It’s Spring Time to Prevent Lyme Disease
May is National Lyme Disease Awareness Month
When you’re outside this spring and summer, prevent tick bites and reduce your risk of Lyme disease and other tick-borne diseases by following these tips.
Though Lyme disease cases have been reported in nearly every state, cases are reported from the infected person’s county of residence, not the place where they were infected.
Ticks that transmit Lyme disease can take 3 or more days to feed fully. If the tick is infected, the chances of transmission increases with time, from 0% at 24 hours, 12% at 48 hours, 79% at 72 hours and 94% at 96 hours. This is the reason it is important to conduct tick checks after working or recreating in tick infected areas, removing any ticks you find promptly
More cases of Lyme disease are reported than any other vector-borne disease in the United States. There were 29,959 confirmed cases and 8509 probable cases of Lyme disease in the United States in 2011; most of these cases are reported from the Northeast and upper Midwest.
Lyme disease is caused by the bacterium Borrelia burgdorferi. People become infected with the Lyme disease bacteria when they are bitten by an infected blacklegged tick.
As we start spending more time outdoors during spring and into summer, we have to be aware of the risk of tick bites. Gardening, camping, hiking, and just playing outdoors are all great spring and summertime activities, but make tick protection part of your outdoor plans as well.
Immature ticks (larvae and nymphs) are so small that they can be difficult to see. However, all stages of ticks need to feed on blood to continue on to the next stagestherefore these tiny ticks can be an important threat.
Ticks also feed on mammals and birds, which play a role in maintaining ticks and maintaining the Lyme disease bacteria. Ticks (including species other than the blacklegged ticks) can also transmit diseases other than Lyme disease, including Rocky Mountain spotted fever, erlichiosis, anaplasmosis, Colorado tick fever, and Powassan encephalitis.
Fortunately there are several tactics you and your family can use to prevent tick bites and reduce your risk of tick-borne disease.
Protect Yourself from Tick Bites
Know where to expect ticks. Blacklegged ticks live in moist and humid environments, particularly in or near wooded or grassy areas. You may come into contact with ticks during outdoor activities around your home or when walking through vegetation such as leaf litter or shrubs. To avoid ticks, walk in the center of trails.
Use a repellent with DEET (on skin or clothing) or permethrin (on clothing and gear). Products containing permethrin can be used to treat boots, clothing and camping gear which can remain protective through several washings. Repellents containing 20% or more DEET (N, N-diethyl-m-toluamide) can be applied to the skin, and they can protect up to several hours. Always follow product instructions! Parents should apply repellents to their children, taking care to avoid application to hands, eyes, and mouth.
· For detailed information about using DEET on children, see West Nile Virus: What You Need to Know about Mosquito Repellent.
· For detailed information about tick prevention and control, see Lyme Disease Prevention and Control.
· For detailed information geared to outdoor workers, see NIOSH Safety and Health Topic: Tick-borne Diseases.
Perform Daily Tick Checks
Check your body for ticks after being outdoors, even in your own yard. Conduct a body check upon return from potentially tick-infested areas by searching your entire body for ticks. Use a hand-held or full-length mirror to view all parts of your body and remove any tick you find. Take special care to check these parts of your body and your child’s body for ticks:
· Under the arms
· In and around the ears
· Inside belly button
· Back of the knees
· In and around all head and body hair
· Between the legs
· Around the waist
Check your clothing and pets for ticks. Ticks may be carried into the house on clothing and pets. Both should be examined carefully, and any ticks that are found should be removed. Placing clothes into a dryer on high heat effectively kills ticks.
What to Do If You Are Bitten by a Tick
Remove an attached tick using fine-tipped tweezers as soon as you notice it. If a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is extremely small. But to be safe, watch for signs or symptoms of Lyme disease such as rash or fever, and see a healthcare provider if these develop
Your risk of acquiring a tick-borne illness depends on many factors, including where you live, what type of tick bit you, and how long the tick was attached. If you become ill after a tick bite, see a healthcare provider.
If you find a tick attached to your skin, there’s no need to panic. There are several tick removal devices on the market, but a plain set of fine-tipped tweezers will remove a tick quite effectively.
How to remove a tick
1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
2. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
Avoid folklore remedies such as “painting” the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible–not waiting for it to detach.
If you develop a rash or fever within several weeks of removing a tick, see your doctor. Be sure to tell the doctor about your recent tick bite, when the bite occurred, and where you most likely acquired the tick.
You can create tick-safe zones in your yard
Image courtesy Kirby Stafford III, Connecticut Agricultural Experiment Station
· Modify your landscaping to create “Tick-Safe Zones.” It’s pretty simple. Keep patios, play areas and playground equipment away from shrubs, bushes, and other vegetation. Regularly remove leaf litter and clear tall grasses and brush around your home, and place wood chips or gravel between lawns and wooded areas to keep ticks away from recreational areas (and away from you).
· Use a chemical control agent. Effective tick control chemicals are available for use by the homeowner, or they can be applied by a professional pest control expert. Even limited applications can greatly reduce the number of ticksa single springtime application of acaricide can reduce the population of ticks that cause Lyme disease by 68100%.
· Discourage deer. Deer are the main food source for adult ticks. Keep deer away from your home by removing plants that attract deer and constructing physical barriers that may help discourage deer from entering your yard and bringing ticks with them. Deer management has also been studied with regard to its impact on tick populations.
Prevent Ticks on Animals
Prevent family pets from bringing ticks into the home. Maintain your family pet under a veterinarian’s care. Two of the ways to get rid of ticks on dogs and cats are putting on tick medicine or using a tick collar. Be sure to use these products according to the package instructions.
Signs and Symptoms of Lyme Disease
If you had a tick bite, live in an area known for Lyme disease or have recently traveled to an area where it occurs, and observe any of these symptoms, you should seek medical attention!
Early localized stage (3-30 days post-tick bite)
- Red, expanding rash called erythema migrans (EM)
- Fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes
Some people may get these general symptoms in addition to an EM rash, but in others, these general symptoms may be the only evidence of infection.
Some people get a small bump or redness at the site of a tick bite that goes away in 1-2 days, like a mosquito bite. This is not a sign that you have Lyme disease. However, ticks can spread other organisms that may cause a different type of rash. For example, Southern Tick-associated Rash Illness (STARI) causes a rash with a very similar appearance.
Erythema migrans (EM) or “bull’s-eye” rash
- Rash occurs in approximately 70-80% of infected persons1 and begins at the site of a tick bite after a delay of 3-30 days (average is about 7 days).
- Rash gradually expands over a period of several days, and can reach up to 12 inches (30 cm) across. Parts of the rash may clear as it enlarges, resulting in a bull’s-eye appearance.
- Rash usually feels warm to the touch but is rarely itchy or painful.
- EM lesions may appear on any area of the body.
Early disseminated stage (days to weeks post-tick bite)
Untreated, the infection may spread from the site of the bite to other parts of the body, producing an array of specific symptoms that may come and go, including:
- Additional EM lesions in other areas of the body
- Facial or Bell’s palsy (loss of muscle tone on one or both sides of the face)
- Severe headaches and neck stiffness due to meningitis (inflammation of the spinal cord)
- Pain and swelling in the large joints (such as knees)
- Shooting pains that may interfere with sleep
- Heart palpitations and dizziness due to changes in heartbeat
Many of these symptoms will resolve over a period of weeks to months, even without treatment2.However, lack of treatment can result in additional complications, described below.
Bell’s (facial) palsy
Loss of muscle tone on one or both sides of the face is called facial or Bell’s palsy.
Late disseminated stage (months-to-years post-tick bite)
Approximately 60% of patients with untreated infection may begin to have intermittent bouts of arthritis, with severe joint pain and swelling. Large joints are most often affected, particularly the knees3. Arthritis caused by Lyme disease manifests differently than other causes of arthritis and must be distinguished from arthralgias (pain, but not swelling, in joints).
Up to 5% of untreated patients may develop chronic neurological complaints months to years after infection. These include shooting pains, numbness or tingling in the hands or feet, and problems with short-term memory.
Lingering symptoms after treatment (post-treatment Lyme disease syndrome)
Approximately 10-20% of patients with Lyme disease have symptoms that last months to years after treatment with antibiotics5. These symptoms can include muscle and joint pains, cognitive defects, sleep disturbance, or fatigue. The cause of these symptoms is not known, but there is no evidence that these symptoms are due to ongoing infection with B. burgdorferi. This condition is referred to as Post-treatment Lyme disease syndrome (PTLDS). There is some evidence that PTLDS is caused by an autoimmune response, in which a person’s immune system continues to respond, doing damage to the bodys tissues, even after the infection has been cleared. Studies have shown that continuing antibiotic therapy is not helpful and can be harmful for persons with PTLDS.
Post-Treatment Lyme Disease Syndrome
Approximately 10 to 20% of patients treated for Lyme disease with a recommended 2-4 week course of antibiotics will have lingering symptoms of fatigue, pain, or joint and muscle aches. In some cases, these can last for more than 6 months. Although often called “chronic Lyme disease,” this condition is properly known as “Post-treatment Lyme disease Syndrome” (PTLDS).
The exact cause of PTLDS is not yet known. Most medical experts believe that the lingering symptoms are the result of residual damage to tissues and the immune system that occurred during the infection. Similar complications and “auto-immune” responses are known to occur following other infections, including Campylobacter (Guillain-Barre syndrome), Chlamydia (Reiter’s syndrome), and Strep Throat (rheumatic heart disease). In contrast, some health care providers tell patients that these symptoms reflect persistent infection with Borrelia burgdorferi. Recent animal studies have given rise to questions that require further research, and clinical studies to determine the cause of PTLDS in humans are ongoing.
Regardless of the cause of PTLDS, studies have not shown that patients who received prolonged courses of antibiotics do better in the long run than patients treated with placebo. Furthermore, long-term antibiotic treatment for Lyme disease has been associated with serious complications. The good news is that patients with PTLDS almost always get better with time; the bad news is that it can take months to feel completely well.
If you have been treated for Lyme disease and still feel unwell, see your doctor to discuss how to relieve your suffering. Your doctor may want to treat you in ways similar to patients who have fibromyalgia or chronic fatigue syndrome. This does not mean that your doctor is dismissing your pain or saying that you have these conditions. It simply means that the doctor is trying to help you cope with your symptoms using the best tools available.
You may be tempted to try treatments that are unproven or non-standard in order to feel better. Unfortunately, many fraudulent products claiming to treat “chronic Lyme disease” are available on the internet or through some providers. These products have not been shown to help and can be toxic and even deadly.
It is normal to feel overwhelmed by your ongoing symptoms. Some things that may help you manage your PTLDS include:
- Check with your doctor to make sure that Lyme disease is not the only thing affecting your health.
- Become well-informed. There is a lot of inaccurate information available, especially on the internet. Learn how to sort through this maze.
- Track your symptoms. It can be helpful to keep a diary of your symptoms, sleep patterns, diet, and exercise to see how these influence your well being.
- Maintain a healthy diet and get plenty of rest.
- Share your feelings. If your family and friends can’t provide the support you need, talk with a counselor who can help you find ways of managing your life during this difficult time. As with any illness, Lyme disease can affect you and your loved ones. It doesn’t mean that your symptoms are not real. It means that you are a human being who needs extra support in a time of need.
Information from the CDC, Connecticut Agricultural Experiment Station and NM Dept of Health.
Today’s post comes to us courtesy of Ken Oswald
Safety and Security Manager for Plateau