(The Albany Times Union) -- Through the accident of geography, Columbia County has become ground zero in the public health battle against Lyme disease.

The rural county that hugs the Massachusetts border has the highest per capita rates of the disease in the nation.

As temperatures begin to warm up, public health officials have launched an aggressive campaign to reduce the number of cases in the county of 60,000 people. Last year, doctors treated about 1,000 patients with Lyme disease, nearly double the number two years ago.

And health officials in Rensselaer and Albany counties to the north are keeping a close eye on their neighbors, fearful that the ticks are headed their way.

"We may be the epicenter now, but we're just the natural path," said Marcia Fabiano, an epidemiologist with the Columbia County Health Department. "Five years from now, Albany and Rensselaer County might be the epicenter."

More than 16,000 Americans are infected with Lyme disease each year, according to the U.S. Centers for Disease Control and Prevention. In New York state, 5,481 people had the disease last year, according to preliminary figures from the state Health Department.

People get Lyme disease when bitten by an infected deer tick -- which might have picked up the bacteria from a mouse or bird. Days to weeks afterward, most people have a red, slowly expanding bull's-eye rash, along with fatigue, fever, headache, stiff neck, muscle aches and joint pain, according to the CDC.

Antibiotics work well, but only if the disease is caught early.

Unfortunately, about 20 percent of people who contract Lyme never get the characteristic rash, health experts said. If the Lyme disease is undetected and goes untreated, weeks to months later some patients may develop arthritis, neurological problems such as meningitis, brain or nerve inflammation, and, rarely, severe heart problems.

Experts are predicting an abundance of ticks this year. Despite the prolonged frigid temperatures the past few months, adult ticks might have thrived over the winter under layers of cozy, insulating snow. Next month, the nymphs will abound -- they are newborn ticks the size of poppyseeds, difficult to see and responsible for the majority of Lyme disease cases.

Long Island and the lower Hudson River Valley were previously the hot spots for Lyme disease in New York. Health experts believe the disease has moved northward due to both the migration of deer ticks and the vigilance of downstate residents who now routinely follow prevention guidelines.

Columbia County has had the state's highest per-capita rates of the disease since 1999. This year, the county has already logged 65 cases of Lyme disease -- in people who were apparently infected last fall and went undiagnosed for months, Fabiano said.

Last year, Dr. Ananthakrishnan Ramani, Columbia Memorial Hospital's only infectious disease consultant, treated hundreds of people with Lyme disease. He saw the most severe cases in Columbia and Greene counties -- those that primary care doctors couldn't detect or treat with antibiotics. Several of his patients had severe and unusual symptoms, including heart block, a condition in which the heart beats irregularly.

Even more patients came into Ramani's office with the suspicion they had the illness, Ramani said. Awareness of the tick-borne illness is so high that people assume they have Lyme when they begin to get symptoms of arthritis or neurological problems.

Columbia County health officials are working on increased prevention and early detection - getting people to wear pants, long sleeve shirts and insect repellant, to check their skin for ticks every time they are outdoors, and to call their local health department or doctor early if they suspect a case.

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