An upswing in the number of lyme cases she's seeing has Cobleskill doctor Susan Emerson concerned-and warning her patients.
When Dr. Emerson first began practicing in Delanson 10 years ago, she saw tick bites-but no lyme disease.
That changed in about 2008, when she started seeing a case or so a year, but as of this mid-July, she'd seen five cases of the tick-borne disease, all of them in a two-week period and at least a couple in people who surprised her.
"I've had positive testing in a two-year-old, a 73-year-old, and a 45-year-old who never goes outside except car-to-apartment," Dr. Emerson said.
"In the past, we saw lyme mostly in people with obvious exposures-people who spent a lot of time outside. But that doesn't seem to be the case here."
Dr. Emerson said at least one of her "indoor" patients has a cat which could have brought a tick inside; because the chance of getting lyme disease from a tick bite is low if the tick's removed within 24 hours, she urged people to check themselves and their family daily.
Schoharie County Public Health Director Asante Shipp-Hilts said they've recorded 13 confirmed and probable cases of lyme as of August with four months left to go; total for 2012 was 18 cases.
The national Center for Disease Control has also issued an advisory for the Northeast for an increase in lyme disease.
For reasons that might include the weather, however, lyme seems cyclic: In 2011 the County Health Department recorded a total of 29 cases.
"It's really important that people take preventative measures when then go outside," Ms. Shipp-Hilts said, tucking their pants into socks, using repellant, and checking themselves for ticks afterwards.
Lyme is very curable, Dr. Emerson said, and easily treated with common antibiotics.
But she's alarmed by another trend that she's seeing:
Lyme that's appearing without the typical bulls-eye rash, which can make it harder to diagnose.
"If you're waiting for the rash, you may never see it," she said, "or you may see a different type of rash...and the tick nymphs are so small, you really have to have a high index of suspicion to find them."
Ticks that are removed within 24 hours won't spread the disease, so Dr. Emerson stressed the need for daily checks.
Anyone who's experiencing vague symptoms of illness for several weeks-symptoms that don't eventually develop into something else like a head cold or a stomach bug-should ask their doctor to be tested for lyme, she said.
"It's very treatable, but people need to keep checking themselves and they need to realize the symptoms may be a little different than they think," she added.