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Mild winter raises Lyme disease risk, doctors say

Lyme disease season has begun on Nantucket, Martha's Vineyard, and Cape Cod, and physicians and health officials there and in other affected areas of Massachusetts are preparing for a possible heavier-than-usual onslaught of disease-carrying ticks.

The region had one of the warmest winters in recent history, with more ticks than usual likely to have survived and reproduced. Some specialists have warned that New England will face a heavy Lyme disease season.

Other physicians and specialists say that if the next few weeks bring considerable amounts of the moisture and precipitation that ticks thrive in, the Lyme-disease season could be nasty.

''If it's moist and cloudy and foggy in the next few weeks, we're going to have a ton of ticks," said Dr. Timothy Lepore, medical director of Nantucket Cottage Hospital, located in one of the state's Lyme-disease hot spots. ''But if it's dry, that may not be the case."

The National Weather Service forecast rain for today, but sun or partial clouds for the next six days.

Last week, at a conference on Lyme disease in Wolfeboro, N.H., specialists from the Lyme Disease Association and the International Lyme and Associated Diseases Society predicted that New England would be hit hard by Lyme disease this summer because of the mild winter. They said this would exacerbate a situation in which the public remains inadequately informed of the risks and the measures needed to avoid the disease.

''This disease is a true epidemic," Dr. Richard Horowitz, president-elect of the International Lyme and Associated Diseases Society, told an audience of about 300 people on Friday.

Dr. Alfred DeMaria, the medical director of the state Department of Public Health, said yesterday that people should prepare regardless of the weather and its impact on ticks: ''There are always plenty of ticks everywhere across New England," he said.

More than 2,000 cases of Lyme disease were reported in Massachusetts last year, among the highest in the nation, DeMaria said. The Bay State accounted for one-tenth of the 20,000 cases reported nationwide. And the disease, which has flu-like symptoms, probably is underreported. Pat Smith, president of the Lyme Disease Association, said the 20,000 figure may represent a fraction of the cases.

DeMaria said that Cape Cod, Martha's Vineyard, and Nantucket typically have the highest concentration of cases, followed by the Cape Ann region, the Quabbin watershed, southern Berkshire County, and parts of the MetroWest area.

''The most important thing people can do is do more frequent tick checks," he said, explaining that transmission risk increases the longer ticks are attached to people and pets. ''Check for them at the end of every day," he said.

Ticks should be removed with tweezers by grasping them as close to the skin as possible, then gently pulling straight out. While not all ticks carry Lyme disease, call a doctor if any symptoms of the disease occur.

DeMaria said ticks tend to lurk where open, grassy areas meet brush and trees. Wearing light-colored clothes makes ticks easier to spot, he said.

''People should use repellent," said DeMaria. ''And people should tuck long pants into socks."

Symptoms of Lyme disease include fever, headache, fatigue, and an expanding skin rash that doctors consider a telltale sign. A few weeks of antibiotics can treat most cases. But left untreated, it can spread to the joints, heart, and nervous system, potentially causing meningitis or debilitating long-term problems.

May, June, and July are the prime months for Lyme disease.

Material from the Associated Press was used in this report.

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