Lyme Disease: Prevention and Control — Outdoor Hazards and Preventive Measures

Lyme disease is the leading cause of tick-borne infectious illness in the U.S. with about 16,000 cases reported annually. In the United States, Lyme disease is mostly localized to states in the northeastern, mid-Atlantic, and upper north-central regions and to several counties in northwestern California. In 1999, 16,273 cases of Lyme disease were reported to the Centers for Disease Control and Prevention (CDC). Ninety-two percent of these were from the states of Connecticut, Rhode Island, New York, Pennsylvania, Delaware, New Jersey, Maryland, Massachusetts, and Wisconsin.

Signs and Symptoms

• Within days to weeks following an infected tick’s bite, 80 percent of patients will have a red, slowly expanding “bull’s-eye” rash (called erythema migrans), accompanied by general tiredness, fever, headache, stiff neck, muscle aches, and joint pain.
• If untreated, some patients may develop arthritis, including intermittent episodes of swelling and pain in the large joints; neurologic abnormalities, such as aseptic meningitis, facial palsy, motor and sensory nerve inflammation, and inflammation of the brain; and rarely, cardiac problems.

Tips to Protect Campersand Staff

• Wear light-colored clothing so that ticks can be spotted more easily and removed before becoming attached.
• Wear long-sleeved shirts and tuck pants into socks or boots, which may help keep ticks from reaching skin.
• Apply insect repellents containing DEET to clothes and exposed skin, and apply permethrin (which kill ticks on contact) to clothes. DEET can be used safely on children and adults but should be applied according to Environmental Protection Agency (EPA) guidelines to reduce the possibility of toxicity. (See DEET Recommendations)

The American Lyme Disease Foundation recommends:

• scanning clothes and any exposed skin frequently for ticks while outdoors;
• staying on cleared, well-traveled trails;
• avoiding sitting directly on ground or on stone walls (havens for ticks and their hosts); and
• doing a final, full-body tick check at the end of the day.

Steps for Tick Removal

The American Lyme Disease Foundation reports that infected ticks begin transmitting Lyme disease an average of thirty-six- to forty-eight hours after attachment. Chances of contracting Lyme disease are greatly reduced if the tick is removed within the first twenty-four hours. The majority of early Lyme disease cases are easily treated and cured.

To remove a tick, follow these steps:

1. Using a pair of pointed precision* tweezers, grasp the tick by the head or mouthparts right where they enter the skin. Do not grasp the tick by the body.
2. Without jerking, pull firmly and steadily directly outward. Do not twist the tick out or apply petroleum jelly, a hot match, alcohol, or any other irritant to the tick in an attempt to get it to back out. These methods can backfire and even increase the chances of the tick transmitting the disease.
3. Place the tick in a vial or jar of alcohol to kill it.
4. Clean the bite wound with disinfectant.

*Keep in mind that certain types of fine-pointed tweezers, especially those that are etched, or rasped, at the tips, may not be effective in removing nymphal deer ticks. Choose unrasped fine-pointed tweezers whose tips align tightly when pressed firmly together.

Information adapted from the Centers for Disease Control and Prevention, www.cdc.gov [1], and the American Lyme Disease Foundation, www.aldf.com [2].

Originally published in the 2003 March/April issue of Camping Magazine.