Healthy Living: May 7, 2019

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BANGOR, Maine (WABI) - Lyme disease has become an inevitable seasonal challenge in Maine that has risen sharply since the early 2000s, with cases reported in every county in the state. Just as we welcome the end of another long winter, so we must guard ourselves against the ticks thriving in the warmer temperatures.

Lyme disease is caused by bacteria that can be carried by deer ticks. In some locations it is estimated that half or more of deer ticks carry the bacteria. The bacteria doesn't harm the ticks, but if the tick bites an animal (or person); the bacteria can spread to them. Anyone can get Lyme disease though children and older adults seem to be the most severely affected.

Most cases of Lyme disease happen in the summer simply because more deer ticks and people are together outside. Ticks like places that are damp and so are fond of wooded and bushy areas, high grass, and areas with a lot of leaf litter. The most common symptom of Lyme disease is a distinctive non-painful rash that it looks like a bull's eye. This rash is diagnostic of Lyme disease infection. It occurs at the location of the tick bite but can take up to 30 days to appear and many infected patients don't ever notice it. Fever, headache, muscle aches and fatigue are early symptoms. If untreated later symptoms can occur including arthritis (especially knees), neurologic symptoms and even heart inflammation.

Prevention of tick bites is the crown jewel to avoid getting Lyme disease and other serious diseases spread by ticks. The Maine CDC's "No Ticks 4 ME" program is one easy way to remember how to protect yourself and others

1. Wear Protective Clothing Outside
a. Long sleeves and long pants that are light in color are the best. In "high tick" areas consider tucking pant legs into socks.
b. Consider using insect repellent (permethrin) for outdoor clothing.
c. Promptly wash outdoor clothing in hot water and dry on high heat to kill any ticks that may be present.
d. Shower/bathe promptly after coming indoors for the day.
2. Use Insect Repellent
a. Four products are approved by the CDC. All should be used as directed and products combined with sunscreen should NOT be used.
i. DEET 20-30% can last up to 6-8 hours and the AAP states ok for infants less than two months of age.
ii. Picardin lasts 4-8 hours and may have less side effect potential than DEET.
iii. IR3535 is considered "moderately effective" and lasts 4-6 hrs. but reported 10-100X less effective than DEET.
iv. Lemon Eucalyptus Oil was found to be as effective as DEET but has a short duration of effectiveness and is not recommended for children less than 3yrs of age.
b. Pets also need to be protected; your veterinarian can give you guidance.
3. Do Daily Tick Checks of the people and animals in your house. Ticks have to be attached at least 24 hours to transmit Lyme disease. If you find a tick, pull it out gently and straightly using tweezers or a tick spoon if available. Wash site well and watch it carefully for the next month for signs of rash.
a. If you want to have a tick identified or tested you can send it to UMaine Cooperative Extension Tick Lab (website below).
4. Use extra caution in high tick habitats.
a. Avoid when possible. When you must go these areas, the hottest and driest times of day are the safest.
b. Stay on cleared trails and paths.
Anaplasmosis, Erlichiosis, Babesiosis, and Powassin are other serious tick related infection present in our state. Protecting yourself against Lyme disease will help protect you against these infections as well. The Maine CDC and the UMaine Cooperative Extension Tick Lab have a wealth of easily accessible information and resources about Lyme disease and other tick related infections in the state.

References:
1. www.maine.gov/lyme
2. www.cdc.gov/lyme/www.lymediseaseassociation.org
3. gateway.maine.gov
Environmental Public Health data portal has real-time data of tick-borne diseases
(103 Lyme, 7 Anaplasmosis, 2 Babesiosis as of this morning for 2019)
4. tickid@maine.edu (Tick Lab at UMaine