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What is Lyme disease?

Lyme disease is an infection cause by a bacteria (Borrelia burgdorferi) that is spread when an infected tick bites. Symptoms usually appear within a week, but can develop up to 30 days after a bite. More than 18,000 cases are reported each year, and children ages 5 to 9 have the highest rate of infection.

Most patients with Lyme disease develop a red-ringed bull's eye rash. Other early symptoms (early localized stage) include swelling of the lymph glands near the bite, fatigue, headache, joint pain and chills.

The next stage (early diseminated stage) symptoms occur 2 weeks to 3 months after a tick bite. These symptoms include areas of rash not at the site of the bite, severe headache and fatigue, stiffness, sensitivity to light, facial paralysis, irregular heart rhythm, fever, and meningitis.

Last stage symptoms only occur if the disease has not been treated.

Who Should be Concerned?

The ticks that spread Lyme disease are most likely to be found in the northeastern and upper midwestern areas of the United States. Those states that report the most Lyme disease are: Connecticut, Delaware, Maryland, Massachusetts, Minnesota, New York, New Jersey, Pennsylvania, Rhode Island, and Wisconsin.

Individuals who live or work in residential areas surrounded by tick-infested woods or overgrown brush are at risk of getting Lyme disease. Persons who work or play in their yard, participate in recreational activities away from home such as hiking, camping, fishing and hunting, or engage in outdoor occupations, such as landscaping, brush clearing, forestry, and wildlife and parks management in endemic areas may also be at risk of getting Lyme disease.

Ticks are found in tall grass, shrubs, or other wooded areas, and are usually near the ground. If you have a pet and they visit these areas, they may also bring the ticks into your home.

Lower your Risk

If you live in one of these states, here are some tips to lower your risk of infection:

• avoid tick habitats, especially shady moist areas with low-lying vegetation in woody, brushy, or overgrown areas
• wear light colored clothing so you can spot the ticks before they bite you
• wear long sleeved clothing and tuck your pants into your socks or boots (high rubber boots can offer added protection)
• use insect repellants that contain DEET and apply them to your clothing and skin (please see our guidelines on applying pesticides safely).
• do daily tick checks on yourself, your children, and your pets. Remove any ticks you find.

About Ticks and Infection

The ticks that carry Lyme disease are small, about the size of a sesame seed. The nymphs (immanture ticks) are about the size of a poppy seed. Both are dark in color, and the female is half red.

It takes at least 36 hours after tick attachment for an infected tick to transmit the bacteria. Daily tick checks are essential.

Most infections occur during May, June, and July.

Removal Instructions

DO NOT use petroleum jelly, a hot match, nail polish, or other products.

To remove a tick, use fine-tipped tweezers. Firmly grasp the tick as close to the skin as possible. With a steady motion, pull the tick away from the body. Clean the area with antiseptic. If parts of the tick stay behind, do not worry as the mouthparts don't carry the bacteria that causes Lyme disease.

Keep an eye on the site and contact your doctor with any concerns. Remember that transmission of the bacteria that causes Lyme disease from an infected tick is unlikely to occur before 36 hours of tick attachment and that only 1.4% of those who are bitten will get Lyme disease. You may want to bring the tick to your doctor. You can kill it by putting it in a jar of alcohol.

For a flash movie of these instructions, go here: http://www.kidshealth.org/parent/general/body/tick_removal.html

More Information

CDC web site: http://www.cdc.gov/ncidod/dvbid/lyme/diagnosis.htm
http://www.kidshealth.org/parent/infections/bacterial_viral/lyme.html