Lyme Disease hits here

John Christensen Chronicle-Express
Most prevalent in the downstate region until recently, Lyme disease reports are on the rise in the Finger Lakes, especially in the Yates County and Ithaca areas.

Yates County Public Health (YCPH) and the Centers for Disease Control and Prevention (CDC) report there has been an increase in Lyme disease in the Finger Lakes Region of New York, particularly in Yates County and the Ithaca area.

According to the CDC, Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged (deer) ticks. Typical symptoms include a characteristic bull's eye-like skin rash called erythema migrans. The rash is circular and 5cm in diameter or more (about baseball size) with an outer red ring. Other possible symptoms include fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes. If the disease progresses untreated, it could lead to arthritis, meningitis, facial palsy, and sometimes heart abnormalities.

Originally detected in the late 1970s in Southern New England, Lyme Disease is named for the towns of Lyme and Olde Lyme, Conn., where the first cases were identified. The CDC now reports the largest number of cases of Lyme Disease throughout the Northeast region of the U.S. all the way from southern Maine to Northern Virginia, as well as in Wisconsin, Minnesota, and the region surrounding Chicago, Ill.

Earlier this week the CDC reported that more than 300,000 cases of the disease are diagnosed each year in the U.S.

YCPH hosted a Ticks & Lyme Disease informational presentation by Dr. Wayne K. Gall, a NYS Dept. of Health Entomologist Aug. 8. He reported that the number of confirmed cases of Lyme disease in humans in the 17 counties of Western New York rose from 50 in 2008 to 95 in 2011, and it continues to rise. In Yates County alone, eight cases were confirmed in 2012, and six have already been identified in 2013.

Nancy Fulkerson of Glenora says she is one of those infected, and knows of three other residents of Glenora who have been as well. She claims the area of Starkey is a "hotspot for Lyme Disease."

Dr. Susan Collins of the Millstone Veterinary Clinic near Dundee confirms that a higher incidence of positive Lyme tests she sees are coming from pets in the area of Seneca Lake near Glenora.

Literature distributed by the CDC, YCPH, and local veterinary clinics describe Deer ticks as being most active from spring through late fall, but can also be active during the winter months in any temperatures above freezing or in protected locations. Deer ticks can be found on other animals, in tall grass, and in wooded areas. In the process of biting the skin to feed on blood, the tick can regurgitate the Lyme disease bacteria into the bloodstream of the host. If the tick is carrying Lyme disease, it must to be attached for approximately 36 hours or more before it can transmit bacteria. Consequently, it is vital to check yourself, children, and pets carefully after exposure to any areas ticks may be.

Collins warns that with the milder winter temperatures of recent years, vets are now seeing active ticks in every month of the year with the most in November. With increased screening for other diseases like heartworm has also come increased detection of Lyme Disease, and more than they have ever seen before. This year, Millstone reports 20 cases in July, 11 in June, 10 in May, 13 in April, 11 in March, four in February, and six in January. Dr. Kimberly Pinkey of Eastview Veterinary Clinic in Benton reports a similar increase with 39 cases detected during two clinics in May, and 39 more in the months of April, June, and July.

Unlike humans, dogs' immune systems are more likely to fight off Lyme Disease. Both vets say that 87 to 93 percent of dogs that test positive show few if any symptoms of the disease. Antibiotic treatment for dogs that test positive for Lyme but show no symptoms is currently a controversial practice in veterinary medicine. Collins says the favored antibiotic, Doxycycline, has recently skyrocketed in price, since it is now produced by only one company. A full course treatment, which used to cost only about $10, is now costing $300 to $700.

With that cost and the far greater health hazard humans face if a tick transfers to them from their pet, Collins strongly recommends the preventive route, using repellants on pets such as Advantix or Frontline, or the new type of collars. Failing that, early detection and removal of ticks is vital. For both pets and their people, she recommends a tick removal scoop, which is given free to all their clients.

Prevention

Prevention of tick attachment is now considered necessary to prevent the disease. To reduce your risk of getting bitten by a tick, experts recommend:

• Use insect repellents on skin and clothing, following the manufacturer's instructions carefully, when going into grassy or wooded areas.

• Wear long pants tucked into the socks and long sleeve shirts.

• Wearing light colored clothing makes it easier to spot a tick, which can be as tiny as a poppy seed.

• Examine yourself, your children, and your pets for ticks at the end of the day after being outdoors.

• If you find a tick on someone or your pet, the tick should be removed carefully as soon as possible before it burrows its head into the skin for a strong attachment.

Removal

To remove ticks from people or pets:

• Use direct light to see the area where the tick is attached.

• Gently place clean, fine-tipped tweezers or a tick removal scoop (available at your veterinarians) as close as possible to the skin.

• Grasp the tick's head and mouth parts where they enter the skin, trying not to squeeze the tick's body.

• Slowly and gently pull up away from the skin. It may take a few minutes of continued effort to ease the tick out from its grip.

• Do not twist or jerk the tick; this can cause the mouth parts to break off and remain in the skin. If this happens, remove the mouth parts with tweezers. If you are unable to remove the mouth easily with tweezers, leave it alone and let the skin heal.

• Place the tick in a container in case you need it examined. A tick can be as small as a poppy seed or as large as a sunflower seed. The larger it is, the more likely it has been attached longer because it is engorged with the victim's blood.

• After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

• Mark a calendar to remember when the tick was removed and when you think it may have become attached. You may need to discuss the tick attachment with your physician or veterinarian. If the identified deer tick was attached for 36 hours or more, or if the body of the tick was squeezed during removal, there is more concern for the transmission of Lyme Disease. You may then want to have the tick tested.

Not all ticks are Deer ticks, and not all Deer ticks carry the bacteria that cause Lyme disease. Your veterinarian can assist in identifying ticks from animals and sending them out to test for the presence of disease.

Details

• Photos of ticks are available at http://www.lymenet.org /pictures.shtml.

• Visit the CDC Lyme Disease home page at www.cdc.gov/lyme/

• Contact Yates County Public Health at 315-536-5160 or your physician or veterinarian.