Monday, April 23, 2012

Lyme Disease Misconceptions and Information

Lyme disease's bullseye rash - which does not always appear,
especially as an early indicator
Lyme disease is a bacterial infection that is spread to people by the bite of infected ticks. It is prevalent in New Jersey.  This spring season is when you often see articles in the New Jersey news about Lyme disease because it's when we start moving our activities back outdoors.

Still, many people are ill-informed about it and there are several misconceptions about it.

5 common misconceptions:
  1. Some people mistakenly call it lime rather than Lyme disease. Lyme disease gets its name from the town of Lyme, Connecticut, where the illness was first identified in the United States in 1975.
  2. It's also important to know that the large brown ticks that are commonly found on dogs and cattle do not carry the Lyme disease bacterium. The "deer tick" or black-legged tick is the culprit in NJ. If you remove a very small tick and want to have it tested for Lyme disease, place it in a clean pill vial or tight-sealed plastic storage bag with a moistened cotton swab. Contact your health-care provider or the local health department.
  3. Though we tend to blame deer for the spread of the disease (especially in suburban areas), in the tick's larvae stage, it is tan, the size of a pinhead, and feeds on small animals like mice.
    The tick that spreads Lyme disease has a 2-year life cycle, and feeds once in each of its three life stages -- larvae, nymph, and adult. During the nymph stage, the tick is the size of a poppy seed, beige or partially transparent, and feeds on larger animals such as cats, dogs, and humans. Adult ticks are black and/or reddish and feed on large mammals such as deer, dogs, and humans.
  4. Early research led logically to warnings for hikers, birders, campers, hunters, fisherman and people who spend a lot of time outdoors and in the woods. But that has changed.
    In the 37 years after it was first identified, the disease has spread far beyond the woods and you are probably more likely in NJ be infected in a park or in your own areas that are less than wilderness and that may not even be rural.
  5. Just because you find a deer tick on you, doesn't mean you will get the disease. Lyme disease is passed to humans and other animals when a tick infected with the bacterium bites the person or animal and stays attached long enough (usually more than 36 hours) to take a blood meal. That is why checking yourself and others (especially children) after being outdoors is so important.

Lyme disease can cause a rash, flu-like symptoms, and aching joints. It can be treated with antibiotics, but without treatment, Lyme disease can cause serious, long-term health problems.

The corkscrew-shaped bacterium, or spirochete, called Borrelia burgdorferi  infects ticks and is spread the disease to humans. In the Northeast, Southeast and Great Lakes region, Lyme disease is spread by the black-legged tick, which lives in wooded areas, grasslands, and yards. ( In the Pacific Northwest, the disease is spread by the western black-legged tick.)

Cases of Lyme disease have been reported by nearly every state in the United States, but the disease is concentrated in the east coastal states, the north central states, and northern California. Connecticut, Rhode Island, New York, New Jersey, Delaware, Pennsylvania, Maryland, and Wisconsin account for about 90% of all cases.

Ticks become infected with the Lyme disease bacterium by feeding on infected animals, such as mice, chipmunks, and other wild rodents. The ticks move on to larger hosts - commonly deer - but humans generally contact the ticks when they brush against them on bushes or low undergrowth. When an infected tick bites a person (or animals such as dogs) and stays attached long enough (usually more than 36 hours) to take a blood meal, then they get the disease.

Signs and symptoms of Lyme disease
  • Tiredness
  • Chills and fever
  • Headache
  • Muscle and/or joint pain
  • Swollen lymph glands
  • A characteristic skin rash, called erythema migrans, that is a red circular patch about 2 inches in diameter that appears and expands around the site of the tick bite. The center may clear as it enlarges, resulting in a "bulls-eye" appearance. The rash may be warm, but it usually is not painful or itchy.
Unfortunately, some infected people do not recognize the early symptoms or do not seek medical attention or are misdiagnosed and more serious complications occur.

Those complications include:
  • Arthritis (swelling and pain) in the large joints, which can recur over many years
  • Nervous system problems, such as numbness, meningitis (fever, stiff neck, and severe headache), and Bell's palsy (paralysis of the facial muscles, usually on one side)
  • Irregularities of the heart rhythm

Unfortunately, the diagnosis of Lyme disease can be difficult and tests are not completely accurate. The symptoms can mimic other diseases. Diagnosis is easiest when there is a skin rash but that is not always present. A physical examination, medical history and lab testing is required.

Lyme disease is treatable with antibiotics taken for 3 to 4 weeks. More difficult cases may require longer treatment and combinations of drugs.

Re-infection from tick bites is possible after treatment and (as far as I know) no vaccine for the disease has been approved yet.

Unfortunately,  avoiding exposure to infected ticks is the only sure way to avoid the disease - but we don't recommend staying in your house and avoiding the outdoors entirely!
  • Be more mindful in areas where wild mice and deer are present. That would include the edges of yards, fields, and woods with low, dense groundcover.
  • During outside activities, wear long sleeves and long pants tucked into socks. Wear a hat, and tie hair back. 
  • You can use insecticides to repel or kill ticks, if you are comfortable with using chemical deterrents. Repellents containing the compound DEET can be used on exposed skin except for the face, but they do not kill ticks and are not 100% effective in discouraging ticks from biting.
  • Products containing permethrin kill ticks, but they cannot be used on the skin -- only on clothing. When using any of these chemicals, follow label directions carefully. Be especially cautious when using them on children.
  • There are also insecticides that can be sprayed on the edges of your property, if you feel that your area is frequented by the mice and/or deer.
  • After outdoor activities, check yourself for ticks and have someone else check you. The body areas where ticks are commonly found are: behind the knees, between the fingers and toes, under the arms, in and behind the ears, and on the neck, hairline, and top of the head. Check places where clothing presses on the skin.
  • Remove attached ticks promptly. Removing a tick before it has been attached for more than 24 hours greatly reduces the risk of infection. Use tweezers, and grab as closely to the skin as possible. Do not try to remove ticks by squeezing them, coating them with petroleum jelly, or burning them with a match.

Healing Lyme: Natural Healing And Prevention of Lyme Borreliosis And Its Coinfections
The Top 10 Lyme Disease Treatments: Defeat Lyme Disease with the Best of Conventional and Alternative Medicine
Cure Unknown: Inside the Lyme Epidemic

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