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Summer is here and in addition to all that we enjoy about this time of year, it is also the season when insects reappear. Some are nuisances (black flies!), some help control nuisances (dragon flies!) and still others carry disease which can profoundly impact our wellbeing. The common deer tick (ixodes scapularis) carries the bacterium (borrelia burgdorferi) which causes Lyme Disease in humans. Here is a link to images of the Lyme tick and some other common ticks (which do not transmit Lyme Disease): http://www.cdc.gov/ticks/life_cycle_and_hosts.html

There are some simple steps you can take to reduce your risk of contracting Lyme Disease.

  1. Know when you are at risk. These ticks reside in wooded areas, leaf piles and tall grass. When you are in these areas wear long pants, long sleeves, and socks. It’s even better if you tuck your pants into your socks.
  2. Reduce the risk in your own back yard. Create a barrier to the ticks by keeping your lawn mowed, remove leaf piles and build a border of gravel or mulch between your yard and woods or long grass.
  3. Use insect repellent. The chemical diethylytoulamide, or DEET, is an effective tick repellent and is found in many commercial insect repellents. It does not have to be 100% DEET, and can be sprayed on clothing and skin. Permethrin powder can also be applied to clothing to ward off ticks.
  4. Better check yourself. When you have been in an area where ticks may live, check yourself and your children carefully for ticks. Have someone else look at your scalp and back to make sure that you haven’t missed any. Bathing after spending time in tick prone areas can also help to reduce risk.       Ticks need to stay on your skin for at least 24 hours to transmit Lyme Disease so early detection and removal can be crucial. Most disease is transmitted when ticks have been on your skin for more than 48 hours.
  5. Properly remove any ticks that you find. This is best accomplished by using tweezers to grasp the tick as close to your skin surface as possible and gently but steadily pull straight up. If bits of the tick remain do not try to “dig them out”. Your immune system will extrude them with time. Once the tick is removed wash the bite area thoroughly with soap and water.
  6. If you have had a tick on you talk to your primary care provider. If the tick was on you for more than 36 hours you may choose to take antibiotics to prevent Lyme Disease, but you can also choose watchful waiting, and treatment if a rash or other symptoms appear. Both options are reasonable and relatively safe. The use of antibiotics to prevent disease does not have to be a long course (in fact , a single dose is recommended). If the classic “bulls eye” rash or other early symptoms appear, treatment may last for 10 days to 3 weeks. Here is a link to view the classic rash of Lyme Disease, called erythema migrans, but it does not occur in every case: http://en.wikipedia.org/wiki/Erythema_chronicum_migrans
  7. If it is possible save the tick in a zip lock bag for your primary care provider to see. It is uncommon now to have to send a tick for identification since most providers are adept at distinguishing between Lyme ticks and the common wood tick. However, it may be necessary in some instances.

There is a great deal of controversy about Lyme Disease and much of the discussion has led to unnecessary fear. The simple steps I’ve outlined are not controversial and can help us all enjoy a happy and safe summer.

Noah Nesin, MD

Dr. Nesin, Vice President of Medical Affairs for PCHC, is a family doctor with 30 years of experience.

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