Dr. Roger Hicks
Spring has arrived and for many people, that means being outside more. Getting some fresh air and exercise is important, especially if you’ve been spending most of your time indoors during this very wet winter, but it’s also important to take some precautions to ensure an enjoyable season.
First, take some time to stretch before hitting the trail or heading out to work in your garden. Bring some water and a healthy snack if you will be out for some time and take a few minutes to inspect any pet that may have joined you and yourself for ticks when you’re done.
Ticks love the climate in Northern California as much as we do, but unfortunately, some of them transmit diseases. Tick-borne diseases include Rocky Mountain spotted fever, relapsing fever and Lyme disease, but the latter is the one of concern in our area.
The only kind of tick found locally that can carry Lyme disease is the Western black legged tick (a.k.a. Ioxedes pacificus, or deer tick). They are common in Nevada County, prefer cool moist areas and can be found on wild grasses and low vegetation.
Ticks will climb to the tip of a low hanging branch or tall blade of grass, especially along trails, and wait for an unsuspecting warm-blooded mammal to pass by – a behavior known as “questing.” Whether it’s you, your dog, or a deer, when they are hungry, these mini-vampires will latch on for their favorite and only food: blood.
While only 48 cases of Lyme disease have been officially reported to the Nevada County Department of Health over a sixteen-year period, some 300,000 cases have been reported to health departments nationwide. Due to misdiagnosis and under-reporting, many researchers believe the number is as much as ten times higher.
Lyme Disease can be difficult to diagnose. Symptoms can mimic a number of other diseases, including multiple sclerosis (MS), fibromyalgia, ALS, chronic fatigue syndrome, autoimmune diseases including lupus and rheumatoid arthritis, thyroid disease, and psychiatric disorders, among others.
It is caused by Borrelia burgdorferi, a spirochete bacteria that looks like a corkscrew under the microscope. Like syphilis, another spirochete-caused infection, untreated Lyme disease progresses in stages, and symptoms and treatment vary depending on the phase of the illness. In very early Lyme disease, people sometimes have flu-like symptoms, including low-grade fever, headache, fatigue, and achy muscles, while many have no symptoms whatsoever.
Estimates vary, but probably less than half of those infected get the classic bull’s eye rash, a series of concentric irregular red rings or lines. Later symptoms, which may take months to appear, are myriad. They include migratory joint pains (pain that moves from one joint to another), dizziness, fatigue, and “mental fog” – difficulty concentrating, memory issues and depression.
Fortunately, not all deer ticks are infected with Lyme disease, and the percent of local ticks that are is difficult to determine. Infected ticks carry the bacteria in their gut. So, if you do find a tick attached to you, remove it with very fine pointed tweezers, grasping the head as close to your skin as possible and gently pulling it straight out in a firm, steady motion. Don’t grab it by the body, as you can squeeze germs out of the tick and into you. If you can’t do this at home, see your doctor or visit an urgent care clinic right away.
Prevention is always best when it comes to health problems, and there are some ways to minimize your chances of getting bitten by a tick. When going into tick habitat, use an insect repellant, wear long sleeve shirts & pants and a hat, and tie back long hair. Avoid brushing against vegetation, logs, and leaf piles, stay on wide open trails, and check your skin, clothes, and shoes often. Most importantly, do a thorough check of yourself, your children, and your pets after your hike or spend time in the garden.
If you do get a deer tick bite despite these precautions, consider consulting with your doctor or visit your local accredited urgent care clinic because of the possibility of contracting Lyme disease. In some cases, an antibiotic to prevent Lyme disease may be indicated. Again, prevention is always better than the cure, and it is much simpler and quicker to prevent Lyme disease after a tick bite than to treat the actual disease.
Should you develop a rash or any other symptoms after a tick bite, see your physician or urgent care provider. Lyme disease can be treated successfully with antibiotics, and the earlier it is diagnosed and treated, the better. While misdiagnosis of Lyme disease has caused a great amount of debate about the risk of contracting it and the proper course of treatment, there is little debate that early detection is key.
So, get outside and enjoy the wonderful spring season, then take a few minutes at the end of the day to insure you did not bring along any unwanted hitchhikers.
A director of the Urgent Care Association of America from 2011 to 2017, Dr. Roger Hicks served as the Association’s treasurer and then secretary. He is a founder and current board member of the Urgent Care Assurance Company, a malpractice company specializing in urgent care. He is the founding President of the California Urgent Care Association. He is also the founding president of the South Yuba River Citizens League and served on SYRCL’s Board of Directors for 30 years.