MASSENA – Massena Memorial Hospital’s infection prevention specialist has seen nine confirmed cases of Lyme disease in little more than a week, and is warning people about the tick that spreads it.

“Lyme disease is an infection with Borrelia burgdorferi, passed on to humans by a tick, usually a deer tick,” explained Karen Wilkins, RN, Director of Infection Prevention. “The disease includes not only a characteristic rash but fever, headache, stiff neck, body aches and fatigue. If left untreated, the disease can progress to persistent, sometimes chronic, symptoms such as fatigue, arthritis, heart or nerve problems (sometimes including partial facial paralysis) and even disturbances of memory and attention.”

Wilkins said she has seen nine confirmed cases of Lyme disease since Aug. 1 that have been processed through the hospital lab service from physician offices, the Emergency Department and Walk-In Clinic. The MMH Walk-In Clinic have treated numerous cases and removed many ticks already this summer.

Incidence of the disease is increasing fairly rapidly in this country, with the number of cases nearly doubling from 1991 to 2000. It has now been identified in nearly every state, although 95 percent of cases still occur in 12 states where deer ticks are most prevalent -- Connecticut, Rhode Island, New Jersey, New York, Delaware, Pennsylvania, Massachusetts, Maryland, Wisconsin, Minnesota, New Hampshire and Vermont.

Ticks pick up the bacteria from the blood of mice, other mammals or birds, then spend much of their adult life on deer, before dropping off in late winter to lurk on grass blades or fallen leaves. Mid-May to mid-June is usually peak season for ticks, but Massena Memorial Hospital reports to be seeing a rise in patients coming in with symptoms, Wilkins added. Ticks are particularly fond of places where the woods and grasslands merge. Ticks are also brought into the home by dogs and cats that go outside.

There's no need to worry about deer ticks jumping or flying at you or dropping on you from tree limbs; humans usually pick them up at the level of the knee or below. Once it's on the human body, the tick then crawls to a more secure location on the torso, often on the back of the neck or the hairline.

Children and older adults are most at risk of Lyme disease, but anyone spending time in wooded habitats of states with high populations of deer ticks can be infected. That includes not just hikers and campers but those who walk or run on wooded trails and even golfers who send an occasional shot into the rough.

“When detected early, Lyme disease is readily treated with antibiotics, but an even better approach is to keep the ticks off from the beginning,” Wilkins said.

Tips for Prevention

If you can't avoid the places where deer ticks might be lurking, you should be sure to keep your skin covered, particularly your legs and feet. Wear closed shoes, long sleeved shirts and pants that fit snugly at the ankles. Some hikers even tape their pant legs closed or clamp pet tick collars around their ankles. Ticks show up better on light-colored clothing.

Before venturing out, spray insect repellant containing DEET on exposed skin except for the face, following the instructions, of course, for safety. Clothing can be sprayed with the insecticide permethrin.

After your walk, shower as soon as possible and wash your clothing. Although water will not necessarily kill ticks, it may wash them away, and spin-drying at high temperatures will kill them.

Even if a tick attaches itself to you, your risk of infection is estimated at less than two percent. Nevertheless, check your skin carefully several times a day and before going to bed. Areas preferred by ticks include the belt line, just under the breasts, around the armpits and groin and above the hairline. Because they are so small, ticks are hard to spot and easily mistaken for a freckle or a speck of dirt.

Remove any ticks you find with fine ¬tipped tweezers, grasping the tick firmly as close to the skin as possible and pulling gently without squeezing the tick's body, Wilkins explained. Mouthparts of the tick left in the skin should not transmit disease, and you may cause more damage to the skin trying to get every piece out. Be sure to wash the area thoroughly and then apply antiseptic.

Early Treatment Is Key

Because the risk of getting an infection from a tick bite is low, most doctors don't prescribe antibiotics unless there are other signs of Lyme disease. A new rapid blood test can be performed in the doctor's office, but it's useful primarily as a first step and does not establish a diagnosis.

The characteristic skin rash of Lyme disease starts as a small red spot at the site of the bite, expanding over a period of days or weeks to form a circular or oval shape resembling a bull's eye. It can range in size from a dime to the entire width of a person's back. Only about 80 percent of Lyme disease patients, however, have a rash.

The flu-like symptoms of early Lyme disease are more likely to be persistent or to recur intermittently compared to those of a viral infection.

If necessary and administered early enough, antibiotic treatment is usually sufficient to head off long-term complications Wilkins explained.

“Everyone should check themselves after being outdoors, especially if they were in a wooded area or high grass. Another key message is to make sure to check your animals once they come inside. The tick can be passed from animals to their owners,” she said. “If you have any concerns or identify a tick, contact your physician office or the MMH Walk-In Clinic, it is opened everyday and no appointment is necessary.”

The MMH Walk-In Clinic is located in the Levine Outpatient Center on the Main Level of Massena Memorial Hospital. It is opened Monday through Friday from 8 a.m. to 8 p.m.; and Saturday and Sunday from 10 a.m. to 6 p.m.