Risk assessment

• Recognize Risk

– The risk of Lyme disease is year round

– Highest risk late spring to early summer

– All non-urban areas of Maryland have risk of Lyme disease

• Reduce risk

– Stay on trails

– Stay out of tall grass, uncleared areas of the forest floor

– Don’t crawl/roll in leaves of forest floor

• Low Risk Areas include

– Athletic fields or cut lawns

Personal protective clothing, repellent and insecticide use

• Clothing for protection

– Wear long sleeves, long pants/tucked into socks, shoes

– Avoid going barefoot, wearing open toe sandals/shoes

• Risk of tick bites can be reduced by using insect repellent such as DEET on the body or Permethrin on clothes

– But these are controversial products that many consider unsafe for use on children. They should not be used on children under 3 years of age

– Parents must use discretion, and may want to consult their doctor before deciding whether or not to use such products

– If parents choose to use them, they should follow all directions carefully

– Permethrin is for use on clothing only

Removal of ticks

• Inspection for ticks

– Parents should inspect the entire body daily for ticks

– Shower daily

• Common sites of attachment

– Underarm, navel, groin, behind ears, behind knees

• Tick attachment time is important

– Removal of ticks within 36 hours of attachment reduces risk of infection

• Removal techniques

– Adults remove ticks with tweezers

– Grasp tick as close to skin as possible and pull slowly/steadily

– Leave remaining mouth parts in skin, wash bite with soap/water

– Do not use topical agents, heat or other ways of getting tick to leave on its own

Recognition of the Rash

• Tick bite reactions are often confused with the rash of Lyme disease

– Only 2% of tick bites result in Lyme disease

– Tick bite reactions are small, less than 1-2 inches in size

– Surrounding redness does not expand when observed over 24-48 hrs

– Reaction at site of tick bite can last days-weeks

• Lyme rash occurs at the site of the tick bite in 80% of people with early Lyme disease

– Incubation period from tick bite to rash is 3-30 days (usually 3-10 days)

– Rash of Lyme disease is:

• round or oval, enlarges in size over days/weeks

• red, sometimes warm. Size usually greater than 2 inches in diameter, often as large as 6-8 inches

• rarely bull’s eye, usually uniformly red

– Lyme rash is often confused with being a spider bite

Requesting and Receiving care

• Diagnosis of Lyme Disease

– Lyme disease is a clinical diagnosis made by a doctor or nurse by examination of the patient

– Acute Lyme disease is not a laboratory diagnosis and a negative Lyme blood test does not exclude Lyme disease in the first few weeks of the early rash

– 20% of people have no rash, only a Flu like illness

– Fever, aches and abrupt severe fatigue can be the main symptoms of acute Lyme

– Lyme disease is difference from respiratory “cold”

– Lyme doesn’t have runny nose, prominent cough

The above is for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Do not use any of the products such as DEET or permethrin without first reviewing safety information and personally accessing the risks and benefits yourself of using these products.