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College of Medicine

Vermont Medicine Magazine

Grace Offers Steps to Prevent the Tick Bites that Lead to Lyme Disease

Christopher Grace, M.D., Professor of Medicine at the University of Vermont College of Medicine and an Infectious Disease Specialist at Fletcher Allen Health Care
Christopher Grace, M.D., Professor of Medicine at the University of Vermont College of Medicine and an Infectious Disease Specialist at Fletcher Allen Health Care (Photo: UVM Medical Photography)

Lyme has spread at an incredible rate over the past decade in Vermont, from 60 cases in 2003 to 890 cases – 671 confirmed and 219 probable – in 2013, according to state epidemiologist Erica Berl, D.V.M., M.P.H. In Vermont, the age groups most affected by Lyme disease include children and teens ages five to 18 and adults ages 45 to 65, she says.

Christopher Grace, M.D., professor of medicine at the University of Vermont College of Medicine and an infectious disease specialist at Fletcher Allen Health Care, says prevention is key to fighting Lyme disease.

“First, try to avoid getting the tick on you. Second, if it’s on you, get it off,” says Grace, who offers the following preventative steps:

 

  • If you’re headed into grassy or wooded areas where ticks like to hang out, then wear long pants, tucked into your socks, and long-sleeved shirts. If it’s hot and you’re wearing shorts, then be extra diligent with tick checks.

  • Spray Permethrin onto your clothes and shoes to repel ticks. You also can buy Permethrin-impregnated clothes.

  • Use a 30 to 50 percent DEET-based product on your skin; it has been found to be safe for you and your kids, Grace says. “DEET has been on the market for 30 years. It’s the only thing that has been shown to have efficacy in keeping ticks from attaching,” he explains. “Just make sure you wash it off at the end of the day.”

  • Check for ticks after you’ve been outside. They can crawl all over your body, he says, and “you need to look in all the nooks and crannies.” Although adult ticks are easy to find, nymphs are not; they can be as small as a pin prick. Pay special attention at key times for the nymph phase of ticks: spring and early summer.

  • If you find a tick, use tweezers or a special tick remover to get right at the edge of your skin and pull off the tick. If the pincers are left behind, that’s OK; they don’t contain Borrelia. And don’t go digging around to remove any remaining pieces. You don’t want a secondary Staph infection. Wash the area with soap and water.

  • If you do remove a tick, watch for signs of rash, but don’t assume that the lack of a rash means you won’t get Lyme disease. “About 80 percent of people will develop these classic rashes, but the vast majority of rashes are not target lesions – the big bull’s eye. Instead, they are big, red, oval rashes,” Grace explains. “Also, where the tick bites you, you may get a localized irritation. It may get red, and it may get itchy.”

  • The early acute stage – where you may or may not see a rash, and you may feel achy and tired, like you have the flu – is the best time to ward off Lyme disease with treatment with a dose of antibiotics, Grace says. This stage occurs three to seven days after a tick bite.

  • And finally: “Not every tick has Lyme in it, and not every tick transmits it. The fact that you have a tick on you doesn’t mean you’ll get Lyme disease,” he says. “Also, the general rule of thumb is: If a tick has been on you for less than 48 hours, you are probably not going to get infected with Lyme disease.” That’s because the process in which the tick sucks your blood into its stomach and then re-injects this mixture back into you takes 36 to 48 hours. “So if a tick is not engorged, it hasn’t transmitted Lyme yet.”

Read the full article on the UVM Brainwaves blog.