By Eileen B. Wyner, NP
Bulfinch Medical Group

We’re hearty New Englanders but we slipped, froze and just plain suffered this past winter. We’re now reaping the benefits of our new season with bright warm sunshine and trees in full bloom, but I’m afraid we’ll be paying a price. All the snow and ice combined with a wet and soggy spring has set up a perfect storm for a tick boom in New England, which is expected to peak in the next few weeks. Here’s some basic information and guidelines for preventing and identifying tick illness while you’re outside enjoying this glorious time of year.

Lyme disease occurs when people are bitten by blacklegged ticks (more commonly referred to as deer ticks here in the Northeast) infected by a bacterium called Borrelia burgdorferi. They can attach themselves to any exposed skin area, but really like skin folds and hard to easily see places in particular. Some areas ticks are fond of burrowing into include the groin, armpit, behind the knee, the waist, and folds of the neck. They also are frequently found in the scalp as hair hides them well. Ticks need to be attached for approximately 36-48 hours or more before the Lyme disease bacteria can be transmitted.

When you’re bitten by a tick, about three-quarters of the time a rash may occur. Sometimes it will look like a small bump and resemble a mosquito bite, lasting for a day or two and disappearing. This is not a rash consistent with Lyme disease. That rash, commonly referred to as a “bull’s-eye” rash, will appear at the sight of the bite within a few days to a few weeks later. The rash may expand over time, and as it gets bigger the center may become darker and firmer while the area between the borders and the center may become clearer (this is where the term “bull’s-eye” comes from). The area may be warm to the touch but it isn’t painful or itchy.

It’s important to have this rash evaluated by a health care provider. The appearance of symptoms such as fever, chills, muscle and joint pain, headache, swollen lymph nodes, and fatigue also require medical evaluation. Let your healthcare provider know if you have any changes in your blood sugar as unexplained elevations can signal infection. These symptoms along with the “bull’s-eye” rash require evaluation by your medical provider to see if any blood tests or other treatments are required.

The best approach to avoiding Lyme disease is prevention. Here are a few tips to try to incorporate into your daily habits:

• Always do a thorough skin examination after being outside, especially if you’ve been in the woods or long grassed fields.
• Ticks can be very small (as tiny as a poppy seed!) and look like a black speck. Wear white or light colored long sleeved shirts and pants tucked into socks so you can spot them easily.
• Wear wide brimmed hats to protect your scalp and neck from a tick falling onto you when walking.
• Wear gloves if you are doing any gardening.
• Wear bug repellant with DEET. Apply to your clothes and to your skin and it will last for several hours. Avoid getting it in your eyes and mouth and wash your hands well after applying.
• Stay on well-marked paths.
• To avoid bringing ticks in the house, take off clothes and bag them before heading in to shower if possible.
• Check your pets. Dogs and cats can’t spread the disease directly to you, but they can carry infected tick into the house.

Also note: every bug bite isn’t Lyme disease. It’s important to correctly diagnose Lyme but it is just as important to avoid misdiagnosing it. Summer in New England has so much to offer and I hope these few simple steps will help you and your family stay healthy and enjoy this season.