Ohio schools closed their doors in March of 2020 to combat the COVID-19 pandemic, and by April 1 42-year-old Cary Gray, a teacher at Georgetown Junior/Senior High School, was ready to get out of the house. Gray, his wife Samantha, and their two children loaded up in their minivan and headed west toward Cincinnati to run some errands. Halfway through their trip, though, Cary Gray felt tired. This wasn’t your average midmorning crash, though: Gray was so exhausted that he couldn’t drive, and by the time the family reached their destination 45 minutes later Cary Gray was burning with fever and in awful pain.
“I’ve had body aches before, but this was not like anything I’d ever experienced,” Gray said. Samantha drove home while Cary sat in the passenger seat with a fever and severe pains in his ankles and back. The symptoms were particularly alarming since COVID-19 was spreading through Ohio, and Gray’s three-year-old son has respiratory issues.
Once the family reached their home Gray quarantined himself in one corner of the house and tried to interpret what it was that had made him so sick so suddenly. The obvious answer was COVID-19, but even though Gray’s fever wouldn’t break he suspected something else: Lyme disease.
“I know two people in our town that have Lyme disease, and one of them has a really severe case that requires treatment in Florida,” Gray said. On March 26th he and his father had been planting trees in a food plot on their property and pulled two ticks off his body that day—one from his knee, one from his side. Regardless of his suspicions, he needed to determine what was making him sick—and quickly.
Because of the pandemic, local doctors were limiting appointments or not accepting new patients, and most were telling people with fevers and suspected COVID-19 symptoms that were young, healthy and not seriously ill to stay home. Gray and his wife continued to search for a doctor that would see him and, eventually, they located an urgent care clinic with an on-staff doctor who would evaluate him. After Gray described his symptoms to the doctor, she agreed that it was most likely a tick-borne illness and not COVID 19. She began a round of antibiotics and initiated testing, and two days later Cary Gray was already feeling better when he got the results from the doctor: He had contracted Rocky Mountain spotted fever.
Gray’s hunch that he had a tick-borne illness was correct, and if he had stayed home and quarantined as directed instead of reaching out for medical help his symptoms would likely have worsened. Rocky Mountain spotted fever is spread by one of two species of dog ticks, or the Rocky Mountain wood tick, and unlike COVID-19 it is a bacterial infection. For that reason, RMSF can be treated with antibiotics, but left untreated the disease can cause paralysis, amputation of limbs, or digits, hearing loss...even death. Because some of its early symptoms—specifically fever, headache and body aches—mimic symptoms of COVID-19 it’s possible to mistake one for the other. But outdoors enthusiasts need to be especially vigilant, especially now that warming temperatures will increase tick activity.
Tick-Borne Illnesses in the United States
Rocky Mountain spotted fever, also known as spotted fever rickettsiosis, is just one of many tick-borne diseases in the United States. Currently the CDC lists 16 different diseases that are spread by ticks, and these include Rocky Mountain spotted fever, Lyme disease, tularemia, tickborne relapsing fever and others as well as the alpha-gal reaction from the bite of the Lone Star tick...which causes an allergy to red meat. And while Rocky Mountain spotted fever is one of the best known of these, it isn’t the most prevalent: in 2017 there were 6,248 cases of RMSF in the United States. Lyme disease, which infected 30,000 people last year, is more prevalent. What’s more, the Natural Resources Defense Council suspects that as many as 9 in 10 cases are never recorded, and that puts the number closer to 300,000 cases.
Living with Lyme Disease
No one understands how dangerous Lyme disease can be better than 43-year-old Jon Ianniello of Fresno, Ohio and his family. When Ianniello’s oldest daughter was 12 she began to experience chronic fatigue, muscle aches in her upper back, sound sensitivity, irritability and over time additional issues like dizziness and poor decision-making began to appear. The real problem, however, was that doctors didn’t immediately recognize the issue. After seeing five different physicians over two years, Ianniello’s daughter finally received the proper diagnosis and began treatment.
“Once we became more educated on the signs and symptoms of tick-borne illness, my wife and I became concerned that the rest of our family was afflicted,” Ianniello said. “It ended up that four out of five of us (me, my wife, our middle and oldest daughter) plus my mother all tested positive for Lyme disease.”
The Iannellos weren’t just battling Lyme disease, says Jon, but also a host of co-infections that are acquired with Lyme disease. Few people who haven’t had the disease are aware these co-infections exist, and many Lyme disease patients suffer from multiple co-infections that are transmitted with the tick bite. Every member of the Ianiello family that tested positive for Lyme disease was also positive for at least three co-infections. Many of the family members suffered from Bartonella henselae infections which can present as purple stretch marks on the skin. Ianniello’s oldest daughter suffered from five co-infections. Interestingly, only one family member had the trademark bullseye rash that is purported to be an early warning sign of Lyme disease.
Since their diagnosis, members of the Ianniello family have recovered somewhat, but they still deal with the effects of the disease. Jon’s middle daughter has undergone three surgeries to correct eye muscle imbalances, a problem associated with Lyme disease. After years of treatments ranging from antibiotics to vitamin C drips to antimalarials, the Ianniello family is still healing. The Lyme disease is gone, but the physical problems remain.
Ianniello offers outdoor enthusiasts the same advice we’ve heard (and many have ignored) for years: Avoid ticks. This means wear bug spray, tuck pants inside your boots and wear long sleeves when outside, avoid tall grass, and check yourself regularly. Black-legged ticks that spread Lyme are tiny and can be very difficult to spot. And since they’re active even in winter, avoiding ticks is a year-round job. But Ianniello’s suggestion to do these things carries more weight. He and his family have seen just how serious Lyme disease can be. Some good news? There are clinical tests underway now in France on a Lyme disease vaccine. But until that is approved and arrives in the States it’s important to be hyper-vigilant. Avoiding a long and difficult struggle with multiple serious infections could boil down to avoiding a single bite.
Ianniello offers some other advice, too: If you suspect Lyme disease, seek out a physician who understands the signs, symptoms, testing protocols and treatments for this disease. The International Lyme and Associated Diseases (ILADS) (www.ilads.org) in Maryland offers a list of Lyme literate health care providers so you can find a doctor that specializes in Lyme disease near you.
Ianniello also says Lyme can be confused with many other diseases.
“It’s called ‘The Great Imitator’ for a reason, as it can mimic over 300 diseases such as fibromyalgia, chronic fatigue, arthritis, Multiple Sclerosis and even Alzheimer’s disease,” he says.