In the Lyme Light

Over the last four years Virginia has seen a significant increase in cases of Lyme disease. Two main reasons for this are that more people are moving into rural areas of Virginia and there is a heightened awareness of Lyme disease and its diagnosis.  

Ticks can harbor and transmit many diseases.  The most common are Lyme disease and Rocky Mountain spotted fever.  First diagnosed in 1977 in Lyme, Conn., Lyme disease is seen mainly in the New England and Mid-Atlantic states.               

It is the most common tick-borne illness in the United States and it is transmitted to humans via the blacklegged tick or “deer tick.” These ticks are tear-drop shaped, have a dark fore-body and light brown or gray hind-body. They are the only ticks with black or dark-chocolate brown legs.  This distinguishes it from the “lone star” tick, which has a light dot on its back, and the dog tick which is larger and reddish-brown in color.  

Lyme disease is caused by a spiral-shaped bacterium called a spirochete.  A tick carrying this bacteria attaches to the human skin and begins to feed off the blood of its host. The bacteria can then enter the human blood from the tick. The tick feeds for two to four days, gets engorged, and then falls off the skin.

Keep in mind several facts in regard to the risk of getting Lyme disease. Only about half or less of deer ticks will carry the bacteria.  Secondly, only the nymph deer ticks can transmit the disease. These are very small ticks, about 1/16 of an inch in size. Finally, the tick must be attached to the skin for at least 36 hours before the bacteria can be transmitted. A tick that is brushed off the skin cannot transmit the disease.  

If you find a tick attached to your skin, the tick should be removed immediately. The best way to do this is by using fine-tipped tweezers, pulling at the mouth part, not the body. Squeezing an attached tick’s body may increase the risk of transmitting disease. Pull firmly and repeatedly until the tick releases its hold. Placing the removed tick in alcohol will kill it and preserve it for identification should symptoms develop. Methods such as using a lit match, petroleum jelly, or nail polish to remove an attached tick are not recommended. The symptoms of early localized infection begin in about seven to 10 days.  About 80 percent of people will develop a circular, red, target-shaped rash with central clearing. The rash will expand over several days. The other 20 percent of those infected won’t have a rash or it goes unnoticed.  Chemical or allergic skin reactions to tick bites can be mistaken for a Lyme disease rash. Flu-like symptoms such as fever, chills, and muscle aches can occur.

Tests for Lyme disease are not 100 percent accurate, so diagnosis should be based primarily on the history of a tick bite and the symptoms. Treatment of Lyme disease should be started only if symptoms develop. Antibiotics are prescribed for two to four weeks to kill the bacteria.  

Like every medical condition, prevention is important.  Measures to reduce your risk of Lyme disease include avoiding tick-infested areas, wearing long-sleeved shirts and pants tucked into socks, wearing light-colored clothing to make it easier to spot ticks on your body, and applying bug repellant (DEET). Also, inspect your skin after coming in from outdoors.   These actions can reduce the number of tick bites and the risk of disease.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.

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