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Healthy Living May 16, 2017 

The State of Lyme Disease in Maine
By: Amy Movius, MD – Eastern Maine Medical Center
Lyme Disease was first reported in Maine in 1986. Since then, the incidence has been steadily rising, with an all time high of 1,485 cases reported in 2016. Though most cases occur in June, July and August, some cases of Lyme Disease have already been reported to the Maine CDC for 2017. Many are expecting this year to be the worst yet.
Lyme Disease is caused by a bacterium (borrelia burgdorfei) that infects some animals. This bacterium is picked up by ticks, specifically deer ticks, when they bite an infected animal. The bacteria doesn’t affect ticks, but they become vectors (I call them “tick taxis”) for spreading the infection to other animals these ticks bite, including humans. Children and older adults are most at risk, though anyone can get infected. Lyme Disease has been reported in every county in Maine. In some locations it is estimated half (or more) of deer ticks carry the bacteria.
As mentioned, most cases of Lyme Disease occur in the summer, because ticks are most prevalent and people are outside more. Ticks are found commonly in wooded or bushy areas, in high grass, and areas with a lot of leaf litter. The most common symptom of Lyme Disease is a distinctive non-painful rash -it looks like a bull’s eye – at the sight of a tick bite. About half of the patients diagnosed with Lyme Disease develop such a rash, and in areas with lots of Lyme Disease, this rash alone is enough to make the diagnosis. Unfortunately, this rash (called Erythema Migrans), doesn’t appear for 3 to 30 days after the bite. For some good news, Lyme Disease is very treatable. A course of oral antibiotics is usually all that is needed; rarely someone may need IV antibiotic. Treatment is extremely important because even in patients with minimal symptoms, untreated the disease can progress and cause serious problems such as arthritis, encephalitis, and heart block.
Avoiding tick exposure is definitely the best defense against Lyme Disease. The Maine CDC has promoted a “No Ticks 4 ME” campaign as a handy way to remember how to protect yourself. Since May is Lyme Disease Awareness Month, it’s the perfect time to arm you and your family against these pervasive critters.
1. Wear Protective Clothing outside; long sleeves/pants that are light in color are the best. If you are in a “high tick” area, consider tucking pant legs into socks. You can also buy insect repellent (permethrin) for clothing. Promptly wash exposed clothing in hot water and dry on high heat to kill any ticks that may be present. It’s a good idea to bathe as soon as possible after coming inside for the day.
2. Use Insect Repellent that contains DEET or picaridin when outside. Outdoor pets also need to be treated with a tick solution.
3. Do Daily Tick Checks of the people and animals in your house. It sounds silly but is really important! Ticks have to be attached to your skin at least 24 hours to transmit Lyme Disease so even if you get a bite, you can stay safe by removing the tick quickly. If you find a tick, pull it out gently and straightly. You can use tweezers or a tick spoon if available. Wash the area well and apply an antiseptic to the region. Most importantly, however, is to watch the area closely for the next month for signs of the tell-tale rash.
4. Use extra caution in high tick habitats.
Though Lyme Disease is the most common tick related disease in Maine, unfortunately it is not the only one. Anaplasmosis, Erlichiosis, Babesiosis, and Powassin are also serious infections acquired through ticks. Following the No Ticks 4 ME advice will help protect you against these diseases as well. The Maine CDC website – and others listed below- have lots of useful resources about Lyme and other diseases, how to identify ticks, what to do if you have a tick bite, and much more information that is easy to access.
References:
1. Maine CDC Report to Maine Legislature, Lyme Disease, January 2017
2. Images of Erythema Migrans easily found on internet sites such as Wikimedia and others
3. www.maine.gov.cdc http://www.maine.gov.cdc
www.cdc.gov/lyme/www.lymediseaseassociation.org <http://www.lymediseaseassociation.org>