4 things to know about ticks and Lyme disease

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Harvard Health Blog

Lyme disease is spread by the bite of the blacklegged tick. While there are cases in various parts of the country, it's most common in the Northeast and mid-Atlantic states, as well as around the Great Lakes. The early symptoms of Lyme include fever, body aches, and a bull's-eye rash. It's very treatable with antibiotics, but if not caught and left untreated, it can lead to serious health problems.

Here is information from the Centers for Disease Control and Prevention on four things that everyone should know and do:

1. Prevention is key.

As is true with all health problems, preventing them in the first place is always best. Be mindful of where your children play, as brush and tall grasses are where the ticks hang out. As much as possible, try to keep to the center of paths. Use a repellent with DEET (at least 20 percent), picaridin, or IR3535 on exposed skin (the Environmental Protection Agency has a great online tool that can help you choose the best insect repellent), and spray clothing (including socks and shoes) and gear like backpacks with permethrin.

2. Do tick checks at the end of every day.

Even if your kids were just playing outside in the yard, get in the habit of looking them over. Ticks like warm, moist areas like the armpits, groin, and scalp, so you should particularly check there. Be sure to look carefully, because the blacklegged tick often transmits when it's in the nymph stage, and nymphs are really tiny.

If you find an attached tick, grab it at the base with a tweezer and pull it upward with steady pressure. You can get rid of a live tick by wrapping it tightly in something or flushing it down the toilet.

Along with checking your human family members, be sure to check pets that have been outside, as they can carry ticks inside with them. You should also check clothing. Anything that isn't going into the wash can be thrown into the dryer for 10 minutes or so (when washing clothes, be aware that if they aren't washed in hot water, they may need extra time in the dryer to kill any ticks on them).

3. Be on the lookout for symptoms.

If you do tick checks at the end of every day you should be fine, because it takes at least 24 hours -- more often 36 to 48 hours -- for an infected tick to transmit Lyme. This is a really important point that many people don't know.

The classic rash of Lyme is an expanding bull's-eye rash at the site of the bite. The rash is present in 70 percent to 80 percent of cases. Of course, that means it isn't present in 20 percent to 30 percent of cases, so if someone in your family had a tick on them for more than 24 hours, or if you live in an area where there are many cases of Lyme and there may have been a tick bite, you should call your doctor if the person has a fever, chills, aches and pains for no clear reason, along with swollen lymph nodes or swelling of one or more joints. While having these symptoms doesn't mean for sure that a person has Lyme, it's worth getting checked out, as early treatment generally leads to a complete cure.

4. Be a cautious consumer of information when it comes to testing and treatment of Lyme.

As with many conditions, there is a lot of misinformation out there about Lyme testing and treatment. It's important to use laboratories that use evidence-based norms and processes. There are many advertised tests for Lyme disease, but some of them are simply not reliable -- and it's really important to have reliable information when making a diagnosis. It's also not recommended to do testing for Lyme in someone who does not have clear symptoms of Lyme disease.

Most people recover completely after treatment of Lyme, but there are some people who have chronic symptoms such as fatigue, pain, or joint swelling after Lyme disease. This is called post-treatment Lyme disease syndrome or post-Lyme disease syndrome. The cause of these syndromes is unknown. Prolonged use of antibiotics is not recommended. Studies have shown that it doesn't help, and there can be serious health problems when antibiotics are taken for prolonged periods of time.

To learn more about Lyme and its treatment and prevention, visit the Lyme disease page on the Centers for Disease Control and Prevention website.

(Claire McCarthy, M.D. is a faculty editor at Harvard Health Publishing at Harvard Health Publishing.)