Microsoft word - june newsletter spring outdoor safety _2_.docx
Springtime outdoor safety
Whether you're relaxing in the backyard, turning up your garden, hitting the pool, or exploring the great outdoors, here are some ways to help keep you and your family healthy this spring and summer:
• Beware of bugs: mosquitoes, ticks, and other insects thrive in warmer weather,
and they can transmit West Nile virus, Lyme disease, and other illnesses. Here are some tips to reduce your exposure:
Use an appropriate insect repellent according to label instructions.
Pay special attention to protection or avoid being outdoors during the prime mosquito-biting hours of dusk to dawn.
Reduce mosquito breeding sites by removing any yard items that may collect standing water, such as buckets, old tires, and toys.
Replace or repair torn window screens to keep bugs out of the house.
Wear light-colored clothing so you can see ticks crawling on you. You can also treat clothing with permethrin, which protects through several washings (follow the label instructions).
After being outside, check your body, clothing, children, and pets for ticks.
Reduce ticks around your home by removing leaves, brush and woodpiles.
What is Lyme disease? What causes Lyme disease?
Lyme disease is a bacterial illness caused by a bacterium called a "spirochete." In the United
States, the actual name of the bacterium is Borrelia burgdorferi
. In Europe, another bacterium,
, also causes Lyme disease. Certain ticks found on deer harbor the bacterium in
their stomachs. Lyme disease is spread by these ticks when they bite the skin, which permits
the bacterium to infect the body. Lyme disease is not contagious from an affected person to
someone else. Lyme disease can cause abnormalities in the skin, joints, heart, and nervous
What are symptoms and signs of Lyme disease?
Lyme disease affects different areas of the body in varying degrees as it progresses. The site
where the tick bites the body is where the bacteria enter through the skin. As the bacteria
spread in the skin away from the initial tick bite, the infection causes an expanding reddish rash
that is often associated with "flu-like" symptoms. Later, it can produce abnormalities in the joints,
Lyme disease is medically described in three phases as: (1) early localized disease
inflammation; (2) early disseminated disease
with heart and nervous system involvement,
including palsies and meningitis; and (3) late disease
featuring motor and sensory nerve
damage and brain inflammation as well as arthritis.
In the early phase of the illness, within days to weeks of the tick bite, the skin around the bite
develops an expanding ring of unraised redness. There may be an outer ring of brighter redness
and a central area of clearing, leading to a "bull's-eye" appearance. This classic initial rash is
called "erythema migrans" . Patients often can't recall the tick bite (the ticks can be as small as
the periods in this paragraph). Also, they may not have the identifying rash to signal the doctor.
More than one in four patients never get a rash. The redness of the skin is often accompanied
by generalized fatigue, muscle and joint stiffness, swollen lymph nodes ("swollen glands"), and
headache resembling symptoms of a virus infection.
The redness resolves, without treatment, in about a month. Weeks to months after the initial
redness of the skin, the bacteria and their effects spread throughout the body. Subsequently,
disease in the joints, heart, and nervous system can occur.
The later phases of Lyme disease can affect the heart, causing inflammation of the heart
muscle. This can result in abnormal heart rhythms and heart failure. The nervous system can
develop facial muscle paralysis (Bell's palsy), abnormal sensation due to disease of peripheral
nerves (peripheral neuropathy), meningitis, and confusion. Arthritis, or inflammation in the joints, begins with swelling, stiffness, and pain. Usually, only one or a few joints become affected, most
commonly the knees. The arthritis of Lyme disease can look like many other types of
inflammatory arthritis and can become chronic.
Researchers have also found that anxiety and depression occur with an increased rate in
people with Lyme disease. This is another important aspect of the evaluation and management
What is the treatment for Lyme disease?
Most cases of Lyme disease are curable with antibiotics. This is so true that some authors of
Lyme disease research have stated that the most common cause of lack of response of Lyme
disease to antibiotics is a lack of Lyme disease to begin with! The type of antibiotic depends on
the stage of the disease (early or late) and what areas of the body are affected. Early illness is
usually treated with medicines taken by mouth, for example, doxycycline, or amoxicillin.
Therefore, if a person finds a typical bull's-eye skin rash (described above) developing in an
area of a tick bite, they should seek medical attention as soon as possible. Generally, antibiotic
treatment resolves the rash within one or two weeks with no long-term consequences.
For the relief of symptoms, pain-relieving medicines might be added. Swollen joints can be
reduced by the doctor removing fluid from them (arthrocentesis). An arthrocentesis is a
procedure whereby fluid is removed from a joint using a needle and syringe under sterile
conditions. It is usually performed in a doctor's office. Rarely, even with appropriate antibiotics,
the arthritis continues. It has been suggested by researchers that sometimes joint inflammation
can persist even after eradication of the Lyme bacteria. This has been explained as an ongoing
autoimmune response causing inflammation of the joint that was initially stimulated by the
original bacterial infection. The doctor also can use oral medications such as ibuprofen (Motrin,
Nuprin) to reduce inflammation and improve function.
How can Lyme disease be prevented? Is there a vaccine?
Because Lyme disease is transmitted by ticks attaching to the body, it is important to use tick-
bite avoidance techniques when visiting known tick areas. Spraying insect repellant containing
DEET onto exposed skin can help. Wearing long pants tucked into boots and long sleeves can
protect the skin. Clothing, children, and pets should be examined for ticks. Ticks can be
removed gently with tweezers and saved in a jar for later identification. Bathing the skin and
scalp and washing clothing upon returning home might prevent the bite and transmission of the
Vaccines were formerly on the market; however, as of Feb. 25, 2002, the manufacturer
announced that the LYMErix™ Lyme disease vaccine will no longer be commercially available.
Further studies of vaccines are needed. For now, ideal prevention focuses on the
recommendations of the preceding paragraph.
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