Lyme disease is an illness caused by the spirochete bacteria,Borrelia burgdorferi, 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 theticks can be infected. The disease gets its name from the town ofLyme, Connecticut, where it was first described in 1975. Many feel if itwere not for AIDS, Lyme disease would be the number one infectious diseasethreat in the United States today.

There were an estimated 3200 reported cases of Lyme disease in New YorkState in 1989 and an estimated 7000 reported cases nationally. To date 45states 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 during1989. It is estimated that as many as 50,000 cases have gone unreported orundiagnosed.

Symptoms and Treatment

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

The later complications of Lyme disease are quite severe. Most commonis arthritis, usually of the large joints (e.g., knees, hips, shoulders). Other complications include meningitis and other neurological problems such asnumbness, 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 heartpalpitations and irregular heart beat. Shortness of breath, dry mouth, voicechanges, and difficulty swallowing can occur. Eye symptoms includeconjuctivitis, double vision, and loss of vision. Remember, some patients donot get the rash and progress directly to these later symptoms. Symptoms,including pain are intermittant and changing, occuring in any combination andlasting from a few days to several months and possibly years.

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

The Deer Tick

Ixodes dammini is responsible for most of the cases of Lyme disease inthe northeastern and northcentral United States(Although most people still refer to the tick as I. dammini taxonomists have changed its name to I. scapularis).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) feedmostly 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 thousandeggs. The larvae hatch from the eggs and seek hosts, often the white-footedmouse, from July through September. The larvae are very small and difficultto spot.

Some of the larvae acquire the Lyme disease spirochete while feeding oninfected hosts. After engorging, the larvae molt into nymphs, which seekhoststo feed on from April to September. Both the larval and nymphal stages attachto a variety of small mammals, white-footed mice being the main reservoir ofth Lyme disease spirochete. Nymphs that were infected as larvae can nowtransmit spirochetes to their new host. In fact, it is the nymphal stage thatappears to 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 ispainless so most people do not know they have been bitten. The nymphs moltinto adult ticks and the process starts all over. The entire life cyclerequires three separate hosts and takes about two years to complete.

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

The lone star tick, a common southern species, as well as several otherIxodes 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 horsesand cows, as are poor fertility, abortions, and chronic weight loss. Temperament changes have been reported in dogs and horses. Untreated animalscan develop chronic progressive arthritis.

If you travel into tick infested areas with your animals, it is possibleto bring ticks home on the animals that will infest your premises. If animalsin your area develop Lyme disease it should alert you that you are also atrisk.

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 wherethe leg meets the body (armpit or groin areas). Because the ticks are sosmall, you must look very carefully. Remove any ticks found and save foridentification.

Tick control on animals

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

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

How to avoid tick bites

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

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

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

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

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

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

- Inspect children at least once daily for ticks. When in heavily infestedareas inspect children every three to four hours.

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

- When working outdoors do not wear work clothes home. Wash work clothesoften 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 thetick with fine tweezers, as near the skin as you can, and gently pull straightout. Since the Lyme bacteria is injected by the tick when it bites, you nustbe careful not to squeeze the tick when removing it which could result in morebacteria 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 (rubbingalcohol will do) and save for identification. Idenification becomes veryimportant if you develop disease symptoms.

Identification of ticks

In most areas, ticks can be submitted for identification through localor state health department offices. Many physicians and veterinarians willalso submit ticks.

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

Notes

Lyme disease and pregnancy: Miscarriage, premature births, and still birthshave been reported. Transplacental infection of the fetus has occured. Transmission through breast milk is thought to occur. Any women suspectingexposure must tell her obstetrician and later, her pediatrician.

Blood tests: may be helpful as an aid in diagnosis but are not alwaysreliable. It is possible to have a negative test during the course of thedisease or following antibiotic therapy and still have active disease. Thediagnosis of Lyme disease must generally be made on the basis of clinical signsand by ruling out other possible diseases. A negative test followingtreatment does not indicate cure.

If undiagnosed, lyme disease can be extremely devastating physically,mentally, and financially.

For additional information contact:

Lyme Borreliosis Foundation, Inc.
National Headquarters
P.O. Box 462
Tolland, CT 06084
(203) 871-2900

State and local health departments in some cases can direct you to sources ofinformation and help.

Brochure design and information after a brochure entitled "Ticks and LymeDisease" done for the National Park Service by Howard S. Ginsberg, JorgeBenach and Edward M. Bossler.

Revised, updated, and new information added By:Lloyd E. Miller, DVM, Troy, NY, March 1990

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