Diseases of Summer: Ticks and Lyme Disease

This post was authored by Theresa Neumann and posted to The Eye Opener on June 30th, 2011.

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Summer is heating up, and there are lots of outdoor activities in which to participate. Along with the thermostat, however, there is also a rise in the deer tick population! This equates to an increase in Lyme disease, the most commonly reported vector-borne illness in America! Maryland, Virginia, Pennsylvania, Delaware and New Jersey all all “hotbeds” for this disease, comprising 5 of the top  12 states comprising 95% of all Lyme disease cases nationwide.

According to a recent post by Roberta Seldon in Boomer Health and Lifestyle, the deer tick population is a “bumper crop” this year, partly due to the wet winter in the Midatlantic and Northeast United States. Tick activity peaks in June and July, and this correlates to rates of illness as reported by the Centers for Disease Control (CDC). The CDC also reported 2009 as the second-highest incidence of disease cases, following 2007; with the estimated increase in the deer tick population, 2011 might go down in the record books as the highest year ever since the beginning of recording/reporting lyme disease (1995). The Maryland Department of Health and Mental Hygiene (DHMH) breaks down the jurisdictions even further into cases per County, with the top two counties being Baltimore and Anne Arundel, with Howard, Harford and Carroll counties being right in the mix.

What is a deer tick and what does it look like?

The deer tick, as it is commonly called, is really the black-legged tick or Ixodes scapularis. This is NOT the same as the dog tick; it is a much-smaller version with different coloration. The Canadian Lyme Disease site provides an excellent pictoral description and differentiation of the various types of ticks and relative sizes. The deer tick, especially in the nymph stage, is so very tiny and nearly impossible to see, and it is this very pinpoint little bug that causes most of the infections.

The CDC website (one of my favorites for all kinds of information related to infectious diseases and other public health topics) details the disease transmission process and prevention, diagnosis and treatment information. The site discusses many myths about the tick, its removal, the disease, its symptoms and long-term sequellae.

Did you know that the tick itself does not cause the disease? The tick carries a bacteria called Borrelia burgdorferi that has to be transmitted through the saliva during feeding. It takes at least 24 hours, if not 36 to 48  hours, of tick attachment and feeding in order to transmit the bacteria. Thus, besides various prevention techniques with appropriate clothing and wearing bug spray with DEET, it is critical to perform (or have someone else perform) a “tick-check” after being in wooded areas or areas known to have deer activity. The best way to remove this little critter is by using tweezers and grasping the head while applying gentle traction in the opposite direction of attachment. Even if you are not the environmental type but you have a dog, be sure to apply tick-prevention remedies to your pet since they can bring these critters into your home.

What are some common symptoms of Lyme disease?

The most common symptom, and the one classically associated with Lyme disease, is the bulls-eye type rash (called erythema migrans) that develops at the site of the infection/tick bite.

There is a central area of redness, and over several days, the red ring starts to migrate peripherally, followed by an area of clearing; it clearly resembles a bulls-eye target. According to the CDC, approximately 68% of those infected report this rash. The next most common symptom is joint pain that can involve one or more joints and typically migrates to various joints. Other more serious presentations include paralysis of the facial nerve (Bell’s palsy), meningitis or encephalitis, and even heart block or problems with the electrical conduction system of the heart leading to irregular heart rhythms.

The Maryland DHMH just released a video on Lyme Disease in Maryland. Dr. Katherine Feldman describes the disease.  It is a 7-minute and 23-second video with lots of good information. Please, click the link to watch and learn!

Other tick-borne illnesses:

Lyme disease is not the only disease transmitted by ticks. Ticks live on the blood of the hosts on which they feed. They can transmit a variety of pathogens via their bite and/or saliva that have been acquired from other hosts. Some of these infections include anaplasmosis, babesiosis, ehrlichiosis and Rocky Mountain Spotted Fever (RMSF). As an aside, don’t let the Rocky Mountain part fool you! North Carolina has one of the highest incidence rates of RMSF nationwide!

QUESTION: Do you know someone who has had Lyme Disease? Were there any unusual circumstances surrounding the diagnosis? Share your story so others can be more aware!

Images courtesy of:

(c) L. Gerlach on Blisstree.com

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