In the Spotlight
Lyme Disease: An Outdoor Threat
Lyme disease is one of the fastest growing infectious diseases in the United States. It is a bacterial (Borrelia burgdorferi) infection that is spread to humans by the bite of certain types of infected ticks. Most infections occur in the late spring and summer when ticks are most active and human activity outdoors is the greatest. Where you live or go on vacation can put you at risk for contact with infected ticks. The Northeast, North Central and Northwest areas of the United States have heavily wooded areas where ticks are most prevalent and exposure to infected ticks is more likely. However, there are also infected ticks in the Southeast.
The majority of Lyme disease infections occur from the bite of the immature (nymph) black-legged (deer) tick. Before they begin to feed, nymphs are the size of a poppy seed with a translucent (semi-transparent) body and a darker head. After they feed, the body swells and appears darker and round, about the size of a mustard seed.
Adult black-legged ticks are about the size of a sesame seed before they feed; females have a black head and dark red belly. After they feed, they expand to look like a gray sunflower seed kernel.
Black-legged ticks are active all year round, whenever the temperature is above 35 degree F. The peak activity for nymphs is May-June, while adults are most active during October-November.
What are the symptoms?
Lyme disease can affect different areas of your body at different times and spread to the joints, the heart, and the nervous system. Symptoms may be multiple, and include fever, chills, headache, muscle pain, fatigue, and an initial skin rash that can look like a bull's-eye.
The time from the bite to the beginning of symptoms is usually 1-2 weeks, but also can be a few days, or even months to years. In the beginning there may not be any noticeable symptoms after being infected. Or you may not be aware of a tick bite yet you are having symptoms. You may notice only one or two symptoms or even mistake the symptoms for another disease. Therefore, it is important that you talk with your healthcare provider when you have been bitten by a tick or you have some symptoms of Lyme disease.
How is Lyme disease diagnosed?
In the early stages, diagnosis is based on symptoms, physical findings and risk to exposure. In the later stages, a blood test is helpful to confirm infection.
How is it treated?
Most cases of Lyme disease are successfully treated with antibiotics. However, a few individuals can continue to have symptoms that last for months or years. The treatment for chronic Lyme disease is controversial. Untreated Lyme disease can lead to serious health problems and affect the heart, nervous system, and/or joints.
How can you reduce your risk for Lyme disease?
Prevention is the key. Following some simple precautions can decrease your risk of contracting Lyme disease.
- As ticks attach easily to bare skin, when you will be in a grassy or wooded area wear clothing that covers your entire body. Tuck pants legs into your socks. Ticks can be seen more easily on light colors.
- Use insect repellent as directed on manufacturer's label.
- Check for ticks - Check all over your body, including your groin, head, and underarms. Check your children after they play outdoors as well.
- Be sure to check for ticks on any gear/equipment you wore or used outdoors.
- Remove ticks promptly - Risk of infection increases between 24-72 hours after a tick attaches itself to the skin.
- When your pets come indoors from outside, use a fine comb and check them for ticks in an area where you can see and then dispose of the ticks.
- When you live in an area where Lyme disease is prevalent, take preventive measures around your home. Clean up the leaves, brush, tall grasses, woodpiles, and fences around your yard or garden to help decrease the ticks and the rodent population that ticks feed on.
- Supplies: gloves when available; fine-pointed tweezers; soap and water; and antiseptic, for example, alcohols used as disinfectant, hydrogen peroxide, or other commercial products
- Use tweezers to grasp the tick close to its mouth that is embedded in your skin.
- Slowly pull the tick until it is released from your skin.
- Avoid pushing or squeezing the tick's abdomen, which can push bacteria into your body.
- If part of the tick stays under your skin, do not attempt to remove it; the remaining part will be expelled by the skin naturally in a few weeks or have your doctor remove it.
- Wash your hands and the area where the tick was attached with soap and water.
- Do not apply petroleum jelly, nail polish, or rubbing alcohol on the tick as this may increase your risk of infection (the tick may panic and regurgitate).
- Do not burn or crush the tick as these actions may spread infectious bacteria. Place the tick into a sealed container or small plastic bag and deposit into the trash.
- Apply topical antiseptic to the area where the tick was attached.
- Watch for signs of infection (i.e., flu-like symptoms, red rash, etc.).
- Generally, ticks feed for a minimum of 36 to 48 hours before they can pass on bacteria that cause Lyme disease. After a tick is removed, watch for signs and symptoms of tick-borne diseases for up to 30 days.
- Click here for a video presentation on removing ticks.
To download information: Lyme Disease - The Facts, the Challenge (National Institute of Allergy and Infectious Diseases, National Institute of Arthritis and Musculoskeletal and Skin Diseases) - PDF file
Click here for a tutorial on Lyme disease.
Updated/Reviewed: July 6, 2007