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.
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