Tuck your pants into your socks. Wear chemical repellents. Avoid wooded, overgrown areas. Check yourself after being outdoors. Anyone living in the Hudson Valley has heard this advice countless times. In her meticulously researched book, Lyme: The First Epidemic of Climate Change, Mary Beth Pfeiffer argues that tick prevention is just one piece of the complex Lyme disease puzzle.
Pfeiffer, an award-winning investigative reporter who worked at the Poughkeepsie Journal for three decades, began reporting on Lyme disease in 2012. Rife with scientific, medical, and environmental intricacies, her book lays out three major problems: climate change's exacerbation of tick-borne illness; the lack of medical consensus surrounding Lyme; and the disease's human toll.
In additional to being terrifying, Borrelia burgdorferi, the Lyme bacterium, is an evolutionary marvel that has found ways to survive and thrive in nature and the human body over millennia. It avoids diagnostic blood tests, breaks through the blood-brain barrier, and affects joints, memory, and the nervous system. Infected ticks are also more likely to outlive their uninfected counterparts for various reasons from increased body fat to more effective food searching.
Pfeiffer outlines the distressing fact that the medical community is at odds about nearly every aspect of Lyme disease. On one side is the Infectious Diseases Society of America and the Center for Disease Control, which contend that Lyme disease can be cured with a single course of antibiotics—and that "chronic Lyme" does not exist. On the other side of the divide are ill patients, some "marginalized but well-intentioned" doctors, and researchers who disagree. The two sides differ on everything from testing to diagnosis and treatment of the disease—and their unwillingness to listen to each other has only served to harm the afflicted. Pfeiffer writes that in her five years of reporting on Lyme disease that she has "found a medical landscape that is breathtakingly controversial and, in many ways, dysfunctional, one characterized less by warring sides than by parallel universes."
Throughout the book, Pfeiffer proves herself to be a wonderfully capable writer who is able to render science and biology beautifully. About the Borrelia pathogen, she writes: "[It's] content to nestle in a dirt-covered tick that has not fed for months, to lay low in the knee of a mutt or a thoroughbred, or to swim in the heart or brain of a billionaire." Pfeiffer laces the chapters with stories of those suffering from Lyme or tick-borne illness, like the tale of Barbara Pronk, the woman who posted her suicide note to a Lyme website and helped push the Dutch parliament to address Lyme disease.
Lyme disease may be difficult to tackle but Lyme: The First Epidemic of Climate Change warns of the dangers if we don't try. Due to global warming, ticks are less dormant, they travel further, and infect more people in woods, suburbs, and cities. Eventually we will reach a breaking point in both medical and human costs—and we can only hope it's not too late.