With the arrival of warmer weather, you may be spending more time enjoying summer pleasures such as picnics, barbecues, hikes and other outdoor adventures. But keep in mind: The height of tick season — and hence Lyme disease risk — is also here, and 2017 is expected to be particularly intense as far as this tick-borne illness goes. One reason: A bumper acorn crop several years ago led to an increase in mice available last summer for larval ticks to feed on, says Dr. John Aucott, an assistant professor of medicine and director of the Lyme Disease Research Center at the Johns Hopkins University School of Medicine. Ticks have also made an earlier appearance than usual, thanks to this year’s warmer weather.
In the Northeast and upper Midwest areas of the U.S., “typically up to 60 percent of adult blacklegged ticks carry the Lyme bacteria and about 25 percent of nymphs [the middle stage] are infected,” says Tom Mather, a professor of public health and director of the Center for Vector-Borne Disease at the University of Rhode Island. “Infection rates in blacklegged ticks in other parts of the country are typically much lower.” And some of the ticks that carry the Lyme bacteria (Borrelia burgdorferi) also carry other microbes — including babesiosis, anaplasmosis and ehrlichiosis — that could make you sick (these are called co-infections).
[Read: Keeping Up With Ticks.]
Consider this added incentive to protect yourself from ticks this summer. “People are afraid of Lyme disease, yet they really don’t have a clue how to protect themselves,” Mather says. “They think it’s out of their control, but it’s not.” Here’s how you can stay safe:
Make your yard a tick-free zone. It’s a myth that you’re safe from Lyme disease if you avoid the deep woods. “Most cases occur in your backyard — a lot of suburban areas have woods or wooded areas nearby, and that’s where the ticks are,” says Dr. Eugene Shapiro, a professor of pediatrics, epidemiology of microbial diseases and investigative medicine at Yale University. “Deer are important for maintaining the life cycle of the tick in nature, but you don’t need deer there to have a tick population in your yard.” In fact, chipmunks, moles, mice, skunks, foxes and birds also carry the types of ticks that transmit Lyme disease.
Wherever there’s brush, scrub and fallen leaves, you’re likely to find mice. That’s why it’s smart to clear away tall grasses and brush from around your home and at the edge of your lawn, Shapiro says. Place a 3-foot-wide barrier of wood chips or gravel between your yard and wooded areas. Mow your grass often and keep your leaves raked. Also, stack wood neatly in a dry area.
Safeguard your body. Wear long pants and long-sleeved shirts when you go hiking or into wooded areas — and tuck your pant legs into your socks. Ticks crawl up from the ground so this way you’ll force them to stay on the outside of your pants. To prevent ticks from crawling onto you, consider spraying your shoes and clothes with a tick repellent that contains permethrin, Mather says. “You can even buy tick-repellent clothes treated with permethrin or have your own clothes treated commercially. If a tick latches on, it will quickly fall off and die,” he adds.
[Read: Lyme Disease: Symptoms, Prevention and Treatment.]
Do regular tick checks. Whenever you come indoors after spending time in grassy or wooded areas, give yourself (and your kids and outdoor pets) a head-to-toe skin check. Ticks can attach anywhere, but they’re partial to the backs of knees, underarms, groin or other warm, dark places. The good news: “If an infected tick is removed within 24 hours, there’s less chance that you’ll get Lyme disease,” Mather says.
To remove a tick safely, grasp it firmly with pointy tweezers as close to the skin as possible and gently but firmly pull it away from the skin, Mather advises. Then, disinfect the skin with rubbing alcohol. To help you identify the most worrisome ticks and gauge your risk of developing Lyme disease, take a picture of your tick and send the photo to TickEncounter. In the meantime, seal the tick in a zip-close bag. “The blacklegged (or deer) tick is the one to be most concerned about,” Mather says. “If yours is a risky tick, you’ll be advised that you can have the tick tested [for Lyme disease].”
Stay alert to worrisome signs. In the early stages, symptoms of Lyme disease can be flu-like — a low-grade fever, chills, body aches, fatigue, headache and swollen lymph nodes. Approximately 75 percent of people who are infected with Lyme disease develop a rash at the site of the tick bite, three to 30 days after the bite, according to the Centers for Disease Control and Prevention. Though it tends to be uniformly red, the rash may not be a perfect circle — it often has an elliptical or oval shape — and it can last for a few weeks without antibiotics, notes Dr. Leonard Sigal, a Lyme disease expert and a clinical professor of medicine and pediatrics at the Rutgers University’s Robert Wood Johnson Medical School. With antibiotic treatment, the rash typically disappears within a few days.
Keep in mind: Not every rash that stems from a tick bite signals Lyme disease, Mather says. “Tick bites also can generate a histamine-mediated sensitivity that is red and may appear rash-like [much like other allergic responses]. Don’t be fooled: A red mark that’s present at the time of the tick bite or within a day after removal is not caused by the Lyme disease bacteria. Also, a tick bite rash is usually smaller than a 50-cent piece and stays that way, while a true Lyme rash grows larger” over time.
Know when to see a doctor. If you have a rash that suggests Lyme disease or you found a tick and developed Lyme disease-like symptoms, head to the doctor. But remember: Timing matters considerably when it comes to testing for Lyme disease. It’s not unusual for people to get a negative result on a Lyme disease test shortly after becoming infected. The reason: While the body’s immune response kicks in quickly, it takes three to four weeks for the antibodies to be detectable, Shapiro explains. Currently, the CDC recommends a two-step testing process: an enzyme-linked immunoassay, or ELISA, followed by a Western blot test if the first step is positive or indeterminate. These tests look for antibodies against the bacteria that cause Lyme disease. If it’s given four or more weeks after a tick bite, the two-step test is reliable. If only the first test is done, there are often false-positive results because the body can make antibodies against other microorganisms that can cross-react with B. burgdorferi, Sigal explains.
[Read: Does Chronic Lyme Disease Exist?]
A two-to three- week course of antibiotics usually cures Lyme disease if it’s caught early (when you notice the rash), Shapiro says. But if the disease has been present long enough to trigger neurological symptoms like Bell’s palsy (paralysis or weakness in the muscles on one side of the face), treatment may last longer. Even then, some people who get Lyme disease report lingering symptoms, including fatigue, joint and muscle aches, sleep disturbances and cognitive problems, after treatment ends, and they might be told they have chronic Lyme disease or post-treatment Lyme disease syndrome, or PTLDS. Aucott says about 10 percent of people who get Lyme disease experience these prolonged symptoms.
“The cause of these [lingering] complaints is poorly understood,” Sigal says, “but there’s some evidence that they stem from ongoing immune system activation, perhaps related to persistence of debris derived from dead B. burgdorferi.” Unfortunately, there is no Food and Drug Administration-approved treatment for these persistent Lyme-related symptoms. Some physicians treat these patients with long-term antibiotics or intravenous antibiotics, based on the unproven hypothesis that there is persistent infection, Aucott says. This is controversial because there’s no evidence that it helps; plus, infectious disease experts discourage this practice because of concerns about side effects and antibiotic resistance.
“One take-home point is that PTLDS is a very real and increasingly important problem,” Aucott says. “The patients have a real illness that isn’t their fault.” Research is urgently needed to figure out how to best help them, he adds.
More from U.S. News
Does Chronic Lyme Disease Exist?
On a Scale From 1 to 10: Most Painful Medical Conditions
How to Avoid Tick Bites (and Lyme Disease) This Summer originally appeared on usnews.com
