This is the season for Lyme disease, and one should be careful walking through glens or high weeds with exposed skin. Saddle River’s deer population is huge and the incidence of Lyme could be quite high. You can be bitten by a tick and not know it until a targeted bulls-eye lesion appears on your skin. This lesion is fairly typical and should not be missed, but sadly it is missed in over 60% of cases. Generally, in the early stages after the tick bite with infection there are no symptoms. Blood tests immediatly after a tick bites you are generally negative. It takes a few days to weeks for the tests to become positive. If the rash is typical and/or you present the deer tick to a doctor (which you have just removed from your body) antibiotics can be given empirically until the disease is confirmed.

As I said, about 60% of the time the rash goes unnoticed. This is a problem. Anywhere from 4 to 8 weeks after the bite patients get nausea, flu-like aches, headaches, and overall weakness. These are common complaints so one never thinks of Lyme disease until most of the general tests are exhausted and all normal. The arthritis does not appear for many months, which can alert you and your doctor to the fact that you might have Lyme disease.

The treatment for Lyme disease prevention is usually doxycycline or another antibiotic if you cannot take tetracyclines. The treatment if given early enough will prevent the disease from appearing.

There is a lot of misinformation out there about “chronic Lyme disease” with people being on IV therapy for months and sometimes years. And there are tests for the disease from urine when the blood tests are negative. Caution is warranted, because there are no other definitive tests for Lyme than those approved by the US Food and Drug Administration and the Communicable Disease Center. If you are uncertain about the diagnosis and need help, call your doctor or our local Board of Health in Saddle River. We track these diseases and would be glad to help you.

Why is it called Lyme Disease?

Lyme Disease is produced by a bacterium named after the person who discovered the bacterium. It is called Borellia burgdorferi after Willy Bergdorf, a microbiologist. Lyme Disease is named after the community in Connecticut called Lyme wherein the first cases were described by Allan Steere MD, a rheumatologist from Yale. We can test for Lyme by looking for the antibodies in the blood.

What are some other tick borne illnesses that I can get?

Other tick-borne illnesses that are out there are not as common as Lyme. They include Anaplasmosis or Ehrlichiosis, Babesia, and finally Powassan virus disease.

Regarding the other tick-borne illnesses, they are a bit more complicated. Erhlichia is common to places like Shelter Island, NY and it is carried by the LoneStar tick. It is really a parasite and the diagnosis is not easy. Its characterized by fever, weakness, headache and chills two weeks after the bite of the tick. It’s actually endemic out in the tip of long island where there are deer infested with this bug. It makes people very ill and quite disabled. Treatment is usually Doxycycline.

Babesia is another parasite which is tick borne and it is common to places along the shore of Long Island and New Jersey, places like Fire-Island. It is also a challenge to diagnose, simply because it requires some lab expertise and –most of all--because the doctor has to think of it as a possibility. The treatment for this infection is intravenous azithromycin plus oral atovaquone (an antiparasitic).

Finally, the newest infection is that of a virus called the Powassan virus. This is serious, has no easy method of diagnosis and there is no treatment. Moreover, it is fatal about 15% of the time and 50% of the people that get the infection have permanent neurological damage. The numbers of people with this condition are rising, but it is still pretty rare. There were only 7 cases reported in NJ from 2008-2017. However, it is carried by the same deer tick that carries Lyme disease. Symptoms are fever, headache, vomiting, weakness, confusion and possibly even seizures.

How can I prevent infection with these ticks?

You can wear bright long pants instead of shorts when walking in the woods. You should also wear a shirt with long sleeves. Avoid high brush areas unless you have sprayed yourself with a repellant that has 20% or more DEET, picordin or IR3535, which is readily available at outdoor camping stores. For clothing, tents, and other gear use products that contain 0.5% Permethrin. I checked a pharmacy in our area, and they stock these kinds of products, but you can also get them on-line. These repellants will provide protection for a period of hours and can be easily washed off in the shower.