Another Dangerous Tick-Borne Disease Spreads To NJ

It may seem early to be thinking about ticks biting in New Jersey, but an early warning is what we have for a new tick-borne disease that has appeared in our state. In this case, people are what is threatened and endangered. Warming weather and more people getting outdoors increases the possibility of tick bites.

The same tick that carries Lyme disease has caused Powassan, otherwise known as POW. It is a virus infection that can impact the nervous system, memory, thinking and balance.

The disease has been recognized in the United States, Canada and Russia. In the United States, cases of POW virus disease have been reported primarily from northeastern states and the Great Lakes region, according to the CDC. These cases occur primarily in the late spring, early summer and mid-fall when ticks are most active.

There is not widespread awareness about the disease, but no need for panic currently. Cases of the Powassan virus remain rare in New Jersey, with just three cases reported since 2013. Those three cases were in Warren and Sussex counties, according to the N.J. Department of Health. The last reported case took place in 2015.

Two types of ticks carry he disease: the woodchuck tick (Ixodes cookei) and the black-legged or deer tick (Ixodes scapularis). The deer tick is found across New Jersey and it is likely that this species is spreading POW in the region.

Some people bitten by a tick do not show symptoms at all. However, symptoms may show up one week to one month after being bitten by an infected tick. The infected tick needs to be attached to a person for a certain amount of time before it may transmit POW virus. The timeframe needed for POW virus is not known, but it is thought to be less than the time needed for other tick-borne illnesses such as Lyme disease (24-48 hours) and anaplasmosis (12-24 hours).

What is frightening is that there is no treatment for POW, which differentiates it from Lyme disease. People with severe POW virus illnesses often need to be hospitalized to receive respiratory support, intravenous fluids, or medications to reduce swelling in the brain. About 10-15% of people that get POW have life-long neurological conditions afterward.

The NJ Department of Health's Communicable Disease Service says that approximately 75 cases of POW virus disease were reported in the United States over the past 10 years. Most cases have occurred in the Northeast United States and Great Lakes regions. Signs and symptoms of infection can include fever, headache, vomiting, weakness, confusion, seizures, and memory loss. Long-term neurologic problems may occur.

Preventative measures are the same as other tick-related diseases:

• Avoid areas with high grass and leaf litter and walk in the center of trails when hiking.
• Use repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours.
• Use products that contain permethrin to treat clothing and gear, such as boots, pants, socks and tents or look for clothing pre-treated with permethrin.
• Treat dogs for ticks. Dogs are very susceptible to tick bites and to some tickborne diseases. They may also bring ticks into your home. Tick collars, sprays, shampoos, or monthly “top spot” medications help protect against ticks.
• Bathe or shower as soon as possible after coming indoors to wash off and more easily find crawling ticks before they bite you.
• Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon returning from tick-infested areas. Parents should help children check thoroughly for ticks. Remove any ticks right away.
• Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed.

MORE INFORAMTION

• Printable (pdf) information sheet from NJ Dept. of Health
• https://www.cdc.gov/powassan/ 
• http://www.raredr.com/news/powassan-makes-way-to-nj-and-pa 
• http://www.nj.gov/health/cd/topics/powassan.shtml

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

Deer Ticks and Lyme Disease Season

We probably wish they were endangered, but as people in the Northeast, Midwest and mid-Atlantic know, deer ticks that carry Lyme and other diseases are growing their populations. Humans are the ones in danger.

Right now is the worst season (May & June). The adolescent “nymphal” ticks are out in force and looking for you.

They are about the size of a poppy seed but you won't spot them in the leaf litter and shady leaf borders where they are now.

Last summer, the Center for Disease Control adjusted upward its estimate of Lyme disease prevalence by a factor of 10, to about 300,000 American cases a year.

In most cases, the disease can be treated with antibiotics IF it is diagnosed and treated promptly. But 10 to 20 percent of cases are not discovered early or do not respond to to antibiotics.

The recommended prevention includes:

• Spray your shoes with repellent containing Permethrin because nymphal-stage deer ticks are in leaf litter, and so as your shoes move through the leaf litter, that’s where those ticks take hold.
• Spray your pant treating the inside as well as the outside.
• Use your dryer as soon as you come inside. 10 minutes on high heat should desiccate any ticks you might carry in.
• Make sure that your dog has effective quick kill product on it like Advantix II or Seresto collars 
• You don't have to out in the woods to encounter ticks. Suburban backyards are also breeding places. Take precautions and if you spray, killing black-legged ticks requires a synthetic pyrethroid. Greener alternatives are appearing but are not proven as effective yet.

Research has shown that days of low humidity will start to kill of populations.

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 backyard.in 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

DIAGNOSIS
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.

PREVENTION
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.

 
MORE INFORMATION

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