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TICK HABITAT
Ticks are active when the temperature rises above 36
degrees, making it possible to gets bite even in winter. People are often
bitten in their own backyards; one does not need to be in the woods" to
encounter a tick. Ticks thrive in humid conditions and prefer tall grass
low brush, flower beds and the area where the grass-line meets the woods.
Ticks act on instinct. They are attracted to CO2 given
off by man and animals. Typically they stay within only a few yards of an
animal trail or home. This includes stone walls flower beds, and ground
hog holes. Ticks are thick in these areas. Animals are creatures of habit
and use the same trails over and over again. Ticks "know' this and lie in
wait on the trails hoping to find a blood meal. AVOID THE DEER PATH and
OTHER ANIMAL TRAILS. Ticks position themselves in spots wine they can
attach themselves to the largest host possible. They climb to the top of a
tall blade of grass and wait for a host to pass. The top of low brush is
up against favorite spot. AVOID TALL GRASS AND LOW BRUSH. Ticks cannot
hop, jump or fly. The host must brush up against one in order for a tick
to attach. AVOID BRUSHING UP AGAINST GREENERY. Ticks love moist humid
conditions, particularly leaf litter where they often lay their eggs AVOID
LEAF LITTER. When walking in the woods stay in the center of the trail.
HOW TO DRESS to AVOID A BITE
Wear light colored clothing so ticks show up. Wear high
tapped shoes with socks pulled up over the pants. Avoid cuffs or
pockets tern ticks can hide. Tuck hair under a cap. Shirts should have
tight sleeves and neck; a turtle neck Is ideal Ticks generally crawl from
the bottom up. You may consider using repellent, especially on shoes and
socks. During an outing, check for ticks and brush them off. Check again
before coming inside.
REPELLENT
The use of repellent is a personal one. Safety,
effectiveness and convenience are all matters to be considered.
Some suggestions:
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Avon Skin So Soft Mosquito, Flee and Deer Tick
Repellent.
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Deet, in concentrations of at least 20 to 30%
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Permanone or Duranon which can be applied to clothing
and lasts for 2 weeks
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Also consider taking Kyolic Odor Free Garlic
Supplements
THE TICK CHECK
Protective clothing and even repellent cannot always
prevent a bite. THE TICK CHECK IS THE MOST IMPORTANT STEP IN PREVENTION.
Ticks may crawl around for a few hour, before feeding. They may begin to
transmit Lyme bacteria as soon as they become attached. The longer they
are on the more bacteria they can inject. They prefer warm, moist, dark
spots. CHECK BETWEEN TOES, BEHIND KNEES, THE GROIN, NAVEL, ARMPITS AND
ESPECIALLY THE NAPE AND SCALP. A magnifying glass may be helpful.
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Brush clothes off outside.
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Remove Clothes and place in the dryer on high heat
for 16 minutes. Ticks can survive the washing machine, but the heat will
kill them. Don't leave clothes on the floor without checking them; ticks
can live in the house for a couple of days.
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Check your body and use a mirror to check behind you.
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Run your fingers over hard to see spots and FEEL for
ticks.
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Comb out hair with a fine tooth comb.
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Take a Shower shampoo and BLOW DRY hair with HIGH
HEAT.
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Repeat the check the next morning. The tick may still
be feeding and will be engorged and therefore easier to see.
REMOVING A TICK
Remove the tick with only a blunt-tip, fine point
tweezers. DO NOT USE YOUR BARE HANDS, Bring the tweezers as close
as possible to the mouthparts and pull straight back using steady gentle
pressure. Do not twist or crush the tick. Above all do not squeeze the
tick which will cause it to inject the bacteria into the person. Place the
tick in an appropriate container such as an empty clear film container, a
pill vile or a ziploc baggy. If the tick is to be tested, leave a moist
towelette and a blade of grass in the container so the tick does not dry
out.
One good lab for tick testing is:
Connecticut Veterinary Diagnostic Testing Labs
University of Connecticut
Department of Pathobiology
81 North Eagleville Road U-203
Storrs, Connecticut 06269
(860) 486-0808
Your local health department may have other
suggestions.
Clean the tick bite with betadine or alcohol and apply
antibiotic cream. Wash your hands with antibacterial soap, and disinfect
the tweezers. Watch carefully for rash or other symptoms. Call the doctor.
YARD CARE
- Keep your property clean. Remove leaf lifter and brush as far away
from your house as possible. Prune low bushes to let in sunlight.
Consider cutting down smaller trees and rake leaves in areas you
frequent.
- Deer are attracted to many ornamental shrubs near your home. Check
with the local nursery to determine which plantings will not attract
deer.
- Keep your woodpile neat, dry and off the ground to discourage mice
which carry ticks.
- Clean gardens every fall. Foliage left on the ground over the winter
provides shelter for small animals which host ticks.
- Avoid sitting on stone walls which also attract small animals.
- Keep lawns mowed short and trim the edges.
- Keep the ground around birdfeeder clean to limit the availability of
rodent food.
- The use of chemicals is one way to control ticks. Three pesticides
to consider include Dursban, Tempo or Sevin. Applications are usually
done in early April, late May or June, and September. Monitor the
property to see if further treatment is necessary.
SOME
SYMPTOMS OF LYME DISEASE
Check the following list, which is by no means inclusive. The hallmark
of Lyme disease is that it is a MULTISYSTEM illness, i.e. there is a
combination of symptoms from the different systems listed below. Usually,
but not always, there is:
1. One or more
CONSTITUTIONAL (#1 on the Symptoms Page) symptom, especially
fatigue PLUS
2. One or more
MUSCULOSKELETAL (#2 on the Symptoms Page) symptom PLUS
3. One or more
CENTRAL NERVOUS SYSTEM (#3,4, 5 on the Symptoms Page) symptoms.
Symptoms from other systems may be present as well. Often one presents
with psychiatric or neurologic symptoms as the dominant complaint. Cardiac
and eye problems are
frequently seen. This list is long and it is surprising to see how many
seemingly unrelated symptoms could actually be Lyme disease. It serves as
a reminder that we must keep Lyme disease in the back of our minds when
making a differential diagnosis.
Early Lyme is considered a bulls-eye rash with NO
constitutional
symptoms. (See #1) The disease is disseminated by the time flu like
symptoms appear.
Central nervous system symptoms (#3, 4 and 5) may indicate later
stage, or more serious illness.
You many have one or more of the symptoms from several categories.
Reactions vary in intensity from mild to severe.
WHAT TO DO IF YOU SUSPECT LYME DISEASE
Seek treatment as soon as possible if you suspect Lyme. Early detection
and treatment is critical. Central nervous system involvement can occur
within a few hours of tick bite. The longer the disease remains
undetected, the more difficult it is to treat. Even if symptoms are vague,
do not put off early diagnosis.
Refer to articles and videos by knowledgeable
physicians. These include:
Dr. Steven Phillips, Ridgefield, CT
Dr. Kenneth Liegner, Armonk, New York
Dr. Charles Jones, Hamden, CT
Dr. Brian A. Fallon, Columbia University, New York
Dr. Sam Donta, Boston University, Massachusetts
Dr. Patricia Coyle, Stonybrook University, New York
Dr. Joseph Burrascano, Southampton, New York
DIAGNOSIS:
Refer to symptom
checklist attached.
A bulls-eye rash is considered diagnostic and should be
treated.
A tick bite from an area where more than 30% of the
ticks carry the disease (most of Fairfield County) should be treated. The
tick must be attached, but not necessarily engorged. Simply finding an
unattached tick on a person is not a bite.
Both an ELISA test, and especially a Western Blot,
should be taken and sent to quality labs like Stonybrook, BBI or Igenex.
Any positive bands at all on the Western blot should be evaluated.
While 5 bands are required by some labs to make the lgG test positive, a
smaller number does not rule out Lyme. Fewer bands on the IgM constitute a
positive test. Moreover, it is not the number of bands, but which ones
that are positive, which is significant.
Negative results on these antibody tests do not rule
out Lyme disease, as specified by the Center for Disease Control (CDC).
The diagnosis of Lyme is a clinical one, meaning that lab tests make up
just one piece of the diagnosis. Other factors such as exposure and
symptoms are important. The hallmark of Lyme is a combination of symptoms
from more than one system on the attached list; usually fatigue or other
constitutional symptoms, and musculoskeletal complaints and neurological
problems.
Antibody tests are not the only tests to use to help
diagnose Lyme. If the Western Blot and ELISA are negative, and there is no
other reasonable diagnosis, ask for Lyme urine antigen tests, neuro-psychiatric
testing, a spinal tap, PCRIDNA tests, an MRI, or Brain Spect. A Brain
Spect is more helpful than an MRI, which is often normal. They are done at
Columbia Presbyterian, NY; or Middlesex Hospital, U-Conn, or Yale in CT.
People with complicated cases of Lyme disease are often negative on the
Western Blot and ELISA.
Newer and better tests, including direct direction
tests such as cultures, are being developed. Make sure you receive
up-to-date information about the availability of these tests.
Test for co-infection of babesiosis, HME, and HGE, and
other illnesses which are also transmitted by ticks and may require
different treatments than Lyme disease.
Common misdiagnoses for Lyme disease include multiple
sclerosis, chronic fatigue syndrome, Epstein Barr virus, ADD, ADHD,
depression, fibromyalgia, and mononucleosis among others. People living in
endemic areas should not accept any of these diagnoses unless Lyme has
been specifically ruled out. The distinctions can be very subtle.
TREATMENT:
The current treatment for Lyme disease is antibiotic
therapy. There are a variety of oral and intravenous medications which are
used. Choice of antibiotic is determined on an individual basis. Duration
of treatment is very important. There of volumes of data which suggest
that current standard treatment lengths may be too short. In general, tick
bites from endemic areas should be treated for a minimum of two weeks.
Early Lyme disease, which is defined as a bulls-eye rash and no other
symptoms, is generally treated for 4 to 6 weeks. Flu-like symptoms are a
sign of disseminated disease and may require longer treatment lengths.
Central nervous system symptoms are more serious and
may require longer treatment lengths or more aggressive therapy to
penetrate the blood brain barrier.
Treatment ends when a patient is symptom free for several weeks; there is
no test for cure.
Symptoms which continue or re-occur despite treatment, or new symptoms
that develop may be a sign of relapse or persistent infection. Do not
accept a diagnosis of fibromyalgia or post-Lyme syndrome.
OTHER:
If your physician is not seeing a lot of Lyme disease or disagrees
with these guidelines, seek the advice of a Lyme
Disease specialist. Call the Lyme Disease Foundation in Hartford at
(860) 525-2000 to recommend a doctor or answers questions you may have.
Remember this is a "new" disease in that doctors are just beginning to
understand its complexities.
Realize that the medical community is divided on issues
concerning the diagnosis, treatment and definition of cure. The very
existence of chronic Lyme disease is challenged by some doctors. Lyme
disease is an illness about which a person must educate himself. Much of
what is in print is simplistic, outdated and controversial. Arm yourself
with current material. Make use of
newsgroups and
websites on the
internet for the most current data. Talk to leaders of the medical
profession as well as political representatives in your town, village,
county and state.
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