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5/29/2014 9:42:00 PM
Lyme disease symptoms, treatment and prevention
A black-legged (deer) tick.Centers for Disease Control photograph

A black-legged (deer) tick.

Centers for Disease Control photograph

Lyme disease information is provided by the Lyme Disease Association.


What is Lyme disease?

Lyme is a multi-systemic disease caused by the bacteria called Borrelia burgdorferi (Bb) which normally is a bacterial spirochete (spiral) shape.

It is usually transmitted by the bite of the black legged tick; also known as the deer tick (Ixodes Scapularis). Lyme disease may also be transmitted in utero; from a mother to her unborn baby.

Borrelia burgdorferi has been found in breast milk; however at this time it is inconclusive as to the transmission of illness. It has also been found in the blood supply; however at this time there are no recorded cases of direct transmission. Other tick-borne infections have been directly transmitted through the blood supply.


Signs and symptoms

Knowing the signs and symptoms of Lyme disease is the first crucial step to getting help.

Approximately 50 percent of patients who contract Lyme disease will remember having a rash. It is usually looks like a bull’s eye in shape. if you have the bull’s eye rash you have Lyme disease! But it’s important to know that less than 40 percent of the people who get Lyme disease get the rash. 

The rash may appear on other places on your body than the bite site. It may begin as a single circular red mark that spreads outwards. As it disseminates over the skin it becomes lighter in the area nearer to the center of the bite.  In people of color the rash may appear more like a bruise. The rash is usually not itchy. The rash can be mistaken for a spider bite.


Studies vary as to how long the tick must feed on you in order to transmit disease. Since Lyme disease is a multi-systemic illness there is a multitude of symptoms associated with the illness. Some include:

• Flu-like illness

• Headache

• Extreme fatigue

• EM rash, other rashes (less than 40 percent of patients)

• Malar flush, red ear lobes

• TMJ/jaw pain 

• Neck and back pain

• Joint pain and swelling, bone pain


Diagnosis and treatment

Lyme disease is a clinical diagnosis. That means that the physician will decide if you have Lyme disease by asking you questions and examining you. Not all tests for Lyme disease are accurate, but may be helpful. You may have the infection and yet your tests can be negative due to the lack of immune response to the bacteria. Your doctor will carefully go over your medical history and symptoms.

Early appropriate treatment will increase chances of eradicating the disease and may prevent you from developing chronic Lyme disease.

Peer reviewed and published scientific research supports that Lyme can become chronic. In some cases Lyme disease has resulted in death of the infected individual. A physician or qualified medical practitioner diagnoses and treats Lyme disease. 

Lyme disease is treated with antibiotics. Antibiotics may be given orally, inter-muscularly (IM) or by intravenous therapy (IV). Only a qualified medical practitioner can prescribe your course of treatment.

You can contract more than one tick-borne disease from the same tick bite. To see the full list, visit http://www.lymediseaseassociation.org/index.php/about-lyme/other-tick-borne-diseases.

The Lyme Disease Association, Inc. recommends the Diagnosis and Treatment Guidelines of the International Lyme and Associated Diseases Society (ILADS). ILADS is comprised of international respected leaders in Lyme disease and tick- borne scientific research. Visit http://www.ilads.org.

The LDA also works closely with the Lyme and Tick-Borne Diseases Research Center at the Columbia University Medical Center. Visit http://www.columbia-lyme.org.


How to remove a tick 

Improper removal of ticks greatly increases the risk of acquiring tick-borne infections. Squeezing the tick or putting substances on the tick to try to make it “back out” may aggravate it enough that it injects into you whatever disease organisms are inside it.

• Do not burn or use any substance on tick

• Do not grasp, squeeze, or twist body of tick

• Grasp tick close to the skin with tweezers

• Pull tick straight out

• Use antiseptic on skin

• Disinfect tweezers

• Wash hands thoroughly

• Always see a physician for possible diagnosis, testing, and treatment

• If desired, can save tick for testing, preferably alive, in a zippered plastic bag or a closed container with a moist cotton ball.


Property protection – tips to stop ticks

Ticks are most likely to be in woods, where woods meet lawn, where lawn meets fields, tall brush/grass, under leaves, under ground cover (low growing vegetation), near stone walls or wood piles, shady areas, around bird feeders, outside pet areas.

What you can do to lower your’s and your pet’s exposure to ticks on your property:

• Keep your lawn mowed (ticks hide in tall grass)

• Rake up leave and grass clippings (ticks hide under leaves/grass clippings)

• Keep ground cover trimmed away from walkways (ticks are close to pathways)

• Place stone walls/woodpiles as far as possible from house (rodents live there and carry ticks)

• Place a wood chip barrier between your property and wooded/field areas (ticks may not cross)

• Place swing sets and other play sets in the sunny areas, away from woods/fields (ticks hate sun)

• Keep bird feeders away from your house (rodents seek dropped bird food & carry ticks)

• Consider controls for small mammals e.g., mice (they carry ticks which get Lyme from them)

• Consider deer repellent or fencing in areas where deer populations are high (deer transport ticks)

• Keep outside pet areas cleared of leaf and other debris.(dogs can carry loose ticks inside)


Lyme disease: History and prevalence

By Craig Turk

of The Lakeland Times


As the prevalence of deer ticks has increased, so has the prevalence of Lyme disease and other tick-borne illness.

Not only that, but the likelihood that a given tick will be a carrier seems to have risen, too.

Phil Pellitteri, UW-Madison Department of Entomology, shared some of what he’s learned as his career as a researcher unfolded with the Lakeland Times earlier this spring.

That four-decade career has witnessed the rise of the black-legged tick (also known as the deer tick) in Wisconsin, so Pellitteri takes a special interest in the subject.

“Lyme disease and the whole unfolding of that basically happened during my career and it’s just been absolutely fascinating,” Pellitteri said. “And then you throw the complications in. You know, there’s at least four to five other, and probably more than that, diseases this deer tick is transmitting.”


Prevalence of Lyme disease

The prevalence of ticks that carry Lyme disease has been on the rise.

“Ten, 15 years ago, if you sampled adult deer ticks in this state, we were running about 18 percent of them that were carrying Lyme disease,” Pellitteri recalled. “Now it’s over 40 percent statewide and we’ve got  ... a couple study spots that Susan Paskewitz in our department is working with that we were over 80 percent.”

He also noted anaplasmosis, ehrlichiosis, babesiosis and other related ailments, and said one Lyme-related organism found near Eau Claire isn’t even named yet. And people might not even really understand how prevalent tick-borne diseases are.

“The thing that got my attention the end of last summer is the CDC (Centers for Disease Control) came out and basically made the statement that they believe that we’re only reporting 10 percent of the true Lyme cases, because the way the recording goes, the paperwork you have to fill out and whatnot.”

That means 3,000-3,500 reported cases in a given year could mean up to 35,000 total in the state.

Under new guidelines, the CDC recommends people in a state in which more than 20 percent of deer ticks are infected with Lyme who find a deer tick on their person that was there for 36-48 hours get antibiotic treatment as a preventative.


Decades of change

Things have changed over the years, especially in southern part of the state, Pellitteri said.

“One of my favorite things to tell people, to try to give them some concept of what I’ve seen in my 40 years of chasing bugs, is that the governor moved us to Missouri and didn’t tell us. I’ve seen a lot of things kind of move up from the south and establish in the state.”

That also incudes the lone star tick, so named for the white spot on the female’s back, which has caught researchers’ attention recently. Pellitteri said it’s a tick normally found in central Illinois and southward.

“In a given year I’d see a couple samples come in the lab, and we’d often write that off. You know, if one was on a bird and the bird flew up here, well, yeah, the tick could fall off and so you could find them. But we really didn’t have a lot of evidence of them breeding. Well, there definitely is evidence in the last couple of years that they are breeding in the southern part of the state.”

Research shows that certain people who are bit by this tick develop an allergy to red meat. The allergy is due to a reaction to the saliva of the lone star tick.

The deer tick, then a southern tick, was first documented in Wisconsin in 1969 by a UW student working on the parasites of mice. He found the tick near Spooner. Since that time deer ticks have spread south and east.

Deer densities seem to be a “critical factor,” Pellitteri said. 

“If you go back far enough, the deer densities might have been low enough not to support the ticks,” he explained. “But in the last 30 to 50 to 60 years, of course, deer densities have gone bonkers compared to what they were historically. And that seems to be a relatively key factor that allows them to kick in.”

Once in, they’re not easy to get out.

“They have done experiments on isolated islands out in New England, where they have removed the deer. Now, you can remove them and have an effect on the tick population, but we’re talking almost total elimination, something like two deer per square mile, which are densities that are really not attainable and would not sit well with the hunting public and people in general, I think.”



Pellitteri pointed out that the diseases spread by deer ticks are rodent diseases.

“Ticks in their youngest life stage prefer to feed on rodents. That’s when thy acquire the disease and then they’re infected for life,” he said.

Disease is twice as prevalent in adult ticks, because they have fed twice, yet most people probably contract disease from the nymphal stage of the tick’s life, when it has fed just once, because the nymphs are most active during the summer, and adults ticks are more active in the spring and then again in October up until snow arrives.

Adults are also more-readily seen and are more likely to be removed before they’ve had time to transmit the disease.

Lyme disease was discovered by Willy Burgdorfer, and Pellitteri recalled Burgdorfer predicting that a number more diseases would be found.

“And it seems as if every three or four years, somebody is coming up with another organism these ticks are transmitting,” he said.

“Really, what the story is here, is the tick is a bridge,” he added. “It acquires these diseases and then feeds on a susceptible animal, and in our case it’s people and dogs that get hit the worst, you’ve got the problem.”

Adding to the issue, the diseases are often difficult to diagnose.

“It’s hard to sort through,” Pellitteri said.

Physicians have become more knowledgeable about Lyme disease over the past few decades, which has helped in its treatment, but the disease doesn’t appear to be going anywhere.

“In the past 10 years, I don’t think we’ve ever seen a decline. It’s always been ... a ramping-up if you look at the Division of Health statistics.”

He noted that there are many ecological interactions in play.

“There’s even studies out showing that when coyotes move into an area, the amount of Lyme disease goes up. And the relationship there is coyotes move in, fox move out. When fox move out, the rodent population goes up – and then once you understand that it makes sense.”

Craig Turk may be reached at cturk@lakelandtimes.com.

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