While most of us enjoyed the unusually warm, dry weather during the winter of 2001-2002, we all have to pay the price – an expected bumper crop of ticks this season. Although the different members of the tick family are responsible for transmitting a number of diseases, perhaps the one of greatest concern to those of us living in the Northeast is Lyme disease.
First recognized in 1975 in Lyme, Connecticut, this disease continues to increase in incidence each year. The most recent data available from the Centers for Disease Control are for 2000, which saw an 8% increase in cases from the previous year. In fact, the 17, 730 reported cases in 2000 were well above the average of 12,745 cases reported annually from 1991-1999. According to the CDC, Connecticut is “leading the nation in the incidence of Lyme disease, with 110.8 cases reported per 100,000 people.”
Lyme disease is caused by bacteria that can be transmitted by the bite of certain kinds of ticks – specifically, the deer tick (also known as the black-legged tick) and the Western-black legged tick. Transmission of the disease occurs when the tick bites and draws a blood meal. The tick embeds its barbed mouthparts under the skin of the host and secretes a cement-like substance to help it adhere to the skin. Left undisturbed, the tick becomes fully engorged in about two to four days, then drops off. The young ticks (nymphs) are primarily responsible for transmitting the disease in the spring and summer, and the adult mating females are the primary agents in the fall.
Since deer ticks are so small (nymphs are about the size of a poppy seed) and most people do not even feel a tick biting, a tick bite may go undetected. But the sooner the tick is removed, the less the chance of a resulting infection. To remove the tick, fine point tweezers should be used to grab it at the place of attachment rather than the body. Exerting gentle pressure, the tick should be pulled straight out. If it is not removed the first time, gently tug repeatedly until it releases its hold. Then wash your hands and disinfect the area of the bite and the tweezers. If you want to have the tick identified, place it in a covered container including the date, the name of the person bitten, the location of the bite, where you believe the tick was acquired, and call the local or state health department.
If an infected tick has remained on the host long enough to transmit the bacteria, a number of symptoms can occur and many body systems can be affected. Lyme disease typically occurs in stages. During the first stage, lasting from initial infection to weeks after exposure, many people experience a “bullseye” rash at the site of the bite about one week after exposure. The rash may be warm to the touch and cause an itching or burning sensation. However, not everyone gets the rash; in fact, some people who become infected exhibit no symptoms at all during the early stage. Additional symptoms can include enlarged lymph nodes, fever and fatigue, headache, achy joints, and other flu-like symptoms.
The second stage of Lyme disease occurs from days to months after the initial infection. Symptoms such as dizziness, irregular heartbeat, weakness, arthritis, poor coordination, memory loss, facial paralysis, and irritability may emerge. Not all people have all the symptoms, and the symptoms between earlier and later stages may overlap. They may even come and go, disappearing completely at times.
The late stages of Lyme disease may occur months to years following onset. Chronic infection is often accompanied by chronic fatigue, severe headaches, changes in thought or behavior patterns, inflammation of the brain, loss of vision, recurring rashes, degeneration of the skin on hands or feet, and disabling joint pain. Even when the disease has been appropriately treated, relapses may occur.
As with many illnesses, Lyme disease is more easily treated in its early stages, but it does respond to medications even in the later stages. Antibiotics are the treatment of choice. Although diagnostic tests can be done, none are 100% reliable, so doctors usually diagnose Lyme disease on the basis of clinical symptoms rather than the test results.
Since prevention of Lyme disease is preferable to treatment, several measures should be employed to reduce the risk of a tick bite. Because ticks thrive in moist, dark places, lawns, groundcover such as pachysandra, and underbrush often harbor ticks, in addition to marshy and wooded locations. So it is wise to keep such vegetation away from the house, using wood chips, gravel, and tree bark for landscaping. Keep grass cut short. When hiking, stay on trails to avoid brushing against vegetation. Wear plain, light-colored clothes, long pants tucked into socks, closed-toe shoes, a hat, and long-sleeved shirt (tucked into pants) with snug cuffs and collar when walking in tick habitats. Apply a tick repellent to clothing according to the directions on the label; check all pets for ticks, check your own and your children’s bodies for ticks every day, and put any clothes that were worn in a tick infested area in the clothes dryer for 30 minutes.
Additional information about ticks and Lyme disease is available at the Central Connecticut Health District, 721-2822.