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Health Fax Articles
Elizabeth P. Sipala, C.R.N.P
Summer is here with all its glory but unfortunately summer may bring an unwanted guest, the tiny but worrisome deer tick. This small parasite can be responsible for transmitting Lymes disease. The Maryland State Department of Health and the Centers for Disease Control both report a steady increase in the number of reported cases. Experts feel this increase is due in part to the growth of the deer population in suburban areas as well as a growing awareness of the disease on the part of consumers and health care professionals. In Maryland the highest rates (per 100,000) occurred in Kent County, followed by Queen Annes, Caroline, and Calvert. Eighty-four percent of these cases occurred between April and October, with the peak occurring in June and July. State officials anticipate a further increase in the number of deer ticks this year due to a mild and moist winter.
Deer, along with some varieties of mice, are the major carriers of the ticks but the disease itself is caused by a bacterium known as Borrelia burgdorferi. This bacterium must be present in the tick and the tick must usually be attached to the body for 24-36 hours before it can be passed along to a human host. Not every deer tick bite causes Lymes disease; a recent study demonstrated that even in an area in which there are many cases of Lymes disease the risk of infection is extremely low even from a tick known to be infected.
Most people who contract the infection will get a circular rash with a clear center giving a "bulls eye" appearance. Other symptoms are fever, headache, tiredness, stiff neck, joint pain and swollen lymph nodes. If treated with antibiotics within a few weeks of the symptoms, Lymes disease often poses few long-term problems. If untreated it can produce chronic health problems, such as nerve damage, arthritis and heart trouble.
LYMErix is the only licensed Lymes disease vaccine in the United States and is approved for use in people 15 to 70 years of age. Three doses are administered by intramuscular injection, at 1, 2 and 12-month intervals. The vaccine proved to be effective in preventing Lymes disease by 50% after the first two doses and 78% after the third. The length of protection after all three doses is uncertain and the need for booster doses has not been determined. The side effects of the vaccine appear to be mild and may include pain at the site of the injection, muscle soreness, mild fever and flu-like symptoms.
Because the vaccine is not 100% effective it is recommended for people at greatest risk, those who are exposed to ticks in wooded, brushy or grassy areas where they live, play, hike, camp or work. Individuals should discuss their personal risks and if they should be vaccinated with their health care provider. Even if you have had Lymes disease in the past or think you may have had it, you may benefit from this vaccine.
Vaccination should not be considered a substitute for other preventive measures because it will not provide any protection against other tick-borne infections and may not prevent illness. Prevention is still the best defense and can be accomplished by avoiding tick infested areas, wearing protective, light-colored clothing, using tick repellent and inspecting your entire body, your childrens bodies and pets after being outdoors. Any attached ticks should be removed by grasping the tick with tweezers, if available, as close to the skin as possible and pulling straight back with a steady force. Clean the area with soap and water as you would any minor wound.
By following these steps consistently you can reduce the hazards caused by summers unwanted visitors.
Elizabeth P. Sipala, C.R.N.P., a nurse practitioner specializing in adult primary care, practices at the Unicorn Health Center in Millington. She earned an MSN degree from the University of Pennsylvania and completed a residency at the Hospital of the University of Pennsylvania.