Spring weather is finally here in Pennsylvania. This will hopefully mean that more people will get to be outside getting fresh air and more exercise. With the quarantine rules in place, the only places that are open are parks and trails. Also, without any organized sports to attend, kids are playing in the woods, building forts, climbing trees and going on adventures, with proper social distancing, of course. One group that did not get the memo for social distancing was those darn ticks! I have found several on my family members already, including our furry family member. This time of year, it is good to take a few extra precautions to prevent those little “buggers” from getting on us, since they obviously are not watching the news to stay six feet away.
It might be first helpful to understand a few facts about Lyme disease and transmission. First anyone can get Lyme disease at any age. Most know that Lyme disease is transmitted by ticks. They are most active in the warm weather. Ticks are blood sucking parasites that can cause a whole “host” of diseases but Lyme disease is the most endemic to our area. Lyme disease is most commonly caused by the bacteria, Borrelia bugdorferi. Ticks are great carriers (vectors) of this disease. Ticks mainly feed off medium and small animals that are infected and then transmit that bacteria to humans through its bite. The trick is to catch them early because they must be on 36-48 hours to transmit the disease. The hard part is that the tick species that transmits Lyme disease, Ixodes scapularis does so in the nymph phase of its lifecycle, when it is the smallest and is almost always painless.
Sometimes you can take all the precautions to prevent getting a tick bite (wearing light clothing that covers your body, changing clothes when you get home from hikes, avoiding high endemic areas and using repellents) but you may still get bit. As soon as you find the tick bite, don’t panic. It is best to remove the tick carefully with tweezers and disinfect the skin.
After removing the tick, especially if you thought it was on longer than 36 hours, watch the area for a rash. Lyme disease can affect multiple organ systems if left untreated. The primary and most common body part it infects is the skin, and it presents one of the earlier signs of Lyme disease.
Just like other diseases, the earlier you catch it the better. The skin shows us the first sign of infection. It is a rash that looks like a bull’s eye and occurs in about 70-80% of cases. A small red bump or flat circle forms a ring and expands with a clear center and it forms around the area of a tick bite. The bull’s eye rash, with a fancy name of erythema migrans, occurs about 7-10 days after the tick bite that will eventually fade in 3 to 4 weeks. This rash may be accompanied by flu-like symptoms of fever, chills, joint pain and headache.
Some lucky patients will have immune systems that can fight Lyme disease or a local infection. If the infection is not treated, many patients will have dissemination (spread) of the infection to multiple organs like the heart, joints and nervous system. Another sign on the skin that signals that the infection has progressed is several bull’s eye rashes on your body. Because of these risks, it is highly recommended that earlier symptoms should be treated early.
The treatment is a course of antibiotics and the earlier it is treated the higher the cure rate. A diagnosis can be made based on history of a tick bite, the clinical picture of a rash or blood work to test for antibodies. A skin biopsy might be taken to rule out other causes. It is important you contact your dermatologist if you have this type or rash with or without these symptoms. If you have a history of a tick bite and flu-like symptoms, it is a good idea to call your primary care provider for further testing.
This information should not discourage you from hiking and letting children have adventures in the woods. Studies show that just 10-30 minutes in nature improves mood, focus and even blood pressure. You can however take preventative measures like wearing light clothing, keeping skin covered with light clothing, spraying repellent and checking yourself and clothes when you get back from your hikes. Also, a great tip is to check your pets daily to make sure they are not bringing home new friends. For extra information on tick bites and Lyme disease this is a great link. Do not hesitate to contact your health care provider and dermatology office if you have any of these symptoms.