(Photo courtesy of Centers for Disease Control)

BOSTON -- A new report is urging Massachusetts officials to take more drastic steps to combat Lyme disease, from launching aggressive public education campaigns to exploring expanded crossbow hunting to cut down on the number of deer that may be carrying ticks.

The report, released Thursday by a special legislative commission, also said the state needs to enhance its Lyme disease surveillance methods to get a better idea of the scope of the ailment.

Up to 14,000 reports of Lyme disease are confirmed by the Massachusetts Department of Public Health each year although officials say the real numbers may be 10 times that due to underreporting.

The disease is spread to humans from tick bites.

State Rep. David Linsky, chairman of the House Post Audit and Oversight Committee, said the disease is a public health epidemic that no longer is limited to certain areas of the state such as Cape Cod.

"We need to let people know how prevalent Lyme disease is in Massachusetts," said Linsky, D-Natick, during a press conference to release the report. "If you ask friends and ask your neighbors, you would be hard pressed to find anyone who hasn't been touched by this."

The report said the state currently fails to capture many cases of Lyme disease either because lab testing isn't routinely reported or testing isn't performed at the appropriate stage of the disease.

Creating stronger reporting procedures would help public health officials determine the extent of the disease, who might be at the most risk, and whether the ticks that carry the disease are concentrated in specific geographic areas.

The report also said doctors need to be kept up to date about the wide spectrum of the disease, including relapsing or recurring symptoms. School nurses also could help track the disease by passing along information about students with symptoms to state health officials.

The disease has been spreading across the state as the tick-carrying deer population explodes and housing developments encroach on natural habitats.

The disease causes flu-like symptoms and can be treated by antibiotics.

The commission also urges mandatory Lyme disease insurance coverage be adopted in the state. The report also recommends:

• Requiring the Pesticide Bureau to add tick-relevant training in pesticide licensing exams

• Studying the costs and benefits of expanded crossbow hunting and having the Division of Fisheries and Wildlife look into allowing 150-foot archery safety zones around homes to better manage deer populations

• Determining how much it would cost to expand mosquito-spraying to cover ticks

• Ramping up public information campaigns

"Educating the public for prevention is the key aspect in helping to prevent transmission and therefor avoiding many of the difficulties that can arise for patients following infection," the report said.

Linsky said he also has asked the Department of Public Health how much it would cost to strengthen efforts to fight Lyme disease and said money should be added to the state budget to pay for those efforts.