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Lyme disease: Prevention is the best medicine

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Warm temperatures will mean more people outside enjoying the great outdoors and more chances to be in contact with Lyme disease-transmitting deer ticks.

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Lyme disease is the most common vector-borne illness in the northern hemisphere. About 20,000 new cases are reported to the Centers for Disease Control (CDC) each year. The CDC acknowledges that 90 percent of cases go unreported. Lyme disease is endemic to much of Minnesota, including Cass, Crow Wing and surrounding counties.

Most cases of Lyme disease occur in late spring and early summer.

Prevention is the best medicine

The best treatment for Lyme disease is prevention. Be cautious when walking in the woods and avoid bushy and grassy areas. Ticks are usually found from ground level to 3 feet above the ground.

Deer ticks do not like to be out during times of high humidity and will tend to stay down in the leaves, Cass County public health reported. When it is sunny and dry, they crawl up and rest on low-lying brush or grass and “catch a ride” on a passing animal or person.

They cannot jump down off of trees. Ticks do not have eyes. They rely on carbon dioxide, scent, body heat and other stimuli to find a host.

The areas that hold a high risk of tick infestation are wooded areas and low-growing grassland. Exercise caution if out in these areas.

Reduce your chance of getting a tick bite

• Avoid tick infested areas, when possible. Avoid short-cuts through heavily wooded, tick-infested areas. Stay in the center of paths, avoid sitting on the ground and conduct frequent tick checks.

• Wear light-colored clothing. This allows you to more easily see ticks on clothing and gives the opportunity to remove them before they can attach and feed.

• Wear a long-sleeved shirt and long pants. This reduces the skin area exposed to ticks. Also, tuck a shirt into pants and pants into socks. This keeps the ticks on the outside of the clothing and thwarts their efforts to crawl onto skin.

• Use EPA-approved tick repellents such as Deet. Use Permethrin spray on clothes or buy Permethrin-treated clothing.

• Conduct frequent tick-checks. This includes a visual inspection of the clothing and skin, followed by a full-body examination in a private location. Shower or bathe immediately after outdoor exposure. Be sure to check the scalp, behind and in the ears, under the armpits and behind any joints.

• Protect your house and backyard from ticks by using tall fences to keep deer out. Clear out your forest borders of excess brush where field mice can live. Treat your property with tick pesticides.

• Remember to treat pets with veterinary products that kill ticks and check pets for ticks. Pets can bring ticks in from outside.

Signs and symptoms

If the deer tick is infected with the disease it must be attached for 24-48 hours before it can transmit Lyme disease.

Symptoms can start days or weeks after being bitten. Generally, a characteristic, circular bull’s-eye rash develops around the tick bite.

This rash may show up several days to weeks after the tick bite. The rash has a reddish outer circle and often continues to expand throughout the days. It can feel warm to the touch but is rarely itchy or painful.

Some Lyme disease rashes are not typical and can be mistaken for spider bites. Take a photo of the rash when possible.

It is important to note that not everyone develops a rash following the bite of an affected deer tick. Therefore, diagnosis should be based on other classic symptoms such as fever, malaise, fatigue, body aches, headaches, pain and flu-like symptoms. These are the early stages of the disease, which if left untreated, can progress to complications and late stage disease that can affect your joints, heart, brain and even your central nervous system.

What if a deer tick bites?

Prompt removal is the key and makes transmission of the bacteria unlikely. Use a fine tweezers and grasp the tick as close as you can to your skin where it is attached.

With firm and steady pressure, pull on the tick backwards until it releases its grip. After removal, wash the area of the tick bite and your hands thoroughly with soap and water or rubbing alcohol.

If some of the mouthparts remain in your skin, do not try to dig them out as this may increase infection potential. In time, these parts will work themselves out.

If possible, save the tick and make an appointment with your health care provider for a physical exam. Don’t take the “wait and see approach” as up to 50 percent of ticks in Lyme endemic areas are infected with Lyme.

Once symptoms become more evident the disease may have already entered the central nervous system and can be hard to treat. This is one situation in which an ounce of prevention really is worth a pound of cure.

Symptoms may or may not include the classic bull’s-eye rash. Currently, there is no one definitive test for Lyme disease.

Because Lyme disease is a bacterial infection, it should be treated promptly with oral antibiotics. There is not a vaccine for Lyme disease and current diagnostic tests can lack sensitivity.

In addition, deer ticks can also carry other tick-borne infections such as babesia, anaplasmosis, bartonella, ehrlichia and other pathogens that lead to co-infections, making treatment even more difficult and in which a single dose of antibiotics does not cure.

Recognizing deer ticks

The deer tick is much smaller than the wood (or dog) tick. The nymph, or immature tick, is the size of a poppy seed while the adult tick is the size of a sesame seed. The nymphs and the adult females carry the disease.

Male ticks will attach, but do not take a blood meal so they don’t transmit Lyme disease. Deer ticks live two to three years and will have three blood meals. The first blood meal occurs during the larva stage.

The larva may pick up a disease at this time, but cannot transmit the infection until the second feed which occurs during the nymph phase.

The final feed occurs as an adult. It is after this feed that the adult female deer tick lays her eggs and dies. If the ticks did not get their blood meal in the fall, they will go dormant over the winter and seek a meal in the spring.

A frost will not kill the deer tick and adults may become active as soon as it is above freezing.

For more information on Lyme disease, contact Renee Lukkason, public health nurse at Cass County Health Human and Veterans Services, at 218-547-1340, ext. 209, or renee.lukkason@co.cass.mn.us.

Online resources include:

http://www.health.state.mn.us/divs/idepc/diseases/lyme/index.html,www.ly..., http://www.mnlyme.org, http://www.cdc.gov/lyme/.

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