experience is becoming increasingly common in some parts of the country as Americans head into another summer vacation season with something lurking in the trees and brush far more dangerous than poison ivy.
"Most of us grew up in a situation where you don't have to worry much about walking in the woods and catching diseases," said Phillip J. Pellitteri, an entomologist and Lyme expert at the University of Wisconsin. "That's changed."
First identified only 14 years ago in Old Lyme, Conn., Lyme disease has swept across much of the Northeast and Upper Midwest. Experts say it has hit epidemic levels in a few hot spots, most seriously in New York, where more than 2,500 cases were diagnosed last year alone.
The U.S. Centers for Disease Control have detected a nine-fold annual increase in cases since it first began systematic tracking of Lyme. A spokesman for the Atlanta-based centers said more than 14,000 cases had been reported nationwide since 1980, most of them on the East Coast or in Wisconsin and Minnesota. Because Lyme is so new and symptoms vary so widely, doctors can fail to recognize the disease and cases may go unreported.
At the same time, however, some experts warn that most outbreaks are localized and suggest that the Lyme threat has been overblown in the media, unnecessarily scaring many people at low risk and sending hypochondriacs scurrying to their doctors.
"In most of the states, only small numbers of cases have been reported," Dr. Theodore Tsai of a federal disease control laboratory in Ft. Collins, Colo., told the Associated Press.
Though chances of contracting the disease are slight in much of the country, health officials say it is spreading and has been detected to varying
degrees in at least 43 states, including California where the bulk of incidents have been limited so far to coastal counties north of San Francisco.
Robert Murray, a Lyme specialist with the California Department of Health Services, said the outbreak is not as serious in the state as elsewhere. But, he said, the department has confirmed about 400 Lyme cases that appear to have been contracted in California between 1983 and 1987.
Ticks capable of carrying the Lyme bacteria have been found in most California counties, but Murray said that to date more than 70% of all cases of the disease in the state have been reported from Marin, Sonoma, Mendocino and Humboldt counties. He added that the number of reported incidents is expected to rise in the wake of regulations, which took effect March 30, requiring doctors in California to notify state health officials of all suspected Lyme cases.
Caught early, Lyme is relatively easy to cure with doses of tetracycline, penicillin or other antibiotics. The problem, however, is catching it early. Ticks are so tiny and their bites often so soft that many victims don't even realize it.
Characteristically, a victim will come down with flulike symptoms and develop a circular rash around the bite area within three to 32 days after contact with an infected tick. But doctors say about half the children and one-third of the adults who get Lyme never develop the telltale rash.
Even if the disease progresses, later stages are also treatable. But the medical regimen is more complex and some symptoms, like the tinnitus in Cohen's ears, may linger. Untreated, Lyme can mimic traits often associated with syphilis, entering into long periods of latency and then resurfacing with serious consequences such as rheumatoid arthritis, paralysis, heart block and even dementia.
Researchers in Minnesota are working on a vaccine, but it is believed to be at least five years away from commercial application.