Author: McLaren Flint
This summer, thousands of Michigan residents are spending time outside at places like campgrounds, golf courses, and hiking and walking trails either in or surrounded by woods.
Whether their adventure is in the western Upper Peninsula, along the Lake Michigan coast, or further inland in the southern part of the state, they will be sharing the great outdoors with bugs, including disease-carrying ticks. Lots of them.
So how do you protect yourself? By covering up as much skin as possible when going to grassy or wooded areas. Wearing a hat, a long-sleeved shirt, and long pants with the legs tucked into socks can be helpful. You can also use a bug repellant that contains a chemical such as DEET, IR3535, or Picaridin.
Always check clothing after being outside, remove any ticks, and toss the clothes in a dryer and run it on the high-heat cycle for an hour to kill any ticks that remain. You should also take a shower within two hours of coming inside.
According to the Centers for Disease Control and Prevention, if a tick is latched on to your skin, it is important to remove it as quickly as possible. But if the tick is already engorged, it would be best to have a healthcare professional remove it.
The best way to remove a tick is to use a pair of tweezers to grip it by its head and mouth so they do not remain embedded in your skin when the tick is pulled away from where it is attached. If a tick is not attached to your skin, a red bump resembling a mosquito bite or a bull’s-eye rash can be a sign of a tick bite, particularly if the bump does not itch and fades away after a couple of days.
Female black-legged ticks, which are also known as deer ticks, are responsible for the spread of Lyme disease. Adult male deer ticks will latch on to humans to feed, but they do not remain attached long enough to transmit the disease. A female blacklegged tick typically needs to be attached to someone for 36 hours or longer for Lyme disease to develop. However, it can be difficult to determine how long a tick has been latched on to someone because the time needed for it to become visibly engorged can vary from two to 30 hours.
“Lyme disease primarily affects the skin, joints, nervous system, and heart,” said Shagufta Ali, MD, FACP, infectious disease specialist at the McLaren Infectious Disease clinic. “There is a broad spectrum of clinical manifestations of Lyme disease which can generally be divided into three phases: early localized, early disseminated, and late disease. However, the clinical features of each stage can overlap, and some patients might present in a later stage of Lyme disease without a history of prior signs or symptoms suggestive of earlier Lyme disease.”
The three phases are as follows:
Early Localized Disease: The first signs are characterized by the appearance of the typical skin lesion, a rash associated with the disease called erythema migrans (EM), with or without the general symptoms of fatigue and fever. EM usually occurs within one month following the tick bite.
Early Disseminated Disease: This manifestation is characterized by multiple EM lesions (that typically occur days to weeks after infection) and/or neurologic and/or cardiac findings that typically occur weeks to months after infection.
Late Lyme Disease: This stage is typically associated with intermittent or persistent arthritis involving one or a few large joints, especially the knee, and/or certain rare neurologic problems, primarily a subtle encephalopathy or polyneuropathy (confusion, nerve pain, tingling, and numbness). Late Lyme disease may develop months to a few years after the initial infection.
“All patients with EM skin rash should be treated for Lyme disease,” said Dr. Ali. “The goal of therapy is to shorten the duration of the signs and symptoms of early disease and prevent progression to later stages of Lyme disease. It is treated mainly with the use of antibiotics for 10-14 days with a choice of antibiotics that may include doxycycline, amoxicillin, or cefuroxime.”
Dr. Ali notes that even after treatment, nonspecific symptoms of Lyme disease, such as headache, fatigue and joint pain, may persist for months. There is no evidence that these persistent subjective complaints represent an ongoing active infection, or that repeated or prolonged courses of antibiotics may provide any benefit.
If you are in need of a primary care provider who is accepting new patients, you can find one here.