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TICKS AND TICK BITES TICK HABITAT Ticks are active when the temperature rises above 36 degrees, making It possible to gets bite even in winter. People are often bitten in their own backyads; one does not need to be in the woods" to encounter a tick. Ticks thrive in humid conditions and prefer tall grass low brush, flower beds and the area where the grassline meets the woods. Ticks act on instinct. They are attracted to CO2 given off by man and animals. Typically they stay within only a few yards of an animal trail or home. This includes stone walls flower beds, and ground hog holes. Ticks are thick in these areas. Animals are creatures of habit and use the same trails over and over again. Ticks "know' this and lie in wait on the trails hoping to find a blood meal. AVOID THE DEER PATH and OTHER ANIMAL TRAILS. Ticks position themselves in spots wine they can attach themselves to the largest host possible. They climb to the top of a tall blade of grass and wait for a host to pass. The top of low brush is up against favorite spot. AVOID TALL GRASS AND LOW BRUSH. Ticks cannot hop, jump or fly. The host must brush up against one in order for a tick to attach. AVOID BRUSHING UP AGAINST GREENERY. Ticks love moist humid conditions, particularly leaf litter where they often lay their eggs AVOID LEAF LITTER. When walking in the woods stay in the center of the trail. HOW TO DRESS to AVOID A BITE Wear light colored clothing so ticks show up. Wear high tapped shoes with socks pulled up over the pants. Avoid cuffs or pockets tern ticks can hide. Tuck hair under a cap. Shirts should have tight sleeves and neck; a turtle neck Is ideal Ticks generally crawl from the bottom up. You may consider using repellent, especially on shoes and socks. During an outing, check for ticks and brush them off. Check again before coming inside. REPELLENT The use of repellent is a personal one. Safety, effectiveness and convenience are all matters to be considered. Some suggestions:
THE TICK CHECK Protective clothing and even repellent cannot always prevent a bite. THE TICK CHECK IS THE MOST IMPORTANT STEP IN PREVENTION. Ticks may crawl around for a few hour, before feeding. They may begin to transmit Lyme bacteria as soon as they become attached. The longer they are on the more bacteria they can inject. They prefer warm, moist, dark spots. CHECK BETWEEN TOES, BEHIND KNEES, THE GROIN, NAVEL, ARMPITS AND ESPECIALLY THE NAPE AND SCALP. A magnifying glass may be helpful.
REMOVING A TICK Remove the tick with only a blunt-tip, fine point tweezers. DO NOT USE YOUR BARE HANDS, Bring the tweezers as close as possible to the mouthparts and pull straight back using steady gentle pressure. Do not twist or crush the tick. Above all do not squeeze the tick which will cause it to inject the bacteria into the person. Place the tick in an appropriate container such as an empty clear film container, a pill vile or a ziploc baggy. If the tick is to be tested, leave a moist towelette and a blade of grass in the container so the tick does not dry out. One good lab for tick testing is: Connecticut Veterinary Diagnostic Testing Labs Your local health department may have other suggestions. Clean the tick bite with betadine or alcohol and apply antibiotic cream. Wash your hands with antibacterial soap, and disinfect the tweezers. Watch carefully for rash or other symptoms. Call the doctor. YARD CARE
SOME SYMPTOMS OF LYME DISEASE Check the following list, which is by no means inclusive. The hallmark of Lyme disease
is that it is a MULTISYSTEM illness, i.e. there is a combination of symptoms from the
different systems listed below. Usually, but not always, there is:
WHAT TO DO IF YOU SUSPECT LYME DISEASE Seek treatment as soon as possible if you suspect Lyme. Early detection and treatment is critical. Central nervous system involvement can occur within a few hours of tick bite. The longer the disease remains undetected, the more difficult it is to treat. Even if symptoms are vague, do not put off early diagnosis. Refer to articles and videos by knowledgeable physicians. These include:
Refer to symptom checklist attached. A bullseye rash is considered diagnostic and should be treated. A tick bite from an area where more than 30% of the ticks carry the disease (most of Fairfield County) should be treated. The tick must be attached, but not necessarily engorged. Simply finding an unattached tick on a person is not a bite. Both an ELISA test, and especially a Western Blot, should be taken and sent to quality labs like Stonybrook, BBI or Igenex. Any positive bands at all on the Western blot should be evaluated. While 5 bands are required by some labs to make the lgG test positive, a smaller number does not rule out Lyme. Fewer bands on the IgM constitute a positive test. Moreover, it is not the number of bands, but which ones that are positive, which is significant. Negative results on these antibody tests do not rule out Lyme disease, as specified by the Center for Disease Control (CDC). The diagnosis of Lyme is a clinical one, meaning that lab tests make up just one piece of the diagnosis. Other factors such as exposure and symptoms are important. The hallmark of Lyme is a combination of symptoms from more than one system on the attached list; usually fatigue or other constitutional symptoms, and musculoskeletal complaints and neurological problems. Antibody tests are not the only tests to use to help diagnose Lyme. If the Western Blot and ELISA are negative, and there is no other reasonable diagnosis, ask for Lyme urine antigen tests, neuro-psychiatric testing, a spinal tap, PCRIDNA tests, an MRI, or Brain Spect. A Brain Spect is more helpful than an MRI, which is often normal. They are done at Columbia Presbyterian, NY; or Middlesex Hospital, U Conn, or Yale in CT. People with complicated cases of Lyme disease are often negative on the Westem Blot and ELISA. Newer and better tests, including direct direction tests such as cultures, are being developed. Make sure you receive up-to-date information about the availability of these tests. Test for co-infection of babesiosis, HME, and HGE, and other illnesses which are also transmitted by ticks and may require different treatments than Lyme disease. Common misdiagnoses for Lyme disease include multiple sclerosis, chronic fatigue syndrome, Epstein Barr virus, ADD, ADHD, depression, fibromyalgia, and mononucleosis among others. People living in endemic areas should not accept any of these diagnoses unless Lyme has been specifically ruled out. The distinctions can be very subtle. The current treatment for Lyme disease is antibiotic therapy. There are a variety of oral and intravenous medications which are used. Choice of antibiotic is determined on an individual basis. Duration of treatment is very important. There of volumes of data which suggest that current standard treatment lengths may be too short. In general, tick bites from endemic areas should be treated for a minimum of two weeks. Early Lyme disease, which is defined as a bullseye rash and no other symptoms, is generally treated for 4 to 6 weeks. Flu-like symptoms are a sign of disseminated disease and may require longer treatment lengths. Central nervous system symptoms are more serious and may require longer treatment lengths or more aggressive therapy to penetrate the blood brain barrier. Treatment ends when a patient is symptom free for several weeks; there is no test for cure. Symptoms which continue or re-occur despite treatment, or new symptoms that develop may be a sign of relapse or persistent infection. Do not accept a diagnosis of fibromyalgia or post-Lyme syndrome. OTHER: Realize that the medical community is divided on issues concerning the diagnosis, treatment and definition of cure. The very existence of chronic Lyme disease is challenged by some doctors. Lyme disease is an illness about which a person must educate himself. Much of what is in print is simplistic, outdated and controversial. Arm yourself with current material. Make use of newsgroups and websites on the internet for the most current data. Talk to leaders of the medical profession as well as political representatives in your town, village, county and state.
Revised: 07/21/02 |
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