Zika Vs Lyme Disease: What's the Bigger Threat?

Richard Krieger, MD, chairman of the Infection Control Committee at Chilton Medical Center, and infectious disease physician at ID care, discusses if Lyme disease poses a bigger threat than Zika virus in New Jersey.

Interview Transcript (slightly modified for readability)

“The populace, now, is more concerned about Zika virus because that’s in the news [more] than Lyme disease. First of all, it depends on where you are. If you’re in Florida, for instance, I don’t know if they even see Lyme disease in Florida, if they do, it’s very rare, whereas Zika virus seems to be increasing. In New Jersey we have yet to see a case of Zika virus that hasn’t been imported from somewhere else. We have mosquitoes in New Jersey that are capable of transmitting [Zika virus], but we don’t seem to have it as an epidemic here yet. [This is] not likely to happen, in my opinion, because we have [cold] winters, so, that kind of stops the spread.

The only way to get Zika virus up here is if you had enough people infected with it who came to this area while they were actively infected, got bitten by mosquitoes, and then the mosquitoes are now infected, and spread it. [In New Jersey] mosquitoes are not active for several months of the year, so, that kind of puts a lid on these mosquito-borne diseases, which is why we don’t see a lot of mosquito-borne diseases in the Northeast.

Even West Nile virus, which got a lot of play, when it really came down to it, [New Jeresey] saw very few cases of West Nile virus. We still do in the Northeast because there the birds are spreading it, so there’s more of a chance of it spreading.

As far as Lyme disease [goes], Lyme disease is endemic in this area. If you live in North Jersey, if you live in Long Island, the islands off [of] Long Island, [or] if you live in New England, you are at risk of developing Lyme disease. If you go out, outside, into the vegetation (which doesn’t mean [that] you have to go hiking in the woods you can be in your own garden in your backyard) [you can be at risk of contracting the infection]. [With] Lyme disease [there] is a much greater risk of catching it in this area.

As far as it being a damaging illness, Zika virus, on the short term, unless one is pregnant, doesn’t seem to have a lot of tendency at this point to cause serious problems. There are some people who get Guillain-Barré syndrome with it, or other things, but, for the most part, most people don’t get terribly disabled from it. [With] Lyme disease, most people won’t get terribly disabled, most people get over it and don’t even know they have it, but there are people who will get the long-term illness and if it’s not diagnosed, they could be ill for a long time.

At this point, I think maybe ten, fifteen, twenty years ago, [long-term Lyme disease-related illness] was more of a problem. I think there is a lot of Lyme awareness, in this part of the country, anyway. Again, other parts of the country where they don’t see so much Lyme disease, I’m not sure. I spoke, for instance, to a physician in a California once, who was seeing somebody who came from New Jersey, was a patient in our area, and she said, ‘Well, we don’t see Lyme disease here, so you want to tell me about it?’ I thought of some illness that they have out on the West Coast that we don’t have here, and I said, ‘Okay, just like everybody who comes into your office probably has that particular illness, everybody that comes into the office here has Lyme disease.’

The clinician needs to be aware of Lyme disease and somebody who comes in ill, need to be aware, but I think most people are. In fact, more often than not, when I see somebody who’s ill, it’s more the case of, I have to convince them [that] they don’t have Lyme disease, unless they come in with a definite diagnosis right away. And even when they do have a definite diagnosis, many of them will say, ‘But could I have Lyme disease?’ and I’ll tell them, ‘Look, if you have Lyme disease, I can’t say you don’t have Lyme disease, but that’s not explaining everything else that is going on here.’”