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DIVISION OF PUBLIC HEALTH
NURSING & EDUCTION

Message from the County Health Officer LYME DISEASE
and Other Tickborne Diseases


Deer Tick
Important Public Health
Concerns in Hunterdon County

Hunterdon County
Department of Health
Flemington, NJ

Lyme Disease: What Is It?
Where are Ticks Commonly Found?
Tick Trivia
Protect Yourself and Your Family
Around Your Home
How is Lyme Disease Diagnosed
Recognize the Early Symptoms
How is Lyme Disease Treated?
Other Tickborne Illnesses
Proper Removal of a Tick

Message from the County Health Officer:

Hunterdon Residents,

What you are about to read on this site will increase your advantage of not becoming a Lyme disease victim. Awareness is the absolute edge when it comes to avoiding Lyme disease. The following information provides you with basics you need to know to protect both yourself and your family.Hunterdon - because of climate and environmental conditions - continues to have one of the highest rates of Lyme disease in the U.S. Check out the actual 20-year growth pattern of Lyme disease in Hunterdon between 1988 and 2008. Despite the sizable increase of Lyme disease cases in our county, it remains within our own personal control to limit our risk of tick exposure. Doingso, we can greatly reduce our risk of contracting Lyme disease and other tickborne illnesses.Be sure to carefully read the following description of the early signs and symptoms of Lyme disease so you'll know what to look for if you spot an infection after finding a tick on you or a family member. Early diagnosis and treatment are most effective in limiting the severity of Lyme disease.

For more information about Lyme disease or a brochure containing the information on this site -- and for other public health issues -- don't hesitate to call the Department of Health at (908) 788-1351 or the Public Health Nursing and Education Office at (908) 806-4570.

To Your Health,
John Beckley, MPH Health Officer

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Lyme Disease: What Is It?

ImageLyme Disease is an infection caused by a spirochete [spy'-ro-keet], which is a type of bacteria. The disease is carried primarily by “Black-Legged Ticks” (also commonly known as “deer ticks”), and can be transmitted to both animals and humans through tick bites. In New Jersey, this tick is primarily responsible for the spread of Lyme disease.

Hunterdon County continues to have one of the highest rates of Lyme disease in the country, most likely due to its heavily-wooded environment and high deer population. Although we particularly need to practice prevention during the spring, summer and fall months, Lyme disease cases are reported throughout the year because ticks are active when temperatures are above 40 degrees.

Because of these facts, it is important that county residents be particularly aware of the signs and symptoms of Lyme disease, and that we learn to follow a few simple precautions to help protect ourselves and our families.

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Where are Ticks Commonly Found?

The deer tick is generally found in areas where deer, mice and other animals roam, such as wooded areas. In addition, longer grass or brush, low bushes and shrubs, and moist leaf litter are common habitats. Ticks crawl very slowly, and can travel distances only by attaching to a person, animal, or bird. This is how a tick can move out of the woods and into gardens and backyards.

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Tick Trivia:

tickTicks go through 3 active life stages -- larva, nymph and adult. In the larva and nymph stages, ticks must find hosts and take blood meals to molt to the next stages. Male adults attach but do not feed, while female adults need blood to produce eggs.

tickFemale deer ticks are only about 3 mm in length (about the size of a sesame seed) and are black and brick red in color. Males are smaller and all black.

tickTick Life Cycle Chart Ticks are not born with the spirochete responsible for Lyme disease. Instead, larvae pick it up from infected rodents, most often the white-footed mouse, and are then capable of transmitting the disease after molting and feeding as nymphs or adults.

tick Ticks are found in wooded areas, suburban backyards and tall grassy areas. Ticks don't fly, jump or spring from trees. They are found in leafy brush waiting for a person or animal to pass by.

tickBecause they are so small and difficult to see, and because they are active in the late spring and summer when people spend more time outdoors, nymphal ticks cause the majority of Lyme disease cases. These ticks are only the size of poppy seeds. The disease is, however, contracted year-round, when ticks come out on warm winter days.

tickTicks need time to attach and feed. In general, ticks must be attached at least 36-48 hours to transmit the spirochete that causes Lyme disease.

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Protect Yourself and Your Family.

When in a tick-endemic area, remember to always apply these simple tips to make life more difficult for hungry ticks.

Protect YourselftickBy tucking trousers into socks, and a long-sleeved shirt into your pants, you can create a barrier between the ticks and your skin. Wearing light colors and tightly woven fabrics helps you to spot ticks on your clothing more easily, and prevent them from getting through the fabric. Wear closed shoes rather than sandals when in a higher risk area. Check clothing often for climbing ticks and remove them when found.

Protect Your FamilytickWear insect repellants containing at least 30% DEET when you are in areas where ticks may be found. Do not use DEET on children under the age of three and do not apply to hands and faces of children.

tickTeach your children to stay in the center of paths and, when possible, avoid tick-infested areas. Show them what a deer tick looks like and how to safely remove it. (See proper removal techniques)

tickUpon returning home be certain to do a thorough tick check, paying extra attention to areas such as underarms, behind the knees, groin area, under the hairline and behind the ears.

tickIf you have frequent or prolonged exposure to tick-infested areas, consider receiving the Lyme vaccine.

Protect Your PetstickFit your pets with tick collars or treat them with one of the repellent products applied monthly to the skin. Speak to your Veterinarian about these options. Inspect pets often and try to keep pets off the furniture!

tickIf you find an attached tick, follow the guidelines for proper tick removal.

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Around Your Home.

Around Your HomeStudies have shown that the majority of Lyme disease cases in Hunterdon County are ‘caught’ around the home, while doing general yard work. This is most likely due to the fact that many homes in the county are surrounded by wooded areas. To help reduce the number of ticks on your property, keep your yard clear of leaf litter which is a common habitat for ticks. In addition, keep grass short, allowing more sunlight to reach the soil. Remember, the more sunlight the better, as ticks do not survive well in dry environments.

Careful use of pesticides, when properly formulated, targeted and timed, can be very effective in controlling various stages of the deer tick. Granular insecticides containing carbaryl (such as Sevin) and labeled for tick control should be applied late May/early June, to provide control of immature ticks. Liquid insecticides, when applied in late October/ early November, have been shown to provide good control of adult deer ticks. Users should be sure to read and follow all precautions and directions on the label. Additional information is available through the county Cooperative Extension Service.

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How is Lyme Disease Diagnosed.

Lyme disease is diagnosed by physicians based upon clinical signs and symptoms, along with a history of known or suspected tick exposure. Blood tests are sometimes used to confirm diagnosis.

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Recognize the Early Symptoms.

Within one month of infection (though the average is 7-10 days), many patients will develop one or more of the following symptoms: flu-like symptoms, such as fever, fatigue, muscle and/or joint pain, headache, swollen lymph nodes or a characteristic skin rash.

This rash, called ‘erythema migrans’, occurs in at least 60% - 80% of patients at the site of the tick bite. It is an expanding red, generally circular patch, often with a clearing in the center, giving it a bull's eye appearance. In general, such rashes are more than 2 inches in diameter. In some cases there may be multiple rashes. Treatment at this stage is almost always curative.

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How is Lyme Disease Treated?

Treatment can sometimes vary depending on when the diagnosis is made. When detected early, typical treatment includes 3-4 weeks of oral antibiotics, such as doxycycline or amoxicillin.

SERIOUS COMPLICATION CAN ARISE IF LEFT UNTREATED

If untreated, the early symptoms described above may disappear only to have more serious problems develop later. Untreated complications can include chronic arthritis, heart problems and nervous system disorders. Intravenous treatment is sometimes necessary in late Lyme disease cases. Remember: early detection is always best.

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Other Tickborne Illnesses.

Two other tickborne diseases, potentially transmitted by the deer tick, have been identified in the United States. Both human granulocytic ehrlichiosis (HGE) and babesiosis have been diagnosed on the east coast.

While both infective agents have been found in Hunterdon County ticks, very few cases of either of these illnesses have been confirmed in the county.

Human Granulocytic Ehrlichiosis (HGE)

HGE is caused by a bacteria. The onset of symptoms generally occurs 1-3 weeks after infection, with the most common being high fever, muscle aches, weakness and severe headache. Patients may also experience confusion, nausea, vomiting and joint pain. Unlike Lyme disease, a rash does not occur with HGE.

Diagnosis for HGE is based on specific clinical symptoms and a history of exposure to ticks. However, tetracycline antibiotics are usually very effective. Because these antibiotics can cause dental staining in children, physicians may contact infectious disease specialists when treating children. Amoxicillin is not effective against HGE. Untreated, the disease can become very serious, even fatal.

Babesiosis

Babesiosis is a malaria-like illness, caused by a protozoan parasite called “B. microti”. Symptoms of this disease usually begin about one week after infection, and include a gradual onset of malaise, fatigue and loss of appetite, followed by fever, drenching sweats, muscle pain and headaches.

Specific laboratory tests are available to detect this infection. Recommended treatment for babesiosis includes quinine plus the antibiotic ‘clindamycin’ (oral or IV).

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Proper Removal of a Tick.

Research has shown that a period of at least 36-48 hours of tick attachment is generally required for transmission of the bacteria. Therefore, frequent and thorough self-examination for ticks, and proper tick removal, can be an effective way to prevent infection.

WHAT TO DO: Removal of a Tick

Move to a well-lit area.

Grasp the tick close to the skin using fine point tweezers.

Pull it out in a steady motion (do not jerk or crush the tick).

Wash the area with soap and water and record on a calendar the site of the attachment and the date you removed the tick.

Watch for signs and symptoms such as an expanding rash, flu-like symptoms, and joint pain and swelling. The expanding rash can disappear quickly, so it is important to see your physician as soon as possible before the rash fades for early diagnosis and treatment. The rash is diagnostic, which means that Lyme Disease treatment can be initiated and late Lyme Disease symptoms can be avoided.

If no rash appears but headache, joint pain, fatigue, and fever appear about 30 days after tick bite, contact your physician and advise him/her of your symptoms and history of tick bite.

WHAT NOT TO DO:

DO NOT attempt to remove tick by twisting, squashing or burning it. Any of these actions can INCREASE your risk of developing Lyme.

DO NOT smother tick with petroleum jelly, alcohol or any other substance. These too may increase your risk or developing Lyme.

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