A black-legged tick. Photo by Erik Karits on Unsplash
Editor’s note: This is part of a series on summer safety, written by Occupational Health Services student interns.
Lyme disease is the most common tick-borne disease in Maryland, spread by bacteria found in the bite of black-legged ticks, also known as deer ticks. Though it’s common, the disease can be difficult to diagnose, sometimes resulting in debilitating symptoms that may have been prevented with proper, timely diagnosis and a simple course of antibiotics.
Those unfortunate enough to be infected by the bacteria, Borrelia burgdorferi (and, rarely, Borrelia mayonii), may initially develop the well-known circular “bulls-eye” rash at the site of the bite, then fever, headache, and fatigue within three to 30 days of being bitten. If left untreated, Lyme disease can spread to joints, the heart, and the nervous system. In extreme cases, the disease can induce a third-degree heart block or cause Lyme arthritis.
Thankfully, not every tick bite results in infection, but early detection is key for successful treatment. This can be tricky—not every infected person gets the rash or notices one, which can cause a troublesome delay in diagnosis.
Current Lyme disease tests look for antibody responses to Borrelia, not for the bacterium itself, and our bodies may take several weeks to develop antibodies, according to the Centers for Disease Control and Prevention, so testing too early can give a false negative result.
A group of scientists in the Immunological Monitoring Laboratory (IML), led by Douglas Kuhns, Ph.D., at the Frederick National Laboratory for Cancer Research (FNL), is dedicated to enhancing detection methods of antibodies to the disease-causing bacteria in humans.
Kuhns’ laboratory is also exploring Post-Lyme Disease Syndrome (PLDS), a name for the list of symptoms, often neurological, that can persist even after the recommended antibiotic therapy for Lyme disease is complete.
Since PLDS symptoms are often like symptoms caused by other diseases—and Lyme rashes can be overlooked (or never appear)—patients can unknowingly suffer for years before receiving a correct diagnosis, emphasizing the importance of early, correct detection.
Reducing Tick Exposure
Better than early detection is prevention. As summer progresses and moves into fall, many of us spend more time outdoors, so avoiding ticks can keep us safer. Tick exposure can occur year-round, but the chances are highest between April and September when ticks are most active.
Ticks love wood piles and areas with lots of vegetation. So mowing the lawn, managing winter firewood stores, or weeding the garden is a good first line of defense to keep these pests away. If you’re doing yardwork, hiking, or enjoying other outdoor activities, you can minimize your tick exposure by using repellant. However, it’s important to know that that generic bug repellant is not effective against ticks.
Siu-Ping Turk, a research nurse specialist in the Laboratory of Clinical Microbiology and Immunology at the National Institute of Allergy and Infectious Diseases, recommends DEET bug repellent as a practical measure against ticks. Although there are some environmental concerns with using DEET and its slightly toxic effect on wildlife, a non-DEET bug repellent’s effectiveness diminishes over time. Using DEET helps protect against black-legged ticks for up to five hours, and using low concentrations (below 50%) reduces the product’s environmental impact.
Tick Removal
After spending time outside, doing a thorough tick check and promptly removing any embedded ticks is essential.
Debra Long Priel, laboratory supervisor in the FNL Neutrophil Monitoring Laboratory, also headed by Kuhns, warned that “ticks are on the rise in the Frederick [Maryland] area, [so] remain vigilant in removing ticks as soon as possible. Studies suggest that if a tick is removed within less than 24 hours from attaching to the body, the chance of getting Lyme disease is extremely small.”
If you do find an embedded tick, don’t panic. The most effective method for tick removal is to place clean tweezers as close to the skin as possible, close them around the body of the tick, and pull up slowly and steadily. Make sure not to twist or jerk the tweezers, as this could rip the body from the head, leaving the mouth embedded. After removing the tick, make sure to clean the bite area and dispose of the tick by either putting it in alcohol or flushing it down the toilet.
If you believe the tick you removed has been feeding for more than about 36 hours, or if you notice a circular rash or other Lyme symptoms, with or without seeing an embedded tick, seek medical care. In most cases, if caught within 72 hours of the bite, a single dose of antibiotics can prevent any tick-borne bacterial infection, including Lyme.
Ultimately, ticks are widespread during the warmer months of the year and can prove to be a significant nuisance. However, following proper safety precautions outdoors, especially in areas likely to be teeming with ticks, can mitigate the dangers of tick bites and keep you safe while enjoying a fulfilling time in nature.
Sneh Gandhi, a rising senior at University of Maryland, College Park, and Sophia Pell, a rising senior at Shepherd University, are summer student interns for Occupational Health Services (OHS). OHS interns assist registered nurses and nurse practitioners with day-to-day clinical tasks, including basic patient intake and triage, venipuncture, vaccine administration, patient charting, and wellness promotion.