Lyme Disease: Challenging Old Stereotypes

[Dan L]

Yale University has a new iPhone application that shows tick population for a given area, and also shows photos of typical ticks and rashes.

It's available for $1.99 from the iPhone apps store and proceeds benefit the American Lyme Disease Foundation.

I'm not sure if it's still available, but the school of veterinary medicine at the University of Connecticut used to test ticks for Lyme for free. Perhaps other universities in high incident areas do this.

[Ken]

Richard,

I believe that what Benjamin meant by calling prophylactic use of antibiotics "antisocial" was that this behavior works against the greater good of society… misanthropy would be a stronger word.

And although completing the reccomended (complete) course of antibiotics would lower the risk of creating resistant organisms, there is still a risk that you will contribute to the rise of super-bugs:

"The primary cause of antibiotic resistance is antibiotic use both within medicine and veterinary medicine. The greater the duration of exposure the greater the risk of the development of resistance irrespective of the severity of the need for antibiotics." (quoted from wikipedia; but there are many sources that will back this up)

Misuse of antibiotics increases the problem; but even appropriate antibiotic use will contribute to the natural selection of antibiotic resistant organisms. Prophylactic use without consulting a physician would be irresponsible.

I think that this was an excellent article – I very much appreciate the detailed medical reccomendations. Articles like this are exactly why I like backpackinglight.com so much… comprehensive information on lightweight backpacking philosophy and technique; not just the latest lightweight gear! Thanks for the well written article, Dan!

[Donald Kevilus]

Great article ! I live in a area of MN that has one of the highest rates of lymes disease in the state. Most folks who spend alot of time in the woods or outside have ether got it or some one in there family has.
Ticks are a way of life here, the worst time being the end of May through June. The commen wood tick , pick 'em off and go on with your day. But the Deer tick look hard and long for. If he bites there is a good chance you will get
Lymes disease.
The good thing here now if you have the tell tale bull's eye rash they treat right away and there is realy good awareness in the medical commuite of the disease.
I find the thicker the brush or grass the worse the ticks.
Also if there alot of deer in your area the bigger chance of the disease from the deer tick.
The best thing is just be aware and check yourself and love ones good once a day and injoy the woods !

[Einstein X]

"…It's the person who never saw the tick who is most likely to get the disease…"
"…the best way to keep ticks off the body is to wear long sleeved clothing, tuck pants into socks, and apply insect repellent…"

Just two phrases that striked me the most in this article. Indeed I think that the best thing to do about Lyme's disease is to increase awareness to the people most likely to get a tick byte. I think this is more effective than increasing awareness under house doctors. That doesn't mean though that doctors should not have more knowledge of the disease. All I'm saying is that since the first 24 hours are so important it is also very important that people likely to get bitten know what to do.

As for myself, I get bitten by ticks a lot when I'm hiking. Usually a two weeks hike will leave me with about 50 bytes. Which I agree is a lot, but since I am very much aware of them common practice is to check myself regularly during the day as well as upon arrival in camp.

Which brings me to the practice of tucking clothes in your socks. I have found ticks between my toes while wearing shoes and sock and I've found them in my privates. Therefore I don't think that tucking your clothes will matter much as they are perfectly able to crawl to wherever they can find a warm and cosy spot to byte. Then again, I like to hike in hiking shorts whereas my hiking partners hike in trousers and they usually have much less than I do.

As one poster said ticks are spiders (they have 8 legs which make them arachnids, the only fact missed in this well written article) and I always thought that DEET only works on insects (which have 6 legs). So since ticks have two legs too much to be insect, does DEET actually work? The way I know of DEET to be effective is that it basically disorientates and insect that tries to come near humans by sense of smell. Since the tick does not rely on smell but on touch I don't think DEET will be very effective when the tick has already fallen on you. I did however once have a camp in Scotland where an army of ticks was crawling my direction and I'm sure that the big one was pointing its legs to me. Was he trying to feel my vibrations or trying to sense my scent?

Permethrine I will definitively try, although it is illegal in my country.

Finally, I'd like to add that after a feed-the-local-tick-population hike I keep a close eye on my body, knowing that the chances of Lyme are very low since I think I catch 99% of the ticks within the 24 hours; as well as visiting my doctor for an blood exam. Lyme has been verified and has been treated effectively with doxycyline. So far I've been lucky and I feel healthy, however there's always a very little bit of fear that my Lyme might pop-up many years from now, because I've read that even after treatment it can lie dormant in your body to manifest many years later, but that might be a popular myth. Who knows?

Eins, is happy that the last two winters in NW Europe have been cold, killing many ticks.

[Rakesh Malik]

"As one poster said ticks are spiders (they have 8 legs which make them arachnids"

They are arachnids it's true, but that doesn't actually make them spiders any more than it does crabs and scorpions, both of which are also arachnids.

Of course, not being spiders doesn't make them less creepy than spiders, either.

I don't know about Lyme's dormancy, but I haven't heard about that. I've heard a lot of stories about it being mis-diagnosed and therefore not treated properly, leading to protracted and worsening problems, as in this article. Naturally the cases where it's properly diagnosed and treated early don't get much mention.

http://animals.howstuffworks.com/arachnids/tick.htm

[Stuart R]

"Ticks that are attached should be removed using fine tweezers, if available"

It is important when removing the tick not to cause distress to the tick, otherwise it will regurgitate it's stomach contents into the bite, increasing the risk of infection. The tick should not be burned, doused in alcohol or pulled off.

There are simple tools to effectively remove ticks, such as the O'Tom Tick Twister (www.otom.com) which are inexpensive and easy to use.

I have used these and always carry one in my first aid kit. I'm surprised they are not mentioned in the article.

[Gustav Bostrom]

Very good article. We have a lot of ticks near Stockholm and I get bitten quite regularly, sometimes even several times daily. Especially after bushwacking walks. Several of my friends and relatives have been diagnosed and treated for Lymes disease (Here the popular name is Borrelia.). Luckily nowadays most people here seem to be aware of the disease and symptoms and get treated promptly. This article provided a lot more insight into the diagnosis and I found this information to be very good. Indeed, this is the kind of stuff I subscribe to BPL for.

To prevent illness I try to examine myself regularly. If possible everyday. Borrelia is one reason, but also the fact that the sooner you remove the tick, the easier it is. You also get less of an itching rash if you remove them quickly (Since ticks really like the groin area, the rash can be seriously annoying.). Thanks to this article I will also investigate whether I can get my clothes Permethrin treated.

A more dangerous disease, but also more rare, is TBE (Tick-Borne Encalphitis?). To prevent this you should consider getting vaccinated if you are hiking a lot in areas of high risk, such as the archipelago of Stockholm or the Baltics.

[Jacob D]

The last time my wife and I hiked park I had several ticks. The most memorable was right on my shaft… yeah the family jewels. I'm in California so I wasn't very concerned with Lyme disease. A few months later I started having some serious problems with my jaw very suddenly and when both my dentist and doctors were coming up with nothing I began reading about Lyme.

It turns out that most of what I thought I knew about ticks was all wrong. Apparently… never twist them, burn them, or smother them (re-iterating some points already mentioned above). Pull straight out. If the head breaks off there is no increased chance of infection. The smallest ticks are most likely to spread Lyme and male/female sex of the tick doesn't matter. Luckily for me I was only having some problems with a bad tooth affecting a nerve connected to just about everything in my face. The tooth is now fixed and compared to the alternative I got off easy.

I recently bought one of the "tick remedy" tools. It seems like it should make removal a little safer than with tweezers, as mentioned squeezing the stomach of an embedded tick is a bad idea.

[Gordon Smith]

Ticks are common in the Columbia River Gorge and I've been bitten there many times. Fortunately Lyme is not common in this area, but I take every bite very seriously all the same. Last year I developed a bullseye rash around a tick bite. It was the first time that's happened to me. My doctor recommended I just go ahead and start a 10-day course of Doxycycline right away. He said Lyme tests can be notoriously inconclusive, especially early on in the course of the disease, which is when the bug is easiest to kill. So I started on Doxy that same day. I didn't really give the superbug issue a lot of thought. Perhaps I should have. The prospect of Lyme is pretty scary though, so the peace of mind of the Doxy was a welcome thing indeed.

The Pro-Tick Remedy tool that Jacob mentioned is available at REI. It's cheap, light, tiny, and very effective. I carry one in my First Aid Kit all the time.

Gordon

[Mark Ryan]

I brought my dog to get a Lyme Disease Vaccination last month. Two shot procedure over a week. I asked the vet if she could give it to me as well half jokingly. She of course said no but went on how she did some research on human vaccines. Apparently I wasn't the first to ask her.

She stated that there used to be a human vaccine years ago but was discontinued because there wasn't much money being made to justify its production. She also went on on how canine and human systems are very similar an the canine vaccine would most likely work for humans. We do share more diseases with canines then with any other animal and it's because of our codevelopment throughout time.

I wish there was a way to have the human vaccine reinstated. I'd pay for it.

Food for thought!

"May the road rise to meet you"

[Aaron Reichow]

One of the scariest things I read recently was that newer studies suggest that the bull's eye rash (EM) we all associate with Lyme's disease is a lot less common than previously thought, with only 20-50% of those infected developing the characteristic rash. Earlier studies suggest that the EM rash happens in 50-80% of cases- not a sure thing, either.

Can't find the article now, but I can keep looking if anyone is interested.

[Elizabeth Tracy]

Those Pro-Tick Remedy tweezers look an awful lot like the little tweezers on my mini Swiss army knife. Are they really functionally different? Can I just use what I have?

[Rakesh Malik]

I think that your tweezers would be fine. The Pro-Tick tweezers are just shaped to make it easier to get under the tick's body — if you don't have specially shaped tweezers, you just have to be a little more careful in order to avoid squashing the bugger rather than gripping it. I've done it before, it isn't hard — unless it's in a spot that's hard to see and/or reach, like the back of your knee. I had to get someone to help me with that one.

[Michael Ray]

> I happen to work with a guy who's an arachnologist, so I emailed him to ask about whether ticks can drop from trees, and about whether Lyme disease is a significant risk here in California.

> He says ticks do not drop out of trees.

Well, they most certainly do in Indiana. I've had 2 separate incidents where they had to have dropped from large trees, not some little sapling. Once I had one land on my open Bible and the other time I found one on my wife's head less than 30 minutes after walking down a gravel road and a small mowed area with no brush that we were anywhere near.

[Joe Clement]

I've had ticks drop on my from trees in Texas.

[* *]

Crabs are not arachnids. They are crustaceans.

Not to confuse matters, but the other "crabs" are actually insects.

[Will Webster]

If I remember correctly, there was some concern that the vaccine could cause the disease. Of course, if someone developed the disease after getting the vaccine, there would be no way to prove whether the person had been exposed before being vaccinated, or the vaccine was ineffective at preventing infection from post-vaccination exposure, or the disease was actually caused by the vaccine. This uncertainty would be no protection against a multi-million dollar jury award. So it's not just a question as to whether enough money could be made off marketing the vaccine (which I think would be substantial), but how much money the manufacturer could stand to lose.

[Ethan A.]

Just pulled out the first embedded deer tick that ever managed to latch onto me, which is amazing considering where I've hiked before in the NE. Was a large adult female, so pretty easy to spot, plus I could actually feel the bite, which felt like a scrape from a branch. There was actually a small red ring around the area where the tick was embedded. I'm 99.9% sure it wasn't on me for more than 1-19 hours (depending on whether it hitched a ride during yesterday evening's hike or this morning's).

Pulled it straight out alive and bagged it in a zip lock and will have it tested this week (many agencies do free testing). Strong little bugger – took an impressive amount of steady force to get it out.

No doc to ask until Monday, but According to the article and comments above, chance of infection is lower with an adult than with a nymph, and chance of infection in N California is low outside of Mendocino, Humbolt and Trinity (hope the study authors are correct).

Even with the excellent article here there is so much information out there that isn't well understood. Doing what you can for prevention seems best.

I will definitely pay more attention to prevention, first by spraying clothing, socks and hats with permethrin.

Anyone know:

1) How long permethrin lasts on clothes?

2) Once it's dry is it set? Does it benefit from a roll in the dryer on low heat?

3) I'm pretty sure it wouldn't, but anyone know if it would survive a wash with DWR-safe vegetable-based washes? Likely need to retreat after every wash.

4) Are pre-treated permethrin clothes and hats worth it? Seems like an excuse to charge a lot of extra money. Would love to know how they embed permethrin in clothing so that it survives washes.

5) Do you spray your shoes, socks, inflatable mats, tents and sleeping bags?

[Kattt]

Two months ago I had yet another embedded tick, this time on my back. It was tiny and the whole area was painful. It tested positive (took 2 weeks!!) but I was already on major antibiotics since I did not know how long it had been in me and since it was the kind known to possibly carry the virus. The whole thing really sucked, pun intended. I had a reaction to the antibiotics and now I need to go back to get tested, just in case :(

[M B]

On a hike in May, my son had a tick crawling on his face within 10 min of starting on trail.

His clothing from the shoes up were treated with permethrin, so was his hat. we also wear compression shorts to exclude them from the harder to check areas.

Did not contact any brush or branches.

We picked ticks off our legs all day long. None had chance to attach. Every 15 min stop and look at legs, flick off ticks.

No explanation for how the tick got on his face. Its very doubtful it could have climbed up his clothing in that time, especially permethrin treated clothing.

[Michael Ray]

That is curious. I know for a fact they drop from trees, but it would still take a while to go from hat to his face. Maybe dropped on his shoulder?

[Ethan A.]

Kat hope you are feeling better both from the bite and the antibiotics. That is really no fun. The nymphs are so small, I really don't know how you could ever find them, especially on hard to see areas, without feeling pain or seeing a rash. You are especially never going to see those little dots in places like your arm pits, private parts, etc.

By the way, the county health office that tests the tick for $15 said that Santa Cruz ticks tested positive for Lyme at the highest rates in the SF Bay Area, which really sucks, as the SC area has some fantastic trails. They test once a week on Tuesday mornings and you get a call back that afternoon if the tick tests positive.

I should mention that the county health office only tests for Lyme, not several other co-infectious illnesses. If you have the tick tested at a local private lab, they charge a whopping $65 for Lyme, and then for each of these co-infections:

Please test the tick by PCR for:
____ Test 140 Lyme Disease (B. burgdorferi) $65.00
____ Test 689 Babesiosis (B microti and/or B duncani) $65.00
____ Test 148 Ehrlichiosis (Ehrlichia) $65.00
____ Test 290 Bartonella henselae $65.00
____ Test 975 Rickettsia $65.00

Since spotting nymphs is so difficult, I'd like to find out the best permethrin info.

[Matt Dirksen]

It looks like a simple urine test may become a way to detect Lyme disease:

http://www.wtop.com/41/2842963/Easier-way-to-detect-Lyme-disease-may-be-on-horizon

I sure hope this pans out. Both my wife and daughter have had to do antibiotics because the ticks we pulled off them carried Borrelia whatever it is…

[Author]

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