By Dr. Samuel Ascioti

For those who love spending time outdoors in the northeast United States, the worry of being bitten by a tick can be constant. Campers, hikers, hunters, workers, weekend warriors, children, dogs and cats – all are susceptible to tick bites. The bites of certain ticks can transmit Lyme disease, that, if left untreated, can cause serious health complications later in life. Because of the prevalence of disease carrying ticks in the northeast United States, this month’s article is about the basics of Lyme disease.

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What is Lyme disease?

As summer starts to creep to a close, many will want to take advantage of what warm weather is left. However, care should be taken to prevent tick bites, as a tick can transmit Lyme disease.

Lyme disease is the most commonly reported vectorborn illness in the United States. A vector is a living organism that can transmit infectious diseases between humans, or from animals to humans – examples include mosquitoes, sandflies, fleas, and in the case of Lyme disease, ticks (8).

Lyme disease is an illness caused by the transmission of the bacterium B orrelia burgdorferi to humans (6). This bacteria is passed to humans through the bite of blacklegged ticks that have been infected with the same bacteria themselves (6). Lyme disease affects about 30,000 Americans every year (2).

What happens during a tick bite?

Ticks do not jump or fly to reach their hosts. Rather, they grasp onto passing animals/humans and scurry around until they find a suitable feeding spot (7). The tick then uses special body parts to cut into their host’s skin, and then insert a feeding tube into the opening created – now the tick can start feeding (7). During feeding, the tick can secrete specialized saliva that acts as an anesthetic to prevent the host from noticing the bite (7). Ticks are relatively small in size and tend to hide in areas that render them harder to detect, such as the scalp, armpit, or groin. These factors can certainly allow ticks to stay unnoticed for long periods of time.

Blacklegged ticks will suck the blood slowly from their host over the course of several days (7). Removing a tick within 24 hours of attachment will greatly reduce the risk of contracting Lyme, as it takes quite a bit of time for the B orrelia burgdorferi to be transferred from the tick to the unsuspecting host.

What are the signs and symptoms of Lyme disease?

One of the most well-known signs is the “bullseye rash” (also known as erythema migrans) around the site of the tick bite. However, signs and symptoms of Lyme disease may vary from person to person. Any person who has found a tick on their person should monitor themselves for the following signs and symptoms (4):

3 to 30 Days After Tick Bite – Early Signs and Symptoms:

• Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes
• Erythema migrans (EM) rash:
  • Occurs in approximately 70 to 80 percent of infected persons
  • Begins at the site of a tick bite after a delay of 3 to 30 days (average is about 7
    days)
  • Expands gradually over a period of days reaching up to 12 inches or more (30
    cm) across
  • May feel warm to the touch but is rarely itchy or painful
  • Sometimes clears as it enlarges, resulting in a target or “bull’s-eye” appearance
  • May appear on any area of the body

An example of the “bull’s-eye” rash, also called erythema migrans

Days to Months After Tick Bite – Later Signs and Symptoms:

• Severe headaches and neck stiffness
• Additional EM rashes on other areas of the body
• Arthritis with severe joint pain and swelling, particularly the knees and other large
  joints.
• Facial palsy (loss of muscle tone or droop on one or both sides of the face)
• Intermittent pain in tendons, muscles, joints, and bones
• Heart palpitations or an irregular heart beat (Lyme carditis)
• Episodes of dizziness or shortness of breath
• Inflammation of the brain and spinal cord
• Nerve pain
• Shooting pains, numbness, or tingling in the hands or feet
• Problems with short-term memory

How do I remove a tick?

1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
2. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
4. Dispose of a live tick by submerging it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers (3).

How is Lyme disease diagnosed and treated?

Lyme disease is diagnosed by a trained medical provider, who examines the patient for certain signs and symptoms (listed above). If Lyme is suspected, a two-step blood-sample process is employed. The first test is called enzyme immunoassay (“EIA”); if the EIA is positive, then a second test is performed, commonly called a “Western blot” test (or immunoblot test). A positive Lyme disease diagnosis requires both a positive EIA and a positive Western blot (1).

If caught early, the administration of antibiotics is usually successful, and those patients usually recover quickly and fully (5). Common treatments include oral doxycycline, amoxicillin, or cefuroxime axetil (5).

Tick Bite Prevention

Always check your body before and after spending any time outdoors, especially if you’re galavanting about in heavily wooded areas or in thick brush. Pay close attention to hard-to-see spots, such as the groin, armpits, and scalp. Long socks, pants, and long sleeve shirts go a long way in preventing the ticks from getting to your skin, but in the summertime this may be difficult. Some commercial insect-repellents may prevent tick bites.

If you’ve been bitten by a tick, or suspect that you have Lyme disease, contact your health care providers immediately. Ticks usually need a bit of time to transmit the disease, so the sooner ticks are detected and removed, the less risk of disease transmission.

References For This Article:

Two-step Laboratory Testing Process. (2015, March 26). Retrieved July 31, 2017, from
https://www.cdc.gov/lyme/diagnosistesting/labtest/twostep/index.html

Lyme Disease. (2015, September 30). Retrieved July 31, 2017, from
https://www.cdc.gov/lyme/stats/humancases.html

Lyme Disease. (2015, November 05). Retrieved July 31, 2017, from
https://www.cdc.gov/lyme/removal/index.html

Lyme Disease. (2016, October 26). Retrieved July 31, 2017, from
https://www.cdc.gov/lyme/signs_symptoms/index.html

Lyme Disease. (2016, December 07). Retrieved July 31, 2017, from
https://www.cdc.gov/lyme/treatment/index.html

Lyme Disease. (2017, May 23). Retrieved July 31, 2017, from
https://www.cdc.gov/lyme/index.html

Transmission. (2015, March 04). Retrieved July 31, 2017, from
https://www.cdc.gov/lyme/transmission/index.html

Vector-borne diseases. (2016, February). Retrieved July

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