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June 2, 2000
Prevention and Primary Care - Elizabeth Smoots, M.D.

Tick Talk
Simple tips for preventing Lyme disease

Summer is here, and the great outdoors is beckoning. Before you lace up your hiking boots and go traipsing through the woods, though, make sure you're prepared to ward off any harmful critters you might encounter. In particular, you need to worry about deer ticks.

While hiking through the forest or brushy areas, you might cross paths with a tick the size of a poppy seed. This innocuous-looking creature, known as a deer tick, feeds on the blood of deer, mice, chipmunks, and humans. A person bitten by a deer tick may contract an infection called Lyme disease, caused by the bacterium Borrelia burgdorferi. Lyme disease usually starts with a rash or flu-like illness and can lead to arthritis or heart and nerve problems.

The incidence of Lyme disease has risen 25-fold in the past two decades. Scientists suspect this rise is due to the slow but steady migration of deer ticks from their native lands, in northeastern and midwestern states, to all parts of the country. Fortunately, practical prevention measures and a new vaccine can help control this pesky tick.

Prevention tips for summer trips

During your next foray into tick-infested areas of the great outdoors, take the following precautions:

  • Choose light-colored clothing so it will be easy to see ticks. Wear a long-sleeved shirt tucked into your pants, and tuck pant legs into your socks.
  • Apply an insect repellent with diethyltoluamide (DEET) to exposed areas of skin. Follow label directions carefully.
  • Spray insect repellent that contains permethrin on your clothes as directed.
  • Stay in the center of the trail while hiking, away from brush or areas of dense undergrowth.
  • Examine yourself and your children once or twice daily for ticks. If you find a tick, apply steady pressure with tweezers to remove it, and clean the area with an antiseptic. If any symptoms of early Lyme disease develop -- rash, fever, fatigue, joint stiffness and pain, or headaches -- call your health care provider. Keep in mind that your risk for Lyme disease goes up if the tick stays on you more than 48 hours.

Lyme disease vaccination

For people between the ages of 15 and 70, a new vaccine may provide protection against Lyme disease. But experts advise caution until more is known about the vaccination, such as long-term effects and the need for booster shots. The vaccine works by stimulating antibodies that kill disease-causing bacteria in a feeding tick's intestines. After a series of three injections over one year, it is 76 percent effective in preventing Lyme disease. The third dose is given a year after the first, early in the spring before tick season begins.

Discuss the pros and cons of the Lyme disease vaccine with your health care provider. The Centers for Disease Control and Prevention makes the following recommendations about the vaccine:

  • People who live, work, travel, or recreate in areas of high or moderate risk should consider vaccination, especially if they have frequent or prolonged exposure to tick-infested areas. High-risk states include Connecticut, Delaware, Maryland, New Jersey, New York, Pennsylvania, Rhode Island, and Wisconsin. Moderate-risk states include Maine, Massachusetts, Minnesota, New Hampshire, and Vermont.
  • Lyme disease vaccine is not advised for children under age 15, adults over age 70, or pregnant women.
  • After receiving the vaccination, continue preventive measures for Lyme disease.

Elizabeth Smoots, M.D., F.A.A.F.P., is a board-certified family physician in Seattle, Washington. A fellow of the American Academy of Family Physicians, Dr. Smoots specializes in prevention and primary care medicine.

Related links:

Rx.magazine feature story: Tick Check

Outside links: The Lyme Disease Network, American Lyme Disease Foundation