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Stay Ticked Off: Let's Talk about Lyme Disease and How to Prevent It

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By Deborah Fisher, Master of Public Health Graduate Student and Dr. Jessica Sapp, Associate Professor, School of Health Sciences, American Public University

Taking a leisurely hike in the woods can have potentially dangerous outcomes in large areas of the United States. The Centers for Disease Control and Prevention (CDC) says that since 2004, vector-borne diseases caused by ticks, mosquitoes and fleas have more than tripled.

With estimates of more than 300,000 cases reported annually, Lyme disease is the most common of these illnesses. Lyme disease is contracted when a black-legged tick infected with the bacteria Borrelia burgdorferi transfers the bacteria to a person through its bite.

Although cases have been reported in all 50 states, 95% of them originate in just 14 states:

  • Connecticut
  • Delaware
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • New Hampshire
  • New Jersey
  • New York
  • Pennsylvania
  • Rhode Island
  • Vermont
  • Virginia
  • Wisconsin

Early Infection Identification of Lyme Disease

Early identification of Lyme disease infections and antibiotic treatment are the keys to a quick and total recovery. Early Lyme disease infection identification varies and can occur as fever, chills, headache, fatigue, muscle and joint aches, swollen lymph nodes, and as erythema migrans (bullseye) rash.

The bullseye rash is the most common symptom, although it is found in 20% to 30% of cases. When the rash is not present, early Lyme disease can be difficult to diagnose and is often mistaken for other ailments. This leads to a delayed diagnosis and the progression of the infection into late Lyme disease.

Late Infection Symptoms

When Lyme disease is not caught in the early infection stage, the symptoms become progressively more severe and have the potential to become mentally or physically debilitating.  Late infection symptoms include:

  • Severe headache and neck stiffness
  • Arthritis and swelling of joints
  • Facial palsy
  • Heart palpitations
  • Dizzy spells
  • Brain and spinal cord inflammation
  • Widespread pain
  • Fatigue
  • Short-term memory loss

Treatment of late infections with antibiotics is usually effective. However, in some cases symptoms can last more than six months following treatment. This is referred to as Post-Treatment Lyme Disease Syndrome.

How to Prevent Lyme Disease

Preventing tick bites is the best way to protect you and your family from contracting Lyme disease. According to Chief Scientist Kirby Sanford III in the Tick Management Handbook, “an estimated three-quarters of all Lyme disease cases are acquired from ticks picked up during activities around the home.”

To keep your yard free from black-legged ticks and other tick species, you can incorporate these techniques to make your yard a tick-free zone:

  • Treat your yard with pesticides: The CDC recommends contacting your local health or agriculture officials to determine when to apply pesticides and which are the most effective in your area.
  • Keep grass mowed and rake leaf litter where ticks hide and nest: Most black-legged ticks are found in wooded areas, but they can also be found in long grasses and ground cover.
  • Discourage rodents and wildlife: The white-footed mouse and white-tailed deer are the primary hosts for ticks that carry Lyme disease. Discourage wildlife from your property by limiting woodpiles, clearing brush and using fences to keep wildlife out.

Personal Protection Tips for the Outdoors

  • Stay on trails: Ticks are usually found on the ground, brush, leaf litter and fallen logs. When spending time hiking or in the woods, stick to trails to decrease the chances of picking up a tick.
  • Treat clothing with permethrin: Permethrin is toxic to ticks, making it difficult for them to move and bite. Permethrin should never be used directly on skin. Clothing should be pre-treated and completely dry before wearing. You can buy permethrin at various outdoor sporting goods stores, including Walmart, Bass Pro Shops and Dick’s Sporting Goods.
  • Use DEET or another EPA Registered Repellent: DEET can effectively prevent tick bites for two to 10 hours, depending on the concentration (percentage of DEET).
  • Wear light-colored clothing: Wearing light-colored clothes when you are outdoors can help make it easier to spot crawling ticks.

Personal Protection Tips for Indoor Locations

  • Shower when you return indoors: Showering within two hours of returning indoors can help wash off any ticks before they can attach.
  • Do a tick check: Ticks can attach themselves anywhere, but ticks prefer warm, moist places. Pay attention to high bite areas (see diagram).
  • Check your pets: Ticks can catch a ride indoors on your family pets. Check pets after they spend time outdoors and use tick control products recommended by your veterinarian.
  • Dry clothing on high heat: Putting clothing worn outdoors directly into the dryer on high heat kills ticks within six minutes.
  • Remove biting ticks immediately: The CDC says that it usually takes between 36 and 48 hours for a tick to transmit Lyme disease.
  • DO: Remove ticks using fine-tipped tweezers.
  • DON’T paint the tick with nail polish or petroleum jelly.
  • DON’T use heat to make the tick detach from your skin.
  • DON’T wait for the tick to detach – you want to remove it as quickly as possible.

Lyme disease tick check CDC

Illustration courtesy of Deborah Fisher. Tick images courtesy of Public Health Information Library, CDC.

For more tips and facts about Lyme disease and other tick-borne diseases, follow #StayTickedOff on the AMU & APU Public Health Facebook page.

About the Authors

Dr. Jessica Sapp is an associate professor in the School of Health Sciences at APUS. She has over 13 years of experience in public health, working in various environments, including government, hospitals, health insurance, community, international, corporate and academia. Jessica earned her D.P.H. in health policy and management at Georgia Southern University and a M.P.H. in health promotion, education and behavior at the University of South Carolina. She also has a B.S. in health science education from the University of Florida.

Deborah Fisher is a 12-year veteran of the U.S. Air Force. She completed her bachelor’s degree in Sports and Health Sciences and is now actively pursuing her Master of Public Health degree. In the past two years, she has had four close family members diagnosed with Lyme disease.

Glynn Cosker Glynn Cosker is the Managing Editor of EDM Digest. Glynn has more than 20 years of writing experience, and he’s the Managing Editor of EDM Digest's sister blog site: In Homeland Security. Born and raised in the U.K., he began his career in government and spent 12 years working in the Consular Section of the British Embassy in Washington – attaining the rank of Vice Consul in the late 1990s. Glynn and his family live in New England.