Lyme Disease: Don't Get Bit by the Tick!

Summer is here and children are playing outdoors during prime tick season. As such, we often find that Lyme disease becomes a subject of concern for many parents during this time of year. Fortunately, the majority of parental concerns can be alleviated with some simple education and diligent monitoring. In this blog post we will review Lyme disease, it's symptoms, how it is transmitted and prevention strategies.

What is Lyme Disease and How is it Transmitted?

Lyme disease is an illness that affects the human body. It is caused by the bacteria Borrelia burgdorferi, and is transmitted by the deer tick (also known as the Ixodes tick or "black-legged" tick). These ticks can be found throughout the Northeast & upper Midwestern United States, as well as southeastern Canada. The incidence of Lyme disease follows the tick population, peaking in July and spanning from May to September/October.

How Do We Come Into Contact with Ticks?

Ticks live on the forest floor where they wait on the tips of grass and shrubs for animals to walk by. Direct contact is the only way ticks will attach themselves because they lack the ability to jump or fly. Attachment occurs within 10 minutes to 2 hours of contact, although you typically cannot feel the bite as their saliva has anesthetic properties. Ticks can be difficult to remove once attached because they secrete a "cement-like" substance that bonds to the skin. Once attached, the tick will slowly suck blood for several days. It is during this time that they can transmit the infectious bacteria.

What do Deer Ticks Look Like?

Deer ticks are brown in color and approximately the size of a poppy seed or pencil point. They are much smaller than the common dog or cattle ticks and are thus harder to spot. Ticks with "white collars" or that have a "white splotch" on their back are not deer ticks, and cannot cause Lyme disease. Please refer to the CDC's tick ID website for more information.

How Likely am I to Get Lyme Disease?

In general, transmission of Borrelia burgdorferi (the bacteria that causes Lyme disease) requires the tick to be attached to your body for at least 36-48 hours. Furthermore, only some deer ticks carry the bacteria. The risk of acquiring Lyme disease following an observed tick bite, even in areas where the disease is common, is only  1.2-1.4 percent. The Connecticut Agricultural Experiment Station (CAES) offers free tick testing to state residents. Further information about the submission process can be found on the CAES website.

What are the Symptoms of Lyme Disease?

Symptoms of Lyme disease can start within 3-30 days after a tick bite, but usually manifest between days 7-14. Symptoms are variable but can include: a relatively rapidly expanding red rash (sometimes in a characteristic bulls-eye pattern), fever, fatigue, headache, joint pain/swelling, muscle aches and Bell's palsy (facial muscle weakness). The most common presenting symptoms are rash, joint pain and, to a lesser degree, Bell's palsy.

How is Lyme Disease Treated?

Lyme disease is a treatable illness that does not typically cause long-term issues. However, a small percentage of people may experience lingering symptoms for some time after treatment. A course of antibiotics is typically started once your provider has made a diagnosis of Lyme disease. Antibiotic resistance has never been shown to exist when using standard treatment practices. Furthermore, there is no reputable evidence to support the existence of so-called "chronic Lyme disease".

How Can I Prevent Lyme Disease?

Avoid tick habitats. Ticks prefer to live in wooded, brushy areas with high grass or leaf litter. When hiking or otherwise enjoying the outdoors, be sure to keep to the center of trails. Remember to bathe or shower soon after coming indoors. Parents should perform a full-body tick check on their children. Be sure to check under the arms, in ears, the belly button, behind the knees, between legs, the waistline and the hair/scalp. Ticks can ride into the home on pets, so be sure to also examine your furry friends and treat them as recommended by your veterinarian. Ticks can also be found on clothing, so be sure to do your laundry using hot water then tumble dry (low heat 90 for minutes or high heat for 60 minutes).

Should I Use Repellent?

The use of insect repellents is recommended. These products will contain either DEET, picaridin, IR3535, oil of lemon eucalyptus or some other chemical repellent. Adults can apply DEET (20-30%) to their child's exposed skin and clothing (be sure to avoid the hands, eyes and mouth). Protection from DEET lasts up to several hours. You can also treat clothing and gear with products containing Permethrin 0.5%, which offers protection through several washings.

How do I Remove an attached Tick?

Use fine-tipped tweezers to grasp the tick as close to the skin as possible. Pull upward with steady even pressure; avoid twisting. Try not to crush the tick's body. Avoid removing the head from the body. If mouth fragments remain embedded within the skin after tick removal then it is best to leave it alone (over time the fragments will automatically be extruded from the skin). After removing the tick, wash the skin and hands thoroughly with soap and water. Refer to the CDC's tick removal instructions for more information.