Hikers and backpackers are at increased risk for contracting Lyme Disease. This is something I’ve written about extensively on SectionHiker and is worth reiterating at the beginning of each hiking season.
Revised numbers from the CDC (US Centers for Disease Control) reflect that they have been under-reporting Lyme disease. Instead of the 30,000 cases a year previously reported, the CDC has now issued a statement that the numbers are more in the range of 300,000 cases a year in the United States alone. 95% of these cases were reported from 13 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Vermont, Virgina and Wisconsin.
Lyme Disease Symptoms
Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected deer ticks. Typical symptoms include fever, headache, fatigue, and a characteristic bulls-eye skin rash. If left untreated, infection can spread to joints, the heart, and the nervous system.
Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks; laboratory testing is helpful if used correctly and performed with validated methods. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat. The ticks that transmit Lyme disease can occasionally transmit other tickborne diseases such as the West Nile Virus
Late Lyme Disease
Different people exhibit different signs and symptoms of Lyme disease. Some people never develop a bull’s eye rash. Some people only develop arthritis, and for others nervous system problems are the only symptom of Lyme disease. Some signs and symptoms of Lyme disease may not appear until weeks, months, or years after a tick bite.
Many of the symptoms of Late Lyme disease are similar to those of other diseases.
- The fever, muscle aches, and fatigue of Lyme disease can be mistaken for viral infections, such as influenza or infectious mononucleosis.
- Joint pain can be mistaken for other types of arthritis, such as juvenile rheumatoid arthritis, and neurologic signs can mimic those caused by other conditions, such as multiple sclerosis.
- Other infections, arthritis, or neurologic diseases can also be misdiagnosed as Lyme disease.
Post Treatment Lyme Disease Symptoms
Even when treated with antibiotics, approximately 10 to 20% of Lyme patients have lingering symptoms of fatigue, pain, or joint and muscle aches. In some cases, these can last for more than 6 months. Called “chronic Lyme disease,” this condition is properly known as “Post-treatment Lyme Disease Syndrome” (PTLDS).
- Arthritis appearing as brief bouts of pain and swelling, usually in one or more large joints, especially the knees.
- Nervous system symptoms can include numbness, pain, nerve paralysis (often of the facial muscles, usually on one side), and meningitis (fever, stiff neck, and severe headache).
- Problems with memory or concentration, fatigue, headache, and sleep disturbance.
- Heart rhythm may occur irregularities
The exact cause of PTLDS is not yet known. Most medical experts believe that the lingering symptoms are the result of residual damage to tissues and the immune system that occurred during the infection. Similar complications and “auto–immune” responses are known to occur following other infections, including Campylobacter (Guillain-Barre syndrome), Chlamydia (Reiter’s syndrome), and Strep throat (rheumatic heart disease).
The Mayo Clinic’s #1 recommended precaution for preventing Lyme disease is to wear long pants, long sleeve shirts, hats, socks, gloves and gaiters when walking in wooded or grassy areas that are potential deer tick habitats. This is just common sense, yet so few hikers take these steps, preferring to hike in short pants and short sleeve shirts.
I love the feeling of warm sunlight on my arms as much as the next guy, but I decided six years ago to cover up whenever I go hiking and to wear Insect Shield (also called Permethrin) treated clothing which kills ticks and other insects. By taking these precautions, I have yet to be bitten or infected by a tick, which is pretty miraculous given the amount of hiking I do in prime deer tick habitat.
When you gear up for this hiking season, I encourage you to look into wearing clothing that has been treated with InsectShield, an industrial process for treating your clothing with Permethrin, a contact insecticide proven to prevent tick bites, that maintains its effectiveness for 70 washings. You can treat your own clothing with Permethrin also, but it will only remain effective for 3-4 washings.
Clothing manufacturers such as Ex Officio, Columbia, Outdoor Research, Buff and my favorite, RailRiders, sell stylish InsectShield clothing and are your best defense against tick bites for hiking, backpacking, and camping in areas with a high incidence of Lyme disease.