Take cover against Lyme disease

Created date

June 9th, 2016
Deer tick warning in the woods.

Deer tick warning in the woods.

In the early 1970s, several children living in and around Lyme, Conn., began showing signs of a mysterious health problem with symptoms similar to juvenile rheumatoid arthritis. Scientists noticed that these cases occurred during the summertime, and that most children reported having a rash at or near the area where a tick had bitten them before developing arthritis.

The constellation of symptoms was termed Lyme disease, but the cause remained unknown until 1981 when researchers from the National Institute of Allergy and Infectious Diseases (NIAID) discovered that deer ticks were the source. 

Today, Lyme disease is the most commonly reported vector-borne illness in the United States even though it does not occur nationwide. About 300,000 people are diagnosed with the disease each year, according to the Centers for Disease Control and Prevention. Most cases are reported in the Northeast and upper Midwest where deer populations (and the ticks that feed on them) tend to thrive in heavily wooded or grassy areas. 

Nonspecific symptoms

After you’ve been bitten by an infected tick, symptoms can begin anywhere from 3 to 30 days. The hallmark symptom that most people have heard about is a nonitchy, nonpainful rash that can form a so-called bulls-eye pattern at the site of the tick bite. This rash, however, can be easily missed. “Ticks usually bite in hidden areas of the body such as the armpit or groin,” says Michael Zimring, M.D., director of the Center for Wilderness and Travel Medicine at Mercy Medical Center in Baltimore, Md. “And even if you notice a rash, a bulls-eye pattern is not always evident.”

Seniors who have contracted Lyme disease are more likely to turn up at their doctor’s office because they think they have the flu. “Common early signs of Lyme disease are fever, chills, body aches, joint pain and stiffness, and fatigue,” Zimring says. “These symptoms taken alone or together could be attributable to numerous conditions.”

Lyme disease-related joint pain, stiffness, and swelling typically affect the knees, but any joint may be involved. “Arthritis is already a problem for many seniors. Lyme disease can exacerbate joint damage and compromise your mobility,” Zimring says.

Lasting effects

Left untreated, Lyme disease can cause serious problems, including prolonged fatigue, neurological problems, heart rhythm irregularities, muscle weakness, and serious joint pain and swelling. Other late-stage complications can include liver inflammation, headaches, nerve pain, and cognitive problems.

Treatment for Lyme disease is fairly straightforward and most effective if started early. “Oral antibiotics can cure the disease,” Zimring says. “If your doctor suspects Lyme disease and recommends antibiotics, start taking them right away. Lab tests can be inconclusive, so don’t wait for results to begin your treatment.”

“Be sure to finish all of the medicine even if your symptoms resolve,” says Vrinda Suneja, M.D., medical director at Fox Run, an Erickson Living community in Movi, Mich. “The bacteria may still be in your bloodstream.”

For people with more severe symptoms, especially involving the nervous system, intravenous antibiotics may be necessary. Beware, however, of bismacine, an injectable compound prescribed by some alternative medicine practitioners to treat Lyme disease. According to the Food and Drug Administration, bismacine contains high levels of the metal bismuth, which is not safe for injectable use because it may lead to heart and kidney failure.

People who still have signs of the disease six months or more after treatment may be diagnosed with “Post-Treatment Lyme Disease Syndrome” (PTLDS). The cause of PTLDS (sometimes called chronic Lyme disease) is unknown, although some experts think it occurs because of residual damage to the immune system and body tissues. There is no proven treatment for this condition—studies show that long-term antibiotics are not effective. “Most people will eventually get better,” Zimring says. “The best course of action is to treat each individual symptom and help patients maximize their quality of life.”

Protect yourself

Before going out to a bushy or woodsy area, pretreat yourself and your clothes. “Use a repellant product containing DEET [chemical name: N, N-diethyl-meta-toluamide] on your skin,” Zimring says. NIAID recommends applying permethrin products (available in lawn and garden stores) to clothes or buying pretreated clothing. Do not spray your skin with permethrin.

Once you are out and about, cover up. “Wear long sleeves and long pants—tuck your shirt into your pants and your pants into your socks for extra insurance,” Suneja says. “Also wear gloves and a hat. Stick to trails and paths, and keep your pet on a leash so they don’t wander off into tall grass or the woods.”

When you come back in, inspect yourself and your pet for ticks. “Ask someone to help you, and remember to check your hair very carefully,” Suneja advises. 

Deer ticks are tiny—about the size of a poppy seed when young—so search meticulously.  “Studies show that deer ticks have to be attached for at least 24 hours in order to transmit Lyme disease,” Zimring says. “It can be helpful to shower after being outside, and also launder your clothing. If you find an attached tick, remove it as soon as possible [see sidebar].”

Even if you have had the disease before, “You need to protect yourself every time you are in a high-risk area,” Suneja says. “You can get Lyme disease more than once.”


Removing ticks safely

Use fine-tipped tweezers to grasp the tick as close to your skin’s surface as possible.

Pull upward with slow, steady, even pressure. Do not twist or jerk—it may cause the mouth parts to separate and remain in the skin. 

Wash the area thoroughly with soap and warm water and apply antibiotic ointment and a bandage, if necessary.

Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag or container, wrapping it tightly in tape, or flushing it down the toilet.