Lyme Disease Dangers

The Untold Dangers of Lyme Disease

The number of cases is at 300,000 per year and rapidly climbing. Even more alarming: If it's not caught quickly, the illness can have irreversible effects on your health. WH uncovered eight surprising truths about this scary scourge, and strategies for protecting yourself.

Photo by Levi Brown

Turns out, it's about so much more than ticks. The tiny suckers are just the transporters of a disease that new research suggests is an incredibly wily adversary. For one thing, it's uberhard to diagnose. That infamous bull's-eye rash may show up in only 20 percent of infections; you might also get a roundish red blotch, or nothing at all. For another, the most common blood tests may not be all that accurate. Then there is the fact that scientists don't fully understand the ins and outs of Lyme bacteria, and, oh yeah, it seems to be spreading—fast. In short, it's a "perfect storm," sanys Samuel Shor, M.D., a Lyme researcher at George Washington University. Okay...deep breaths. Before you freak and vow never to tromp around outside again, know that awareness and prevention are your best weapons. Lyme can be headed off or, in many cases, effectively treated if you know what to look for and when.

Deer Are to Blame—But So Are Mice
All of the old rules about where you're safe from Lyme disease (namely, anywhere outside of the North Atlantic states or the Midwest) need to be thrown out, says leading researcher Daniel J. Cameron, M.D. Why? Well, in part because deer—notorious tick carriers—are surging in numbers, and more and more housing developments are bringing humans in closer contact with deer. But other animals, including the white-footed mouse, might be equally at fault. Such forest mice can carry Lyme disease and pass it to the ticks that have hitched a ride. From there, a mature, infected tick can give it to a larva that has latched on for a first feeding and gets more than it bargained for. (That same tick could later bite and infect a deer—or you.) Because of climate change, mice are multiplying and moving into new geographic areas, carrying ticks and Lyme with them, says Robert Lane, Ph.D., a tick-borne-disease expert at the University of California at Berkeley.

Ticks Are Predators with Proclivities
Despite their poppy-seed size—and the fact that they are totally blind!—ticks are crafty creatures, says Thomas N. Mather, Ph.D., of the University of Rhode Island TickEncounter Resource Center They can sense and move toward vibrations (e.g., your feet crunching leaves as you walk in the wild) and carbon dioxide (i.e., the stuff in the breath that you exhale). As such, they tend to gravitate toward the edges of hiking trails, where they wait on shrubs and blades of grass, ready to pounce. The critters are typically most active at dawn and dusk, and many species love humidity. Translation: Morning fog and summer nights are prime times to get bitten, and piles of damp leaves or grass are ideal tick havens. Plan accordingly.

Lyme Symptoms Can Be Acute or Outgoing
Antibiotics have the power to fight most bacterial infections. If only they always worked for Lyme. The bacteria comes in multiple strains, which can show up at any time and cause a wide variety of symptoms, including rashes, fever, fatigue, muscle pain, or worse. Many docs now group Lyme into two general categories: early Lyme disease (symptoms develop two to 30 days post-bite and stay localized) and late Lyme disease (symptoms develop and/or persist for months or years post-bite and spread throughout the body). A patient with Lyme who does not respond to antibiotics has what some call "chronic Lyme." It's a topic of fierce debate; experts remain divided over what causes its symptoms, some of which can mirror conditions like arthritis, multiple sclerosis, or ALS. "We know that certain strains have the potential to cause an illness that mimics other diseases," says Lyme researcher Elizabeth Maloney, M.D. "But we can't yet test for specific strains. So if someone has chronic symptoms, we don't know if she's still infected, if her immune system is in overdrive, or if she has some sort of coinfection. We have lots of questions and not a lot of answers."

MORE: Lyme Disease Is on the Rise

They Look for Easy Access
Ticks don't jump, leap, or fly. They crawl, usually upward. Once on your body, they aim for thin skin, which allows easy access to your blood vessels. However, if on their quest they run into any clothing barriers, they're more than happy to settle for second best. Memorize these bug gathering spots and check them often.
Ideal Spots: scalp; back of the neck; inner thighs
Would Settle For: hairline; bra strap; waistband; top of socks

Catching Fast Is the Key
If a tick sinks its mouth into you, you have a short window in which to hop into action. Lyme bacteria and other nasties reside in a tick's gut; once you're bitten, they move through the insect's digestive track into its saliva—then into your body.
Within 24 Hours:
The tick shoots out a substance that dulls your body's pain sensation. You probably don't feel a thing on your skin.
It also starts secreting cement-like saliva, which locks it in place so that it can't easily be brushed off.
 Now in sucking mode, the tick extracts water from your blood, nourishes itself, and then spits what it doesn't need back into you.
This goes on for the first 24 hours—about the amount of time it takes for the bacteria in the tick's mid-gut to start moving into your system.
 If the tick goes unnoticed, it will keep up its feeding-spitting-feeding cycle for three to seven days. The longer it's at it, the higher your risk for infection becomes.

MORE: Would You Know If You Had Lyme Disease?

Know What's Crawling Where
Ticks are now spreading a wide range of misery all across the U.S. Here, a primer on where some types are often found:
The Amierican Dog Tick. It mainly lives east of the Rockies and in some Pacific Coast terrain. It's responsible for transmitting Rocky Mountain spotted fever, which can cause headaches, abdominal and muscle pain, vomiting, and fever. It could also transmit tularemia, a bacteria that usually causes an ulcer at the bite site.
The Western Black-Legged Tick. Home base is typically the West and Southwest, where it carries the organisms that cause Lyme and anaplasmosis, a Lyme-like infection that spurs fever, headaches, fatigue, and muscle aches.
The Rocky Mountain Wood Tick. Found in its namesake region, it can transmit Rocky Mountain spotted fever and tularemia.
The Gulf Coast Tick. Teeming in the Southern Atlantic states, it carries a form of spotted fever similar to Rocky Mountain.
The Lone Star Tick. Often active in the Southeast and Midwest, it transmits ehrlichiosis (see right), as well as the Southern tick-associated rash illness (STARI), which also causes a bull's-eye rash.
The Black-Legged Tick (a.k.a. The Deer Tick). Typically based in the Northeast and Midwest, many of these seemingly ubiquitous suckers harbor Lyme or some other disease-causing parasite or bacteria such as anaplasmosis or ehrlichiosis (another Lyme-like infection that leads to the requisite fever, headaches, fatigue, etc.). Researchers continue to find new disease-causing pathogens in deer ticks. As of press time, the count had hit six.

The Bacteria Is a Stealth Bomber
Once Lyme bacteria enter your body, the clock starts running again, and the sooner you launch an antibiotics attack, the better, says Eva Sapi, Ph.D., director of the Lyme Disease Program at the University of New Haven. Her research shows that Lyme can sheathe itself in a protective layer that helps it evade your immune forces. And then it does something weird: It heads straight for your lymph nodes, says Nicole Baumgarth, Ph.D., of the University of California at Davis. Why Lyme marches toward your body's front line of defense is unclear, but "once there, it seems to tamper with the immune system so that an effective response can't be mounted," says Baumgarth. And the longer the bacteria runs rampant, the more likely it is to move into your bones, joints, heart, or brain, where it can cause some serious damage.

You Can Outsmart It! 
The best ways to stay safe:
 Buy clothing with built-in tick repellent.
Or apply permethrin to your clothes, sleeping bags, tents, or other gear (but not your skin). The insecticide may stick through 70 washes.
► Check your bod for ticks
Look extra closely at areas where ticks might get caught (see diagram, at left). Scan your pets for ticks too.
 Know how to remove one.
With pointy tweezers, grasp the tick and slowly pull it straight out, as you would a splinter, trying to avoid squeezing its body. Never attempt to burn a tick off, which could make it release infected fluids into your skin. Trying to wash off a tick won't work either—the soap just makes it harder to grasp with tweezers.
 Hang on to the critter.
This can go a long way toward helping you and your doctor figure out what kind of tick it is, which could then help you find the most effective treatment, if needed.
 Line up a doc who knows about Lyme.
Certain antibiotics have been shown to reduce the risk for Lyme disease if they're taken within two days of a tick bite. This makes it especially crucial for you to get a script, stat. Talk to your doc about her thoughts on Lyme, your risk for exposure, and a potential treatment plan if you are bitten. "Being well prepared means having a doctor who isn't going to take a wait-and-see approach," says Thomas N. Mather, Ph.D. "One bite can really change your life, which is why knowledge and prevention are key."

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Issue date: September 2014

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