Lyme disease used to be thought of as a Northeastern problem.

Don’t make that mistake. Here’s why…

  • Today, Lyme-infected deer ticks are found in most states—covering nearly half of all US counties.
  • The epidemic continues to explode not only in the Northeast, but also in north central states. There has been a 320% increase over the past 20 years in the number of counties in northeastern states with Lyme-carrying ticks, according to the Centers for Disease Control and Prevention (CDC).
  • Lyme ticks are now found on both coasts and in the South.
  • They are spreading serious new diseases as well.

“We have patients from almost every state in the US with Lyme disease and ‘Lyme-like’ syndromes,” says Richard Horowitz, MD, medical director of the Hudson Valley Healing Arts Center in Hyde Park, New York, and author of How Can I Get BetterAn Action Plan for Treating Resistant Lyme & Chronic Disease. (It includes a new 38-item diagnostic questionnaire for chronic Lyme, which we’ll explain below.)

“Yes, there are hot spots, but even in places like the Carolinas, Texas and Florida, there are reports of Lyme,” he says. In fact, an estimated 360,000 people are diagnosed with Lyme disease in the US each year, according to the CDC, while other estimates put that number even higher.


“People need to realize that we’re in the middle of a Lyme epidemic—and there are new species of bacteria emerging that are not found with standard testing,” says Dr. Horowitz. “Ticks are becoming infected with more than just Lyme.” Examples…

  • Borrelia miyamotoi, which is a disease similar to “tick-borne relapsing fever” with severe Lyme-like symptoms including fever, chills, headache, joint pain and fatigue. One-quarter of patients require hospitalization. It was first reported in the US in 2013, but by 2015, it had spread throughout areas where Lyme is prevalent.
  • Borrelia mayonii, found in 2016, also can lead to hospitalization, with serious symptoms ranging from vomiting to neurological problems.
  • Borrelia sensu lato, recently discovered in Florida and now found in the Carolinas and Texas, can cause Lyme-like syndromes.

These new species of bacteria are not picked up with standard Lyme testing. To learn more about other diseases that the Lyme tick can carry, including malaria-like babesiosis, as well as bartonellosis (aka cat-scratch fever), see Bottom Line’s article “When It’s Not Just Lyme.

While Lyme is curable in most people when caught early—in the first month or so—if you have Lyme-like symptoms that don’t improve after a month of antibiotic treatment, ask your doctor to test for these other infections.


Chronic Lyme, which can occur months or even years after infection—often mimicking other chronic diseases such as lupusfibromyalgia and chronic fatigue—is much harder to diagnose than early Lyme. To improve the odds, Dr. Horowitz has developed a questionnaire that checks for six signs and symptoms. The questionnaire is based on a recently validated research study.

You don’t need to have all six markers, but the more that you answer “yes” to, the more likely you are to have Lyme—and should get checked out. Here they are…

  1. Do you have many different symptoms? You may have a cluster of symptoms, such as fatigue, joint and muscle pain, headaches, memory problems, poor concentration, mood or sleep disorders.
  2. Do your symptoms come and go with no obvious cause?
  3. If you have muscle, joint and/or nerve pain, does it migrate around your body—it could be in your shoulder one day, your knees the next? (If only your knees ache, for example, it’s not necessarily caused by Lyme—although it could be a symptom if only one knee aches.)
  4. If you’re a woman in your child-bearing years, do your symptoms worsen around your period? For example, while it’s normal for any woman to get headaches and mood swings around her period, it’s unusual to experience significant increases in fatigue, joint/muscle pain, insomnia and memory/concentration problems around your period.
  5. If you’ve recently taken antibiotics—whether for Lyme or an unrelated infection—did your symptoms get much better but only temporarily…or worse? (With Lyme, antibiotics can make symptoms temporarily better or worse.)
  6. Have you ever had a positive blood test for Lyme or an associated tick-borne infection? Have you had Lyme (borrelia) specific bands on a Western blot ( i.e., 23, 31, 34, 39, 83/93 proteins) indicating exposure? Even if you were treated and declared “Lyme-free,” this could be a clue, because Lyme can “hide” in some people after antibiotic treatment.


How can chronic Lyme symptoms persist—even after early antibiotic treatment? According to Dr. Horowitz, these lingering symptoms occur about 25% of the time. “We think it is because the bacteria change forms and hide inside cells while creating ‘persister’ cells, which are resistant to antibiotics,” says Dr Horowitz, who has laid out a treatment plan in his new book. He has been doing pilot studies on patients using old established drugs to treat persister bacteria such as tuberculosis and leprosy and having positive results. One drug, diaminodiphenylsulfone (Dapsone), has antibacterial and antimalarial properties and statistically improved all symptoms except headaches in chronic Lyme sufferers. Supporting research has been published in a peer-reviewed medical journal.


The new range and infectiousness of deer ticks means it’s more important than ever to protect yourself when you’re in tick-infested areas. Wear long clothes when you can, apply insect repellent, and when you come inside for the day, take a shower and do a full-body tick check. If you see a tick, remove it with tweezers and a magnifying glass—try to get underneath it and pull it out straight up (don’t twist it).

For more ways to protect yourself, see Bottom Line’s articles “5 Top Myths About Lyme Disease” and “Don’t Let Your Pet Make You Sick.”

For more from our report “Frightening Tick Alert—What You Need to Know Now,” please see the following stories…

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