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Lyme Disease Scare

Lyme Disease Map of US

Whew! I thought I had contracted Lyme Disease earlier this week. I had some of the major symptoms and went in for a blood test at the doctor's on Monday. Just got the results back and they were negative, but I was scared. Real scared.

I had a rash on my hip just below the waistline and I was experiencing uncharacteristic fatigue and severe muscle aches, about 10 days after returning from a two week hike through prime deer tick territory in New York and Connecticut.

My doctor doesn't have an explanation for my symptoms but my blood doesn't show any Lyme antibodies or an elevated white cell count, so I believe I'm in the clear.  Blood tests for Lyme are not conclusive evidence that people haven't been infected, especially if the test is performed early in disease onset before antibodies have been produced, but together with a dissipation in symptoms, I'm considerably less nervous about  it than before.

The rash turns out to be a fungal infection that I'm treating with over-the-counter meds and the muscle aches have tapered off after a few days of Vitamin I. I guess my defensive clothing systems worked after all.

About 4 years ago, I started wearing long pants on all my hikes to prevent Lyme infected tick bites. I wear Insect Shield treated long hiking pants, and spray all of my hiking clothes with Permethrin, (the active ingredient in Insect Shield) an insect neurotoxin that kills bugs that land on my clothing. It's not a repellent, but kills them dead.

Still, this incident was a wake-up call. I know people who've had Lyme Disease and it an be extremely debilitating with crippling neurological, cognitive, and arthritic-like symptoms that persist for years, if patients are not treated early in the disease cycle. Treating Lyme disease early is as simple as taking a long cycle of antibiotics, so early detection is important.

If you're not up to date on Lyme Disease and it's signs, and you hike in areas with a lot of dear or ticks, the Center for Disease Control (CDC) and Wikipedia publish some good reference information that is worth reading periodically. There's a lot you can do to protect yourself from Lyme Disease and if you or you family spend a lot of time outdoors, you owe it to yourself to be on top of this subject.

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  1. Yikes! I've plucked so many ticks off of myself in the past several years that I'm amazed I haven't had any scares like that myself. Still, this spring will be my first real test of permethrin and longer clothing. I'm excited to see how it works.

    A good friend of mine contracted Lyme Disease several years ago, but luckily he was able to get it treated successfully. It probably would have been better if he hadn't waited a few weeks before seeing a doctor, but this is the problem with not having health insurance. You get in the mentality of "it's not something serious… it'll go away with some advil and rest."

    Backpackinglight ran a very interesting article on Lyme Disease last summer. Did you happen to catch that?

  2. No I don't remember that article – I'll take a look. Would you believe that I've never plucked a tick off myself. Either I can't recognize them or I'm covered up too well.

  3. That can't be right :)

    Here's a link to the BPL article. I thought it was pretty crazy… http://www.backpackinglight.com/cgi-bin/backpacki

    No ticks so far this season, but I haven't been out too much just yet. I'm sure they're voracious in NJ-CT right now. On the AT in 07 I regularly found from 2 to 13 of them on me per day in those states this time of year.

  4. Thanks for posting the link – beat me to it. I just read the article and am going to print it out and send it to my doctor. The worst time to hike is in late spring and summer, when the tick eggs hatch and ticks mature.

    I talked to Kim last night about the Cohos. Small world. Mentioned that we're doing stuff together for the AMC in a few weeks.

  5. Philip, so glad to hear that it was negative, can't imagine what a scare that would have been. I'm always surprised at how small some of the ticks are. You always see enlarged images online and image them to be much bigger (at least I did) but in reality some of them are tiny and actually hard to spot.

    At a recent Cub Scout camp out with my son Jack we spotted a few tiny ticks on some of the other boys. Fortunately none of them had latched on, but it was definitely a wake up call to several of the parents.

  6. I finally got around to treating my clothes this spring and promptly forgot to wear them. Ground a tick in under my shoulder strap and had a mess but I've found plenty of ticks attached over the years, some I didn't notice until the site got inflammed pretty bad, and never got symptoms of lyme. I try to take off my shirt and towel myself briskly 2 or 3 times a day. I never found one below the belt so I don't check there until bedtime.

    Here's a plumped up one I found on the trail earlier this spring; thought it was an oddly shiny deer turd at first; I made sure to kill it so it wouldn't lay eggs.

  7. What do they look like when they've attached themselves to you. Are they on the surface of the skin or embedded under it?

  8. Hikers in Scotland may want to pay attention to this discussion. You have a lot of deer in that country and Lyme has landed there.

  9. I believe I read somewhere the tick has to be attached for at least 48 hours to spread Lyme disease.

  10. I read some historical info indicating lyme-like symptoms were recorded in Scotland a bit before the New World but it could have originated in either place.

    Early on they lie flat but as they burrow in deeper over many hours, their butt sticks outward and they get easier to feel when brushing your hand over your skin. After about two days the bite area gets painful and inflamed and the swelled skin will surround their heads and I can usually only pull the body off. I've had little rash areas including a small bullseye one that had me worried but pics on the internet plus a kid I know that had lyme show pretty big rashes that I never got. I've found the tiny ones crawling on me but never attached. I think the infection rate is pretty low even after 48 hours and noticed a lack of published info on that particular data, typical for scientists who want to keep people alarmed.

  11. Thanks again for yet another timely, informative article as I'm about to depart for NJ. I've decided to hike in long pants and a long t-shirt after last year's bug encounters. I'll be careful to watch for early symptoms.

    Might follow up with a post on how to treat clothing.

  12. Here's a post on how to treat your clothing with Permethrin. http://sectionhiker.com/treating-your-clothes-wit

    I'm glad to hear that you'll be using long pants. I think that's the most effective thing you can do to mitigate the danger. Have a great hike!

  13. Remember to tuck the t-shirt in, I seldom do and find a lot of ticks attached just above my belt.

  14. Phil you should definitely check out the BPL article – very informative.

    How long does Permethrin last once applied? How many days/washes? Should it be applied to clean wet clothing and allowed to dry, or to dry clothing? Should it be applied and then placed in the dryer on low heat, like when applying DWR coatings? Haven't used it before but should given that we're in major tick country.

    Your fatigue and muscle ache could have been due to a variety of more straightforward causes such as working harder than you realized, or a nutrient deficiency, etc. Do you take any kind of high quality multivitamin on the trail? One of the worst episodes of muscle ache and fatigue I ever experienced happened after a challenging day hike with a lot of elevation gain and loss, following a long stretch of weeks of too many desk hours. Yet I experienced much less muscle pain after other far more significant physical challenges, such as a 45 mile overnight run, as I was better prepared for them. I'm not saying you were out of shape for this hike – you are very active – but is it possible the trip was a bigger leap in physical demand than you realized?

  15. Permetrin is good for 5 washes. Apply to dry clothes. Insect Shield is rated to 70 washes. Same key ingredient, different application process.

    My doctor thinks it might have been psychosomatic. I was forced to spend 4 days with close family almost immediately after returning from a long solo hike. Maybe I was just crashing physically. Hard to say, but it's never happened like that before.

  16. LOL without a doubt family can do that to you, especially considering the contrast and shock after a beautiful trip!

  17. Past Spring, I must have stepped into a nest without noticing, because when I took off my boots back at the car after a long day hike, my right foot was BLACK with the suckers. Hundreds, of the tiny tiny (nymph) variety, they must have crawled right through the webbing of my UL boots and the socks as well. I had a bottle of Permethrin in the car, and not knowing what else to do, I sprayed my foot with it, hoping that it would kill off the suckers before they had a chance to throw up their Lyme guts into me. Apparently, it worked, no symptoms besides the initial numbness from the Permethrin itself, but boy, I'd rather not repeat that experience, ever!

  18. My understanding is that 24 rather than 48 hours is the necessary amount of time a tick needs to be attached in order to transmit the Borrelia bacteria. The late April/early May period (in southern New England, at least) is a particularly dangerous time for hikers because of the emergence of the Ixodes nymphs which are roughly the size of poppy seeds; post-frost/pre-snow season is also dangerous as many people incorrectly assume frost kills the adult ticks in the forest.

    The use of gaiters or high boots (to keep your trouser cuffs tucked) is helpful, as is keeping your shirt tucked in. Use of DEET or picaridine on exposed skin combined with permethrin on clothing is the usual prescription. If you use boots with drainage holes there are permethrin-impregnated socks on the market and I know a lot of people who apply DEET or picaridine around their waistline under there clothing to discourage the entry of ticks there.

    Some folks find treating their hats and socks with permethrin to lead to skin irritation. Neither has ever bothered me, but in any case pre-treated socks and headwear exists and are much less likely to induce a reaction.

    Permethrin is great stuff, but do keep it and treated clothing away from cats and fish tanks! Ironing or a long dryer cycle after an application has fully dried is said to bind it to treated items for a bit longer. Anecdotally I have been told it can gum up Gore-Tex. If used in combination with DWR it needs to go on after the DWR coat as it is a contact insecticide. By the same logic, repellents like DEET and picaridine should go on after sunscreen.

  19. I had a couple of deer ticks attached to me a few summers ago. I blame a dog that slept on my bed. One attached to my upper leg and I noticed it was there when I felt a slight itch and tried to brush it away. It was embedded. I tweezed it out, but it left a small wound. A few nights later another one attached itself in the same spot and by the time I awoke, it was embedded too. Gross. At first I kept running to the doctor in a panic for the antibiotic regime. Then a few weeks later I found another one in my ankle. I called the doctor and they said not to come in. The tick had only been in for about 12 hours at most so they didn't think it had lyme. I think one of them got sent for testing and came back negative.

    The worst part of it was that the wounds from the ticks continued to itch and swell for months. Even now, they will sometimes just bump up for no reason.

  20. I'll have a scar of sorts for up to a year if I don't get ticks off within a day or so but I think people are getting conditioned to panic way too much from an attached tick. It's probably a million in one chance of getting lyme if you get the tick off within 24 hours and the bpl story with the woman immediately starting antibiotics after finding a tick demonstrates the dark side of scaring people over lyme. Wait for some symptoms.

  21. Thanks for the pointer to the article. I've had my share of "lyme scare" (fortunately not the disease), and must admit that doxycycline does seem to do better at relieving aches than glucosamine (can you spell placebo?).

  22. Your illness sounds just like the one I had in fall 2009, when I, too, tested (twice) negative for Lyme Disease. What a shock in the summer 2010 when I tested positive for Babesia, a tick-borne co-infection, that often is transmitted with Lyme. My symptoms also faded after that initial rash and flu-like symptoms, but they returned on and off for 9 months until I started aggressive antibiotic treatment. There are many reasons why those with Lyme are not testing positive, and a cessation of symptoms is not a good indicator that you do not have Lyme. By the way, the CT govt says ticks may only have to be attached up to 4 hours…just FYI for all those who think they're okay because they caught the tick early. Track your symptoms and notate ANYTHING that's unusual – even down to a fever that comes and goes overnight. It'll be useful when it's time to visit an LLMD.

  23. I'm in Massachusetts, and I had Lyme and Ehrlichiosis (http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002357/). It's quickly becoming more common to have other diseases (juneau's babesia included). The transmission has been generally accepted at around 24 hours. If there's a small redness around the tick as it's attached to you, it's probably been on long enough to transmit any diseases it has. The Ehrlicky put me in the hospital with very advanced symptoms. I don't remember the first day of a week long stay of alternating IVs of antibiotics and synth-morphine. I lost about 20 pounds during the treatment after I got home. The treatment lasted 3 weeks, and then a relapse, and another four weeks of Doxycycline. I couldn't eat anything more complex than white toast, rice, and tea. It was constant pain from hunger, the disease and the wretching if you happened to eat anything in significant quantity. Now, if they test for the lyme, I will show positive because the test is looking for your body's reaction to the lyme, not the lyme itself, so anyone that's had lyme will test positive. So far, my 8 yr old daughter and my dog have been infected. Interestingly, my dog's dosage was the exact same as mine, but he's a Newfie, so it's not THAT surprising.

  24. I just started thinking about Lyme disease a lot lately for no apparent reason other than being a hypochondriac. Luckily, northern NY (where I do most of my backpacking) is not a hotspot for the disease….yet. I am starting to think I should start using permethrin on my cloths just to be on the safe side. Nootkatone is a natural insect repellent (extracted from grapefruit) that shows promise against ticks and other pests but it is not commercially available yet. I hope it makes it to the market before I start discovering ticks on myself after a trip. Then I won't have to freak out and run to the doctor’s office for a Lyme disease test!

  25. I just heard about that Grapefruit stuff. Can't wait to try it. I also heard that they've figured out that mice are the cause of the disease, not deer as previously though. Mice are everywhere….

  26. Which ties into my theory that killing off snakes is a major factor in lyme ticks rapid spread–Huge difference in snake population since my childhood.

    I recently had a buddy put a tick he took off himself on my freshly permethrinned shirt, I rubbed it over lightly and watched it for 10 minutes as it's movements became increasingly uncoordinated and it flipped over several times and just about stopped moving altogether. So the stuff works good, also was sitting on the ground or wherever for three days and never found one on me.

  27. Recently, I read about an interesting tactic New York State uses to combat tick populations (I assume in southern NY where the tick population is higher). They spread permethrin-soaked cotton around in places where mice and humans congregate (like in lean-to shelters). The mice take the cotton back to their nest where it continues to kill ticks in the nest and on the mice. I thought this was pretty clever and I might just try it in the Adirondacks if (when?) the tick population picks up.

  28. That IS very clever. Easy to implement around shelters, too.

  29. Very interesting. I actually contracted Lyme disease a few years ago after a trip to New England (I live in the UK), and had to be treated with Doxycycline. And just a couple of summers ago our Chocolate Labrador was very ill with Lyme Disease after our vacation in Scotland. We had no idea ’till then that dogs could get it! She was also treated with Doxycycline.

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