Brandi Silvonek-Durko remembers taking a tick off the back of her head in 2004. She flushed it down the toilet and didn't think anything of it.
When she was diagnosed with Lyme disease 10 years later, she wondered if that was the tick that infected her.
After struggling for a decade with an illness she couldn't classify, the Chesterton woman now warns others to watch out for tick-borne infections like Lyme, which has been on the rise in Indiana.
"The disease is very smart and tricky," said Silvonek-Durko, 33, who is on medical leave from work as she is treated for the illness. "You can get bit and show symptoms immediately or weeks, months, years later. I always look back to that first tick bite."
Health officials have warned that the tick season, which typically occurs in the late spring and early summer, could be particularly severe in Indiana this year because of the mild, wet weather. Indiana's health commissioner advised doctors around the state to be on the lookout for signs of tick-borne diseases in patients. That advisory followed the death of a 2-year-old central Indiana girl in June from Rocky Mountain spotted fever, another infection spread by ticks.
Reported cases of Lyme disease have increased in Indiana each of the past three years. That infection is spread by deer, or black-legged ticks, which experts say are most prevalent in this part of Indiana. Northwest Indiana has the largest cluster of Lyme disease cases, according to maps created by the Centers for Disease Control and Prevention.
"That area of the state has been recognized for a long time for being the worst part of the state for Lyme diseases and black-legged ticks," said Keith Clay, a distinguished professor of biology at Indiana University in Bloomington. "They're extremely abundant in the dunes, fish and wildlife areas, state parks."
He said deer ticks are plentiful in areas with sandy, acidic soil, pine and oak trees, and blueberry-type plants.
"The northwest quadrant of the state is really the most under siege," said Robert Pinger, professor emeritus of health science at Ball State University.
Years ago, he and his students would check deer brought to the hunting check station at the Jasper-Pulaski Fish & Wildlife Area. "They all had deer ticks," he said. "Some of the very first counties where we found infected ticks were Newton, Jasper, Pulaski, Porter."
He believes hunters — and their dogs — brought their bugs back from hunting trips to Wisconsin and Minnesota, causing the ticks to spread here.
"We see more cases of Lyme disease in the northwest corner of the state," said Taryn Stevens, vector-borne disease epidemiologist with the Indiana State Department of Health.
She said the rise in tick-borne infections in Indiana, consistent with national trends, is due to one or more of three potential factors: increased incidence, enhanced surveillance and heightened awareness among health care providers and the general public.
Pinger said this part of the year is generally the most risky for Lyme disease. Ticks are now in their nymph stage, which is when they usually transmit the infection.
The insects also don't like the extreme heat that often comes later in the summer, Clay said. But deer tick numbers tend to increase again in the fall, he noted.
Lyme disease, often indicated by a bullseye rash followed by flu-like symptoms, can be treated with antibiotics if caught early. However, if the disease festers the symptoms can include fatigue, muscle and joint pain and neurological deficiencies. At that point, treatment becomes more intensive and less effective.
"Usually what happens is a person goes to multiple physicians trying to figure out what's wrong with them," said Dr. Jeffery Smith, a general practitioner in Griffith and Valparaiso. "Lyme disease encompasses multiple symptoms in different areas: the muscles, nervous system, skin."
This is what Silvonek-Durko experienced. She went from doctor to doctor, getting misdiagnosed several times. She finally found a rheumatologist who, after doing a battery of tests, told her she had Lyme disease. She has had to undergo years of intravenous antibiotics and other treatments but is still not completely healed.
Now she's trying to be an advocate for others with the disease. She started a website — missiontoremission.com — with Lyme disease information and support services. She starred in a video, on YouTube, about her battle with the illness.
She wants to correct inaccuracies about the disease: that a tick has to be on you for days to be infected, that ticks can be safely removed with matches or essential oils, that an infection is always accompanied by an immediate, perfect-circle rash.
"Over the last couple of years, I've had to be my own advocate and learn the ins and outs of the disease," she said. "It's so upsetting to talk about, because I've been dealing with this for so many years. And there are so many people out there like me."