Daniel Cameron is a doctor in private practice.

By DANIEL CAMERON
MOUNT KISCO?
The Town of Greenburgh is so fed up with its abundance of deer that it has formed a committee to survey residents on their choice of shooting or poisoning them, or trapping and shipping them somewhere else. This is all well and good if you’re trying to save shrubs and reduce motor vehicle accidents, two of the reasons cited for eliminating deer, but it won’t help with another goal: lowering cases of Lyme disease, which have more than doubled nationwide during the 15 years that I have been treating the disease.

Instead of blaming deer, we need to look at our own activities. Perhaps the most effective way to fight Lyme is not to get rid of deer, but a beloved fixture of suburban yards: the birdfeeder.
The problem starts with a bug that should never have been called a deer tick. Its proper name is the black-legged tick. Deer aren’t even carriers of Lyme disease; the main carrier is the white-footed mouse, while birds and rabbits also carry the disease. It’s true that deer provide a blood meal to ticks that have been infected by white-footed mice and other carriers, but so do dogs, raccoons and striped skunks.

The disease moves into suburban backyards in part because the infected ticks are attracted to birdfeeders, as are Lyme-carrying birds and small mammals. People who acquire the disease in their backyards aren’t getting it just (or even mostly) from ticks on deer — all 27 species of birds in one Connecticut study carried the ticks that cause Lyme.

Instead of fixating on the deer population, we should be looking at other alternatives for combating Lyme and reducing our chances of developing this chronic disease. Getting rid of birdfeeders would help. DEET insect repellent, when used on clothes and shoes, can ward off 90 percent of the ticks. The American Academy of Pediatrics advises that DEET can be used on children if used sparingly and not applied to “a child’s face, hands, or skin that is irritated or abraded.” Spraying yards with the pesticides carbaryl and granular deltamethrin once or twice a year would eliminate up to 90 percent of the nymphal ticks. Pesticides should be used sparingly to protect other insects. And removing brush and leaf litter or creating a buffer zone of wood chips or gravel between forest and lawn or recreational areas can reduce the number of ticks by 50 percent to 90 percent.

And another focus of our attention should be how to treat this serious disease. I have witnessed the ravages of Lyme on countless occasions. I see patients who have been sick with Lyme disease for more than two years because a doctor would not treat them unless they had a positive laboratory test. I also have patients who have been sick for more than six months because they were never told that fatigue, poor memory, irritability and poor sleep could be symptoms of neurologic Lyme disease. I have treated teenagers who were too sick to attend school leaving them with home tutoring as the only way to complete their education.

A National Institutes of Health trial found 107 chronic Lyme disease patients who were sick for more than four years. Quality of life was worse for them than for patients with diabetes and recent heart attacks.
Yet as debilitating and fast-spreading as the disease is, doctors differ over how to diagnose and treat it . The Infectious Disease Society of America, for instance, recommends a one-time short-term treatment of 10 to 30 days.

In contrast, the International Lyme and Associated Diseases Society guidelines on the prevention and management of chronic Lyme disease, which I wrote, recommend more aggressive treatment for people at risk. Since the disease is chronic in up to half of patients treated for Lyme, these guidelines call for treatment of symptoms even when blood tests are negative for Lyme, and the early and prolonged use of antibiotics, including repeated courses should the disease recur. We still need lots of testing and research to find the best way to treat Lyme.

For those who are frustrated with Lyme disease, forget about the deer. Killing them won’t do the trick. Instead, lobby your local leaders for more financing on Lyme disease research and look in your own backyard.