Lyme Disease Is Back in Season

As the weather warms up and more of us are active outdoors, Lyme disease again becomes a topic in the news.

Lyme disease is a bacterial infection that is spread to people by the bite of infected ticks. It is prevalent in New Jersey.

At one time, it was a disease associated with people who spent time in the woods - hikers, birders, campers, hunters and  fisherman. However, it has been more than four decades since it was first identified, and you are just as likely to get it in areas that are less than wilderness, like  a local park or your backyard.

Lyme disease gets its name from the town of Lyme, Connecticut, where the illness was first identified in the United States in 1975.

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.

It is caused by a corkscrew-shaped bacterium, or spirochete, called Borrelia burgdorferi. Ticks infected with the bacterium spread the disease to humans.

In the Northeast and Great Lakes region, Lyme disease is spread by the black-legged tick, which lives in wooded areas, grasslands, and yards.

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. Studies show that 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.

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.

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.

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.

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.

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 and are diagnosed only after 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

Lyme disease is diagnosed by a physical examination and medical history. The clinical diagnosis is supported by laboratory testing. Unfortunately, the diagnosis of Lyme disease can be difficult. Current tests are not completely accurate, and the symptoms can mimic those of other diseases. Diagnosis is easiest when there is a skin rash.

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.

A Lyme disease vaccine is under development but is not yet available. The only sure way to prevent the disease is to avoid exposure to infected ticks. Especially avoid areas where wild mice might live, such as 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.


Use insecticides to repel or kill ticks. 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 and be especially cautious when using them on children. "Natural" products are also available, but are generally less effective, though many people prefer them.

Beyond insecticides, careful observation after outdoor activities, is also very important. Check yourself for ticks, and have a "buddy" check you, too. Check body areas where ticks are commonly found: 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. Lyme tick removers and testing kits for humans and pets are commercially available. 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.
 
NOTE: The large brown ticks that are commonly found on dogs and cattle do not carry the Lyme disease bacterium.

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 and local health department.

RESOURCES and FURTHER READING

• http://www.dhpe.org/infect/Lyme.html
• Everything You Need to Know About Lyme Disease and Other Tick-Borne Disorders
• 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