Do you have fatigue? Migraines? Joint pain? Does the pain wander around your body?  Are you struggling with anxiety? Depression? Do you have an autoimmune disorder?  These are all associated with tick-borne infections.

 

Pennsylvania is a hot spot for tick-borne infections. We have had the highest number of cases of Lyme disease in 11 of the last 13 years[i]. Since 1990 there have been an estimated 1.5 million cases of Lyme disease in Pennsylvania.[ii]  Twenty percent of those cases will result in long-term chronic illness.[iii] And Lyme is not the only tick-borne illness in Pennsylvania. Known as co-infections, Babesia, Rocky Mountain Spotted Fever, Tick-borne Relapsing Fever, anaplasmosis and others are all present in ticks in Pennsylvania.  Like Lyme disease, these infections can cause fever, fatigue, and headaches, but they can also cause different symptoms including shortness of breath, night sweats, purplish stretch marks, pain in the soles of your feet, intermittent fevers and many others. If you have unusual chronic symptoms, it is a good idea to ask a doctor about tick-borne infections.   

 

Living in Pennsylvania, it is crucial to learn about tick-borne diseases.  Prevention is the first thing to know. Tick bites can be prevented with a two-pronged approach, spraying permethrin on your shoes and socks and a repellant on your skin.  Repellant options can be found at EWG.[iv]  Prevention is especially[ka1] [AT2]  important if you know you will be in tick habitats. Common tick habitats include shady areas, especially in the woods, the edge of the [ka3] [AT4] woods where the grass meets the trees or tall grass where ticks quest. Ticks like leaf litter, wood piles and the base of trees – anywhere with moisture and where small critters frequent. In Pennsylvania, ticks are so prevalent that many people get tick bites in their own yards.

It is also important any time you have potential tick exposure to do a tick check. Check your entire body for ticks as soon as possible - p[jw5] [ka6] aying extra attention to head, hair, armpits, groin, behind knees, feet, elbows, fingers and toes.  Nymphal deer ticks are the size of a poppy seed, so look carefully. Put your clothes directly in the dryer on high heat to kill ticks and shower promptly. A shower will remove ticks that haven’t attached yet but once attached, it will not remove them. If you do discover a tick, visit our website for tick removal instructions and consider sending the tick in for testing. Tick testing is free for residents of Pennsylvania at Ticklab.org.

 

What if you have a tick bite or a bull’s eye rash? It is important to get treatment as soon as possible. Bull’s eye rashes may not have the characteristic bull’s eye circle - they can be purple, asymmetrical or multiple bull’s eye rashes can appear all over the body.[v] If you have a known tick bite and develop an enlarging rash, get antibiotics – 4-6 weeks if the doctor will prescribe them.

 

Maybe you had a tick bite and they tested you for Lyme disease and told you that you don’t have it. Or maybe you had Lyme disease, it was treated, and you have been told there is nothing to do about the remaining symptoms. There is more you should know about Lyme disease. One important thing to be aware of is that testing is not always reliable. In an endemic state like Pennsylvania, if you have a bull’s eye rash, testing is not needed. The bull’s eye confirms [jw7] [ka8] that you have Lyme disease.[vi]  It is also worth knowing the accuracy of the standard 2-tiered testing can be as low as 30%–40%, especially during early infection.[vii]  If you get tested soon after a tick bite your body may not have developed an antibody response and you will test negative even if you have Lyme disease.  False negative results are common especially early in the infection process. Specificity is high (>95%) during all stages of disease, which means that there are few false positives.[viii]  If you tested positive, you most likely have Lyme disease. Some doctors use specialty testing to increase the accuracy of results, but no Lyme test is 100% accurate.

 

Finally, many people are aware there is a lot of controversy about Lyme disease. The controversy revolves around whether the Lyme bacteria can persist after antibiotic treatment. There is evidence to support both possibilities, and different treatment guidelines exist based on these different perspectives. Most traditional doctors follow IDSA guidelines which agree with the CDC perspective that Lyme disease is easily treated with a couple weeks of antibiotics. Other doctors trained by the International Lyme and Associated Diseases Society (ILADS) believe that the Lyme bacteria can persist after antibiotic treatment. While often dismissed as lacking in scientific evidence, the ILADS guidelines are based on over 700 peer reviewed studies that show Lyme antigens, Lyme DNA and sometimes Lyme bacteria can persist after antibiotic treatment[ix]. Many ILADS doctors have additional training in tick-borne infections and will treat them with longer courses of antibiotics. Some will also use a combination of anti-inflammatory and herbal supplements to help deal with long term symptoms. 

 

For more information about tick-borne infections, please consider attending PA Lyme’s Parents and Patients Conference on April 6 in Hershey or visit PA Lyme’s website, www.palyme.org. For more in-depth information about tick bite prevention, consider booking one of our free DARE 2B Tick Aware seminars. 

 

If you have questions about tick prevention, Lyme disease or tick-borne diseases, or need a doctor referral, you can connect with PA Lyme on Facebook, Instagram or on our website. Questions can also be sent to [email protected].

 

PA Lyme Resource Network is a 501c3, and the largest Lyme and Tickborne disease non-profit in Pennsylvania. PA Lyme represents the interests of Pennsylvanians affected by Lyme and other Tickborne diseases.