                                                                   
 Subj : [l/m 1/26/93] Lyme Disease:. Distilled Wisdom (19/28).XYZ               


                         TICKS, LYME DISEASE, and YOU

LYME DISEASE

      Lyme disease is an illness caused by the spirochete bacteria, _Borellia
burdorferi_, which are transmitted to man and animals by tick bites.  Although
not all ticks carry the disease, in some areas as many as 90% of the ticks can
be infected.  The disease gets its name from the town of Lyme, Connecticut,
where it was first described in 1975.  Many feel if it were not for AIDS, Lyme
disease would be the number one infectious disease threat in the United States
today.

      There were an estimated 3200 reported cases of Lyme disease in New York
State in 1989 and an estimated 7000 reported cases nationally.  To date 45
states have reported cases.  The states of New York, Massachussetts,
Connecticut, Rhode Island, and New Jersey account for the majority of cases.
Cases from other parts of the country have increased significantly during
1989.  It is estimated that as many as 50,000 cases have gone unreported or
undiagnosed.

SYMPTOMS AND TREATMENT

      In about 60% of the cases, a characteristic rash or lesion called
erythema migrans develops.  It begins a few days to a few weeks after the bite
of an infected tick.  The rash generally looks like an expanding red ring with
a clear center, but can vary from a reddish blotchy appearance to red
throughout.  Sometimes there are two or more lesions.  Unfortunately, in those
patients who never get a rash, the dignosis can be difficult.  At about the
same time that the rash develops, flu-like symptoms may appear along with
headache, stiff neck, fever, muscle aches and general malaise.

      The later complications of Lyme disease are quite severe.  Most common
is arthritis, usually of the large joints (e.g., knees, hips, shoulders).
Other complications include meningitis and other neurological problems such as
numbness, tingling and burning sensations in the extremities, severe pain,
loss of concentration, memory loss, confusion, loss of confidence, withdrawal,
depression, fatigue, (often extreme and incapacitating), and Bell's palsey
(loss of control of one side of the face).  Cardiac symptoms include heart
palpitations and irregular heart beat.  Shortness of breath, dry mouth, voice
changes, and difficulty swallowing can occur.  Eye symptoms include
conjuctivitis, double vision, and loss of vision.  Remember, some patients do
not get the rash and progress directly to these later symptoms.  Symptoms,
including pain are intermittant and changing, occuring in any combination and
lasting from a few days to several months and possibly years.

      It is important to seek medical attention if any of these symptoms
appear, especially after being bitten by a tick or visiting an area where Lyme
disease is common.  Timely treatment with antibiotics (within a few days of
symptoms appearing) will increase chances of recovery and may lessen the
severity of any later symptoms.  If ignored, the early symptoms may disappear,
but more serious problems can develop months to years later.  Chronic Lyme
disease, because of its diverse symptoms, is particularly difficult to
diagnose.  Treatment for later stages is more difficult and is often less
successful, sometimes requiring several months of intravenous antibiotic
therapy.

THE DEER TICK

      _Ixodes dammini_ is responsible for most of the cases of Lyme disease in
the northeastern and northcentral United States.  These ticks are found in
grassy areas (including lawns), and shrubby and woodland habitats, even on
warm winter days.  The adult ticks (about the size of a sesame seed) feed
mostly on white-tailed deer but will also attack other mammals including man.
If infected, they can transmit the Lyme disease spirochete to their hosts.
After engorging, adult female ticks drop to the ground to lay several thousand
eggs.  The larvae hatch from the eggs and seek hosts, often the white-footed
mouse, from July through September.  The larvae are very small and difficult
to spot.

      Some of the larvae acquire the Lyme disease spirochete while feeding on
infected hosts.  After engorging, the larvae molt into nymphs, which seekhosts
to feed on from April to September.  Both the larvaland nymphal stages attach
to a variety of small mammals, white-footed mice being the main reservoir of
th Lyme disease spirochete.  Nymphs that were infected as larvae can now
transmit spirochetes to their new host.  In fact, it is the nymphal stage that
appearsto be responsible for nearly 90% of the Lyme disease cases in people.
This stage is also very small (about the size of a poppy seed).  Their bite is
painless so most people do not know they have been bitten.  The nymphs molt
into adult ticks and the process starts all over.  The entire life cycle
requires three separate hosts and takes about two years to complete.

      Spread primarily by wildlife, infected ticks have been found on 29
species of mammals including deer, mice, rabbits, chipmunks, squirrels,
raccoons, opossum, and fox.  Infected ticks have also been found on over 49
different species of birds.  Indeed, birds may be the primary means by which
the ticks are spread from one area to another.  The tick prefers deer for
reproduction, but will utilize other animals when few deer are present.

      The lone star tick, a common southern species, as well as several other
_Ixodes_ ticks can transmit the disease.

LYME DISEASE IN DOMESTIC ANIMALS

      Lyme disease has been diagnosed in dogs, cats, horses, and cows.
Symptoms include loss of appetite, soreness, and lameness, often with fever
(102.5 to 106 degrees F), swollen glands, and joints.  Heart, kidney, liver,
eye and nervous system problems can develop.  Laminitis is reported in horses
and cows, as are poor fertility, abortions, and chronic weight loss.
Temperament changes have been reported in dogs and horses.  Untreated animals
can develop chronic progressive arthritis.

      If you travel into tick infested areas with your animals, it is possible
to bring ticks home on the animals that will infest your premises.  If animals
in your area develop Lyme disease it should alert you that you are also at
risk.

WHERE TO FIND TICKS ON ANIMALS

      Ticks are most commonly found on the front parts (head, neck, chest),
between the toes, on or in the ears, and inside the front and back legs where
the leg meets the body (armpit or groin areas).  Because the ticks are so
small, you must look very carefully.  Remove any ticks found and save for
identification.

TICK CONTROL ON ANIMALS

      To protect animals from infection and to keep them from bringing ticks
home requires regular use of tick repellent and control products plus daily
examination for ticks.

      Veterinary assistance is important in selecting safe tick control
products and designing a control program.

HOW TO AVOID TICK BITES

      When out of doors several precautions can minimize your chancesd of
being bitten.

- Tuck your pants leg into your socks and your shirt into your pants.  The
ticks grab onto feet and legs and then climb up.  This precaution will help
keep them outside you clothes where they can be picked off.

-Wear light colored clothing.  Dark ticks are more easily spotted against a
light background.

-Inspect clothes often for ticks.  Have a companion inspect your back.

- Apply repellents according to label instructions.  Applying directly to
clothing appears to be most effective.

- Inspect you body thoroughly when you get in from the field.  Especially
check groin, navel, armpits, head and behind knees and ears.  Have a companion
inspect your back, or use a mirror.

- Inspect children at least once daily for ticks.  When in heavily infested
areas inspect children every three to fou hours.

- When hiking stay in the middle of trails.  Do not bushwhack.

- When working outdoors do not wear work clothes home.  Wash work clothes
often or put them in the dryer to kill any ticks on them by drying.

WHAT TO DO IF BITTEN BY A TICK

      Remove the tick as soon as possible.  The easiest method is to grasp the
tick with fine tweezers, as near the skin as you can, and gently pull straight
out.  Since the Lyme bacteria is injected ny the tick when it bites, you nust
be careful not to squeeze the tick when removing it whcih could result in more
bacteria being injected.  Do NOT attempt to remove with lighted cigarettes,
matches, nail polish, or vaseline.

      Once removed put the tick in a small jar containing alcohol (rubbing
alcohol will do) and save for identification.  Idenification becomes very
important if you develop disease symptoms.

IDENTIFICATION OF TICKS

      In most areas, ticks can be submitted for identification through local
or state health department offices.  Many physicians and veterinarians will
also submit ticks.

      When submitting a tick put it in a tightly closed container with a small
amount of alcohol.  Mark it with your name, address, and phone number, date
collected, host collected from (animal or man) and recent travel history.

NOTES

_Lyme disease and pregnancy_: Miscarriage, premature births, and still births
have been reported.  Transplacental infection of the fetus has occured.
Transmission through breast milk is thought to occur.  Any women suspecting
exposure must tell her obstetrician and later, her pediatrician.

_Blood tests_:  may be helpful as an aid in diagnosis but are not always
reliable.  It is possible to have a negative test during the course of the
disease or following antibiotic therapy and still have active disease.  The
diagnosis of Lyme disease must generally be made on the basis of clinicalsigns
and by ruling out other possible diseases.  A negative test following
treatment does not indicat cure.

IF UNDIAGNOSED, LYME DISEASE CAN BE EXTREMELY DEVASTATING PHYSICALLY,
MENTALLY, AND FINANCIALLY.

FOR ADDITIONAL INFORMATION

      Lyme Borreliosis Foundation, Inc.
      National Headquarters



