With spring in the air, many county residents may make it a point to venture into the great outdoors. But not only are humans increasingly found outdoors with the warming weather - so are disease vectors.

Lyme disease, transmitted by ticks, is primarily a problem on the East Coast, but cases have been documented in California and even locally.

According to Angel LeSage of the Amador County Public Health Department, there have been three official cases of Lyme disease reported in the county in the past five years and an additional case is still pending investigation.

If the pending case is confirmed, 2007 could be a record year for Lyme disease in Amador, with one case already reported this year.

Annually, there are approximately 22,000 new cases of Lyme disease in the United States, according to the Lyme Disease Association.

Dave Daugherty of Jackson was bitten by a tick near his home last October after coming back from a walk, when he noticed a small irritation on his chest. Daugherty did not carefully remove the tick with tweezers or keep it for testing, as is recommended.

"I just grabbed it with my fingers and probably injected the crud into my blood stream as I was pulling it out," he said.

He started experiencing flu-like symptoms around Valentine's Day. By March, his dizziness and nausea became so bad that he collapsed, prompting a visit to the emergency room.

Daugherty was diagnosed and has been on an antibiotic regimen since March 28, which will last several months.

Most of Daugherty's symptoms are now gone, however he is still weak, tires easily, has some problems sleeping and occasionally his back spasms.

But he continues to hope for the best. "I am personally optimistic I will make a full recovery," he said.

For others, there is a different prognosis.

Steve Diers, a ranger and naturalist with the East Bay Municipal Utility District, contracted Lyme disease in the spring of 1995 when working on a trail near lakes Pardee and Camanche.

He said symptoms began to appear two weeks to 30 days after the event, and included headaches, neckaches, pain in his large joints such as the knees and hips, and memory problems.

Diers had to be on intravenous antibiotics for five months.

Although his situation is much better now, he still experiences symptoms that are brought on by physical, mental and emotional exertion. Diers is expected to have these symptoms for life.

According to the Centers for Disease Control and Prevention, Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans via the bite of infected black-legged ticks.

Diers said the Western black-legged tick is easy to identify, as it has an orange body and black legs.

According to CDC, several parts of the body can become infected by the bacteria when a person is bitten, producing different symptoms at different times.

The first sign of infection is usually a circular rash called erythema migrans, which occurs in approximately 70 to 80 percent of infected persons and begins at the site of a tick bite after a delay of three to 30 days, according to the CDC Web site. A distinctive feature of the rash is that it has a bull's-eye-like appearance.

According to Diers, just 40 percent of infected individuals show the characteristic rash. Neither Diers nor Daugherty exhibited the bull's-eye rash.

Some infected individuals also experience symptoms of fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes, according to CDC.

If left untreated, the infection may spread to other parts of the body within a few days to weeks. Symptoms include a loss of muscle tone on one or both sides of the face, severe headaches and neck stiffness due to meningitis, shooting pains, heart palpitations, neurological problems, dizziness and pain that moves from joint to joint.

National Institutes of Health studies have shown that most patients can be cured with a few weeks of antibiotics taken orally. However, patients with certain neurological or cardiac forms of the illness may require intravenous antibiotics.

Diers seemed less optimistic. "Of the 30 people I know who have it, two have gotten treated in time and don't have lifelong symptoms," he said. "Once you get it, if you don't get treatment in time, you'll have it for life."

Diers' wife, Stephanie, also has chronic Lyme disease. "Stephanie is disabled and can no longer work as a result of this devastating disease," he said. "Had we both received prompt and uncompromised medical care, we wouldn't be dealing with these health challenges."

The cost and side effects of the medications associated with chronic Lyme disease are substantial. According to Diers, medications for his wife, who also has other tick-borne co-infections, cost about $70,000 to $80,000.

"The medications that she is on are strong and lay her low about every day," he said. "If her Lyme literate doctor recommends that she go on intravenous antibiotics, which are very costly, we are going to have to take out a loan against our home."

Contrary to popular belief, Diers claims Lyme disease is prevalent in Amador and Calaveras counties.

"On average, most people go to seven doctors and go for 22 months before being diagnosed," he said. "The challenge is that the symptoms are similar to other diseases and the tests for it are extremely inaccurate. Also, physicians are told we don't have Lyme disease in this area."

According to CDC, reducing exposure to ticks is the best defense against Lyme disease and other tick-borne infections.

"There's no need to change your outdoor recreation or activities," Diers said, "it's just a matter of being cognizant. Education is the best prevention."

Steps to prevent Lyme disease include using insect repellent, checking for ticks and removing them promptly. Diers said a good repellent is Permanone, which is sprayed directly onto clothing two hours before it is worn and lasts through several machine washes.

Avoid areas with a lot of ticks, such as wooded and bushy areas, game trails, high grass and places that are damp.

Wear pants, long sleeves and long socks to keep ticks at bay. Light-colored clothing will aid in the spotting of ticks.

And, reminded Diers, May is Lyme Awareness Month. "That's the time when most people get bitten," he said.

For more information about Lyme disease or to find support groups for those who've been infected, visit the California Lyme Disease Association Web site at www.lymedisease.org. Typical symptoms of Lyme disease:

Fever

Headache

Fatigue

A characteristic skin rash called erythema migrans

- Centers for Disease Control and Prevention