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 Annual 2014

Annual 2014

 

           

Tick Attack

Hard-to-detect Lyme disease heads west to California.

If you think ticks and Lyme disease are only found on the East Coast, think again. While still relatively rare on the West Coast, the Centers for Disease Control and Prevention, or CDC, reported 61 cases of Lyme disease in California in 2012.

Lyme disease is an infection caused by a type of bacteria carried by the blacklegged tick, also known as the deer tick. When the bacterium is transmitted through a bite, a round bull’s-eye–shaped rash normally appears around the site of the bite.

“We typically see about two cases a year in Alameda County,” says Dr. Erica Pan, director of the Division of Communicable Disease Control and Prevention and deputy health officer for Alameda County.

While Lyme disease is still rare in Alameda County, the CDC reports that the blacklegged tick, responsible for spreading Lyme disease, has been found in 56 of California’s 58 counties. The agency also reported that ticks testing positive for Lyme disease have been found in more than 40 counties.

If you get bitten by an infected tick but remove it within 24 hours, you may not become ill with the symptoms of Lyme disease. Tick bites are largely preventable, so it’s important to be aware of where ticks live, how to avoid bites, and the symptoms of Lyme disease.

Deborah Bass, public relations officer for the Contra Costa Mosquito and Vector Control District, says of the three common ticks found in the area, only the Western blacklegged tick is capable of transmitting Lyme disease. Adult females are about 1/8 of an inch long and are reddish-brown in color, while males are slightly smaller and are brownish-black in color.

“Tweezers are the best way to remove a tick,” Bass says. “Many methods of removing ticks, such as lighting a match or petroleum jelly to coax the tick out, can actually increase the risk of contracting a tick-borne illness.”

Since the risk of Lyme disease transmission increases significantly after 24 hours of attachment, it is important to remove the tick as soon as possible, and to remove the tick completely. Some experts recommend keeping the tick in a jar in the event that you become sick, so that you can have it tested for Lyme. To do this, you will need to send the tick to an outside lab such as IGeneX in Palo Alto.

“If a person is bit by a tick with Lyme disease, their first symptoms are often a red bull’s-eye–type rash near the site of the tick bite and flu-like symptoms,” says Pan. “At these early stages, Lyme disease can be treated with antibiotics, but left untreated, it can lead to health problems including arthritis, fatigue, and cognitive complaints.”

Many Bay Area residents discuss their personal Lyme disease stories on the Bay Area Lyme Foundation’s site, www.bayarealyme.org. Some sufferers reveal there they never developed the telltale bulls’-eye rash, but went on to experience symptoms dizziness, heart palpitations, and fatigue. Sometimes went years without a Lyme disease diagnosis. Oakland author Amy Tan also shares her story of contracting Lyme disease and how she had to advocate for her own health, visiting numerous doctors before finding what she calls a “Lyme-literate physician.”

Since patients don’t always get the characteristic rash at the site of the tick bite, Lyme disease, which is named after the Connecticut towns of Lyme and Old Lyme where cases were detected in the mid 1970s, can sometimes be difficult to diagnose. Besides a rash at the site of the bite, Pan says symptoms to look for include joint pain that migrates from one site to another, fever, chills, fatigue, and body aches. Experts say that Lyme disease is often misdiagnosed and that 9 out of 10 cases go unreported.

For those who are traveling to Connecticut, New Jersey, Pennsylvania, and upstate New York (areas with the highest rates of Lyme disease) or to California’s northern coastal counties of Sonoma, Humboldt, Lake, and Mendocino, where the percent of infected ticks is slightly higher, there are a number of steps that can be taken to avoid tick bites. Pan offers this advice:

• Stick to the trails and avoid wooded and bushy areas with high grass where there is a high concentration of ticks.

• Wear a long-sleeve shirt, long pants, and tuck your pants into your socks or boots.

• After coming in contact with logs, sticks, or trees, check yourself, family, and pets for ticks.

• Consider wearing a bug repellant with DEET when you’re hiking or camping.

• Talk to your veterinarian about options for controlling ticks on your pets.

 

Tips to Help Recognize Lyme disease

Lyme disease can sometimes be difficult to diagnose because many of its symptoms (fever, chills, fatigue), can mimic those of other conditions such as the flu, arthritis, Lupus and Multiple Sclerosis. In addition, the trademark bull’s-eye rash is absent or goes unnoticed in at least one-fourth of the people who become infected. Although a tick bite is an important clue for diagnosis, many patients don’t remember being bitten by a tick—not surprising since ticks are small and their bite is often painless. Many medical experts agree that Lyme disease can be hard to diagnose and say that a Lyme disease test with more accuracy is sorely needed. Researchers are working on this.

If you discover a tick on your body, remove it immediately; laboratory studies show it can take 24 to 48 hours before an attached tick starts transmitting bacteria to the human it’s feasting on.

Currently, doctors diagnose Lyme disease based on a patient’s symptoms, history, and blood test results. Blood tests can’t be used to diagnose Lyme disease alone, but they are used to confirm a diagnosis.

If you suspect that you were bitten by a blacklegged tick and start experiencing any symptoms, it’s important to seek treatment. Here are some steps to take:

> If you are bitten by a tick and still have the tick specimen, IGeneX, a Palo Alto–based lab, can test the tick for Lyme for a fee and is the only testing facility in California. Visit www.igenex.com.

 > The CDC recommends a two-step process for Lyme disease blood tests: ELISA or IFA test. The first tests used are either enzyme-linked immunosorbent assay, or ELISA, or an indirect fluorescent antibody, or IFAtest. ELISA is the immune test used most often for Lyme disease. (The IFA test is less accurate but may be used when ELISA isn’t available.) Positive results from any of these tests still require confirmation with a western blot test.

> Western blot. If the ELISA or IFA test is positive or uncertain, it is followed by the western blot test. This test is more accurate and is very helpful in confirming the diagnosis. The western blot creates a visual graph showing bands of different colors or shading that laboratories use to interpret the immune response. Some doctors say the western blot test can be negative, even if a patient presents with a headache or fever, if their antibodies are slow to respond. Some doctors recommend retesting patients whose symptoms persist.

> Become an informed patient. In addition to knowing the signs and symptoms of Lyme disease, some researchers are pushing for additional diagnostic methods. Locally, the Bay Area Lyme Foundation, a Silicon-Valley based nonprofit, is working to make Lyme disease easy to treat and simple to cure and is pushing for more reliable diagnostic tests that will ensure early treatment. For more information on the organization’s work, visit www.bayarealyme.org or call 650-530-2439. The website also includes stories of Bay Area residents who had Lyme disease and were mistakenly misdiagnosed, and includes how they finally got the medical help they needed.

> Get a second opinion. If you suspect you have Lyme disease but don’t feel as though you are getting appropriate care, consider seeking a second opinion from a physician who specializes in tick-borne illnesses. To find a physician in your area, visit the International Lyme and Associated Diseases website at www.ilads.org or call 301-263-1080.

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