Safeguard Yourself from Ticks, Lyme, and other Tickborne Diseases
By Jennifer Kraus, MD, Virtua Health Infectious Disease Specialist
Each spring, tick season predictions ramp up, and most people cite harsh winter weather for a lighter tick season or mild winter weather for a heavy tick season.
However, according to the Centers for Disease Control (CDC), it’s complicated to predict the number of Lyme disease or other tickborne infections, including how an upcoming season will compare with previous years. Many factors can affect those numbers, including temperature, rainfall, humidity, and the availability of hosts for the ticks to feed on, such as mice, deer and other animals.
It’s also tough to predict whether the coronavirus pandemic will affect numbers, as people spend more time playing and exercising outdoors.
What IS known is that deer ticks are everywhere. In fact, New Jersey is third in the country for reported tick-borne disease from 2004-2016. These ticks transmit Lyme disease—and other serious tick-borne diseases—which are treatable if caught early.
If you’re spending more time outside, read the important information below to see how you can protect yourself and your family from ticks and tick bites.
How Lyme disease is transmitted
Lyme disease is the most common zoonotic (transmitted from animal to human) disease in America. It’s caused by the bacterium Borrelia burgdorderi, which is carried by the black-legged deer tick that's common in New Jersey and surrounding areas.
People often encounter deer ticks after spending time in heavily-wooded areas, but you don’t need to be a hiker to be bitten by one. Those with pets should be aware that a cat or dog can easily bring a tick into the house. This means you should be on alert even if you don’t spend much time outdoors.
Spraying your skin with a DEET-containing insect repellent, or spraying your clothing (and clothing only) with a permethrin-containing insect repellent, are options for keeping ticks at bay.
What to do if there’s a tick on you
If a tick is crawling on you outside and you brush it off, you don’t need to be worried about Lyme. The tick must be attached for at least 36 hours to spread the disease to you.
Check your body and clothes for ticks after spending time in a high-risk environment. If you find a tick attached to you, quick removal will ensure you never come into contact with the Lyme bacteria.
But, keep in mind, ticks are good at hiding. Check your scalp, back and in the folds of skin—especially the back of the knee, the underarm, and between the legs.
What are the symptoms of Lyme disease?
These are early symptoms of Lyme disease:
- A “bulls-eye” rash
A bulls-eye rash is one of the most recognizable symptoms of Lyme. A few days after a tick bite, this rash will expand outward and may turn into a red outer ring with a clear area inside it. Looking for that pattern is important, because almost all people will have some degree of redness and hypersensitivity to a tick bite, as with any insect bite. It’s also important to note that this rash isn’t tender, which is unusual. If it looks like it should hurt and it doesn’t, that’s a cause for concern.
- A flu-like reaction
This can include fever, headache, neck stiffness and fatigue.
These are the symptoms of the later stages of Lyme disease, and can occur months after infection (if untreated):
- Joint pain with swelling
This tends to affect the large, weight-bearing joints like the hip and especially the knee. It mimics arthritis, except it’s usually accompanied by swelling, and again, it will tend to be less painful than it looks.
- Cranial nerve inflammation
Cranial nerve inflammation is more unusual, but tends to affect the nerves of the face, affecting facial movements. If you experience this, you should see your doctor right away.
How Lyme disease is treated
Generally, Lyme disease is easily treated with 2-3 weeks of oral antibiotics. Studies have shown no difference in outcomes between those treated for 3 weeks with oral antibiotics versus those treated for 3 months with intravenous antibiotics. Some studies have even suggested that a shorter treatment of 10-14 days might even be just as effective. Also, a single dose of the oral antibiotic doxycycline given when someone COMES IN with an engorged deer tick still attached, but showing no other symptoms, is highly effective at preventing disease.
If, after 2-3 weeks of oral antibiotics, you’re not feeling any better, there’s a good chance you don’t have Lyme. In this case, continuing to take doxycycline likely won’t help, and other diseases should be ruled out with the expert guidance of an infectious disease specialist.
Beware of these other tick-related diseases
The same tick that carries Lyme disease can also carry other diseases that you should be aware of:
- Ehrlichiosis and anaplasma can cause a flu-like illness that may be mild or may cause symptoms of headache, chills, fever, rash, and fatigue. These symptoms can develop up to 2 months after the tick bite. Much like Lyme disease, this is treatable with the oral antibiotic doxycycline but you should see your physician.
- Babesiosis is another tick-borne illness to think about during warmer months. You may develop symptoms 1-6 weeks after a tick bite including fatigue, fever, joint aches, and abdominal pain. People who would be at risk for severe disease include those who have had their spleen removed, those over age 50, anyone on immunosuppressive drugs, and patients with HIV. This is usually treated with a combination of antibiotics.
- Powassan virus is transmitted by the same tick that carries Lyme disease and can infect all age groups from the very young to the very old. The most common symptoms are fever and headache but people may also get muscle aches and a mild rash. Unfortunately, this virus can't be treated with antibiotics, and there's no vaccine available at this time. If you think you or a family member have been bitten by a tick and have the above symptoms that progress to changes in mental status, you definitely want to go to the nearest emergency room so a doctor can evaluate you.
- Additional tick-borne diseases: With the warmer weather we've experienced in the last few years, some scientists say that tick-borne diseases have flourished. Despite our location, we've seen Rocky Mountain spotted fever in the Northeast. Along with symptoms like fever and muscle aches, Rocky Mountain spotted fever also is associated with a headache and rash. In addition, emerging illnesses include the Heartland virus and the tick-borne relapsing fever caused by Borrelia miyamotoi. Symptoms are similar to the other tick-borne illnesses. As always, speak to your primary care doctor and, if needed, he or she can refer you to an infectious disease doctor for further evaluation.
If you have been bitten by a tick and have the above symptoms and risk factors, you will want to speak to your doctor.
Updated June 1, 2020