Lyme Disease: What Should Doctors Tell Their Patients?

By Nancy Wurtzel

Health experts are warning there will be increased odds of contracting Lyme disease this spring and summer, due to an explosion of infected ticks and an earlier, warmer spring.

First identified – and named for – Lyme, Connecticut in the 1970s, the disease has spread steadily.  It’s now found in almost half of the counties across the U.S.  The Center for Disease Control and Prevention (CDC) estimates as many as 300,000 individuals may be infected with Lyme each year, the vast majority of cases going unreported and untreated.

Kiersten Kugeler of the CDC told NPR News, “What’s important for people to know is that the ticks are spreading to new areas — and tick-borne diseases are coming with them.”

Facing an increased risk, should patients be advised to stay indoors?

Public health professionals say no.  It’s good to be out in nature, gardening, walking, hiking, biking, camping and more.

“Ticks are a problem along with a lot of other outdoor hazards, but you don’t need to fear going outdoors,” said Richard Dolesh, Vice President of Strategic Initiatives at the National Recreation and Park Association.

Instead, patients should be encouraged to focus on prevention and early intervention.
.

These are some tactics and strategies to avoid being bitten, and what to do if you are:
.

• The deer and black-legged ticks that carry the Lyme bacteria are tiny, even as small as a poppy seed, and their bite is painless. They are most likely to be found in areas of woods, fields, tall brush or high grasses, but the ticks are also found under leaves or ground cover and other low-growing vegetation.   Keep your yard free of debris and consider fencing the yard if you have wild animals that could pass through.
  .
• Cover as much skin as possible. If ticks are unable to reach your skin, they can’t bite.  Long-sleeved shirts are a good option and tuck the bottom of pants into socks.  Ticks seem to like hiding behind the ears, on the scalp, in the armpit, on the back, and also the groin.
  .
• After spending time outside, do a tick check. Wearing light-colored clothing makes this a lot easier.  It’s also a good idea to shower after spending time outdoors.
  .
• Certain insect repellent will help keep the ticks at bay. The best choice is one that contains 20 to 30 percent DEET on exposed skin and clothing.  Products containing 0.5 percent permethrin can be used on clothing and outside equipment, but never on skin.
  .

Visit the Environmental Protection website to learn more about repellents.

If you find a tick that has already latched on and is attached to your skin, don’t despair!

The first step is to remove the tick.  Never use heat to remove a tick or attempt to crush it with your finger.  Instead, use a tick-removal device you can find at most local drug stores, or a fine-tipped tweezers, which can work just as well.  Using the tweezer or other device, grasp the tick at its head and close the surface of the skin, then pull upward with a steady, even amount of pressure.  Avoid any twisting motion so you don’t break the tick.
.

Here’s how to stay safe from ticks:
.

• After the tick is removed, clean the bite area and your hands with alcohol, an iodine scrub, or soap and water. To dispose of the tick, first submerge it in alcohol and then either flush it down the toilet or place it in a sealed bag or container and dispose of it in the garbage.
  .
• Tell patients to be on the lookout for symptoms and don’t assume they will just go away. See a doctor if symptoms appear within days or weeks of the bite.  However, it is important to know that if you have symptoms but never noticed a bite, you can still have Lyme’s disease.
  .

Early detection is important for diagnosing and treating Lyme disease.

In the days and weeks following a bite, LymeDisease.org, a advocacy, education and research website, says individuals might see a distinctive red bullseye or a round rash, followed by flu-like symptoms, fever, headache, fatigue, muscle and/or joint pain, and sometimes a weakness in the limbs.  Some patients might also experience partial facial paralysis, shortness of breath, heart palpitations, and severe swelling of the larger joints.

A round of antibiotics can cure Lyme disease and patients usually recover completely.

However, if Lyme goes undetected and untreated, it can lead to serious, chronic health problems.  The CDC outlines these conditions, including significant neurological issues like short-term memory loss, inflammation of the brain and the spinal cord, nerve pain, facial palsy, sensitivity to light.

Lyme is diagnosed through the evaluation of symptoms, a history of exposure to infected ticks, and through a laboratory blood test.  To avoid misdiagnoses, the CDC strongly recommends a two-tier process when testing blood for any evidence of antibodies against the Lyme disease bacteria.