May 8, 2000 -- Because the tick population has increased after three mild winters, outdoor workers should take preventive measures against Lyme disease and ask their doctors about vaccination, according to a new warning issued by the U.S. Occupational Safety and Health Administration (OSHA).
Transmitted by ticks from infected deer, Lyme disease is a bacterial infection that's prevalent in the northeast and north central U.S. Many of those bitten develop a red bull's-eye rash and flulike symptoms for up to a week, but often the cause isn't recognized. The condition can progress and become chronic, causing destruction of joints, heart problems, neurological symptoms, and other serious complications.
"Removing ticks within 36-48 hours is the best way to prevent the infection," says David Weld, the executive director of the American Lyme Disease Foundation. "That's why daily tick checks are so important for anyone who spends a lot of time in wooded areas." Ticks that transmit Lyme disease are very small, however, and can be hard to detect.
Weld tells WebMD that many ticks are found on the back of the neck and should be removed carefully. "Remedies like matches, petroleum jelly, and nail polish remover can cause the tick to inject bacteria," says Weld. "The best method is to lay a pair of tweezers on the skin and grab the tick by its neck, rather than its body."
Other preventive measures recommended by the CDC include wearing long-sleeved shirts, tucking long pants into socks, and spraying clothing with insect repellant containing DEET (such as OFF! and Cutter).
The CDC also recommends vaccinations for those people between the ages of 15 and 70 who are at high risk. The new vaccine, which has been available for less than a year, is 70-80% effective in preventing the infection, according to Lyme disease expert Sam Donta, MD, an infectious diseases specialist and professor of medicine at Boston University.
Donta tells WebMD that many managed care plans cover the vaccine, but some people may want to hold off. "People with rheumatoid arthritis, osteoarthritis, and lupus should probably wait until more is known about the vaccine," says Donta. "There are no specific problems, but as with any new treatment, issues sometimes arise after release."
For those without insurance coverage, out-of-pocket costs are manageable. "The vaccine is a series of three injections, which are administered about a month apart," says Donta. "Each shot costs between $50 and $80, but it's a bargain if it prevents chronic Lyme disease."
The terms chronic Lyme disease or post-Lyme disease syndrome refers to symptoms that persist after treatment with antibiotics. "Disabling fatigue, unrelieved aches and pains, and poor concentration have ended both marriages and employment," says Donta. "That's why it's so important to get early treatment."
Patient outcomes are significantly improved if the disease is caught within six months to a year. "The longer you wait, the harder it is to treat," adds Donta. "So nobody should ignore, accept, or feel embarrassed about minor symptoms. Even though it's not life threatening, Lyme disease affects quality of life for millions of Americans."
In fact, whole families have been diagnosed with the disease. "My husband, myself, and our three daughters all had positive blood tests," says Janice Schutten, 49, a patient of Donta's for two years. "For me, it was like a flu that didn't go away. I never even found a tick [on a family member], but I did remove them from our dogs."
Schutten tells WebMD that Lyme disease explains her joint pain. "I had back pain and a sore knee five years before I was diagnosed, but we never put it together. It's a very insidious disease," she says. "My daughters and I have to stay on antibiotics until our symptoms improve and there are no new symptoms."
When asked about insurance coverage, she sighed. "Getting reimbursement for the girls' blood tests was a struggle, but I pursued it vigorously and they paid it," says Schutten. "Recently, I've heard that the HMOs are developing guidelines for Lyme disease treatment."
- Lyme disease is a bacterial infection transmitted by ticks. Often, a rash that resembles a bull's-eye appears, but the disease can be difficult to diagnose. Serious long-term problems can occur, including arthritis, neurological symptoms, and heart disease.
- Removing ticks within two days is the best way to prevent the infection. Other preventive measures include wearing long-sleeve shirts, tucking long pants into socks, and spraying clothes with insect repellant that contains DEET.
- Vaccinations are recommended for outdoor workers and others who spend time in wooded areas. The vaccine is a series of three injections and is up to 80% effective in preventing the disease.