Experts weigh in on ticks, Lyme

Experts on ticks and Lyme disease, from left, Asha Shah, Goudarz Molaei and Joseph McMillan, give a talk at the Darien Library called Fight the Bite. — Sandra Diamond Fox photo
Experts on ticks and Lyme disease, from left, Asha Shah, Goudarz Molaei and Joseph McMillan, give a talk at the Darien Library called Fight the Bite. — Sandra Diamond Fox photo

It’s not necessary to go to neighborhood parks in order to encounter ticks. Seventy-five percent of Lyme disease cases are contracted in one’s own backyard.
That’s just one of the facts shared by experts at a recent community conversation at Darien Library, called Fight the Bite.
The talk, which was sponsored by the Darien Library and the Darien Health Department, featured several scientists including Dr. Goudarz Molaei, Ph.D. Molaei is a research scientist and director of the Passive Tick Surveillance and Testing Program at CAES (Connecticut Agricultural experiment station).
Increased tick activity
The CDC (Centers for Disease Control and Prevention) recently reported that during the last 13 years, the number of diseases as a result of tick, mosquito, and flea activity has tripled, according to Molaei.
Nearly 94 percent of all diseases are tick-related and only 6 percent are the result of mosquito activity, he added.

“Ticks are highly efficient vectors of human diseases,” Molaei said. “They are abundant. A single black-legged tick can lay up to several thousand eggs. Each one of those eggs develops into a larvae and the cycle continues.”

Compared to mosquitoes, ticks have a very long life cycle. Once they are infected, they can carry that infection and have the potential to transmit the disease agent to humans, according to Molaei.
In regard to the reproductive cycle of ticks, the two peak activities for female adult ticks occur in April and May. There is a smaller peak in October and November, Molaei said.
Ticks throughout the U.S. carry a number of bacteria pathogens responsible for diseases, including Lyme disease. They also have the capability to carry viruses.
“Based on the infection rate that we see in ticks, Lyme disease cases are still high,” according to Molaei.
Land use or land cover changes, changes in vegetation structure, climate change, and increased diagnosis and reporting are among the factors that account for the increase in ticks.
This year, one out of two ticks are infected with at least with one disease agent, he said.
Avoiding tick bites
According to the experts, ways to avoid a tick bite include:

  • Be aware of surroundings

  • Avoid wooded areas, brushy areas, and grassy areas

  • Fixing holes in window screens, cracks in your doors

  • Remove trash and debris that hold water

  • When going to parks, consider walking in the center of trails, avoid tall vegetation, wear light-colored clothing, tuck pants into socks

  • Perform tick checks every three hours when in infested areas, including under the arms, in and around the ears, inside the belly button, and around the waist.

  • Use DEET insect repellent, reapply after swimming and exercise

  • Use pesticides on clothing

  • Shower and scrub vigorously when returning from being outdoors

Tick testing
David Knauf, health director for the Town of Darien, said people should take ticks they find on themselves into the health department offices for testing.
“We send them off to the AG station for testing,” he said, adding the lab turnaround time is about 10 days.
Identifying a mosquito
According to Dr. Joseph McMillan, a post-doctoral research scientist with CAES, the characteristics of a mosquito is a three-part body, which is comprised of a head, thorax and abdomen; six pairs of jointed legs; compound eyes; a pair of antenna; and a proboscis, which is a mouth part used for piercing skin to suck blood.
Lyme disease
Asha Shah, who is a board certified infectious disease specialist with the Stamford Health System and the Stamford Health Medical Group, said that those at risk of Lyme disease include: Active children spending time outdoors, those with outdoor occupations, such as landscapers and forest rangers, and those who take part in outdoor recreation activities, like hiking or hunting. She added that gardeners are at risk if their garden is near deer or mice or near the forest edge.
There are three phases of Lyme disease, Shah said. In the early phase, there are a set of symptoms that can occur within days to weeks of a tick bite. There is a bull’s-eye rash —which is a central clearing of redness — as well as swollen lymph nodes, fatigue, headache, and low-grade fever.
“Patients feel like they have the flu,” Shah said. “They can’t get out of bed for a couple of days.”
The rash occurs in up to 90% of infections, usually less than one month after a tick bite. It can usually be found near the armpit, groin, behind the knees, and at the belt line. It may burn or itch.
Ticks like warm, moist places, Shah said. The rash typically expands over a few days.
In the second phase of Lyme, which occurs days to months after a tick bite, symptoms can include cardiac inflammation, conjunctivitis, and meningitis.
In the late phase of the disease, which occurs months to years after the onset of infection, the most common symptoms are arthritis in a few large joints, and neurologic manifestations.
Post-Lyme disease, nonspecific symptoms include headache, muscle and joint aches, and fatigue. For most people infected with Lyme disease, symptoms improve gradually over six to 12 months, Shah said.
Testing for Lyme
Testing for Lyme disease involves an Elisa test followed by a Western Blot test.
“If your screening test is negative, you don’t have Lyme disease,” Shah said. “If your test is positive, we go for further testing.”
Treatment for the early stage of Lyme includes taking doxycycline, amoxicillin, or cefuroxime for 10 to 21 days. If there are more serious symptoms, additional medication is available.
The majority of people see their symptoms go away within 20 days, Shaw said.
If someone isn’t experiencing symptoms of Lyme, there is no need to test for it. Patients can’t get a “yearly Lyme test just because they live in Connecticut,” she said.