It's that time of year again, and spring is here! The days are longer, the weather is warmer, and we can all spend more time enjoying the outdoors.
Outdoor recreation, sports and exercise are highly encouraged by your local public health professionals. Hiking, camping, playing sports, gardening and even yard work can be good for your heart, health and soul.
But please be aware that if you participate in outdoor activities — even mowing your lawn — you should know about ticks, Lyme disease and how to prevent it. Here are some of the questions you may have and the answers you need to know.
What are ticks? Ticks are small bugs that feed on the blood of mammals, birds and reptiles, and may spread different disease-causing germs if they bite you.
There are two different kinds of common ticks found in Massachusetts that can spread disease — deer ticks and dog ticks. Both types of ticks bite people and carry different diseases.
Ticks are active year-round if it is above freezing, but they are most active from April through October. Lyme disease is the most common tick-borne disease in the United States, and derived its name after an unusual outbreak of arthritis near Lyme, Conn., in 1975.
What is Lyme disease and how is it spread? Lyme disease is caused by bacteria carried by an infected deer tick. An infected deer tick can transmit the bacteria to a person or animal that it bites and cause Lyme disease.
What are the symptoms of Lyme disease? There are early stage symptoms and late stage symptoms of Lyme disease. The most common early stage symptom of Lyme disease is a rash where the tick was attached. It often, but not always, starts as a small red area that spreads outward, clearing up in the center so it looks like a donut or "bull's-eye."
Early symptoms typically occur within a few days to a few weeks. Other symptoms that may occur in the early stages are flu-like symptoms, such as fever, headache, stiff neck, sore and aching muscles and joints, fatigue and swollen glands. Even if these symptoms go away without medical treatment, some people will get the rash again in other places on their bodies, and many will experience more serious problems. Treatment in the early stage can prevent later, more serious problems.
Later stages of Lyme disease can begin from a few weeks to years after exposure, if left untreated. People with untreated Lyme disease will most commonly develop problems with their joints, nervous system and heart. More than half of the people with untreated Lyme disease develop arthritis in their knees, elbows and/or wrists. People can also develop nervous system problems, including meningitis (an inflammation of the membranes around the brain and spinal cord), facial weakness (Bell's palsy) or other issues with the nerves of the head. People can also develop pain or weakness in the hands, arms, legs and feet, often shifting between mild and severe. Heart problems, including slowing of the heart rate and fainting, can also occur.
Is there treatment for Lyme disease? Yes, Lyme disease is treatable and preventable. People diagnosed with Lyme disease can be treated with antibiotics. A bacterium transmitted from the deer tick is the cause, and antibiotics are the cure. Prompt treatment during the early stage of the disease can prevent more serious problems later.
How can I protect my family, my pets and myself? Lyme disease is preventable and can only be contracted from an infected deer tick, so prevention begins with you!
If you spend any time in your yard, garden, near the woods, brushy areas, grassy areas, etc., the single most important thing you can do is check yourself for ticks when you come inside or when you get back to your car after hiking, etc.
Ticks' favorite places to bite are warm and moist. A tick can attach to any part of the human body but are often found in hard-to-see areas. Always check between your toes, the back of the knees, groin, armpits, behind the ears, scalp and along your hairline. Don't forget, they can be found crawling anywhere in between while they are looking for a place to bite. Ticks can be pretty small, so you may want to ask for help checking the back of your neck and hairline for ticks. You can rarely feel a tick bite or crawl on you, so these checks are extremely important.
Wear light-colored clothing! Ticks are dark and easier to see on light clothes. Wear socks, long pants and long sleeves if at all possible. This may be difficult when it's hot, but it will keep ticks away from your skin and make it easier to spot them.
This next tip won't win any fashion awards but it really helps — tuck your pants into your socks and your shirt into your pants. Ticks come from low lying vegetation, grasses and brush and won't be able to get under your clothes at all!
Use bug repellents that contain DEET. It's recommended to spray insect repellent containing 20 to 30 percent DEET on clothes and skin. There are more than 200 repellents containing DEET with concentrations that range from 5 to 100 percent DEET. Please read the product label and follow the instructions. Do not use DEET on infants under 2 months of age. On children older than 2 months, you should use concentrations between 10 and 30 percent. Repellents with permethrin also work, and should be used on clothing only. Permethrin kills ticks on contact and is very effective when applied to shoes, socks and pants. Please read all labels and only use as directed.
Talk to your veterinarian about the best way to protect your pets from ticks. There are numerous products available, such as tick collars, repellents, etc. for your pets' protection. Do tick checks on your pets, too. Pets can carry ticks into your house.
What should I do if I find a tick on myself? The first thing is, don't panic! The tick should be removed carefully and as soon as possible. Use a pair of fine-point tweezers to grip the tick as close to the skin as possible. The tick should not be squeezed or twisted, but pulled straight outward with steady, gentle pressure. You should NOT apply petroleum jelly, nail polish, kerosene or a hot match tip, etc. These measures are not effective. Circle the calendar date and note where on the body the tick was removed. You may want to save the tick for identification and your physician may want to treat you following a deer tick bite. Notify your physician if a deer tick has bitten you or if you develop a rash or other signs of illness following the tick bite.
How long does a deer tick need to be attached to transmit Lyme disease? In general, the longer an infected tick remains attached to a person or animal, the higher the likelihood of disease transmission. The Centers for Disease Control and Prevention (CDC) state that the tick must be attached for 36 hours before the Lyme disease bacterium can be transmitted, which is why it is so important to do daily tick checks if you are outdoors and possibly around ticks.
What if I am pregnant and find a tick attached? Prevention and early diagnosis of Lyme disease are important during pregnancy. Lyme disease acquired during pregnancy can lead to infection of the placenta and pregnancy complications if not detected and treated. According to the CDC, studies have shown that women infected during pregnancy have no negative effects on the fetus if the mother receives appropriate antibiotic treatment for her Lyme disease in the early stage.
How can I reduce the number of ticks around my home? There are a few things you can do around your house to keep ticks away. Keep your grass cut short, remove leaf litter and brush from around your home. Ticks like moist, cool and shaded areas. They don't like sunlight, so you can prune low-lying bushes to let in more sun. You can also use a 3-foot wide wood chip, mulch or gravel barrier where your lawn meets the woods. Ticks are less likely to cross this type of barrier onto your lawn because they are prone to drying out and will die quickly in drier environments. It also serves as a reminder that people who cross that barrier into the wooded area may be at a higher risk of getting ticks.
Can ticks transmit other diseases? Yes, deer ticks and dog or wood ticks do carry other disease-causing bacteria, but Lyme disease accounts for 95 percent of all tick-borne diseases transmitted to people. Other, more rare diseases such as Rocky Mountain spotted fever, babesiosis, anaplasmosis, and tularemia are carried and spread by the two different species of ticks.
I hope the information in this article helps you protect your family, your pets and yourself from Lyme disease and ticks. Get outside, be active, enjoy the nice weather, and remember to be safe, and always watch out for ticks!
For more information and a Tick Identification Card, you can go to your local Public Health Department's web page, the state Department of Public Health website (www.mass.gov/dph), the CDC website (www.cdc.gov), or you can call your local Health Department.
• • •
Brian J. LaGrasse is the director of public health for the city of Methuen.
