Ticks and Lyme DiseaseDr. Jorge Parada
- National Pest Management Association
Tuesday, August 13, 2013
Lyme disease is a multisystem inflammatory disease that affects
the skin in its early, localized stage, and then may spread to the
joints, nervous system and, to a lesser extent, other organ systems
in its later, disseminated stages.
In the United States, there are only two tick species that are
known to transmit Lyme disease - deer (or black-legged) ticks
(Ixodes scapularis) in the East and upper Midwest and the related
western black-legged ticks (Ixodes Pacificus). As these two species
are specific to only certain parts of the country, it’s not
surprising that the hyperendemic areas (areas with a high tick
infection rate) of Lyme disease are principally the Northeast,
followed by the upper Midwest.
Because ticks are more active during the warmer months, as are
people, doctors typically see the highest number of Lyme disease
cases during June, July and August.
What are the symptoms and
diagnosis of Lyme disease?
Most commonly, the first sign of Lyme disease is an expanding
rash with central clearing known as Erythema migrans. This
“bull’s-eye” rash is the typical rash of Lyme infection, and occurs
in about 70 percent to 90 percent of cases. It starts as a small
red spot that expands over a period of days or weeks, with central
clearing giving it a bull’s-eye appearance.
Other classic signs and symptoms of Lyme disease include joint
pain, chills, fever and fatigue. As the infection spreads through
the body, involving the neurological system, increasing fatigue,
headache, neck stiffness, tingling or numbness in the extremities
or temporary paralysis of facial muscles can occur. More subtle
changes such as memory loss, difficulty with concentration, and a
change in mood or sleeping habits have also been associated with
Lyme disease. After several weeks of being infected with Lyme
disease, approximately 60 percent of those people not treated with
antibiotics develop recurrent attacks of painful and swollen
joints. Fewer than one out of ten Lyme disease patients develop
heart problems, which may present as an arrhythmia, or irregular
heart beat or block.
Diagnosis is made on a combination of suspicious signs and
symptoms, followed by laboratory confirmatory testing.
How is Lyme
If diagnosed and treated early with antibiotics, Lyme disease is
almost always readily cured. Treatment begun after the first three
weeks will also likely provide a cure, but the cure rate decreases
the longer treatment is delayed. Your health care provider will
determine the best course of action for confirming the diagnosis of
Lyme disease and for administering the appropriate treatment
regimen for the infection.
I do if I find a tick on my body?
First, remove the tick. Use fine-tipped tweezers to grasp the
tick as close to the skin's surface as possible. Pull upward with
steady, even pressure. Don't twist or jerk the tick as this can
cause the mouth-parts to break off and remain in the skin. Avoid
squashing the tick because spreading tick blood in the bite wound
might increase the risk of infection. Once the tick is removed,
clean the area with soap and water and perhaps an antiseptic. If
you develop a rash, headaches, pains or fever, call your doctor
How can I
prevent Lyme disease?
Obviously, the best way to avoid Lyme disease is to not pick up
the infected ticks in the first place. When outdoors, use clothing
that doesn’t expose skin, and that can act as a barrier to the
ticks. Flip-flops, sandals, shorts and a T-shirt are not
recommended when planning a hike to areas that are likely to have
ticks. Instead, wear boots, and long socks, and remember to tuck
your pants into your socks went hiking. The best chemical
protection against ticks consists of permethrin-treated clothing
and gear, combined with DEET applied to exposed skin.
Keep in mind that most ticks need to feed for 24-48 hours before
they can successfully transmit infections. So, it is very important
that after hikes you do a full body check (including in the hair)
to look for ticks. If ticks are removed promptly, before they
become engorged with blood, infection is unlikely.
- Reported Cases of Lyme Disease -
United States, 2010. United States Centers for Disease Control and
Prevention. Available at: http://www.cdc.gov/lyme/resources/ReportedCasesofLymeDisease.pdf
- Erythema migrans, or
“bull’s-eye” rash of Lyme disease. Source: CDC, Public Health Image
Library (PHIL) image ID# 9875
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