For discussion

July 2014

Ticks Bite: Protect Yourself Against Lyme Disease

Jordyn Wallenborn is an American Indian Project Manager and a Graduate Assistant at the Center for Social Research. She has a B.S. in Community Health and an MPH in Infectious Disease Management. Her previous research experience is on Hand, Foot, and Mouth Disease in Taiwan. In this article, she discusses Lyme disease and ways to protect yourself during summer months.

Midwest summers can be full of fun and adventure, but an unknown danger can be lurking in the fields or grassy lands- Lyme disease, carried and spread by the deer tick. Protecting yourself during summer months when Lyme disease cases are prevalent is important to help you have a happy and healthy summer.

Q: What is Lyme disease?

Lyme disease is the most frequently reported vector borne illness, an infection that is transmitted by blood-feeding arthropods (i.e., invertebrate animals characterized by an external skeleton, segmented body, and jointed legs or limbs). In the United States, geographic locations with the highest prevalence of Lyme disease are the upper Midwest and Northeast states, where deer ticks can be found in their natural habitat. Lyme disease cases occur year round, but the majority of cases are reported during the summer months of June, July, and August. Lyme disease is carried by the black-legged tick, otherwise known as the deer tick, which can be found in grassy or heavily wooded areas.

Deer ticks become infected when they bite a mouse, deer or human that is infected with the bacterium. Most human Lyme disease infections are caused by immature ticks (nymphs) that are active during spring and summer months. Ticks must feed for at least 24 hours to transmit the bacterium. The longer the tick feeds, the higher the probability of transmission. According to the Centers for Disease Control and Prevention (CDC), as a tick feeds, there is a 0 percent chance of transmission at 24 hours, 12 percent at 48 hours, 79 percent at 72 hours, and 94 percent at 96 hours. Therefore, the quicker you remove the tick, the less likely you are to become infected with Lyme disease.

Q: What are the symptoms and treatment of Lyme disease?

Symptoms of Lyme disease can appear 3 to 30 days after a tick bite. Symptoms and severity of Lyme disease vary, but the most common symptom, present in approximately 70 to 80 percent of cases is erythema migrans (EM). EM is a localized red rash that is found where the tick was feeding. The most common sites of EM include: thighs, groin, trunk, and armpits. Other common symptoms include fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes.

Once diagnosed with Lyme disease, the standard treatment is usually 14 to 21 days of antibiotics. If not treated, a variety of complications can arise. Approximately 60 percent of people infected with Lyme disease develop arthritis if they are not treated with antibiotics. Moreover, untreated Lyme disease can cause facial palsy, neuropathy, cognitive defects (i.e. impaired memory), and heart rhythm irregularities. If you have been bitten by a tick and start to experience symptoms, see your primary care physician.

Q: Is Lyme disease chronic?

Yes. Often called chronic Lyme disease, the correct term is Post-Treatment Lyme Disease Syndrome (PTLDS). What causes PTLDS is unknown, but research suggests that the residual damage to the body causes the chronic symptoms. Symptoms of PTLDS include fatigue, pain, and joint and muscle aches that can last for several months. The majority of people with PTLDS will be healthy after a few months.

Q: Is Lyme disease in North Dakota?

Yes. Since Lyme disease became a reportable disease in 1998, there have been 124 reported cases in North Dakota. The largest annual number of cases reported in North Dakota was 33 in 2010. The eastern border of North Dakota tends to see higher case numbers, which may be linked to the high case numbers of Lyme disease in Minnesota. In 2012 alone, Minnesota confirmed 912 Lyme disease cases. Having a neighboring state with high case numbers classifies North Dakota as a transitional area. Transitional area refers to the area between two geographic locations frequented by tick-hosting mammals (e.g., deer and rodents). Even though North Dakota does not report a high number of cases, Lyme disease is important for North Dakotans due to summer travel and the possibility of infected ticks crossing the border.

Q: Why is Lyme disease important?

Lyme disease is a major public health problem that has the ability to affect anyone, no matter their age. Because there is no developed immunity, people can be infected with Lyme disease as many times as they are exposed to the bacterium. Lyme disease affects a large portion of the population and varies in severity; community members throughout the upper Midwest and Northeast states should take precautions to prevent Lyme disease throughout the year, especially during summer months.

Q: What are the best ways to prevent Lyme disease?

The best ways to prevent Lyme disease include: avoiding tick-infested areas, using insect repellent containing 20 percent concentration of DEET (oil that is a common active ingredient in insect repellents), performing daily full-body checks, bathing and showering soon after being outdoors, wearing long-sleeved clothing when in an area where ticks may be present, and preventing ticks on animals you come in close contact with on a daily basis.

Due to the small size of ticks, spotting one can be very difficult. Once you have located a tick on your body, the best way to remove a tick is by tweezers. To properly remove the tick, grasp it as close to the skin as possible and firmly pull away from the skin with steady even pressure. This will ensure the whole body of the tick will be removed. Once the tick is removed, clean the area thoroughly with soap, iodine scrub, or rubbing alcohol.

There are a variety of tick removal techniques that are not suggested. These include: using nail polish, petroleum jelly, and burning the tick while it is attached to your skin. These methods have been proven ineffective.