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Looking out for Lyme disease

May 17, 2012
By KELLY FOSNESS - DMG writer ( , The Daily Mining Gazette

HANCOCK - Over the last five years, there have been 21 lab-confirmed cases of Lyme disease in the Western Upper Peninsula Health Department.

"The state lists Lyme disease as an endemic in Ontonagon and Gogebic counties," said Ray Sharp, manager of community planning and preparedness for the Health Department. "That means you should take special precautions there."

Lyme disease is a bacterial infection that can be transmitted to humans and also pets, especially dogs.

According to Dr. David Kass, family practice physician for Portage Health, the disease is spread by deer ticks, which carry the bacteria called Borrelia burgdorferi.

"That particular tick is smaller than a wood tick," he said. "Usually it's about the size of the end of a pencil so they're quite small."

First identified in Lyme, Conn., hence its name, Lyme disease occurs primarily in three regions in the United States, the Midwestern states of Michigan, Minnesota and Wisconsin, among those regions.

Kass said the bacteria are transmitted when a tick bites a person. Symptoms usually begin in the form of a rash.

"Seven to 14 days after a tick bite, that usually starts as a rash around the bite," he said. "People describe it as a bull's eye rash because it spreads outward and then it becomes pale in the center."

Additional symptoms that can develop early on include fever, chills, fatigue and body aches.

"There's lots of different symptoms that occur," Kass said. "We tell people, if they have a tick that's embedded and they can't remove it easily or they think it's been present for more than 36 hours, they should be seen by a doctor to have an examination to determine whether it needs to be treated or not with antibiotics."

According to a "Preventing Lyme Disease" article from Krames Online, if a tick is not yet attached to the skin, remove it with tweezers or a tissue and flush it down the toilet. Or, use a piece of tape to lift it off to avoid contact with bare hands.

If a tick is attached to the skin, it's recommended to carefully remove it with tweezers, grasping as close to the skin as possible. Pull slowly and gently without twisting the head or body. Do not crush or squeeze the body as it may release bacteria.

If the tick cannot be removed, seeking medical attention is recommended.

Kass said Lyme disease is treatable with antibiotics. The earlier it's identified the more effective the treatment is against infection.

"The problem is sometimes it's difficult to identify," he said. "If the person doesn't remember being bitten by a tick and they come in weeks or even months afterwards, symptoms can vary from arthritis symptoms to cardiac symptoms to neurological symptoms."

In that case, Kass said, the patient has to backtrack.

"There are a lot of other things that have to be considered besides tick bites," he said.

On the other hand, he said, if you see a tick and there's a characteristic rash, it's easy to treat at that point.

While Kass said he hasn't seen a Lyme disease case yet this year, a number of patients have been seen for tick bites.

"I had somebody come in for a physical exam yesterday (Tuesday) who didn't know they had a tick bite," he said. "Tick bites are very common. There seems to be a lot of tick bites this year ... with the warm weather."

Kass said tick bites usually occur in hidden areas of the body such as along the waistband and under the arms.

When a patient comes in with a bite, Kass said the obvious identifying factor during an examination is seeing the actual tick embedded in the skin. Also helpful is if the patient knows they've been bitten and there's a rash present.

Bell's palsy, a form of facial paralysis resulting from a weak cranial nerve that causes a side of the face to droop, can be associated with Lyme disease as well.

"If you've got a droopy face, especially in a younger person where it's not related to a stroke, we typically test for Lyme disease," Kass said.

While data from the Michigan Disease Surveillance System lists Lyme disease as an endemic in Ontonagon and Gogebic counties, Sharp said anecdotally, it seems there are more cases in recent years in Houghton County.

"They may not have all been laboratory confirmed, but people have been symptomatic and they've been treated by doctors," he said. "Sometimes you can get a negative on the laboratory test, but likely they have the disease and the doctor will treat it."

As far as prevention, there are a number of ways one can protect themselves from tick bites, starting with clothing.

"Wear a long-sleeve shirt and tuck your pants into your socks," Kass said. "Wear light-colored clothing so you can see the ticks."

Spraying the pant legs and boots with insect repellant containing DEET can add further protection.

While antibiotics are used to treat tick bites in humans, Kass said there are vaccinations for pets.

"There was a vaccine for humans but it was taken off the market," he said. "It wasn't well accepted. There were some concerns regarding safety."

For more information about Lyme disease and prevention, visit,s,85237 or,s,40914.



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