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by Pramod Narula, M.D.


   When temperatures rise above 40 degrees, the carrier of Lyme disease — the deer tick — is much more prevalent. While walks through wooded areas or tall grass provide the highest risk of picking up a deer tick, dogs, cats and mice can also bring deer ticks into the home. During outdoor activities such as camping, extra precautions should be taken to avoid this unpleasant illness.

  Awareness is the key.  Avoiding ticks is, of course, best, but recognizing the early warning signs of the disease is also vitally important.  The sooner a physician diagnoses Lyme disease, the easier it is to treat.  By recognizing the symptoms, patients play an important role in helping physicians determine the cause.

   When camping or hiking, wear light-colored clothing so that ticks can be spotted more easily.  Tuck both your pant legs (avoid wearing shorts) into socks or boots and your shirt into pants, and tape the area where pants and socks meet so that ticks cannot crawl under clothing.  You may want to consider spraying insect repellent containing the chemical DEET on your clothes or on exposed skin, except for your face.  Another chemical called permethrin, when used on clothes, can kill ticks but, unlike DEET, it should never be applied to your skin.  When you come inside, carefully perform a "tick check". A tick is as tiny as the period at the end of a sentence.

   If you do find a tick, the best course it to stay calm. It usually takes 36 hours after the tick attaches itself before the disease can spread. The presence of a tick does not mean you have been bitten.  Carefully pry the tick loose with fine tweezers, being careful not to crush or break it.  If possible, store it in a plastic bag for later analysis.  Finding a tick — even one that has clearly fed on you — does not necessarily mean that you have the disease, but you should consult your physician.

   Even if you do not spot any ticks, you should remain vigilant for signs of Lyme disease after the camping trip.  One common sign is the "bull's eye rash", or a red rash with a clear center. Other early warning signs may include flu-like symptoms, such as fever, nausea, headaches, fatigue and achiness.  If these symptoms occur within a few weeks of your trip, see your doctor. Lyme disease has long-term symptoms such as ringing in the ears, jaw aches and even mild memory loss.

   The treatment regimen — four to six weeks of antibiotics — must be followed strictly.  Although patients may feel better after taking the antibiotics for 10 days, it is important to not discontinue the medications because the disease has not yet been fully eliminated.  A severe recurrence may occur if one does not finish their regimen the first time.

   Hopefully you and your family will enjoy a tick-free trip, and remember: Your best defense against this small but dangerous critter is awareness.

DR. NARULA is chairman of the pediatrics department at NY Methodist Hospital in Brooklyn.

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