Lyme Disease Prevention

 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