Spring
Bites:
Preventing Lyme Disease: As spring unfolds, people across the
country emerge from their wintertime captivity to enjoy the
great outdoors. Unfortunately, another creature makes an entrance
in the spring too -- the deer tick, best known as the carrier
of Lyme disease. Lyme disease is a serious bacterial infection
that can affect your joints, nervous system and heart. The key
to preventing the disease is avoiding tick bites. Stay bite-free
and keep your children and pets bite-free too. Please vaccinate
your pets, ask your veterinarian.
Lyme
disease was first described in the United States in the town
of Old Lyme, Connecticut in 1977, but has now been reported
in most parts of the United States. Most cases occur in the
Northeast, upper Midwest, and along the Pacific coast. Mice
and deer are the most commonly infected animals that serve as
host to the tick. Most infections occur in the spring and summer.
The bacteria that causes this disease is named: Borrelia
burgdorferi, it is a spirochete (as is Syphilis). Lyme Disease
is NOT contagious from one person to another, although the spirochete
has been shown to cross the placenta. If you are pregnant and
think you have Lyme Disease consult with your health care provider.
The
disease is difficult to diagnose, because the symptoms mimic
other diseases. A characteristic red rash usually occurs at
the site of the bite; however, the bite may go unnoticed. A
few months after the bite, muscle paralysis, joint inflammation,
neurological symptoms and sometimes heart symptoms may occur.
The
initial infection is called primary Lyme disease, secondary
Lyme disease and tertiary Lyme disease may develop.
From left to right: The deer tick
adult female, adult male, nymph, and larva on a centimeter
scale.
These
carry the bacteria Borrelia
burgdorferi, so
it’s not really the tick at all, but the bacteria that
it carries. That is why we call it a vector. NOT all ticks carry
the bacteria. The large ones you might find on your dog usually
do not.
Prevention
If
you reside, work, or play in areas where you are frequently
exposed to ticks, you may want to consider being immunized with
LYMErix vaccine to prevent Lyme disease. Contact your health
care provider if you live in a Lyme disease high-risk area.
The following precautions also help lower your risk of becoming
infected. When walking in on near wooded areas use insect repellent
with DEET.
When
walking or hiking in tick infested areas, tuck long pants into
socks to protect the legs, wear shoes and long-sleeved shirts.
Ticks will show up on white or light colors better than dark
colors, making them easier to remove from your clothing. Check
yourself and your pets frequently. If you find ticks, remove
them immediately by using a tweezers, pulling carefully and
steadily. Insect repellent may be helpful.
Symptoms:˛
Early
symptoms (seven to
ten days):
An
illness with flu-like symptoms during spring and summer.
A
skin rash which varies in size, shape and color, but often looks
like a “bull's eye”.
Joint
or muscle pain
A
flat or slightly raised red lesion (erythema migrans) at the
site of the tick bite. This lesion is larger than 3 to 5 centimeters
in diameter often with a clear area in the center. (Children
often get the rash, but many adults do not for some unknown
reason. (I had Lyme twice and never had a rash).
Expansion of the red lesion to several inches over several days.
The resulting rash will usually clear in the center, creating
an annular rash.
Fever
Headache
Fatigue
Muscle pains
Stiff neck
Joint inflammation in the knees and other large joints
Headache at the base of the neck
Strange, unusual or hostile behavior (not so common, but can
occur in later disease).
Later
symptoms
(months to years):
Arthritis, especially in knees and hips.
Problems with the nervous system.
Heart problems
Tests
For Lyme Disease
Physical examination
Antibodies to B. Burgdorferi by immunofluorescence (IFA)
or ELISA.
Borderline ELISA tests are confirmed with a Western blot test.
Treatment˛˛˛
Antibiotics
are prescribed based on disease stages and manifestations. Doxycycline,
cefuroxime, ceftriaxone, and penicillin are some of the choices.
Anti-inflammatory medications are prescribed to relieve joint
stiffness. (Note: doxycycline is usually not prescribed for
children until after all the permanent teeth have erupted; it
can permanently discolor teeth that are still forming).
If
diagnosed in the early stages, the disease can be cured with
antibiotics. If left untreated, complications involving joints,
the heart, and the nervous system can occur.
Call
your health care provider if symptoms of Lyme disease develop.
Can
It Be Prevented?
Avoid tick bites to prevent Lyme disease:
Be knowledgeable about the risk of tick bites in your area.
Wear protective clothing outdoors, a hat is good too, they can
get on the scalp too.
Check yourself, children and pets for ticks.
Clear away brushy or grassy areas around the home.
Use a tick repellent on clothing. Make sure it has DEET in it.
Prevention
Outside Your Home
For
those
of you who enjoy spending time in your yards in high risk areas,
reduce the tick population around the home by:
Keeping lawns mowed and edges trimmed.
Clearing brush, leaf litter and tall grass around houses and
at the edges of gardens and open stone walls.
Stacking woodpiles neatly in a dry location -- off of the ground.
Keep the ground under bird feeders clean so as not to attract
small mammals, or avoid bird feeders all together. Yes, squirrels
carry the deer ticks now in many Mid-Atlantic States.
Have a licensed professional spray the residential environment
(only the areas frequented by humans) with an insecticide in
late May (to control nymphs) and optionally in September (to
control adults). I know this is not
good for the water supply in many areas, find out where your
well is if you have one. It is worse to get Lyme Disease than
to do this for yourself and your family.
To
Remove a Tick
Using a pair of fine tipped tweezers, grasp the tick as close
to the skin as possible and pull it straight out until it releases
its hold on the skin. To reduce the chance of contact with the
bacterium, try not to crush the tick’s body. After removing
the tick, wash the bite area with soap and water.
Do
not use mineral oil, vaseline or a hot match to remove a
tick! These methods do not make the tick “back out”.
This may cause the tick to inject bacteria into the skin. Remember
that if you remove a tick before it is attached for more than
48 hours, you can greatly reduce the chance of contracting Lyme
disease.
Watch
the site of the bite for the appearance of a rash beginning
3 to 30 days after the bite. At the same time, learn about the
other early symptoms of Lyme disease and watch to see if they
appear in about the same timeframe. If a rash or other early
symptoms develop, call your health care provider.
Lyme
disease was first described in the United States in the town
of Old Lyme, Connecticut in 1977, but has now been reported
in most parts of the United States. Most cases occur in the
Northeast, upper Midwest, and along the Pacific coast. Mice
and deer are the most commonly infected animals that serve as
host to the tick. Most infections occur in the spring and summer.
The bacteria that causes this disease is named: Borrelia
burgdorferi, it is a spirochete (as is Syphilis). Lyme Disease
is NOT contagious from one person to another, although the spirochete
has been shown to cross the placenta. If you are pregnant and
think you have Lyme Disease consult with your health care provider.
An
illness with flu-like symptoms during spring and summer.