Each year, the Centers for Disease Control and Prevention report that 30,000 people are diagnosed with Lyme disease, the most common vector-borne disease in the U.S. But those diagnoses represent only a small percentage of the number of people who actually contract the disease, which the CDC estimates is likely close to 300,000.
Because Lyme disease becomes more prevalent during warmer months, Lowcountry Parent asked Dr. Linda Bell, the state epidemiologist at the S.C. Department of Health and Environmental Control and the director of DHEC's Bureau of Communicable Disease Prevention and Control, to answer a few common questions about the disease.
Q: What is Lyme disease?
A: Lyme Disease is a bacterial disease transmitted to people by deer ticks. Lyme disease cannot be transmitted from person to person and is rarely, if ever, fatal. In the U.S., most infected ticks are found in the northeast, north central and Pacific coastal states. Lyme disease is rare but does occur in South Carolina. It is most common in the spring and summer months.
Q: What are the symptoms?
A: Within one to two weeks of being infected, most people will have a bulls-eye rash at the site where the tick was attached, along with fever, headache, and muscle or joint pain. Some people have a fever and flu-like symptoms without a rash, or have pain that moves from joint to joint, rashes on other parts of the body, or inflammation of the heart or nerves. If the disease is not treated, some patients can get additional symptoms such as swelling and pain in joints or mental changes months after being infected.
Q: How does someone contract Lyme disease?
A: Ticks become infected by feeding on small mammals that have the bacteria. The ticks then transmit the bacteria to humans and other mammals. Lyme disease cannot be transmitted from person to person. Transmission of the bacteria from an infected tick most often occurs after a tick has been attached and feeding for a day or more.
Q: Is it rare? What is the incidence of Lyme disease in South Carolina?
A: Each year, approximately 30,000 cases of Lyme disease are reported to CDC by state health departments and the District of Columbia. However, this number does not reflect every case of Lyme disease diagnosed in the United States every year. Recent estimates using other statistical methods suggest that approximately 300,000 people may get Lyme disease each year in the United States. South Carolina provides information to the CDC and this information. In 2018, there were 38 confirmed cases of Lyme disease.
Q: Is it life-threatening?
A: Although most cases of Lyme disease can be cured with a two- to four-week course of oral antibiotics, patients can sometimes have symptoms of pain, fatigue, or difficulty thinking that last for more than six months after they finish treatment. This condition is called Post-Treatment Lyme Disease Syndrome (PTLDS). Why some patients experience PTLDS is not known.
Q: What is the treatment?
Most people can be successfully treated with antibiotics if diagnosed in the early stages. If the disease is diagnosed months after infection, the patient may require prolonged oral or intravenous antibiotic treatment.
Q: What can parents do to protect their children from it?
A: Reducing exposure to ticks is the best defense against Lyme disease, Rocky Mountain spotted fever, and other tickborne infections. Tick exposure can occur year-round, but ticks are most active during warmer months (April-September). You and your family can take several steps to prevent and control Lyme disease. Before you go outdoors: (1) Know where to expect ticks. Ticks live in grassy, brushy, or wooded areas, or even on animals. Spending time outside walking your dog, camping, gardening, or hunting could bring you in close contact with ticks. Many people get ticks in their own yard or neighborhood. (2) Treat clothing and gear with products containing 0.5 percent permethrin. Permethrin can be used to treat boots, clothing and camping gear and remain protective through several washings. Alternatively, you can buy permethrin-treated clothing and gear. (3) Use Environmental Protection Agency (EPA)-registered insect repellents containing DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone. EPA’s helpful search tool can help you find the product that best suits your needs. Always follow product instructions. Do not use products containing OLE or PMD on children under 3 years old. (4) Avoid wooded and brushy areas with high grass and leaf litter. (5) Walk in the center of trails.
After you come indoors: (1) Check your clothing. Ticks may be carried into the house on clothing. Any ticks that are found should be removed. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed. If the clothes require washing first, hot water is recommended. Cold and medium temperature water will not kill ticks. (2) Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and daypacks. (3) Shower soon after being outdoors. Showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease and may be effective in reducing the risk of other tick-borne diseases. Showering may help wash off unattached ticks and it is a good opportunity to do a tick check. (4) Check your body for ticks after being outdoors. Conduct a full-body check upon return from potentially tick-infested areas, including your own backyard. Use a hand-held or full-length mirror to view all parts of your body. Check these parts of your body and your child’s body for ticks: under the arms, in and around the ears, inside the belly button, back of the knees, in and around the hair, between the legs and around round the waist.