Posted: Wednesday, May 7, 2014 8:00 am | Updated: 10:19 am, Wed May 7, 2014. 0 comments Forest Lake-area physician Betty Maloney doesn’t think enough attention has been paid to preventing Lyme disease. So Maloney, well-versed on tick-borne illness through close association with the Minnesota Lyme Association (MLA), wrote the following prevention handout, released just last month. The information is courtesy of Partnership for Healing and Health Ltd., of which she is president. It is intended for educational purposes only and not to replace or supersede care by a health care provider. The MLA meets in White Bear Lake the second Tuesday of every month. See mnlyme.com. Lyme disease is a bacterial infection that may develop after a bite from a Lyme-infected deer tick. The Centers for Disease Control estimates that more than 300,000 new cases of Lyme disease occur each year in the United States. Here’s how to prevent and recognize Lyme disease: Avoid ticks Stay out of tick habitat, especially areas with long grass, lots of brush or leaf litter. Stay in the center of hiking and biking trails; don’t sit on fallen logs. Many people become infected around their home. Clear away brush and fallen leaves, keep your grass short. Place lawn furniture and play structures in sunny areas of the yard. Bird feeders and wood piles attract tick-carrying mice so keep them far from the house. Don’t feed deer or use plants that attract them. Pets that go outdoors can bring ticks indoors; perform tick checks and ask your veterinarian for a list of appropriate tick products. Use insecticides and repellents Insecticides and repellents reduce the risk of a tick bite. Insecticides kill ticks; repellents encourage them to leave before biting. Look for products with: • Permethrin, an essential insecticide. Apply it to clothing, sleeping bags and other gear, but not skin. It remains effective for two-six weeks and through multiple washings. • DEET, the best-known repellent. Use concentrations of 30 percent or higher. DEET is safe to apply to unbroken skin, wool and cotton, but it can damage other fabrics and materials. The EPA considers DEET to be safe for children older than 2 months old, but Canada’s health department recommends against using DEET on children. • Picaridin, a newer repellent that’s as effective as DEET. Use concentrations of 20 percent. Apply it to unbroken skin and fabrics. It is non-toxic and safe for children. • BioUD, a newer repellent derived from wild tomato plants. A concentration of 8 percent is two to four times more active than 98 percent DEET against deer ticks. It can be used on clothing but doesn’t last as long as permethrin. It’s only available online at www.homs.com. Tick checks are vital Check for ticks frequently while in tick habitat and for 1-2 days after exposure. Promptly remove and save attached ticks in a resealable container so your doctor can examine them. The risk of contracting Lyme disease depends on how long the tick was attached and how likely it is to be infected. Few infected ticks transmit Lyme in less than 24 hours. At 48 hours, roughly 20 percent will transmit; at 60 hours, 50 percent pass on the infection and when infected ticks feed until full, 94 percent will transmit Lyme disease. In many high-risk areas, half of the deer ticks are infected with Lyme. Ticks may be infected with other diseases and these infections, often called co-infections, are also transmitted through bites. Anaplasmosis and babesiosis are known co-infections and bartonellosis may also be a tick-transmitted disease. Tick removal Don’t put anything on the tick; irritants like liquid soap don’t make the tick release its bite but do make it harder to grasp. Specialized tick removers work well, but so do finely pointed tweezers. Grasp the tick close to the skin (avoid squeezing its body) and use a steady motion to pull it straight out. Wash the bite site with soap and water. Antibiotic treatment Certain antibiotics may reduce the risk of Lyme disease if taken within two days of a bite. Contact your doctor to discuss this strategy. Following a “wait and see” strategy is risky because 30 percent of patients never develop a Lyme rash. Basing treatment decisions on blood tests done shortly after a bite isn’t a good idea because the results are unreliable. Antibiotic approaches are changing; ask your doctor to review a paper published in April 2011 in the Wisconsin Medical Journal and available at: www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/110/2/78.pdf or Prescribers’ Letter from June 2012. Lyme disease symptoms Lyme disease causes a wide variety of symptoms. Symptoms come and go, vary in intensity, change over time and differ from patient to patient. These variations sometimes make it difficult to recognize the infection. • Early Lyme disease occurs within 2-30 days of a bite. In 70 percent of CDC-reported cases, patients developed a rash at the site of the bite. Rashes are usually oval-shaped and solid-colored. The classic bull’s-eye is seen in less than 20 percent of cases. Patients may also have fever, chills, muscle and joint pains, neck stiffness, headaches, fatigue and sore throat. When the rash is absent, these flu-like symptoms may be the only clue of infection. Some patients are asymptomatic in early disease. • Early disseminated disease develops weeks to months after a bite. In this stage, the infection has spread beyond the skin to other body sites. Multiple rashes, fatigue, muscle and joint pain, generalized pain, severe headaches and stiff necks (indicating meningitis), Bell’s palsy, sleep and/or concentration difficulties may be seen. A small percentage of patients experience abnormalities in their heart rate. • Late Lyme disease occurs months to years after the bite. Patients may notice several seemingly unrelated problems, including: arthritis, nervous system abnormalities or nonspecific problems with fatigue, headaches, generalized pain or muscle pain, recurrent fevers, difficulty thinking or and changes in mood. A tricky diagnosis Because symptoms are variable and lab tests are not always reliable, Lyme disease can be a tricky diagnosis to make. If you spend time in tick habitat or areas known to have Lyme disease or co-infections and develop symptoms of these infections, be sure to let your doctor know about your exposures.   © 2014 Your local online newspaper. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Top Ten Things Everyone Should Know About Ticks These Days By Thomas Mather Back in the day, we had ticks. Big, yucky American dog ticks. They usually crawled to the top of your head, you felt a lump, pulled the tick out, flushed them (or found some other form of revenge), and that was that. Usually no one got sick. Ticks were mostly just an annoyance, and that’s what people knew about ticks. American dog ticks are still around but these days, there’s another tick, a tiny blacklegged tick, smaller than a freckle. It's also known as the deer tick, and it crawls up under clothes, latches on without much fanfare, and these ticks are LOADED with disease-causing pathogens. Once attached to people or pets, deer ticks are just hard to find! Their numbers are on the rise and they occur in more & more places – even your backyard! Read our “Top 10 Things Everyone Should Know About Ticks These Days” and stay disease-free.   10. Ticks crawl up Ticks don't jump, fly, or drop from trees onto your head and back. If you find one attached there, it most likely latched onto your foot or leg and crawled up over your entire body. Ticks are "programmed" to try and attach around your head or ears. On their normal hosts, ticks also usually crawl up; they want to blood feed around the head, neck, and ears of their host, where the skin is thinner and hosts have more trouble grooming.   9. All ticks (including deer ticks) come in small, medium and large sizes Ticks hatch from eggs and develop through three active (and blood-feeding) stages: larvae (small-the size of sand grains); nymphs (medium-the size of poppy seeds); adults (large-the size of apple seeds). If you see them bigger, they're probably partially-full or full of blood.   8. Ticks can be active even in the winter That's right! Adult stage deer ticks become active every year after the first frost. They're not killed by freezing temperatures, and while other ticks enter a feeding diapause as day-lengths get shorter, deer ticks will be active any winter day that the ground is not snow-covered or frozen. This surprises people, especially during a January thaw or early spring day. Remember this fact and hopefully you'll never be caught off-guard.   7. Ticks carry disease-causing microbes Tick-transmitted infections are more common these days than in past decades. With explosive increases in deer populations, extending even into semi-urban areas in the eastern and western U.S., the trend is for increasing abundance and geographic spread of deer ticks and Lone Star ticks; and scientists are finding an ever-increasing list of disease-causing microbes transmitted by these ticks: Lyme disease bacteria, Babesia protozoa, Anaplasma, Ehrlichia, and other rickettsia, even encephalitis-causing viruses, and possibly Bartonella bacteria. Back in the day, tick bites were more of an annoyance but now a bite is much more likely to make you sick.   6. Only deer ticks transmit Lyme disease bacteria The only way to get Lyme disease is by being bitten by a deer tick or one of its "cousins" found around the world. Deer ticks also are known as blacklegged ticks in the U.S., sheep ticks in Europe, or Taiga ticks in Asia. Dog ticks, Lone star ticks and other types of ticks just don't seem to be able to transmit Lyme disease. While that's good news, it makes saving any tick that you find biting more important so you can identify it. Doing so may save a lot of unnecessary doctor visits and treatments.   5. For most tick-borne diseases, you have at least 24 hours to find and remove a feeding tick before it transmits an infection Even a quick daily tick check at bath or shower time can be helpful in finding and removing attached ticks before they can transmit an infection. You'll probably want to check even more carefully if you know you've likely been exposed. Many of the disease-causing microbes transmitted by ticks need a "re-activation" period in the tick once it begins to feed. The germs eventually make their way into the tick's salivary glands and the tick spits them into you while feeding. Some infections, especially viruses, move into the tick salivary glands faster than others. Lyme disease bacteria take at least 24 hours to invade the tick's saliva.   4. Deer tick nymphs look like a poppy seed on your skin And with about 1 out of 4 nymphal deer ticks carrying the Lyme disease spirochete and other nasty germs in the northeastern, mid-Atlantic, and upper mid-western U.S., it's important to know what you're really looking for. They're easy to miss, their bites are generally painless, and they have a habit of climbing up (under clothing) and biting in hard-to-see places.   3. The easiest and safest way to remove a tick is with a pointy tweezer Think of a tick as a little germ-filled balloon. Squeeze it too hard on its back end, and all the germs get pushed to the front end, which by the way, is attached to you by the tick's straw-like mouthpart. Using really pointy tweezers, it's possible to grab even the poppy-seed sized nymphs right down next to the skin. The next step is to simply pull the tick out like a splinter. Don't worry if the mouthpart stays in your skin as long as you've got the rest of the tick by its head. Other tick removal methods, like a hot match, Vaseline, dish soap and cotton, or various little key-like devices don't work as consistently as pointy tweezers on all types of ticks. Remember to save the tick and try to identify it (see # 6).   2. Clothing with built-in tick repellent is best for preventing tick bites An easy way to avoid tick bites and disease is to wear clothing (shoes, socks, shorts or pants, and shirt) with permethrin tick repellent built-in. This strategy can be especially effective for protecting children. Dressing kids in tick repellent clothes everyday is a safe and easy way to keep ticks from biting and transmitting disease. Commercially-treated tick repellent clothes last through at least 70 washes, while using kits or sprays to treat your current outdoor wardrobe can last through 6 washes. Tick repellent on clothing, not skin is something everyone needs to know about to stay safe outdoors.   1. Tick bites and tick-borne diseases are completely preventable There's really only one way you get a tick-transmitted disease and that's from a tick bite. Reducing tick abundance in your yard where you spend a lot of time, wearing tick repellent clothing everyday, treating pets every month with tick repellent spot-on products, getting into a habit of doing a quick body scan for attached poppy-seed sized or larger ticks, and pulling ticks off quickly and safely are all great actions for preventing tick bites. These days, ticks are more than just an annoyance. One bite can make you sick, even change your life! Remember these 10 things and you'll stay safer.

Indiana Sees 82 Percent Spike In Lyme Disease Cases Indiana's confirmed human cases of Lyme disease soared 82 percent over a five-year period, and experts say the surge might have been caused by an increase in the tiny ticks that spread the illness to humans. LAFAYETTE, Ind. (AP) — Indiana's confirmed human cases of Lyme disease soared 82 percent over a five-year period, and experts say the surge might have been caused by an increase in the tiny ticks that spread the illness to humans. The Journal & Courier reported (http://bit.ly/paPVQD ) that Lyme disease cases in Indiana rose from 34 in 2005 to 62 in 2009, the most recent year for which detailed data has been released. Health officials aren't sure what's behind the increase, but theories range from an upswing in reporting of cases to an increase in ticks infected with the Lyme disease bacterium. Deer ticks, which are black-legged and about the size of sesame seeds, feed on deer and can pick up the bacterium when they also feed on white-footed mice. Infected ticks then spread it to humans by feeding on them. Purdue University entomologist Timothy Gibb said the deer tick is most likely being transported south and east across the state on the backs of deer, especially as the state's deer population increases. Antibiotics easily cure most people of Lyme disease. But early symptoms are vague and flu-like, except for Lyme's hallmark round, red rash. People who aren't treated can develop arthritis, meningitis and some other serious illnesses. "Chances of transmission are pretty slim but still the consequences of the disease are serious enough that we've got to be careful about it,'' Gibb said. "It's prudent for people to use discretion as much as possible to prevent it.'' In northwestern Indiana, where a possible surge in cases has occurred, nearly 20 people at a recent town hall meeting in Ogden Dunes said they had Lyme disease. Jennifer House, an epidemiologist with the state health department, said she could not confirm the number of Lyme disease cases in that area. She said the situation in Ogden Dunes, a town along Lake Michigan, is under review. Gibb said it would not be surprising for that area to see a surge in cases since northwestern Indiana, northeastern Illinois and southern Wisconsin are "traditionally a hot spot for deer.'' He said less than 3 percent of deer ticks — the only tick species that transmits Lyme disease — are infected with the bacterium. State health officials say May through September is the period in which ticks are most active. In 2009, 83 percent of Lyme disease cases were reported during that span, with the bulk occurring in June, July and August. Six cases were reported in September and five in October. Gibb said that as adults, deer ticks primarily feed on deer and not people. "So hunters or taxidermists who deal with deer will sometimes get the adult ticks on them,'' he said. Other ticks such as the American dog tick are more common and often find their way onto humans, Gibb said.