SAFETY IN THE FIELD: Preventing Lyme Disease
The ARS Sojourner
Lyme disease was first identified almost twenty years ago. It is caused by a spirochete (bacteria-like microorganism) that is spread by deer ticks.
The number of reported cases has been increasing annually. Lyme disease is diagnosed by physical signs, and by blood or spinal fluid tests.
It can be successfully treated with antibiotics, but is often quite difficult to diagnose.
Very recently several companies have announced vaccines that offer some protection.
Ninety percent of reported Lyme disease have come from 10 states: Connecticut, Rhode Island, New Jersey, New York, Pennsylvania, Delaware, Massachusetts, Wisconsin, Minnesota and Maryland.
There have been cases reported along the west coast, and a few from other regions.
It appears that the disease may be spreading into new areas.
Those at highest risk for illness are hikers and others who spend time in tick-infested areas where there are many deer.
Ticks should be removed as soon as they are found. Burning, application of gasoline etc., to remove ticks is rarely effective and may injure the hiker.
I prefer to gently grasp the tick with a small medical clamp and pull it off. Ticks do not bury their heads in the skin, but they do have small pincher-like mouth parts that can remain behind if the ticks are crushed or cut.
About half of those with early Lyme disease complain of fever, chills, muscle aches and other flu-like symptoms.
Often the first sign of Lyme disease is a red spot (erythema migrans) at the site of a tick bite. The spot appears one to four weeks after the bite occurs. It is usually larger than 2 inches in diameter. It can be round, oval, bull's eye or unusually shaped.
The red spot and other symptoms go away even if antibiotics are not given, but the infection can persist and invade other organs.
Secondary signs indicating a disseminated infection may not appear for weeks or even months. The sufferer may develop rashes away from the site of the bite, nerve palsies or meningitis, muscle pains and swollen joints.
Joints (especially the knee) may become briefly red and swollen repeatedly over a period of years. Heart muscle and connective tissue inflammation and even heart block (rhythm disturbance) can occur.
Unless treated, the infection can slowly spread and grow worse over months and years. The damage to organs can be severe. Arthritis and permanent heart and nerve damage (including confusion and memory loss) can be the result.
The new vaccine is expensive, and is currently recommended only for those at high risk. Three doses of vaccine are given over a one year period at carefully planned times relative to the tick season. Boosters will probably be needed every one or two years.
The vaccine hasn't been tested in those older than 70 or younger than 15 yet, so its use is not cleared for the elderly or the young at this time.
Whether or not vaccinated, those who hike should protect themselves against tick bites.
The following are good rules to avoid Lyme disease and other tick-borne illness:
1. When possible, avoid tick-infested areas.
2. Wear long pants and long-sleeved shirts.
3. Use insect repellent. (Warning! Young children can be poisoned when they absorb insect repellent through the skin.)
4. Examine yourself and remove attached ticks promptly.
5. Seek treatment early if you show signs of Lyme disease.
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Dr. Bob Armstrong, N7XJ, an avid QRPer and outdoorsman, is Health & Fitness editor of The ARS Sojourner. He lives in Manti, UT.