If you work or recreate in or near wooded regions in New England, the Mid-Atlantic, the northern Midwest or southern Canada, you should be especially concerned about the summer risk of Lyme disease, spread by tick bites. Laborers working on road crews in the rural areas of these regions are most at risk and should take precautions (see sidebar).

Prevent Lyme Disease

  • Avoid areas with lots of ticks – wooded and bushy areas with high grass and leaf litter.
  • Be particularly careful in May, June and July when ticks that transmit Lyme disease are most active.
  • Use insect repellant with 20 to 30 percent DEET on adult skin and clothing. It is available at drug, grocery and discount stores.
  • Permethrin is also effective but should not be applied directly to skin. Apply to pants, socks and shoes; it will remain effective through several washings. It also will kill ticks on contact. It is available at outdoor equipment stores.
  • Wear long pants, long sleeves and long socks to keep ticks off your skin. Light-colored clothing makes it easier to spot ticks. Tucking pant legs into socks or boots will help keep ticks on the outside of clothing.
  • Remove ticks from clothing before going indoors. To kill any that may be missed, wash clothes in hot water and dry in high heat.
  • Perform daily body checks, including armpits, scalp and groin. Remove ticks immediately with fine-tipped tweezers. Do not use petroleum jelly, nail polish or matches. Cleanse area with an antiseptic.
  • If at tick is attached to your skin for less than 24 hours, the chance of getting Lyme disease is extremely small. Just to be safe, monitor your health closely after a tick bite, be alert to any signs or symptoms of the disease and contact a doctor if any present.

Although generally cured within a few weeks through antibiotic treatment, the disease can be slow to heal if treatment is delayed and painful if left untreated. Initial symptoms include fatigue, chills, fever, headache, muscle and joint aches and swollen lymph nodes.

If untreated, the infection may spread to other parts of the body, producing such symptoms as loss of muscle tone on the face (Bell’s palsy), severe headaches, neck stiffness, shooting pains, heart palpitations (rapid beating), dizziness and pain that moves from joint to joint. Untreated, the disease can take months to resolve, and about 60 percent of patients will experience bouts of arthritis, including severe swelling and pain in the joints, particularly the knees. A small number (five percent) of untreated patients develop chronic neurological complaints, including shooting pains, numbness or tingling in the hands or feet and problems with concentration and short-term memory.

A distinguishing feature of Lyme disease is a rash called erythema migrams (EM) which develops in three out of four infected persons. It is circular and expands outward from the site of the bite after a delay of three to 30 days. It can reach up to 12 inches across and, sometimes, the center clears, resulting in a bull’s-eye appearance.

Approximately 20,000 new cases of Lyme disease are reported annually in the U.S., most during May, June and July. Though several of the states with high rates border on Canada, much fewer cases are reported in Canada, perhaps due to misdiagnosis and underreporting. According to the U.S. Centers for Disease Control, 93 percent of all U.S. cases come from just ten states – Connecticut, Delaware, Maryland, Massachusetts, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island and Wisconsin. Columbia and Dutchess counties in New York and Dukes County in Massachusetts have the highest rates (300 cases per 100,000 residents annually).

Summer is the peak season for ticks, tick bites and Lyme disease. If you work outdoors in rural areas, take necessary precautions and check yourself regularly for ticks.

[Steve Clark]