May is Lyme Disease Awareness Month


May is Lyme Disease Awareness Month, though I've already seen tick bites with bullseye rash as early as March. Although the deer ticks can be active even in winter, as the weather warms, more ticks start moving from the larval stage to the nymph stage.  The nymph of the deer tick may be more likely to transmit Lyme disease. These things are tiny. The picture above is a nymph deer tick, and represents just how small they are. You might not ever see these things coming, or going. 

The CDC now acknowledges that ticks carrying Lyme disease have been confirmed in at least half of all US counties. While we often think we're safe here in the Pacific Northwest, Lyme disease is not just an 'East Coast thing.' Confirmed Lyme disease cases in humans and animals have been reported all over Oregon, as far west as the Astoria peninsula. As Oregonians, we love our outdoor life, and camping season has already started, the weather has been increasingly great for hiking. I don't want you to panic, but I do want you to stay safe and take good care of yourself and your loved ones, including your four-legged family members.

What you can do

First, avoid being bitten if possible.  Ticks like to crawl up, rather than dropping down from above. Keep your feet and ankles covered with shoes and white socks that go beyond the ankle. As non-fashionable as it is, tuck your pants into your socks.  Walk in the middle of the trail. Also, you may have ticks in your yard, as we have a high population of deer living in many of our communities. Prevent tick bites in your yard by keeping the grass cut, and foliage well maintained.

Consider a repellent.  A regular flea and tick preventive may be the best way to go for your pet. The CDC recommends DEET and permethrin, and there is clothing with the permethrin embedded in the fabric, so you don't have to apply it directly to the skin. There are other, more natural options that appear to be effective according to the EPA, including products with lemon oil and eucalyptus. Brand names include Citrapel Lotion Insect Repellent, First Bite 6 Hour, Repel Essential Insect Repellent Lotion or Pump Spray, and In2Care Bug Shield. 

Next, check yourself, each other and your pets for ticks. Keep in mind how small these things are, about the size of a poppy seed. Removing any ticks as soon as possible is important to prevent Lyme. The less time a tick is attached and feeding, the lower the risk of Lyme or other disease transmission. 

Then remove the tick as carefully as possible.  Do not try to burn or suffocate the tick in an attempt to get it to let go.  The best way to get the tick to detach is to use small, pointed tweezers at the forefront of the body behind the head, and pull with steady, gentle pressure.  You want to avoid squeezing near the back, as that may push any potential germs from the tick into its saliva and into you.  Don't worry if the mouth parts stay embedded, as long as the head is removed.  

Finally, save the tick and have it sent for testing as soon as possible. If the tick is free of Lyme or other infections, there's no need to worry.  Not all ticks carry Lyme disease. If you start to develop any symptoms of Lyme, like a bulls-eye rash, stiff neck, severe headache, Bell's palsy, fever, joint pain, or flu like symptoms, consult a Lyme literate physician as soon as possible.

While I have success in treating Lyme disease at any stage, it is much easier and generally very successfully treated in the earliest stages. Many physicians in the area still are under the misconception that Lyme isn't really present in the PNW, however I see many patients with positive Lyme tests after only local exposures.