Summer is here, and with it comes...Ticks. And tick-borne illnesses. 

Lyme disease is a relatively new tick-borne illness. we didn’t used to have it around here, but it’s become more and more common in the last few years. It is carried by the deer tick, and the actual organism that causes the infection (the germ) is called Borrelia brugdorferi. 

In kentucky, there are two main types of ticks that you will see. One is the dog tick, which seems to be more common. It looks like a flat spider with really short legs, and is about the size of a lentil. It does not carry lyme disease. there are a few other strange conditons it can cause, but usually it doesn't.

The other kind of tick is the deer tick. It looks like a paler version of the dog tick, and is ever so much smaller. Both kinds of ticks are found in the same types of habitat-- woods, weeds and underbrush-- and both of them will attach to you and suck your blood. but only the smaller tick carries lyme disease, as far as we know (actually there is another type of tick out west that carries it, but not here in ky). 

The best way to prevent infection is to not get bitten by a tick. Clothes that protect the body may be helpful (although they are hot). Bug spray doesn’t work for ticks. Thoroughly checking for ticks after being in an area that might have them is a really good idea. People used to say that a tick had to be attached for 72 hours before it could transmit the infection, but this is not necessarily true. I’m not even sure that ticks (of this sort) can tell time. Anyway, the longer they are attached the worse.

Anti-infective agents are usually pretty effective for getting rid of the infectious organisms. Some doctors use doxycycline and some use tetracycline. I usually use usnea and goldenseal for helping the immune system to do its job at this point-- a small dose of antiinfectives might be used after exposure but before any symptoms develop.

The initial stage of Lyme disease, if someone gets it, usually consist of a bulls-eye shaped rash (usually on the thigh, groin or armpit area), sometimes with other rashes on the skin, and flu-like aches and pains.

At this point, it’s usual to give someone the antiinfective for a month or even a few months. the symptoms usually clear up pretty quickly, but sometimes the person feels sicker before they feel better, because of substances being released by the Borrelia as it dies. 

Later on, especially if the illness is not noticed or treated in the initial stages, all sorts of symptoms might develop, including muscular, nerve, and joint pains. These can potentially lead to serious problems with the function of the body (up to and including paralysis of the heart, for instance). If these later symptoms (sometimes called stage II) develop, I like to treat people with substances that modulate the immune system as well as ones that strengthen the nervous system-- in addition to another round of antiinfective substances.

So, to summarize-- 1. Prevention-- try not to get bit by a deer tick. 
2. post-exposure prophylaxis-- get ticks off ASAP and take antiinfective.
3. First stage of illness- long round of antiinfectives
4. second stage of illness-- long round of antiinfective with nerve/immune support.