A brawny 17-year-old nature-lover was following his mother into their house in Poughkeepsie, New York, when he collapsed on the lawn in 2013.
Hours later, Joseph Elone was dead, according to Medium’s interviews with his family.
Joseph had spent a month in the woods a week prior, doing a prestigious environmental fellowship. He loved the experience so much he already wanted to come back in the fall to go to Brown University.
But instead, he brought something back to Poughkeepsie with him: a tick.
That invisible passenger from the environment he so loved would be the death of him – though doctors wouldn’t know it until months after the bright high school student had died.
Joseph had developed Lyme carditis, a rare – although likely under-diagnosed – complication of a bite from an infected tick.
At least nine other people have died from the hard-to-detect heart infection in the US, but it may be set to surge as the warming climate makes more regions of the US fertile breeding ground for infected ticks.
Joseph Elone (pictured) was one of just nine known fatalities from Lyme carditis, a life-threatening heart infection that develops after bites from infected ticks in rare cases
Joseph grew up in tick country.
Poughkeepsie isn’t far from the center of the cluster of Northeastern counties of the US where Lyme disease cases are most concentrated.
If Poughkeepsie is central, though, Rhode Island is at the heart of Lyme country.
Every year, 30,000 new cases of the tickborne disease are confirmed in the US, and that number is climbing steadily.
Most of those can be eradicated with a couple weeks of antibiotics. Some are cured after a longer course of the bacteria killing drugs, and a handful of patients are left with long-term symptoms even after the disease is no longer detectable with blood tests.
And for an exceedingly small percentage – about one percent – the devastating Lyme bacteria sneak into the tissues of the vital organs, most devastatingly, the heart.
Some cases of Lyme carditis clear up with antibiotic treatment, as Lyme does.
In other instances, Lyme isn’t detected in the first place and goes untreated with life-threatening costs.
After developing mild symptoms like a low-grade fever, achiness, fatigue gastrointestinal symptoms, cough and sore throat, Joseph paid a visit to his pediatrician.
The first exam suggested Joseph just had a cold. The doctor prescribed water and rest.
But Joseph only got worse, and became woozy and sensitive to bright light, so he returned to the pediatrician, who ran blood tests, including one to check for Lyme disease.
The results were only preliminary – it can take sometimes take a couple of weeks for Lyme bacteria to show up in blood tests – but they were negative for Lyme and a host of other conditions.
The deer tick is the most common carrier of Lyme disease in the Northeastern US
A few days later, his mother took Joseph to the pharmacy with her to get some cough drops for his worsening respiratory symptoms. As they walked back into the house, he collapsed.
He was rushed to a hospital, where doctors tried to stabilize him, then transferred to another hospital.
Joseph hung on through the night, but died early the following morning, Medium reported.
The family was left heartbroken and utterly perplexed.
Instead of one autopsy, it took months of medical examinations to determine the cause of Joseph’s tragic death, according to Medium.
At long last, medical examiners found Lyme spirochetes, the proverbial breadcrumb trail that Lyme bacteria leave in their wake, in Joseph’s lungs, liver, brain and, fatally, his heart.
The bacteria can create a ‘heart block’ by interrupting the electrical currents that keep the heart beating in rhythm.
In some patients’ this causes an arrhythmia that can be righted with a course of antibiotics and, in some cases, a temporary pacemaker, according to the Centers for Disease Control and Prevention.
Joseph grew up in the heart of Lyme disease country (blue) which experts predict will expand as temperatures climb in the US
But by the time there were any signs that Lyme was what was ailing Joseph, it was too late.
Lyme diagnostics and treatments present a conundrum for healthcare providers and officials because so often patients don’t meet the criteria for aggressive treatment.
And, while some people become debilitated – both physically and mentally – by so-called post-treatment Lyme disease syndrome (PTLDS), deaths are so rare that it can’t be assumed that people who don’t have Lyme’s signature bulls-eye shaped rash or test negative for the bacteria are actually infected.
But, then again, Joseph had no visible signs of a tick bite, he had no rash, and yet Lyme proved fatal for him.
The International Lyme and Associated Diseases Society, however, wants to give doctor’s more discretion in the clinical criteria for when a course of Lyme treatment is appropriate, especially given predictions that more and more people will contract the devastating, and sometimes deadly, disease.