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Lyme Disease Update

From Shady Grove Adventist Hospital in Rockville, Maryland
Health Tips of the Week




Approximately 20,000 cases of Lyme disease are reported in America annually.  In the 10 states where Lyme disease is most common such as in Maryland, the average is 30.2 cases per 100,000 persons. Other states  where the disease occurs frequently include Pennsylvania, New York, Connecticut, New Jersey, and Massachusetts.  Infection has been found on all continents and due to under-reporting, the disease case count is likely to be 13-15 times higher.  

Definition 

Lyme disease is an infection caused by the bacterium, Borrelia burgdorferi that is carried by deer ticks. This bacterium has been in the U.S. for more than 100 years.  These very small ticks have been described as being about the size of the period at the end of a sentence.

The bacterium normally lives in mice, squirrels, and other small animals.  It is transmitted to humans through the bites of the deer tick. Ticks go through four stages: egg, larva, nymph, and adult. Each of the last three stages requires a blood meal.  Ticks that transmit Lyme disease can retain the infection throughout their life.  Fewer than five percent of adult ticks south of Maryland are infected, while up to 50 percent are infected in hyper-endemic areas of the northeast. 

Ticks will attach anywhere on the body, but prefer body creases such as the armpit, groin, back of the knee, and nape of the neck.  

The highest numbers of reported cases are during the months of June, July, and August. 

Symptoms 

The first sign of infection is usually a circular rash called erythema migrans. This rash occurs in up to 80-90 percent of infected persons and begins at the site of a tick bite after a delay of 3 to 30 days.  It gradually expands.  The center of the rash has a bull's eye appearance.

General symptoms include fatigue, chills, fever, headache, muscle/joint aches, and swollen lymph nodes.  

Most cases can be cured with antibiotics, especially if treatment is begun early.

5 to 25 percent of those treated will develop the chronic form of Lyme disease with on-going symptoms. Many with persistent Lyme disease are mislabeled as having fibromyalgia or chronic fatigue syndrome. 

Untreated, the infection may spread resulting in Bell's palsy, severe headaches, neck stiffness, heart palpitations, shooting pains, and dizziness. After several months, approximately 60 percent of patients with the untreated infection will begin to have intermittent bouts of arthritis.  Up to five percent of untreated victims may develop chronic neurological complaints months to years after infection. 

Vision changes, difficulty breathing, kidney problems, gastrointestinal distress, sleep disorders, seizures, behavioral changes, cranial nerve involvement, and psychiatric manifestations are some of the other symptoms that have been reported. 

Prevention

Clear brush and leaves where ticks live.  Stack woodpiles in dry, sunny areas off the ground.

Treat the environment and your pet(s) with products designed specifically for ticks.

Stick to trails and avoid walking through tall grass or heavily wooded areas.  

Wear long pants tucked into your socks, long sleeves, enclosed shoes, and gloves.

Tie back long hair.  

Avoid sitting directly on the ground or on stone walls.

Apply an insect repellent with a 10 to 30 percent concentration of DEET.  This protects adults for about two hours. 

Check yourself, your children and your pets for ticks daily. The longer the tick remains attached to your skin, the greater your risk of getting the disease.  

Shower as soon as you come indoors. 

Put clothes in the dryer for 20 minutes to kill any unseen ticks. 

Tick Removal

Use pointed tweezers and grasp the head or mouthparts where they enter the skin.  

Pull firmly and steadily.  

Do not twist the tick out or apply alcohol, a hot match, or any other irritant.  

Do not crush the tick as it may release infected fluids.  

Disinfect the bite site and tweezers after removal.


Sources:

CDC

Lyme Disease Foundation 

Mayo Clinic  

American Lyme Disease Foundation  

Baltimore Magazine

Washington and Shady Grove Adventist Hospitals.  


The Health Tip of the Week is for educational purposes only. For additional information, consult your physician.

Please feel free to copy and distribute this health resource.
Shady Grove Adventist Hospital is located at 9901 Medical Center Drive in Rockville.  For more information or to receive our newsletter with details about medical services, health classes, and upcoming events, go to www.ShadyGroveAdventistHospital.com.  To find a local physician, call 1-800-642-0101 24 hours a day, 7 days a week.







Page Updated June 29, 2008

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