The summer ("tick season") is the time of year for Lyme disease and there are thousands of cases reported annually in the United States. Although reported in almost every state and the District of Columbia, the disease is found in certain areas more than others. According to the Centers for Disease Control (CDC), more than 90 percent of all reported cases have been from the Northeast, mid-Atlantic, and North central states (Connecticut, Delaware, Maryland, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island, Wisconsin, and Minnesota). Your local health department can give you information about the risk of Lyme disease in the county where you live.

How Lyme disease is contracted
The incidence of Lyme disease is on the rise probably because healthcare providers and patients are more aware of it, know more about it, and perhaps because the true incidence may actually be increasing. The germ (spirochete Borrelia burgdorferi) that causes Lyme disease is spread through the bite of a deer tick, which is found most often in wooded areas, high grasses, marshes, and some beaches. For the tick to transmit the spirochete to a person, it must be attached for at least 24 to 48 hours. Moreover, not all deer ticks carry this germ; in fact, a majority in most areas do not.

Symptoms
The illness usually begins as a localized disease with a circular rash at the site of the tick bite. This circular rash tends to get bigger in size and then flu-like symptoms, such as fever, lack of energy, headache, and joint pain, may follow. Without treatment, symptoms may worsen and involve the heart (carditis), nerves of the face (facial weakness or Bell's Palsy), the central nervous system (meningitis), and the joints (arthritis). Antibiotics are effective in treatment, but who and when to treat needs to be individualized. There is a vaccine available, but only for people between the ages of 15 and 70.

Hank Bernstein
Children's Hospital