Douglas MacQueen, MD

Special to the Ithaca Journal

The incidence of Lyme disease can be expected to continue ramping up in Tompkins and surrounding counties and extra precautions about the tick-borne disease are warranted for those traveling to the Hudson Valley, New England and mid-Atlantic coastal areas.

The New York State Department of Health reports about 100,000 cases of Lyme since the disease was first reported in 1986. About 3,736 new cases were recorded in 2014, the most current year with statewide data. The bacterial infection can be transmitted to people by the bite of an infected deer tick. Ticks obtain the bacteria after feeding on the blood of a small mammal or bird that is infected.

Where are the Lyme disease host spots in the state and region?

State health department data show counties in the Hudson Valley had the highest incidence of Lyme per 100,000 residents in a 2011-13 study. Tompkins and Schuyler counties were the Lyme hot spots in the Finger Lakes area, but far less affected than Hudson Valley counties. In the region, the U.S. Centers for Disease Control data show a coastal arc stretching from Virginia and Maryland up through southern Maine where the Lyme disease risks are highest.

What are the symptoms of Lyme disease?

Untreated Lyme disease can produce a wide range of symptoms, depending on the stage of infection. Early symptoms that may develop three to 30 days after tick bite include: fever, chills, headache, fatigue, muscle and joint aches and swollen lymph nodes. In most cases, a circular or splotchy red rash appears at the tick bite site after about two weeks.

Should you seek medical care if you find a tick attached to your body?

You do not need to routinely see your doctor for every tick bite. Less than half of the local deer tick population carries Lyme disease. Ticks are inefficient at transmitting it, and that further reduces the infection risk. You should see your doctor if you develop Lyme symptoms and the site becomes red, painful, or swollen.

What should I do if I discover an attached tick?

The risk of getting Lyme disease from a tick is reduced if the insect is removed within 36 hours and before becoming engorged with blood. To remove the tick, use tweezers to grasp tick near its mouth parts and as close to the skin as possible. Pull the tick in a steady, upward motion away from the skin. Wash and disinfect the bite. Record the date and location of the tick bite so it can be monitored for Lyme disease symptoms.

Should I take a preventive antibiotic if I’m bitten?

Taking prophylactic antibiotics for every tick bite is unnecessary, and taking too many unnecessary antibiotics is not good for us. Instead, watch for the development of symptoms of Lyme disease and then seek treatment if they develop.

How is Lyme disease treated?

Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil. Patients with certain neurological or cardiac forms of illness may require intravenous antibiotics. Patients treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Lyme disease is completely curable at any stage of its development.

Should I get a blood test for Lyme disease?

Early in the course of a Lyme infection your body has not made enough antibodies for the blood test to be positive. Getting tested when you have fever and a Lyme rash is not helpful and could give you and your doctor a false sense that you don’t have Lyme. If you develop a Lyme rash, skip the test and get treated with antibiotics.

How can I prevent getting Lyme disease?

Infected deer ticks live in shady moist areas and can be found throughout New York State. Adult deer ticks are the size of sesame seeds and are most active from March to mid-May and from mid-August to November. Young deer ticks, called nymphs, are active from mid-May to mid-August and are about the size of poppy seeds. Both nymphs and adults can transmit Lyme disease.

During tick season wear long pants and long sleeves when you are outside. Use products that contain permethrin on clothing. Bug spray with DEET is also an effective tick deterrent. After you have been outdoors, check for the presence of ticks, especially in the groin, armpits, and hairline where it is easy to hide. Be sure to check your young children because they may not notice a tick.

Dr. MacQueen is an infectious disease specialist who is board certified in internal medicine. He is on the medical staff of Cayuga Medical Center and can be reached at the Cayuga Center for Infectious Diseases at (607) 241-1118.