Researchers are studying the growing prevalence of Lyme disease, which has traditionally been a problem concentrated in the wooded region of the northeastern United States. Recent news and research, however, show that Lyme disease is becoming a regional problem in the Midwest and many other states, such as California, where vectors of disease have been found near beaches. Dr. James Marvel, an emergency physician at Stanford Health Center and an expert in desert medicine, is currently studying the factors contributing to the spread of Lyme disease in the United States. He says that when we look at data from the United States over the past few decades, Lyme disease has “blossomed” in a number of states and counties, especially in the northeastern United States.
“There is some suspicion that climate variables are contributing to this, especially in the context of global warming,” Marvel said, adding that the environment may be more conducive to ticks. However, ticks have a two-year life cycle, he says, making it difficult to track. “It’s not as simple as saying a hot day means there will be more ticks,” he explains.
Other factors, such as people expanding construction in a wooded environment filled with ticks, may also contribute to the increase in Lyme, Marvel says. Dr Andres Bran, an infectious disease specialist at the University of Missouri Health, says the pandemic may have brought more people outdoors and forced them to engage in activities that would expose them to tick bites, such as tourism.
“You see a change to go out to be socially distant,” Bran said.
If caught early enough, Lyme disease can be easily treated, but if not properly diagnosed and treated in time, it can lead to permanent disease. To better understand Lyme disease and how to stay safe outdoors, we spoke with Bran and Marvel about best practices, including how to protect yourself, what to do if you find a tick, and more.
Protection against ticks 101
Staying outdoors increases the risk of contact with all walks in nature, including ticks. But if you live in a wooded area or you are very out in nature, and especially if you live in a country where Lyme disease is present, it is important to protect yourself from tick bites.
“Ticks don’t fly or jump like fleas or anything,” Marvel said. “The only way to reach a person is through direct contact.” They do this by waiting on the edge of grass, tall reeds or something, he says, and then grab each other when something touches them.
Tick exposure can occur at any time, but ticks are most active in the spring and summer, or from April to September, according to the CDC. To check yourself for ticks at the end of the day spent outdoors, the CDC recommends paying close attention to these areas of your body: under your arms, ears, abdomen, between your legs, hair, waist and back of your knees. You should also inspect your pets and equipment, as ticks can enter your home by climbing on a pet, backpack or clothing, the CDC says.
To keep out of ticks, avoid areas with tall grass or a brush, stick to the center of the aisles, and wear clothing that covers your skin as much as possible. You can also treat your clothes with permethrin, an insecticide or use an insect repellent. Bran says apply the repellent every 4 to 6 hours and find one that has a 30 to 35% concentration of DEET. Sprays with a lower concentration of DEET work, he says, but not as well. Bran also recommends not using sunscreen / repellent mixtures because they are not as effective.
“You have to apply your sunscreen before the repellent and then use any product as a repellent,” he says.
What to do if you find a tick
Depending on the area, anywhere from less than 1% to more than 50% of ticks carry Lyme disease, according to Johns Hopkins Medicine. If you find a tick on your body, you need to remove it.
Marvel says the best way to remove a tick is to use tweezers and “catch the tick” as close to the base as possible, which is close to the tick’s head, and then firmly “pull out with a slight slip.”
“People can keep ticks if they want, just to help with identification to see if it’s a species that can transmit Lyme disease,” Marvel said. “But it’s not recommended that we do a routine bacterial tick test to guide treatment.”
Both Marvel and Bran say contact your doctor if you find a tick and live in an area where Lyme disease is present. Bran says that if a tick bite has occurred within 72 hours of finding it and treatment has begun, the infection can be prevented.
How long does it take for an infected tick to attach in order to transmit Lyme disease? Given that many people may not know they have been bitten until they develop symptoms, this may make no sense. But with careful checking of the tick, the time may be on your side. Bran says the “magic number” of the time it takes ticks to attach to cause an infection is 36 to 48 hours.
“Anything that is less than 36 hours is considered low risk,” says Bran. “It’s not impossible, but it’s very unlikely.”
Symptoms of Lyme disease
When infected with a lime-carrying tick, people have flu-like and nonspecific symptoms, including headaches, muscle aches, fatigue, fever, swollen lymph nodes and muscle aches, Bran said. Many patients – up to 80% for CDC – will develop a rash about three to 30 days after being bitten by an infected tick. It is most commonly known that Erythema migrans rash associated with Lyme disease resembles a “bull’s eye”, with a red infected circle that clears as it spreads, but the rash can take many forms, according to CDC guidelines. for Lyme disease rashes.
“The important thing to keep in mind is not all patients with the characteristic rash,” says Bran. However, if you have a rash, it is considered a “home” diagnosis, he says, and a dose of the antibiotic doxycycline is used to treat the disease. “If you have a rash, you don’t need expensive testing,” Bran added. “You need doxycycline.”
Tests may be needed to determine if someone has lime or not, including a blood test that detects antibodies to Lyme disease. The problem with this, says Marvel, is that the antibodies can take some time to show up in a blood test – which can also contribute to under-reported cases of Lyme disease.
“This can be complicated in acute cases because it relies on antibodies in the blood,” says Marvel. “And in the acute situation of this infection, in the first days to weeks, you still haven’t generated antibodies.”
“Lyme disease is generally a complex diagnosis,” Marvel added. The CDC reports nearly 35,000 cases of confirmed Lyme disease in 2019. Research shows that the actual number of cases of Lyme disease in the United States is probably 10 times higher, according to Marvel.
“I think it gets more complicated the further you get out of the initial tick bite or potential exposure,” Marvel says.
If not diagnosed, Lyme disease has consequences. “Presenting acute Lyme disease is a flu-like symptom, but if left untreated, it can progress and some of the complications could be Lyme encephalitis, where it can actually affect the brain,” Marvel said. Inflammation of the joints and heart and facial paralysis are other symptoms of a longer and more serious acute infection, he said.
Long-term Lyme disease
According to the CDC, most cases of Lyme disease can be cured within two to four weeks with antibiotics. However, some people may develop what the CDC calls “Lyme disease syndrome after treatment” and experience pain, fatigue, or difficulty thinking that lasts for more than six months. The CDC says some experts believe that the bacteria that cause Lyme disease can trigger an autoimmune response, leading to symptoms that “continue well after the infection itself disappears.”
Chronic Lyme disease may be synonymous with PTLDS in terms of symptoms, but according to the National Institute of Allergy and Infectious Diseases, the “lack of a clear clinical definition” of CLD has led many experts in the field to avoid using the name altogether. But this does not mean that the experience of people living with symptoms after Lyme disease is not realistic – in a 2013 study, 36% of patients diagnosed with early lime developed symptoms of PTLDS.
The information contained in this article is for educational and informational purposes only and is not intended for health or medical advice. Always consult a doctor or other qualified health care provider about any questions you may have about your medical condition or health goals.