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Lyme disease: preventable and treatable

Ulysses Wu, M.D., Infectious Disease physician [November 08 2013]

Warmer weather provides ample opportunity to enjoy life outdoors. From cook-outs with friends to hitting the trails with your dog, Connecticut summers can be pleasant and fun-filled. Along with protecting yourself from harmful UV rays and dehydration, be mindful to combat other risks, especially microscopic ones. One of these preventable risks is Lyme disease. Aptly named, as the first cluster of U.S. cases was near the town of Lyme, Conn., this worldwide disease is transmitted whenever a person is bitten by an Ixodes (blacklegged or deer) tick carrying the Borrelia burgdorferi bacteria. Fortunately, it is a preventable disease as well as a highly treatable one, especially if caught early.

Ixodes ticks make their habitat in wooded, bushy areas with high grasses and leaf litter. Many of them are ferried into gardens and yards via deer and white-footed mice or outdoor pets. Although adult ticks can carry the disease, transmissions usually result from the immature tick nymphs as they are much harder to see. These nymphs are roughly the size of a poppy seed and attach themselves to a passing host. They can attach onto any part of the body, but most favor hard-to-see areas like the scalp, ears, behind the knee, underarms or the groin.

The disease is generally transmitted 36 to 48 hours after attachment. Symptoms include:
• A “bull's-eye” rash appearing three to 30 days after the tick bite. The rash can start as a normal red rash but can become a rash with a white center and a red outer rim. It may feel warm to the touch but rarely is itchy or painful.
• Malaise and fatigue
• Headache
• Swollen lymph nodes and muscle or joint aches
• Fever and/or chills

The following preventative steps can be taken to minimize your chances of a tick bite:
• Avoid tick-infested areas.
• Wear insect and tick repellents containing at least 20 percent DEET.
• Walk in the center of trails to minimize foliage contact.
• When hiking or spending time in densely wooded areas, wear long clothing, the hair up and under a hat, or clothing specifically pretreated with Permethrin.
• Shower/bathe as quickly as possible after spending time outdoors to wash off any ticks.
• Perform self-checks with a mirror, searching for any raised bumps on the skin as the bump may be a tick.
• Mow the lawn frequently and keep leaves raked.
• Place a three-foot wide barrier of wood chips or gravel between the edge of the lawn and woods to prevent tick migration.
• Keep play and patio areas in sunny locations and away from lawn edges, if possible.
• Apply tick-preventative products to your dog or outdoor cat.

What do you do if you find a tick? Using fine-tipped tweezers, pinch the tick as closely to your skin as possible, apply steady pressure and pull gently but firmly in an upward motion. Do not crush, puncture or squeeze the body of the tick or twist or jerk, as this will cause the mouth-parts to break off and remain in the skin. After removal, thoroughly disinfect the bitten area with alcohol, an iodine scrub, or soap and water. Tick removal devices are also available on the market. Avoid folklore remedies like applying heat or nail polish over the tick as the only reliable method to remove one is to pull it out.

If Lyme disease symptoms start to appear within a few days of the bite, contact your physician. Patients started on antibiotics soon after symptom appearance recover rapidly and completely. The most common antibiotics used to treat early-stage Lyme disease are doxycycline and amoxicillin.

With a few easy and preventative measures, along with some vigilance, there is no reason to not enjoy the natural beauty and enjoyment Connecticut summers can offer. Ticks are part of the landscape, but they don't have to be part of your summer plans.

Dr. Ulysses Wu is a member of The Hospital of Central Connecticut (HOCC) medical staff. For referrals to HOCC physicians, please contact our free Need-A-Physician referral service by phone at 1-800-321-6244 or online, www.thocc.org.