Rural Areas Prone to Higher Cases of Lyme Disease

Doctors taking heed to recognize symptoms

Outdoor lovers need to take precautions to protect themselves from the deer ticks that often carry Lyme disease.

“It’s a growing problem in our area,” said Bette Casey, infection preventionist for New London Family Medical Center (NLFMC) and Riverside Medical Center (RMC) in Waupaca.

Lyme disease is a rapidly emerging bacterial infection that is spread to people by the bite of infected deer ticks. “If possible, bring in the tick that was removed so the provider can determine the type of tick,” said Dan Sutton, MD, a family physician at ThedaCare Physicians-Waupaca.

According to the State Health Department, in 2011 there were 95 confirmed cases in Waupaca County and 31 confirmed cases in Outagamie County. In 2010, there were 81 confirmed cases in Waupaca County and 43 confirmed cases in Outagamie County.

“Compared to Pennsylvania, where I practiced prior to coming to Wisconsin, I have seen many more cases in Wisconsin,” Michael Fetterolf, MD, a family physician at ThedaCare Physicians-New London.

Nine states, including Wisconsin, account for 90 percent of the disease. In Wisconsin, Lyme disease is spread by the black-legged tick, which lives in wooded areas, grassland, and yards.

The warm weather months provide brush and long grass, which is home to a tick’s host animal like mice, cats, dogs and deer. Companion pets can bring the ticks into the home, putting humans at risk for Lyme disease, said Casey. Ticks are the vector, feeding off the animals that have the bacteria, which is then spread when ticks feed off humans, she added.

“A lot of times the people who are coming down with Lyme disease are not the healthy men in the woods,” said Casey. “We see a lot of Lyme disease in the elderly and the very young.”

Anyone and anything that has been outdoors should always be checked for ticks, said Casey. “Sometimes it just becomes commonplace and then you’re not checking for ticks frequently enough,” she said.

The early stage of Lyme disease is usually marked by symptoms like tiredness, headache, chills and fever, muscle or joint pain, swollen lymph glands and a characteristic skin rash, which is often a red circular patch that expands around the site of the tick bite. The center may clear, resulting in a “bulls-eye” appearance. The rash may be warm but is not painful or itchy.

According to the Centers for Disease Control, a deer tick needs to be attached for 36-48 hours before transmission of the bacterium that causes Lyme disease can occur. “To remove ticks, the only method that should be used is to slowly pull the tick straight out of the skin by grasping it as close to the skin as possible with a tweezers,” said Dr. Sutton. “Do not twist. Do not use any other methods such as Vick’s or burning a match.”

Not all Lyme disease symptoms are evident and sometimes they mimic other diseases, said Dr. Fetterolf. “Often times we order a tick panel to see what the patient may have for potential disease processes,” he said.

Casey, who was diagnosed with Lyme disease five years ago, knows the complications the disease can pose on one’s body. “It’s really good at crippling your immune system,” said Casey, who was unaware she’d been bitten by a tick until symptoms plagued her for years. “It really affects your whole body.”

If a deer tick has been attached for more than 24 hours, and symptoms are developing such as rash, fever or new joint pain, be evaluated by the doctor “within 1-2 days so you can receive timely care,” said Dr. Sutton.

However, patients cannot be tested right away because a waiting period is required. “There is no benefit to testing for Lyme disease within 1-2 weeks of a tick bite,” said Dr. Sutton. “It takes 3-4 weeks for the antibodies that we test for to show up, so there should not be a ‘rush to the doctor to get tested’ if a tick bite occurred a few days ago.”

The disease, said Casey, likes to hang out in places of the body where there is low blood flow, making it harder for the antibiotics to reach.

When venturing outdoors in rural areas, take precautions like wearing long sleeves and long pants tucked into socks, wearing a hat and tying hair back, using insecticides to repel or kill ticks and checking yourself for ticks after outdoor activities.

Casey said local doctors in the area are really taking heed to symptoms that could be related to Lyme disease. “I think we’re just really starting to learn the mass of affects it has on your health,” she said, noting that left untreated, Lyme disease can pose other health risks. “I think they have really done a good job with keeping Lyme disease in mind now when they do see a patient.”