Saturday, November 28, 2015

Don't let Lyme disease tick you off

Public health is everywhere, even lurking in the bushes.

Don't let Lyme disease tick you off

The black-legged tick (Ixodes scapularis), left to right: adult female, adult male, nymph, and larva on a centimeter scale (2.5 cm=1 inch). (
The black-legged tick (Ixodes scapularis), left to right: adult female, adult male, nymph, and larva on a centimeter scale (2.5 cm=1 inch). (

Public health is everywhere, even lurking in the bushes. Last week, while playing disc golf at Sedgley Woods in Fairmount Park and trying not to think about work or school, I couldn’t help but ponder Lyme disease—a public health issue that I realized I knew relatively little about.

Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted through bites of black-legged ticks. Ticks acquire the bacteria by biting dear, mice, chipmunks, and other animals that have the disease. Lyme disease is most prevalent in the Northeast region of the United States—Pennsylvania and New Jersey each reported about 3,300 confirmed cases in 2010.

Early symptoms of Lyme disease are similar to those of the flu, and may include fever, muscle pain, and a “bull’s eye” rash around the bite. If the disease goes untreated, symptoms can become more serious and include paralysis of face muscles, severe joint pain, heart palpitations, and speech problems.

Lyme disease typically is treatable with antibiotics, but about 10 to 20 percent of people treated for it experience lingering symptoms. Such chronic symptoms, technically known as “Post-Treatment Lyme disease Syndrome,” have been the focus of major medical controversy. People suffering from chronic Lyme disease-like symptoms have sought to legitimize their condition and promote treatment through long-term antibiotic therapy, while many medical experts and professional societies hold that their symptoms are caused by some other, unknown pathogen (a controversy which we’ll discuss in an upcoming post).

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Lyme disease first appeared on the public health radar in 1975 after a number of residents of Lyme, Conn., began reporting strange arthritis-like symptoms. By 1977, 51 cases had been reported and black-legged ticks were identified as being responsible for transmitting the disease. In 1982, B. burgdorferi was pinpointed as the cause, prompting Connecticut health officials to employ a range of strategies—public education, serology testing, mandatory reporting of all cases by physicians—to prevent the disease from spreading. Federal funding first became available in 1991.

While Lyme is considered to be an emerging infectious disease—meaning that it’s a new pathogen for which incidence has increased dramatically in the past 20 years—research indicates that it has been endemic in human populations for millennia.

Genetic testing of Ötzi the Iceman, a 5,300-year-old naturally preserved mummy, found the mark of B. burgdorferi bacteria in his DNA, making him the first known case of “Lyme disease.”

If you, like me and Ötzi, spend a lot of time outdoors, here are a few things you can do to protect yourself against Lyme disease:

  • Use bug repellant that contains at least 20 percent DEET—ticks hate the stuff.
  • Cover up when romping around outdoors. Wear long-sleeved shirts and pants, closed-toed shoes, and high socks (tuck your pants into your socks if you value your health more than style).
  • Thoroughly examine your body, your clothes, your gear, and your pets —Fido can get Lyme disease, too—for ticks. Take a shower and tumble dry your clothes on high heat to kill ticks you may have missed.
  • If you find ticks, remove them ASAP with a pair of tweezers. Be careful not to break the body, leaving part of the head inside you; here is a good step-by-step guide on how to do it effectively.

By the way, the first two of the above—strong bug repellant and covering up—will also go a long way toward protecting you from a disease that made its North American debut just a decade ago, this one spread by mosquitoes: West Nile virus.

Read more about The Public's Health.

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About this blog

What is public health — and why does it matter?

Through prevention, education, and intervention, public health practitioners - epidemiologists, health policy experts, municipal workers, environmental health scientists - work to keep us healthy.

It’s not always easy. Michael Yudell, Jonathan Purtle, and other contributors tell you why.

Michael Yudell, PhD, MPH Associate Professor, Drexel University School of Public Health
Jonathan Purtle, DrPH, MSc Assistant Professor, Drexel University School of Public Health
Janet Golden, PhD Professor of history, Rutgers University-Camden
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