We did it! We are number one! Pennsylvania tops the list! Blacklegged ticks have determined that Pennsylvania is our nation’s most livable state. A recent study revealed that blacklegged ticks, or “deer ticks,” have been found in all of Pennsylvania’s 67 counties. But cancel the balloons and parade, these meddlesome neighbors often play host to a bacteria called Borrelia burgdorferi. Infection with Borrelia burgdorferi causes Lyme disease which is an inflammatory condition marked by fever, headache, body aches and often a rash. If left undiagnosed, it can lead to arthritis and neurologic or cardiac disorders. The bad news is that because of our blacklegged neighbors, PA currently leads the country in new, confirmed cases of Lyme disease. Yikes! The good news is that Lyme is preventable and treatable. Though Lyme disease is admittedly complicated and in many ways poorly understood, here are the absolute essentials:
- Inspect daily for ticks, especially in those “hard to reach” spots; may require some assistance.
- If tick is found attached, carefully remove with tweezers immediately. For practical purposes, you can assume it is a blacklegged tick. All current evidence supports that it takes longer than 24 hours of attachment for the bacteria causing Lyme disease to transmit to you.
- If uncertain as to timing, see a medical provider to consider if it is appropriate to initiate Lyme prophylaxis. A one time, 200mg dose of Doxycycline, if given within 72 hours of tick removal, has been shown to be effective in preventing infection. Doxycycline is only appropriate if 8 years old and older. If allergic to Doxycycline or if under 8 years old, you should observe closely for any signs of infection.
- As many of the patients who develop Lyme disease were unaware of ever having been host to a tick, it is essential that you see a medical provider immediately if you develop symptoms suggestive of Lyme. This includes any unusual rash, whether it has the typical “bull’s eye” appearance or not. The Lyme rash can take many forms and even involve multiple locations simultaneously. As the rash is estimated to be present in less than 70% of cases, any symptoms of fever, HA and body aches that are otherwise without clear explanation should prompt evaluation with a medical provider.
- Short of developing obvious signs and symptoms, diagnosis can be elusive. This is in part related to the fact that it can take 4-6 weeks after infection for your body to make a detectable number of antibodies to the Borrelia burgdorferi. Initial testing involves looking for these antibodies. Thus, treatment should always be initiated if infection suspected.
- Again, Lyme disease is an inflammatory condition caused by a bacterial infection. This bacterial infection is treatable with antibiotics. The longer the delay in diagnosis of the infection, the increased likelihood of complications related to the associated inflammation. Treatment usually involves oral antibiotics (Doxycycline, Amoxicillin or Cefuroxime) for 21 days. IV antibiotics are appropriate if oral treatment failure or in the case of neurologic or cardiac disease.
- Bottom line: If in doubt, check it out!