May is Lyme Disease Awareness Month
Lyme is the most prevalent vector-borne disease and one of the fastest spreading diseases throughout the United States, and the subjects of diagnosis and treatment of Lyme are politically-charged.
This series of diaries is designed to provide information to the Daily Kos community both for Lyme disease prevention and for those Kossacks living with Lyme. Because the disease is often missed by physicians, these diaries may assist an individual or two in pursuing testing which might otherwise have been missed.
The Lyme Disease Awareness series will be eclectic including personal statements, informational pieces about the science of Lyme, and calls to action for community and political advocacy.
We hope you'll all join us in learning about this rampant disease and the medical/industrial/political morass in which Lyme patients find themselves.
Collect the complete set of diaries at LymeDiseaseAwareness
Today's diary by: 42 LymeDiseaseAwareness
In the first two parts of this mini-series-with-in-a-series, I talked about tick tenacity and why the government takes these cesspools of disease seriously. Today I hope to help you find ways to protect yourself from these bloodsucking vermin.
Who is at Risk for coming into contact with ticks?
According to the CDC from 2003-2005 incidence of Lyme disease were highest in two age groups – children, especially boys aged 5 to 14 years old, and adults aged 55 to 64 years.
If you live in a rural or suburban area your risk of encountering a tick increases threefold. Exceptions abound, though. Unfortunately one does not need to be an avid outdoors sports enthusiast to meet up with ticks. Deer ticks and Lyme disease transmittal have been documented within large city limits, even in New York City’s Central Park. Air travel has even been disrupted by the discovery of ticks in the plane.
You are at a higher risk of a tick encounter if you live in a single-family house, more so if you have a yard, or woods are attached, or if you live within 100 feet of woodland. Unfortunately having dogs or cats that have access to the outdoors also puts you at a higher risk of contracting tick-borne diseases. Dogs are excellent sentinels for the presence of ticks in an area. Heavily infested dogs, if not groomed outdoors first, will bring ticks into the house, where they can dislodge. Tick collars tend to increase the number of ticks brought indoors. Sad to say, ticks brought into the house are a common source of human infestation.
So many of us have birdbaths in our yards, and like to feed the birds during the winter. However, those bird feeders also attract deer, and mice. Besides, the average bird has 2 -3 ticks on them, which can drop off at any time. Birds and bird migration are more reasons for the increasing spread of Lyme and TBD (tick borne diseases).
Of course, in a Lyme endemic area, (An endemic area is defined by the CDC as a county that has more than 2 documented cases of Lyme disease). hunting, hiking, and fishing bring you closer to nature and to the ticks. So does horseback riding, sports (Little League and Pop Warner games) - especially if the playing areas are close to or abutting fields and woods. This holds true for golf as well. Any activity in an outdoor area that is frequented by deer or mice makes one more vulnerable to a tick bite.
So what to do?
First and foremost is to PROTECT YOURSELF. Avoid open fields, roadside areas or uncut grassy areas as much as possible.
Avoid sitting directly on the ground or fallen logs; use a blanket or other ground cover. When walking near bushes or trees, avoid touching them. Walk in the center of trails. Avoid sitting on stonewalls or woodpiles; these are places deer ticks like.
Wear light-colored long pants and long sleeves and white closely knitted socks when outside. Tuck your shirt into your pants and tuck your pants into your socks. This will help prevent a tick from crawling under your clothing and getting to your skin. Wear light colored gloves. The light color makes it easier to see a tick crawling on your clothing or gloves. Wear a hat to protect your head from deer ticks when working around bushes.
Consider wearing Rynoskin protective underwear. It is made of a closely knitted but breathable stretch fabric that ticks apparently have difficulty penetrating. It is especially helpful for hunters and those outdoors when the weather is cooler. It is available in long sleeved tops, long bottoms, socks, hoods and gloves. Ticks can also be picked up when sitting on mowed areas. They are also more abundant on stone walls (due to mice activity), fallen logs, and the undersides of picnic tables. Before going back indoors remove all ticks form your clothes. Wash clothes in hot water and dry them in high heat for at least 1 hour in order to kill ticks that you have missed. LymePA
Studies from University of RI over the past few years, show that ticks are building up a resistance to DEET. It now takes a a 65% concentration to be effective - and that protection does not last all that long. Permethrin, on the other hand, kills ticks- usually within a minute, while DEET only repels them.
Spraying your clothes,and especially your shoes/sneakers with a permethrin based product (Sawyer’s Clothing Spray, Insect Shield, Permanone) is highly effective for protection. One application of these products will last about a month and through several washings. Buzz-Off™ and other lines of clothing with tick repellent already applied can be purchased as well.
Most importantly, despite any and all precautions, daily tick checks are a must!
*A. Check all body parts that bend including:
- behind the knee
- between fingers and toes
- underarms
*B. Check other areas where ticks are commonly found including:
- belly button
- in and behind the ear
- neck
- hairline
- top of the head
- entire groin area
*C. Check pressure points including: (ticks will stop when they meet resistance)
- where underwear elastic touches the skin
- where bands from pants and skirts touch the skin
- anywhere else where clothing presses on skin
*D. Go back and visually check all other areas, there may be more than 1 tick.
*E. Run fingers gently over skin. If there is a tiny tick and it is
attached, it will feel like the last piece of scab left before a cut
completely heals.
*F. Shower after all outdoor activities are over for the day. If the tick
is still wandering it may wash off.
*G. Re-run a tick check three days later, just in case you missed
something the first time through.
IF a Tick is Found... and still attached:
Do not squeeze the body of the tick!
Do not apply Vaseline!
Do not use a hot, burnt match!
Do not use alcohol to get the tick to detach.
Do not follow the advice from forwarded e-mails about some ‘nurse’ who states that applying a soapy cloth (or other handy-dandy, no muss - no fuss method) will suffocate the tick and make it detach. (urban legend!).
Any of these actions could cause the tick to regurgitate and transmit any pathogen it is carrying! If you weren’t infected beforehand, you soon could be.
To avoid transmission of disease, use a blunt-tipped tweezer, grab the tick as closely to the skin as possible. Pull straight up(or in the direction the tick is attached).
There are several good tick removal tools available, but avoid any that "unscrew" the tick. Counter to popular belief, ticks do not screw themselves into the skin.
After removal, disinfect the site, wash your hands and mark the calendar as to the date of the bite for future reference if needed. If you see a rash(es), even if it is not at the site of the bite, you or your physician should take a picture of it, date it, and the doctor should place a copy of it in your medical records.
Many states and private labs will test the tick to see if it is infected with the Lyme spirochete. (As with other tests for Lyme disease, it isn’t 100% accurate). For testing, the tick will need to be placed in a vial with a damp piece of paper so it won’t dry out.
What to Consider if Bitten
You can contract many tick-borne diseases simultaneously from the same tick bite. Present tick testing does NOT test for other tick-borne infections.
Being bitten by an infected tick does not always mean that you will get Lyme disease.
The longer the tick is attached the greater the chance of infection.
Not everyone infected with Lyme disease will develop a rash, however if you get the Erythema Migrans rash, you do have Lyme disease. Seek immediate medical attention.
The rash or rashes may be raised, hot to touch, itchy, crusty, oozy, circular, spreading out, oval, triangular, long-thin line, disappear and return, at the site of the bite or on other parts of your body. Time for Lyme
Current tests for Lyme disease are not definitive and according to ILADS guidelines, people with the disease may test negative yet be infected.
Centers for Disease Control (CDC) guidelines suggest that the diagnosis of Lyme disease be clinical, based on exposure and symptoms. According to CDC estimates, the real incidence of Lyme disease is 8-10 times the reported number.
If infected, symptoms may not appear for days, weeks, months, or years after being bitten.
Symptoms may range from subtle to severe, may come and go, and difficult to recognize because it mimics other diseases (The Great Imitator).
According to the CDC, the bacteria that cause Lyme disease can potentially enter the central nervous system within days of a tick bite, making treatment more difficult.
More on early Lyme Disease symptoms can be found here.
Protect Your Property
According to the CDC, simple landscaping practices can reduce exposure to ticks by 50-90%.
• Remove leaf litter and clear tall grasses and brush around homes
and at the edges of lawns.
• Place wood chips or gravel between lawns and wooded areas to
restrict tick migration to recreational areas.
• Mow the lawn and clear brush and leaf litter frequently.
• Keep the ground under bird feeders clean.
• Stack wood neatly and in dry areas.
• Keep playground equipment, decks and patios away from yard edges
and trees.
• Increase sunlight to property
• Move bird feeders/ birdbaths
• Get rid of mice; deter chipmunks, squirrels and deer from the
property
Create Tick Free Zones
Perimeter spraying with an acaricide (tick pesticide) twice a year (late May and early October) by a professional pest control applicator is the single most effective way to eliminate ticks from your yard. Make sure that they thoroughly disturb the leaf litter, and spray the undersides of the plant branches and leaves.
Since mice transmit many pathogens to ticks, ridding your property of mice or treating the ticks already on the mice can go a long way to a healthier environment.
Most studies support the notion that white-footed mice (Peromyscus leucopus) are the main reservoir host for Lyme disease spirochetes, Babesia protozoa, and Anaplasma bacteria; in most settings, mice are the primary culprits for producing infected ticks. These mice are common and often quite abundant in rural, suburban, and semi-urban settings across much of the eastern United States.
Tick Tubes are stuffed with cotton nesting material impregnated with permethrin. If mice are present, they typically are very attracted by this nesting material. If tubes are placed in areas harboring mice, the mice will steal the treated nesting material and place it in their nests. Once mice have treated nests, they almost never are infested by ticks. With complete coverage in a yard, in time nearly all of the mice will have treated nests. In this way, targeting the ticks that feed on mice can greatly reduce the number of infected ticks in your yard. It's easy to apply Tick Tubes, [although you need to think like a mouse-where would they feel safe searching for nesting material?]. Do it yourself, or hire a professional applicator. It is best to apply Tick Tubes in late July/August (when larvae are active)and in April (before nymphs emerge). tickencounter
For larger properties, the use of 4-poster feeding stations which focus on the adult ticks on deer can reduce the tick population over the span of a few years.
Protect Your Pets
Dogs
Unfortunately our pets are not immune to Lyme Disease either. In fact, the American Veterinary Medical Association studies suggest that dogs are 50% more susceptible to Lyme Disease than humans.
The peak time for canine Lyme disease is late spring and fall (not midsummer, as is common in humans). The incubation period for naturally-infected dogs is unknown, but laboratory showed clinical signs developing two to five months after infection.
The clinical signs seen in dogs are variable and nonspecific. The characteristic rash seen in humans is uncommon in dogs, and those that do occur are localized and transient.
While lameness is a common symptom of canine Lyme disease, the crippling, chronic, non-antibiotic-responsive arthritis seen in humans is rare in dogs.
The most commonly reported acute clinical signs of Lyme Disease in dogs include:
* fever [103˚-105˚F degrees]
* recurring shifting leg lameness and stiff gait
* lethargy and depression
* enlarged lymph nodes
* general malaise and loss of appetite.
Several additional distinct clinical syndromes may be recognized in dogs, including:
* kidney disease
* nervous abnormalities, including behavioral changes and seizures
* heart problems, such as irregular heart rhythms and heart inflammation
After a tick bite, the bacteria disseminate by actively moving through the tissues to the central nervous system and can be found there as soon as 12 hours after infection.
Pet Shed
Using the Snap® 4DxTest by Idexx, veterinarians are able to test dogs for Lyme, E. canis (ehrlichiosis), anaplasma and heartworm, and have the results within 10 minutes. The cost for this test is under $100. Treatment in "routine" cases is tetracycline for 30 days. Pain medication is also given. Dogs usually respond well, feeling better after just a few doses. In serious infections with fever, severe pain, kidney problems, dogs need to be hospitalized for IV antibiotics, fluids and pain medications.
There is a Lyme vaccine available for dogs, but controversy surrounding the use of it. Flea and tick baths are helpful. Topical preventatives are also available. K-9Advantix kills and repels fleas, ticks and mosquitoes. It is not a systemic and can kill ticks before they bite and attach. Frontline Plus is another product, but it can take up to 2 days to kill a tick after it starts feeding.
Avoid products containing the pesticide cyphenothrin (SentryPro XFC) as it is under investigation for adverse and potentially deadly effects.
Cats
Perhaps because of their fastidious grooming habits, cats seem less susceptible to Lyme. However, infection is not unheard of. Be on the watch for lameness, fever >103˚F, loss of appetite, fatigue, eye damage, unusual breathing, heart involvement or "zombie like trance". Many cats do not show noticeable symptoms, despite being infected.
Feline disease is treated with antibiotics such as amoxicillin, tetracycline or doxycycline.
There is currently no vaccine, nor specific lab tests for tick-borne diseases for cats. There are 2 ways to protect your cat. Keep the indoors or use specific topical preventative especially designed for cats. NOT ALL of the topicals can be safely used on cats!
Horses
Horses are susceptible to both Babesia and Lyme infections.
A recent equine journal studied horses in New England and in the Pacific Northwest and reported that 45% of horses tested in New England showed signs of Lyme exposure though they may not have been symptomatic. In the Northwest the number was in the teens.
Lyme infected horses generally do not have a fever, but may have lame or stiff joints, laminitis, depression, or refuse to eat. This bacterial infection may be a cause of moon blindness or loss of vision. There have been reports of spontaneous abortion and encephalitis in horses infected with Bb (Borrelia burgdorferi, the causative agent of Lyme). Neurologic signs include head tilt, difficulty swallowing, or aimless wandering. Transplacental transmission occurs. Colts born to infected mares have displayed birth defects. Many horses may be infected with the spirochete, but display no symptoms.
Lyme disease rarely affects sheep, goats, chicken or deer. Consult your veterinarian about further prevention and treatment of Lyme disease in your animals.
Enjoy the holiday weekend, and keep safe!
