Hagerstown, MD (June 29, 2010) - Since May 2010, there have been 50 cases of possible Lyme disease reported to the Washington County Health Department.

The Washington County Health Department would like to remind Washington County residents that spring and summer are the seasons when the chances of acquiring a tick-borne illness are the greatest.

Two illnesses in particular are of concern - Lyme disease and Rocky Mountain spotted fever, both of which can result from the bite of an infected tick.

Lyme Disease

Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans by the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash. If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks; laboratory testing is helpful in the later stages of disease. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics.

The first sign of infection is usually a circular rash. This rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite after a delay of 3-30 days. A distinctive feature of the rash is that it gradually expands over a period of several days, reaching up to 12 inches (30 cm) across. The center of the rash may clear as it enlarges, resulting in a bull's-eye appearance. It may be warm but is not usually painful. Some patients develop additional, similar rashes in other areas of the body after several days. Patients also experience symptoms of fatigue, chills, fever, headache, and muscle and joint aches, and swollen lymph nodes. In some cases, these may be the only symptoms of infection.

Untreated, the infection may spread to other parts of the body within a few days to weeks, producing an array of discrete symptoms. These include loss of muscle tone on one or both sides of the face (called facial or "Bell's palsy"), severe headaches and neck stiffness due to meningitis, shooting pains that may interfere with sleep, heart palpitations and dizziness due to changes in heartbeat, and pain that moves from joint to joint. Many of these symptoms will resolve, even without treatment.

The Lyme disease bacterium can infect several parts of the body, producing different symptoms at different times. Not all patients with Lyme disease will have all symptoms, and many of the symptoms can occur with other diseases as well. If you believe you may have Lyme disease, it is important that you promptly consult your health care provider for proper diagnosis.

Rocky Mountain Spotted Fever

Rocky Mountain spotted fever is one of the most severe tick-borne illnesses in the United States. This disease is caused by infection with the bacterial organism Rickettsia rickettsii. Rocky Mountain spotted fever is a seasonal disease and occurs throughout the United States during the months of April through September. Over half of the cases occur in the south-Atlantic region of the United States (Delaware, Maryland, Washington D.C., Virginia, West Virginia, North Carolina, South Carolina, Georgia, and Florida). The highest incidence rates have been found in North Carolina and Oklahoma. Although this disease was first discovered and recognized in the Rocky Mountain area, relatively few cases are reported from that area today.

The organism that causes Rocky Mountain spotted fever is transmitted by the bite of an infected tick. The American dog tick and Rocky Mountain wood tick are the primary ticks that transmit Rocky Mountain spotted fever bacteria in the United States.

Patients infected with Rocky Mountain spotted fever usually visit a physician in their first week of illness, following an incubation period of about 5-10 days after a tick bite. The early expression of illness is often nonspecific and may resemble many other infectious and non-infectious diseases.

Initial symptoms of Rocky Mountain spotted fever may include fever, nausea, vomiting, muscle pain, lack of appetite, and severe headache. Later signs and symptoms include rash, abdominal pain, joint pain, and diarrhea.

A diagnosis of Rocky Mountain spotted fever is based on a combination of clinical signs and symptoms and specialized confirmatory laboratory tests.

Prevention

Limiting exposure to ticks reduces the likelihood of infection with tick-borne diseases. In persons exposed to tick-infested habitats, prompt careful inspection and removal of crawling or attached ticks is an important method of preventing disease. It may take extended attachment time before organisms are transmitted from the tick to the host.

It is unreasonable to assume that a person can completely eliminate activities that may result in tick exposure. Therefore, take the following precautions to protect yourself when exposed to natural areas where ticks are present:

• Wear light-colored clothing which allows you to see ticks that are crawling on your clothing. Tuck your pants legs into your socks so that ticks cannot crawl up the inside of your pants legs.
• Apply repellents to discourage tick attachment. Repellents containing permethrin can be sprayed on boots and clothing, and will last for several days. Repellents containing DEET (N,N-diethyl-meta-toluamide) can be applied to the skin, but will last only a few hours before reapplication is necessary. Use DEET with caution on children.
• Conduct a body check upon return from potentially tick-infested areas by searching your entire body for ticks. Use a hand-held or full-length mirror to view all parts of your body. Remove any tick you find on your body.

Check children for ticks, especially in the hair, when returning from potentially tick-infested areas. Ticks may also be carried into the household on clothing and pets and only attach later, so both should be examined carefully to exclude ticks.

Removing Ticks That Have Become Attached To The Body

1. Use fine-tipped tweezers or notched tick extractor, and protect your fingers with a tissue, paper towel, or latex gloves (see figure). Persons should avoid removing ticks with bare hands.
2. Grasp the tick as close to the skin surface as possible and pull upward with steady, even pressure. Do not twist or jerk the tick; this may cause the mouthparts to break off and remain in the skin. (If this happens, remove mouthparts with tweezers. Consult your health care provider if illness occurs.)
3. Pull upward with steady, even pressure
4. Do not squeeze, crush, or puncture the body of the tick because its fluids may contain infectious organisms. Skin accidentally exposed to tick fluids can be disinfected with iodine scrub, rubbing alcohol, or water containing detergents.
5. After removing the tick, thoroughly disinfect the bite site and wash your hands with soap and water.
6. 6. Save the tick for identification in case you become ill. This may help your doctor make an accurate diagnosis. Place the tick in a sealable plastic bag and put it in your freezer. Write the date of the bite on a piece of paper with a pencil and place it in the bag.

Note: Folklore remedies such as petroleum jelly or hot matches do little to encourage a tick to detach from skin. In fact, they may make matters worse by irritating the tick and stimulating it to release additional saliva, increasing the chances of transmitting the pathogen. These methods of tick removal should be avoided. In addition, a number of tick removal devices have been marketed, but none are better than a plain set of fine tipped tweezers.


Source: Centers for Disease Control