Summer Hazard: Lyme Disease

Ah, summer. Prime time for outdoor barbecues, golf games, hiking, walking through the woods…and—uh, oh–ticks that can spread Lyme Disease.

Sorry for the potential monkey wrench in the dreamy summer scenario, but forewarned is forearmed. Lyme Disease affects about 300,000 Americans annually, the CDC estimates. Most will recover. The usual treatment is a course of antibiotics. However, some will develop long-term problems.

Educating yourself with facts about the disease (not to mention arming yourself some good insect repellent) will go a long way towards reducing your risk.

Lyme 101

No one can predict with certainty how bad this year’s tick season will be. However, a winter with lots of snow (like 2017-2018) typically means a boom in ticks by spring and summer, says Gary Wormser, MD,  director of the Lyme Disease Diagnostic Center, New York Medical College, Valhalla, and a spokesperson for the Infectious Diseases Society of America. Heavy snow, the experts, say, can serve as a ”quilt” for ticks lying in the leaves underneath it.

To spread the disease, ticks have to be infected with the bacterium that cause Lyme, Borrelia burgdorferi. Typical symptoms include:

• Bullseye rash
• Body aches
• Fever
• Muscle and joint pain
• Swollen lymph nodes
• Headache and chills

Recognizing the Little Buggers

Ticks that cause Lyme Disease are so tiny they can be difficult to spot. Dr. Wormser compares them to the size of a poppy seed or a sesame seed on your bagel, depending on their stage of growth.

They also like to hang out in shady areas on your body. “If you pick a tick up on the arm, it’s not unusual for it to go up to your armpit,” Dr. Wormser says.  “If you encounter a tick on your ankle, it might end up in the groin before it starts biting you.”

While these parts of your body may be trickier to check, the ticks’ desire to find a good bite spot is actually helpful. As Dr. Wormer explains, “It takes at least 36 hours of attachment before you can get Lyme Disease from a tick bite.” And, doctors can estimate how long the tick has been on your body by calculating how engorged it is (or is not) with blood. If it’s not engorged, it hasn’t sucked out its ”blood meal” from you yet, or has just had a snack.

Not all ticks cause Lyme Disease. Black-legged ticks spread Lyme disease in the northeastern, mid-Atlantic and north-central United States. The western black-legged tick spreads it on the Pacific Coast. These ticks can land on people or animals. Those are the common areas of spread, the CDC says—but not the only areas.

How to Prevent Lyme

There is not a vaccine for Lyme Disease. In the past, one was available, but it was withdrawn in 2002, with the maker citing lack of demand. A new one is being developed, but is not yet on the market. Meanwhile, how to reduce your risk?

• Use insect repellent. Choose one with permethrin to spray on clothing, says Phillip J. Baker, PhD, a microbiologist and executive director of the American Lyme Disease Foundation. “Spray your socks and the lower legs of your pants,” he says. For exposed skin, use EPA-registered repellents (such as DEET-based), the CDC says.
• Take a bath or shower within two hours of potential exposure to ticks, such as when you return from the woods, Dr. Wormser says.
• Put the clothes you wore hiking, golfing or walking through the woods into a clothes dryer on the hot cycle for at least 10 minutes (and wash them later).
• Check your skin thoroughly. It’s ideal to have another person do this for you, so you don’t miss any spots, Dr. Wormser says.

If You Have Been Bitten or Suspect Lyme Disease

• Tweezers is the best way to remove the tick, Dr. Wormser says. Be gentle. “We don’t recommend putting a match to it.” Sometimes, a portion of the tick will remain in the body. “The tick will fall off on its own when it’s done with its blood meal,” he says.
• If you feel ill, see a doctor. Describe your symptoms. If at all possible, take the dead tick or ticks along to the doctor.
• Blood tests can detect if your body has made antibodies to the bacteria, but the levels of them are often not detectable for a month or more.

Treatment Options

The usual treatment is a course of antibiotics, such as doxycycline. They are given for various amounts of time, from 10 days to nearly a month.

In a small percentage of cases, the symptoms of muscle aches and fatigue persist for more than six months. This is popularly called chronic Lyme disease but known medically as post-treatment Lyme Disease Syndrome. It is sometimes difficult to diagnose, because the symptoms are similar to other diseases, such as arthritis and mononucleosis. The CDC warns that prolonged treatment with antibiotics have not been found to be superior than not taking them for very long periods, and may lead to complications.

Here’s a refresher course on Lyme Disease from the CDC. Be sure to send it to family and friends in high risk areas.

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