Lyme Disease Prevention

There are many diseases carried by different ticks.  Of greatest concern to those of us living and traveling in New England are the illnesses spread by blacklegged ticks (a.k.a. Deer Ticks) – especially Lyme disease. 

Lyme disease is the most commonly reported vector-borne disease in the United States.  According to the Centers for Disease Control and Prevention (CDC), there are over 300,000 new cases of Lyme disease each year in the United States, and the number of cases is on the rise. Lyme disease cases are concentrated in the Northeast and upper Midwest, with 14 states accounting for over 96% of cases reported to CDC.

Lyme disease is caused by the bacterium Borrelia burgdorferi which is transmitted to humans and animals through the bite of infected blacklegged ticks.  While the most common months for tick exposure are early spring through the fall, ticks can infect year round. 

Ticks require human or animal blood to complete their life cycle. In the process of feeding, ticks may transmit illness. There are nine tick species responsible for infecting humans with a dozen different pathogens in the United States.  Symptoms vary from mild to life threatening.  In some instances, one tick bite can result in multiple infections. Learning about ticks in the areas where you live and travel makes good health sense.  

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Lyme symptomsTypical symptoms of early Lyme disease include fever, headache, fatigue, and a characteristic skin rash called erythema migrans (EM). If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks.

Symptoms generally appear 2 – 30 days after the bite of an infected tick.

Early Signs and Symptoms (3 – 30 days after tick bite)

  • Fever, chills, headache, fatigue, muscle and joint aches, swollen lymph nodes
  • Erythema migrans (EM) rash:
    • Occurs in approximately 70% - 80% of infected persons
    • Begins at the site of a tick bite after a delay of 3 – 30 days (average about 7 days)
    • Expands gradually over a period of days reaching up to 12 inches (30 cm) or more 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

Later Signs and Symptoms (days – months after tick bite)

  • 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 1 or both sides of the face)
  • Intermittent pain in tendons, muscles, joints, and bones
  • Heart palpitations or an irregular heart beat
  • 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

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Laboratory testing is helpful when used to support clinical symptoms and timed correctly.  Antibodies against Lyme disease bacteria usually take a few weeks to develop, so tests performed before this time may be negative even if the person is infected. Most early cases of Lyme disease can be treated successfully with a few weeks of antibiotics. However, if you continue to feel sick, you should visit your healthcare provider. Click here to learn more.

  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. Connecticut residents should bring engorged, blacklegged ticks removed from family members to their local Health Department for free testing. Some towns charge a minimal processing fee. Results will be emailed to you.  Ticks are tested for Lyme disease, anaplasmosis and babesiosis. Package in a zip- lock bag or plastic vial for delivery. If a tick is infected, it DOES NOT mean that the person it was attached to has contracted disease. It DOES mean that you should watch for early symptoms and discuss the options with your healthcare provider. University and private labs do offer additional types of tick testing for a fee.
  5. Dispose of a live tick not being submitted for testing by submersing 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.

One of the easiest ways to remember the most effective tick-borne disease prevention tips is to think of the acronym B.L.A.S.T

B - BATHING soon after spending time outdoors. A recent study showed that people who bathed or showered within 2 hours of coming indoors did not contract Lyme disease as frequently as those who did not bathe or shower. Unattached ticks will rinse off. Removing clothing items that may have ticks still on them is also key. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors.

L – LOOK AT YOUR BODY FOR TICKS DAILY and remove them properly. Speedy removal helps avoid disease transmission. Remove ticks carefully by their mouth parts with a tweezer and save them in a plastic bag for identification. Contact your local health department for tick-testing policies and notify your physician if you have any concerns. “L” also reminds use to look for expanding rashes and report them to your physician in a timely manner. The painless erythema migrans (EM) rash sometimes seen with Lyme disease can often go unnoticed and will eventually disappear while the infection remains. Other early symptoms include fatigue, headache, fever and achy muscles and joints.

A  - APPLY TICK REPELLENT and  become educated about repellants so you can use them appropriately.  The CDC recommends using a repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin for protection that lasts several hours. Application of 0.5% permethrin-based insecticide to clothing is highly effective at repelling and even killing ticks. Clothing treated with permethrin can be washed several times and still retains its repellant properties. The use of repellants, while proven effective, is a personal decision. The Environmental Protection Agency (EPA) has an online tool to help you select the repellant that is right for you and your family

– SPRAY YOUR YARD to reduce tick abundance. Homeowners should consider the benefits of applying pesticide to tick habitat areas including dense groundcover, leaf litter, stone walls and the perimeter of the yard. Studies have shown that even one application of pesticide at the right time of year and in the best location can reduce blacklegged tick populations by 85 to 90%. Complete information on  landscape management for tick reduction can be found in the Connecticut Agricultural Experiment Station’s Tick Management Handbook.

T – TREAT YOUR PETS. Owning dogs and indoor-outdoor cats increases one’s chances of exposure to tick-borne diseases. Veterinarians offer a variety of methods for protecting animals from tick bites – i.e. vaccines, topical treatments, collars. The CDC recommends daily pet tick checks, avoiding sleeping with pets and using approved repellent products to protect pets and their owners. 

Helpful resources for the prevention of Lyme disease can be found at the BLAST Lyme & Tick-Borne Disease Prevention Program