Lyme Disease
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By Wilma Dickerson-Felty, RN, BSN
We are now into the outdoor season and with that come certain risks. One of those is Lyme disease. The highest risk areas are the northeastern, mid-Atlantic, upper north-central regions and several counties in northwestern California. As summer is also the time for vacations and traveling, this information is pertinent for everyone. more
Lyme disease is transmitted by the bite of deer ticks and western-blacklegged ticks. In some areas deer ticks are the culprit. These ticks are much smaller than the ticks that we find on our pets and livestock. They feed on the white tail deer and white-footed mouse as well as other mammals and birds. Exposure to these ticks happens during property maintenance or recreational and leisure activities such as hiking, camping, fishing and hunting in tick habitat. Persons whose professions take them outdoors, such as landscaping, brush cleaning, forestry and wildlife and parks management, are also at risk.
Lyme disease is rarely ever fatal but it can leave the infected person with chronic and disabling illness. The incubation time for the infection varies from 3 to 30 days; typically it is 7 to 14 days. The first symptom is usually a "bulls-eye" rash which may or may not be immediately accompanied by fever, fatigue, headache, muscle and joint aches, and a "just don’t feel well" feeling. The rash may appear first and then the other symptoms will show up weeks later. Other individuals may show no initial symptoms considered as primary symptoms but will develop secondary symptoms weeks later. These can include joint pain and swelling, especially the weight bearing joints. Rarely, heart disease such as inflammation of the heart muscle and irregular rhythms can occur, some of which will end up with the person needing a temporary or permanent pacemaker. Latent symptoms may show up as chronic pain in the limbs and mental changes.
Lyme disease is diagnosed with blood testing. Early diagnosis and proper antibiotic treatment are important to avoid the complications from the chronic illnesses that can appear.
How do people protect themselves from this disease? Whenever possible, one should avoid entering areas that are likely to be tick-infested, especially during spring and summer. These areas are described as moist, shaded environments such as leaf litter and low-lying vegetation in wooded, brushy or overgrown grassy habitat. If a person is going to be in an area that risks exposure, they should wear light-colored clothing so that ticks can be spotted more easily. They can then be removed before becoming attached. The practice of wearing long-sleeved shirts and tucking pants into socks or boot tops may help keep ticks from reaching the skin. Wearing high rubber boots may provide additional protection, as ticks are usually located close to the ground. Insect repellants should include DEET when they are to be applied to the skin and clothes, and permethrin will help keep them from attaching while on clothes. DEET is safe for both children and adults but should be applied according to EPA guidelines to prevent toxicity.
The transmission of Lyme Disease does not usually occur until the tick has been attached for at least 36 hours. Therefore, daily tick checks and prompt removal will help prevent infection. According to instructions on the CDC web site, embedded ticks should be removed using fine-tipped tweezers. Do NOT use petroleum jelly, a hot match, nail polish or other products. Grasp the tick firmly and as closely to the skin as possible. With a steady motion, pull the tick’s body away from the skin. The tick’s mouthparts may remain in the skin, but this is not dangerous. The bacteria that causes the disease is found in the midgut of the tick. The CDC advises that the area be cleansed with an antiseptic. Post-bite treatment depends on the area of the country and the probability of exposure to the bacteria. I would advise anyone who is bitten to check with his or her doctor or call the CDC to find out what the current risk is for the area where the bite occurred.
Prevention is aimed at environmental controls. Leaf litter, brush- and woodpiles in residential areas should be removed. Trees and brush can be cleared to admit more sunlight and reduce the amount of suitable habitat for deer, rodents and ticks. Ticks have also been suppressed with the application of pesticides to residential properties. There is a vaccine available. Decisions regarding its usage should be made based on the assessment of individual risk.
In summary let me say that although an area may be deemed low risk, that should not be taken lightly. And, when traveling to the high-risk areas, please keep the protection recommendations in mind. I obtained the information for this article from the CDC web site. More detailed information regarding demographics and symptoms can be found by going to this site.
Wilma Dickerson-Felty is a health educator with Reid Memorial Hospital, Richmond, Indiana.
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