Lyme Disease Prevention - 101
Learn how to prevent this worrisome disease

Learn how to prevent this worrisome disease
With Summer approaching, it is a good time to review prevention strategies for tick-borne diseases. In Massachusetts, Lyme disease is the most common and best known tick-borne disease. Fortunately, tick-borne disease can be prevented or detected and treated, if parents are aware of some basics facts.
How does one get Lyme disease?
Lyme disease is caused by a corkscrew-shaped bacteria called a spirochete. When an infected deer tick bites a human, the spirochete is transmitted into the human bloodstream. Deer ticks are found near wooded areas, tall grass and brush. Ticks crawl very slowly and can latch on to a person or pet who brushes against them. They are carried by deer, birds, fields mice, chipmunks, and other small mammals. It is the nymphal tick, which is about the size of a poppv seed, that is the cause of most Lyme disease in humans. The problem is that because it is so small, it frequently goes undetected on the body. Adult ticks can also spread the disease, but since they are larger, about the size of an apple seed, they are easier to detect and are often removed before the spirochete is transmitted. The tick must remain attached to the skin for at least 24 hours in order to transmit the disease. It should be noted not all deer tick carry Lyme disease. Larger ticks like wood ticks do not carry Lyme disease.
The nymph stage of the deer tick is from May to July, so this is the greatest risk period for humans. Adult ticks which can also transmit disease are active from fall through spring. Areas where the deer tick is endemic include Cape Cod, Martha's Vineyard and Nantucket.
What are the symptoms of Lyme disease?
The first symptoms of Lyme disease are a distinctive rash and flu-like illness, including a headache, stiff muscles, and sometimes a low-grade fever. About 60 per cent (some sources say as high as 80 to 90 percent) of people with Lyme disease develop a"bull's eye rash at the site of the bite a few days after being infected. This telltale rash usually begins with a red dot on the skin, encircled by increasingly faint rings. The bull's eye rash starts out measuring two and a half inches in diameter, but can increase to a size of six to eight inches across. The Lyme disease rash does not itch or hurt. A second rash can appear on other parts of the body 3 to 5 weeks after the tick bite. This rash is also a red annular rash but is usually smaller than the first bull's
eye rash. If the disease is not treated during the early phase, later symptoms include joint pain, arthritis and neurological manifestations.
Prevention
Whenever possible, avoid tick infested areas. When your child plays in wooded or marshy areas dress him in long-sleeved shirt with long pants tucked into high socks, and a hat. In hot weather children can be dressed more lightly, but make sure he wears high socks. Light-colored clothing is best so that ticks can be more easily spotted. Permethrin can also be sprayed onto clothes. This is effective in decreasing tick attachment. If insect repellent is used it should contain at least 30 percent DEET. This should not be applied directly to your child's skin but sprayed on your child's clothing. Even products with lower concentrations of DEET should never be applied to a child's hand or face or to broken skin. These preparations should be washed off when he comes in for the day. A shower may even help wash off unattached ticks. This is also a good time to inspect your child's body and clothing for tick exposure. Special attention should be given to the exposed hairy region such as the head and neck. Other areas where ticks may be difficult to notice are behind the ears and knees, under the arms and in the groin area.
If an attached tick is spotted, it should be removed promptly. Embedded ticks should be removed using fine-tipped tweezers applied close to the skin. The tick should be gently pulled straight out without a twisting motion, take care not to squeeze the body of the tick. If fingers are used to remove ticks, they need to be protected with plastic gloves or facial tissue and washed after removal of the tick. The tick should be flushed down the toilet or saved in a closed container for later identification . Do not become alarmed if the tick's mouth parts remain in the skin, the bacteria that causes Lvme disease is in the tick's midgut or salivary glands. After removing the tick cleanse the area with an antiseptic.
Additional precautions
Ticks that hitch rides on your pets, but fall off before biting them present an additional risk. In fact, dogs are six times more likely to get Lyme disease than their owners. Cats also play host to ticks, but are infected less often, perhaps because they regularly groom themselves. Discuss tick-control products with your veterinarian. There is a vaccine currently available for dogs. This, of course, will not prevent them from bringing ticks into you home so, pets should be checked daily for ticks.
Infected ticks can be carried into your back-yard, especially if the yard adjoins a wooded area. Take the following precautions to help keep deer ticks and their hosts out of your yard:
*Keep your lawn trimmed and mowed and remove fallen leaves and brush. *Keep wood-piles off the ground, in a sunny area (or underneath a plastic cover), and as far from the house as possible.
*Discourage deer from entering your yard by removing plants that attract them.
Your local nursery can advise you regarding plants deer don't like.
* Birds and mice (both of which carry ticks) are attracted by bird feeders.
Position bird feeders away from the house and remove bird food that has fallen
to the ground. Better yet, take feeders down during the Spring and Summer
months when the danger of contracting Lyme disease is greatest. Vaccine for Lyme disease
A vaccine was licensed in 1998, but as of February 24, 2002 is no longer commercially available.

Early diagnosis and treatment
If Lyme disease is contracted, it can be easily treated in most patients when diagnosed in the early stages of the disease.

Article written by Nancy DelGiudice,RN-C,PNP