I do not like to blow things out of pro­por­tion like the typ­i­cal main­stream media, but this has not been heav­i­ly pub­li­cized and needs to be said.

I firm­ly believe that there is an epi­dem­ic on the Appalachi­an Trail. I haven’t thru-hiked the Appalachi­an Trail since the win­ter of 2005/2006. How­ev­er as an active mem­ber in the long dis­tance hik­ing com­mu­ni­ty, I receive reports from var­i­ous sources and feel it is my respon­si­bil­i­ty to write this post.

I would esti­mate that at least 30% of the thru-hik­ers on the AT, and prob­a­bly more than 40%, are con­tract­ing Lyme Dis­ease – many undi­ag­nosed. The AT pass­es through grassy fields and wood­lands while tra­vers­ing prime Lyme ter­ri­to­ry. I remem­ber days, where I pulled hun­dreds of ticks off Yoni. Since there were so many, they would crawl back on to her while I was pulling them off. I start­ed drop­ping them into my fuel bot­tle so I wouldn’t have to pull them off twice. There was a sick, masochis­tic feel­ing. After an hour my dena­tured alco­hol bot­tle was so thick with ticks that it looked almost like clear bub­ble tea. Each evening I would pour some out into my tuna can stove when I cooked din­ner and get some extra satisfaction.

Lyme is scary for many rea­sons. The first is that many of the symp­toms can be com­mon­ly mis­tak­en for gen­er­al hik­er/thru-hik­er mal­adies – joint pain, mus­cle aches, headaches, stiff neck, and fatigue. Who hasn’t been tired one day, had mus­cle aches, joint pain, or a headache on a hot day or dry stretch? (The infa­mous and tell­tale bulls-eye rash does not always occur – and if it does you are one of the lucky ones since it is eas­i­er and quick­er to diag­nose). Many deer ticks, espe­cial­ly the nymphs, can be much small­er than a sesame seed.

It’s also a tricky lit­tle bug­ger and com­mon­ly gets false neg­a­tives in the CDC approved blood test. Cur­rent­ly the CDC eval­u­ates med­ical stud­ies every 5 years. They are odd­ly dis­con­nect­ed from the beliefs of many Lyme Lit­er­ate Med­ical Doc­tors (LLMDs).

Most LLMDs believe that Lyme can sit dor­mant if not treat­ed imme­di­ate­ly. The bac­te­ria can “hide” from your immune sys­tem and come out at a lat­er time when your immune sys­tem is weak­ened. This can make it very dif­fi­cult to diag­nose and treat. The CDC does not cur­rent­ly believe that there is any­thing con­sid­ered “Chron­ic Lyme” or “Long Stand­ing Lyme”. I have had mul­ti­ple friends that I met on the AT get diag­nosed years after their thru-hikes.

Fur­ther­more, many LLMDs also acknowl­edge that Lyme is often accom­pa­nied by a co-infec­tion. If you catch it ear­ly these are both treat­ed togeth­er with antibi­otics. If yopu wait these can be much hard­er to treat. Some com­mon co-infec­tions include ehrli­chio­sis and babesio­sis. The Igenix blood test will also test for some co-infec­tions, unlike the com­mon Lyme blood test approved by the CDC.

Keep in mind that many doc­tors in your area might not be aware of Lyme. It could be up to you to self-diag­nose and let your doc­tor know that you have hiked the AT or in a Lyme preva­lent area. The range is cur­rent­ly spread­ing, with the Mid­west being the fastest grow­ing region, but Lyme has been report­ed in much of the coun­try and even Europe and South Amer­i­ca. Sta­tis­tics could be skewed because of false report­ing or mis­di­ag­no­sis. I live in Cal­i­for­nia and many doc­tors would not even think of Lyme Dis­ease for a diag­no­sis, even though there have been report­ed cas­es in the foothills of the Sier­ras, Coastal Range, and oth­er areas.

None of the rec­om­men­da­tions below are fool proof but I rec­om­mend tak­ing prop­er pre­cau­tions and being extra careful:

• Wear light col­ored cloth­ing to make it eas­i­er to spot ticks crawl­ing on you.
• Do dai­ly body checks. If you are thru-hik­ing, get in the rou­tine of doing body checks every evening/night before you go to sleep and quick scans at breaks. Make sure to check warm areas, like arm pits, head, behind your knees, and groin. Often you can find ticks crawl­ing on you before they bite you. If they have bit­ten you and you get the tick off before 24 hours, then you have lit­tle to no chance of con­tract­ing Lyme. After 24 hours your chance increas­es. If the tick has been in you for three or more days, you prob­a­bly con­tract­ed Lyme — if the tick has it. For ref­er­ence, in South­ern NY near where the AT pass­es through, 25% of the deer ticks cur­rent­ly spread Lyme.
• If you devel­op a bulls-eye or are wor­ried about a tick bit, go to a doc­tor as soon as pos­si­ble. Pull the tick out and save it if you can.
• Keep the symp­toms in mind and if fatigue, mus­cle aches, or joint pain are at all abnor­mal or longer last­ing than usu­al don’t hes­i­tate to vis­it a doctor.
• This may seem a lit­tle far-fetched since it can cost upwards of $350–500, but I would con­sid­er fac­tor­ing this into your bud­get. If I ever hike the AT again I will prob­a­bly get the Lyme blood test imme­di­ate­ly upon com­ple­tion of the AT.

If you are hik­ing with a dog, I would rec­om­mend pre­ven­ta­tive mea­sures. There is a dog Lyme vac­cine and Front­line type prod­ucts work great. I wish they had these for people!

Tip: When you are pulling the tick out try to get it as close to the head as pos­si­ble. The infec­tions, like Lyme, are usu­al­ly stored in the ticks body. After the tick bites you the flu­ids start to move from the body to the head. That’s why you typ­i­cal­ly have 24 hours to remove the tick before it would spread an infec­tion to you. If you can get the entire tick out that is good, but if you rip the head off at least you have killed the tick and stopped the trans­fer of bac­te­ria toward its head — if it is a fresh bite.