There is no way to sugar-coat it: May is the official start of Lyme disease season. Carried by the Black-legged, or deer, tick reported cases of Lyme disease are on the rise in Maryland, the state where I live. According to the Centers for Disease Control and Prevention (CDC), over 28,000 confirmed cases of Lyme disease were reported nationwide in 2008. This is 5% more than reported in 2007, and double the number reported in 1991, with the most cases reported in the Northeast.

About the size of sesame seed, when the deer tick latches onto a host it passes along Borrelia burgdorferi, the bacteria that causes Lyme disease. In its early acute phase, (also known as the First Stage) most individuals with Lyme disease will first see a circular or oval rash (called erythema migrans) at the site of the tick bit. It can appear within 3 days of the bite, but sometimes may take as long as 30 days to develop. The red rash can grow up to 12 inches across, and often has a clearing in the center that gives it the look of a bulls-eye. Other symptoms include fatigue, fever, headache, chills, muscle and joint aches, and swollen lymph nodes. These symptoms are seen with other ailments causing Lyme disease to often be misdiagnosed.

If caught within approximately the first 60 days most people recover quickly and completely after 3 to 4 weeks of oral antibiotics, usually doxycycline. For patients experiencing symptoms with neurological or cardiac involvement, a second course of intravenous antibiotics would be given.

If undiagnosed for several months, Lyme disease enters what can be called the Second Stage. It can lead to pain and weakness in the limbs, poor memory and impaired concentration skills, severe fatigue, fainting, recurring headaches, recurring rashes all over the body, palpitations and even paralysis of the face muscles.

In the Third Stage, a chronic (or late) form of Lyme disease may set it. It's characterized by arthritis of the large joints, especially the knees, nervous system ailment, sleeplessness, and chronic pain.

Testing Available

There are tests for Lyme disease, the ELISA or IFA tests are usually given first. If positive, a second blood test, the Western blot, may be administered to confirm the results. However, many physicians will administer Lyme disease testing, and start antibiotics immediately without waiting for test results. Their diagnosis rests on the physical symptoms, and possibility of exposure to ticks.

An Ounce of Prevention…

Ticks thrive in humid wooded areas, areas with tall grass or lush bushes, and in large piles of leaves, so enticing to children. Ticks may be hard to avoid in many areas, but Lyme disease is highly preventable. Some precautions are easy to follow, and others may put a crimp in your summer style. However, it’s important to remember the best offense is still a good defense.

The CDC recommends the following:

• Use an insect repellent preferably with DEET as the active ingredient. DEET levels range from 5 to 30%, and in general, the higher the concentration, the longer the protection. A concentration of 10% is effective for approximately 2 hours, while a 30% DEET repellent should remain effective for 6 hours. These repellents are readily available at drug and grocery stores. Although the Maryland Department of Health states that children can use insect repellents with a maximum of 30% DEET, the American Academy of Pediatrics (AAP) advises only going as high as 10%. The AAP also states that DEET repellents should not be used on children younger than two months. (Check with your veterinarian about tick control products for your pets.)
• Spray repellents on exposed skin AND clothing.
• Wear light-colored clothing so it’s easier to spot a tick. Wear long-sleeved shirts and long pants. Be a tucker — tuck pant legs into socks and shirts into pants.
• Once indoors do a head-to-toe tick check on yourself, and your loved ones. Don’t forget to check your pets. Take a shower or wash skin that was treated with repellent. Ticks like warm spots, so be sure to check your armpits, groin area, waistband area, and don’t forget your scalp. A daily tick check, especially of children, is a good habit to have.
• If you find a tick attached to your skin, remove it as quickly as possible. According to the CDC, the chances of getting Lyme disease are “extremely small, if the tick is attached to your skin for less than 24 hours.” But just to be safe, note the date, and monitor your health closely. Be alert for any symptoms.
• If you do find a tick on your clothes, remove it before going indoors. To further protect against any missed critters wash your clothes in hot water, and dry for an hour on high heat.
• When walking in the woods stay close to the center of the path.

Don’t be lulled into complacency if your idea of the great outdoors is a small patch of grass in your back yard. Even urban backyards can become infested with ticks that have hitched a ride on small animals, like squirrels and mice.

The CDC has instructions on how to remove a tick.