Lyme Disease especially NY, NJ, PA MA, CT & RI

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bubba

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Just reminded of the Deer Tick situation, so thought I'd share this link about Lyme Disease.

The above states are most prone to contact... interesting that VT and NH and ME are not. Remember preventive measures while in the outdoors. Stay safe - we don't want to lose any members! :eek:

Here's a quick overview/reminder:

Lyme Disease (LD) manifests itself as a multisystem inflammatory disease that affects the skin in its early, localized stage, and spreads to the joints, nervous system and, to a lesser extent, other organ systems in its later, disseminated stages. If diagnosed and treated early with antibiotics, LD is almost always readily cured. Generally, LD in its later stages can also be treated effectively, but because the rate of disease progression and individual response to treatment varies from one patient to the next, some patients may have symptoms that linger for months or even years following treatment. In rare instances, LD causes permanent damage.

See site for symptoms and treatment info.

Prevention & Control

Larval and nymphal deer ticks often hide in shady, moist ground litter, but adults can often be found above the ground clinging to tall grass, brush, and shrubs. They also inhabit lawns and gardens, especially at the edges of woodlands and around old stone walls where deer and white-footed mice, the ticks' preferred hosts, thrive. Within the endemic range of B. burgdorferi (the spirochete that infects the deer tick and causes LD), no natural, vegetated area can be considered completely free of infected ticks.

Deer ticks cannot jump or fly, and do not drop from above onto a passing animal. Potential hosts (which include all wild birds and mammals, domestic animals, and humans) acquire ticks only by direct contact with them. Once a tick latches onto human skin it generally climbs upward until it reaches a protected or creased area, often the back of the knee, groin, navel, armpit, ears, or nape of the neck. It then begins the process of inserting its mouthparts into the skin until it reaches the blood supply.

In tick-infested areas, the best precaution against LD is to avoid contact with soil, leaf litter and vegetation as much as possible. However, if you garden, hike, camp, hunt, work outdoors or otherwise spend time in woods, brush or overgrown fields, you should use a combination of precautions to dramatically reduce your chances of getting Lyme disease:

First, using color and size as indicators, learn how to distinguish between:

- deer tick* nymphs and adults
- deer ticks and two other common tick species - dog ticks and Lone Star ticks (neither of which is known to transmit Lyme disease)

*Deer ticks are found east of the Rockies; their look-alike close relatives, the western black-legged ticks, are found and can transmit Lyme disease west of the Rockies.


Then, when spending time outdoors, make these easy precautions part of your routine:

- Wear enclosed shoes and light-colored clothing with a tight weave to spot ticks easily
- Scan clothes and any exposed skin frequently for ticks while outdoors
- Stay on cleared, well-traveled trails
- Use insect repellant containing DEET (Diethyl-meta-toluamide) on skin or clothes if you intend to go off-trail or into overgrown areas
- Avoid sitting directly on the ground or on stone walls (havens for ticks and their hosts)
- Keep long hair tied back, especially when gardening
- Do a final, full-body tick-check at the end of the day (also check children and pets)

When taking the above precautions, consider these important facts:

- If you tuck long pants into socks and shirts into pants, be aware that ticks that contact your clothes will climb upward in search of exposed skin. This means they may climb to hidden areas of the head and neck if not intercepted first; spot-check clothes frequently.
- Clothes can be sprayed with either DEET or Permethrin. Only DEET can be used on exposed skin, but never in high concentrations; follow the manufacturer's directions.
- Upon returning home, clothes can be spun in the dryer for 20 minutes to kill any unseen ticks
- A shower and shampoo may help to dislodge crawling ticks, but is only somewhat effective. Inspect yourself and your children carefully after a shower. Keep in mind that nymphal deer ticks are the size of poppy seeds; adult deer ticks are the size of sesame seeds.


Any contact with vegetation, even playing in the yard, can result in exposure to ticks, so careful daily self-inspection is necessary whenever you engage in outdoor activities and the temperature exceeds 40 degrees F (the temperature above which deer ticks are active). Frequent tick checks should be followed by a systematic, whole-body examination each night before going to bed. Performed consistently, this ritual is perhaps the single most effective current method for prevention of Lyme disease.


If you DO find a tick attached to your skin, there is no need to panic. Not all ticks are infected, and studies of infected deer ticks have shown that they begin transmitting Lyme disease an average of 36 to 48 hours after attachment. Therefore, your chances of contracting LD are greatly reduced if you remove a tick within the first 24 hours. Remember, too, that the majority of early Lyme disease cases are easily treated and cured.

To remove a tick, follow these steps:

- Using a pair of pointed precision* tweezers, grasp the tick by the head or mouthparts right where they enter the skin. DO NOT grasp the tick by the body.
- Without jerking, pull firmly and steadily directly outward. DO NOT twist the tick out or apply petroleum jelly, a hot match, alcohol or any other irritant to the tick in an attempt to get it to back out. These methods can backfire and even increase the chances of the tick transmitting the disease.
- Place the tick in a vial or jar of alcohol to kill it.
- Clean the bite wound with disinfectant.

*Keep in mind that certain types of fine-pointed tweezers, especially those that are etched, or rasped, at the tips, may not be effective in removing nymphal deer ticks. Choose unrasped fine-pointed tweezers whose tips align tightly when pressed firmly together.

Then, monitor the site of the bite for the appearance of a rash beginning 3 to 30 days after the bite. At the same time, learn about the other early symptoms of Lyme disease and watch to see if they appear in about the same timeframe. If a rash or other early symptoms develop, see a physician immediately.

Finally, prevention is not limited to personal precautions. Those who enjoy spending time in their yards can reduce the tick population around the home by:

- keeping lawns mowed and edges trimmed
- clearing brush, leaf litter and tall grass around houses and at the edges of -- gardens and open stone walls
- stacking woodpiles neatly in a dry location and preferably off the ground
- clearing all leaf litter (including the remains of perennials) out of the garden in the fall
- having a licensed professional spray the residential environment (only the areas frequented by humans) with an insecticide in late May (to control nymphs) and optionally in September (to control adults).
 
Good and important info, Bubba. Both my son and I had Lyme. Given the time line, we're fairly certain we got it in our back yard, not while hiking. Fortunately we both caught it in time, took the fairly standard three-week antibiotic treatment, and were fine. A friend of mine was not so lucky, and has been suffering from its effects for years.
 
Usually the colder states will not have as much effect cause the ticks don't like the extreme cold. I don't think they "die" in the extreme colds like NH/VT/ME, but they do go dormant which is why it is a big problem for lower states like lower NY, CT, NJ, DE, PA, MD, where it doesn't get terribly cold all the time.

[edit ] Found this:

As winter closes in, adult ticks unsuccessful in finding hosts take cover under leaf litter or other surface vegetation, becoming inactive in temperatures below 40 degrees F. Generally, winters in the northeast and upper mid-west are cold enough to keep adult ticks at bay until late February or early March (an exception was the warm winter of 1997-1998) when temperatures begin to rise. At this time, they resume the quest for hosts in a last-ditch effort to obtain a blood meal allowing them to mate and reproduce. This second activity peak typically occurs in March and early April.

below:

http://www.aldf.com/DeerTickEcology.asp

Jay
 
Lyme's Disease

Very scary! My daughter had it several years ago and went undiagnosed for several weeks, she was very sick. She was treated with antibiotics for 6 months and was fine after the treatment, with no ill effects. But I do know several people who still suffer with symptoms, months and years after being diagnosed.
I'm from CT and we unfortunately have a very high incdence of Lyme's disease.
Thanks for posting the info.
kmac
 
"If you DO find a tick attached to your skin, there is no need to panic. Not all ticks are infected, and studies of infected deer ticks have shown that they begin transmitting Lyme disease an average of 36 to 48 hours after attachment. Therefore, your chances of contracting LD are greatly reduced if you remove a tick within the first 24 hours. Remember, too, that the majority of early Lyme disease cases are easily treated and cured."

While you're more apt to get Lyme than attacked by a bear or struck by lightning, it's not that big a deal unless it goes untreated. The big, red "bulls eye" rash and migrane headache tipped me off. The Dr. phoned in the script and I took it.

The idea of identifying the tick or avoiding leaves and such is pointless. I'm sure my tick road into the house on my dog or dropped from brush while I was mowing the lawn.
 
Granted this is not life or death... just a reminder that the time is upon us.

February or early March (an exception was the warm winter of 1997-1998) when temperatures begin to rise. At this time, they resume the quest for hosts in a last-ditch effort to obtain a blood meal allowing them to mate and reproduce. This second activity peak typically occurs in March and early April. -JAY

...zactly!! Late Feb, early March... got that: "QUEST FOR HOSTS!!"

Actually, I like the earlier part about "staying on cleared trails and not siting on the ground". If we all payed attention to that we'd wipe out our sport/pastime!! :(
 
Been there. Done that. Fairly certain I contracted the tick in Upstate NY, in a field near John's Brook Lodge. I got the rash so it was pretty easy to diagnose, even though my tests all came out negative. The antibiotics worked well, and after a month, I was right as rain. Whenever I get a tick now I circle the bite area with indelable marker so that I can remember where I was bit in case a rash forms. "A couple deadly bugs aint gonna keep me outta no woods."

-percious
 
Chip said:
"If you DO find a tick attached to your skin, there is no need to panic. Not all ticks are infected, and studies of infected deer ticks have shown that they begin transmitting Lyme disease an average of 36 to 48 hours after attachment. Therefore, your chances of contracting LD are greatly reduced if you remove a tick within the first 24 hours. Remember, too, that the majority of early Lyme disease cases are easily treated and cured."

While you're more apt to get Lyme than attacked by a bear or struck by lightning, it's not that big a deal unless it goes untreated. The big, red "bulls eye" rash and migrane headache tipped me off. The Dr. phoned in the script and I took it.

True enough, but not all ticks are easily found, and (more insidious) not everyone experiences the classic symptoms.
 
In "The Complete Walker", Colin Fletcher recomends that you and your companion (assuming the right kind of companion) engage in a game of 'search the body for ticks.' This can be a lot more fun than simply picking ticks off your legs.
 
percious said:
Been there. Done that. Fairly certain I contracted the tick in Upstate NY, in a field near John's Brook Lodge. I got the rash so it was pretty easy to diagnose, even though my tests all came out negative. The antibiotics worked well, and after a month, I was right as rain. Whenever I get a tick now I circle the bite area with indelable marker so that I can remember where I was bit in case a rash forms. "A couple deadly bugs aint gonna keep me outta no woods."

-percious

One of the nasty facts about Lyme's disease is that the tests are not reliable. See here, here, and here.
 
The tick usually need to be attached for 24-48 hours before transmitting LD so doing a "tick check" after boing outdoors is important. Up to 50% of people with Lyme do not get the rash.
 
Pete_Hickey said:
In "The Complete Walker", Colin Fletcher recomends that you and your companion (assuming the right kind of companion) engage in a game of 'search the body for ticks.' This can be a lot more fun than simply picking ticks off your legs.
I'll bring my solo tent if I ever go on a trip with you!!!!!! :D
 
rhihn said:
One of the nasty facts about Lyme's disease is that the tests are not reliable. See here, here, and here.
Quite true. The other problem is many doctors habitually refuse to prescribe antibiotics, it appears to be a mission for some, especially if the inconclusive test comes back neg. If you THINK you have symptoms, you need to find another doctor that will phone in a script.
 
Many years back,my wife(ex) was diagnosed with one of the first reported cases in Northeastern MA. Back then,there was only one way to be tested. You wrap $75 In cash around the vial of blood,which was sent to the lab of Dr. Alan Stearman,the guy who discovered the Lyme outbreak.
About 10 days later,there's a guy from CDC knocking on our door,telling her it's positive,and he has to do an interview. Scary stuff!
 
I'm not to worried about it in the northern mountains. However, birding in the shrublands and woods in CT is a different matter. I had a tick last year but I took the indicated homeopathic remedy prophylacticly and had no problem. But without a ELISA titers to baseline and control..who knows. I alwasy cary this remedywith me Ledum pulastre 30c. it is indicated for tetnus, lymes, etc.
 
percious said:
Been there . . . Whenever I get a tick now I circle the bite area with indelable marker so that I can remember where I was bit in case a rash forms. . .
That's a good, practical, common sense idea.

G.
 
lyme disease

wow --
reading this thread i am shocked at the degree of misinformation out there. as the center for disease control website mentions, the lab tests are often falsely negative in the acute (fever,rash,headache) stages of the disease as it is too early to detect;however, the lab tests are quite reliable after a 2-3 week period. circling the site of the bite is not of great use because the bulls eye rash can appear anywhere and sometimes more than one is present. a nickel sized red ring around the bite itself is merely the body's reaction to the bite and not the bulls eye rash. the bulls eye is a pinkish spot greater than 5cm diameter. it is present in about 70% of cases. if you google "erythema migrans" under images section you can bring up photos. a tick needs to be on for at least 24 hours so showering and checking after time spent in the yard or hiking is generally a good idea. there has been one study done suggesting taking a one time dosage of antibiotics within a day or two of a bite may offer decent prophylaxis. one study is enough to make this a controversial idea but for a person who is very anxious about contracting lyme it is an option. the current treatment for lyme is a 21-28 day course of oral antibiotics. sounds like a long course but it is the same antibiotic used to treat adolescents with acne, meaning it is benign in most occasions, and therefore better to err on the side of caution and take it if there is any question in diagnosis. "chronic" lyme is another controversial topic and several month long courses of antibiotics (depending of course upon the situation) is extremely controversial. in sum, the acute phase of lyme (fever, headache, bodyache, rash) appears within three weeks of a bite and is quite easy for majority of health care professionals to identify esp in areas where lyme is most prevalent. if the acute phase is untreated the acute symptoms resolve and months to years later a second set of symptoms arise, much like the progression of syphilis. if i or a family member had symptoms falling into this category of lyme disease i would seek treatment from an infectious disease specialist with a lyme disease focus. there are plenty out there, including boston and portland maine. primarily because it becomes quite complex and the overlay of symptoms can be difficult to determine what is lyme and what is not lyme. at the risk of angering some i will also mention that there are many nontraditional healthcare practitioners out there prescribing several month courses of antibiotics for "lyme disease." if i personally received that recommendation for treatment from a non-infectious disease specialist i would seek a second opinion. if your practitioner frowns on second opinions it is time to be suspect.
also permethrin (sp?) soaked clothing and deet are helpful prevention-wise.
the cdc web site is an excellent resource for more info. uptodate.com is superb -- i think a guest membership can access it. if not i would be happy to forward a copy to anyone interested.
i am certainly not an expert in lyme but have diagnosed and treated over two dozen cases in the past three years. it is a very straightforward diagnosis at this point. if you have specific questions asking your doctor at a routine visit is very reasonable. hope this helps.
oh i almost forgot...there has also been a jump in cases of erlichia and babesiosis, other tickborne diseases, in se new england. bottom line if you have a rash or are feeling "fluey" after a recent tick bite see your doctor. :)
 
I contracted lyme disease mountain biking several years ago in early March in 40 degree temps on the Cape (Cod)... bugger managed to get under my jersey under my Camelbak. Fortunately the bite was itchy because the head was still in (which wigged out the doctor and she wouldn't take it out!), so I got it early. Didn't think they were active in such cool temps, but now i know...

Social grooming is de rigeur for mountain bike rides... we pluck the ticks, but no one has been wiling to pop one in their mouths yet...
 
runnynose said:
wow --
as the center for disease control website mentions, the lab tests are often falsely negative in the acute (fever,rash,headache) stages of the disease as it is too early to detect;however, the lab tests are quite reliable after a 2-3 week period.QUOTE]

Quite right, it takes 14 days after initial exposure to build an IgG antibody response to any antigen, the tests are indirect, that is they are looking for your antibodies built against the bacteria which causes lyme disease.

There are however, new "direct" tests for dogs that look for the antigen (in this case some proteins on the cell membrane itself) that are extremely sensitive, including detecting current infection from past exposure/immunization; but they aren't on the human test market yet.

That said, some people never seroconvert and create antibodies to the bacteria that causes Lyme (or various other things for that matter). These folks will always test negative on the ELISA method. There are different tests that will look for antibodies to various other protien peices of the bacteria , though. The ELISA test is looking for our antibody to the flagella of Borrelia burgdorferi.

In Lyme endemic areas though, appearence of erthyma migrans or fever and very suggestive symptoms, most docs will start tx and retest in a couple of weeks to confirm. Its one of those diseases that most state Health Departments track, so testing is necessary for epidemiologic studies. However, with health ins, etc, some docs will forgo and help a pt out with antibiotics and not test.

That said, watch your furry trail buds, dogs are very suceptible to Lyme and in some breeds (Labs) chronic, subclinical Lyme infection has been shown to lead to renal failure.

Ticks in NY especially Dutchess county are coinfected with Lyme agent as well as Ehrlichiosis equi. Ehrlichiosis can be fatal, unlike Lyme. Ehrlichia is an intracellular invader of white blood cells (evades destruction of digestive enzymes in wbcs who's job is to engulf foreign particles ) and the bacteria replicates within the cell as well as hitching a ride quickly into the tissues, spleen, even bone marrow. The treatment for Ehrlichiosis is the same antibiotic but THREE times the dosage and duration as Lyme. So if you or your dog think you have Lyme, please consider testing for a full tick borne panel; to be safe. TBD (tick borne diseases) are on the rise and Lyme is actually the more benign one to get.

OK, sorry this got long. I know alot about this
a. because I'm a Clinical Laboratory Scientist
and
b. my dog Terra nearly died from a Lyme/Ehrlichia coinfection, because we only tested for Lyme.

Hike safely and check yourself and your furkids after.

BTW, FWIW Frontline (which is now sold over the counter) is NO LONGER considered effective protection against Lyme or Ehrlichiosis for dogs, because the ticks may pass these infections to the dog before Frontline kills the ticks. K9Advantix is the only proven prevention for dogs right now on the market -- but it can't be used on dogs who live with cats because its a kitty poison.

Back to lurking,
Sabrina
with Terra Firma
and
Orca the Killer Whale
the Traildoggies
 
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