Hello, we are a group of nursing students from Umass-Lowell who, through a community assessment of North Andover, have discovered that the town of North Andover has a high rate of Lyme disease. As a school project we have created a web page for the community to cover the basics of Lyme disease. Lyme disease information can be found in many places so we decided that we would make it more accessible to community members by having all of the information in one place. We ask if you could please start by taking a pre-test prior to reading the educational part of this exercise to test your prior knowledge. After reading the educational component, we also ask that you take the same test, known as the post test, so that we may evaluate how useful our project was in increasing the knowledge of the town of North Andover on Lyme disease. Parents in the community
are encouraged to educate their children on the prevention of Lyme disease. We have included a contest for 4th and 5th graders in the community to draw a picture displaying originality on ways of preventing Lyme disease. A winner will be chosen from each grade level and will win free passes to Laser Craze. Thank you in advance for your time.
Lyme disease is a growing infection in North Andover that is caused by a type of bacteria called Borrelia burgdorferi. This bacterium is carried by a deer tick. Not all deer ticks are infected with the bacteria Borrelia burgdorferi. This varies depending on the area you live in. The reason it is called a deer tick is because this specific type of tick is known to feed and breed on the species of deer. Lyme disease is spread when the tick attaches itself to a persons’, or animals’, skin and transfers the bacteria into the persons’, or animals’, blood stream. In order to contract Lyme disease, the tick must be attached to the skin for a time period of 2 days. Lyme disease only affects the person that was bit by the deer tick. Lyme disease is not
contagious. Sometimes, not always, when a person is bit by a deer tick they will develop a rash. This rash is known as an erythema migrans rash or an EM rash.
The first symptom of Lyme disease would usually be the erythema migrans rash (EM rash) if a person was to develop a rash. An estimated 25% of individuals who have Lyme disease do not develop the EM rash. If a rash was to develop it usually appears within a couple of weeks. The EM rash is sometimes referred to as a bull’s eye rash because its characteristics resemble a target. The center of the rash is red which is then surrounded by a clear area and then on the outside of the clear area there is a red boarder around the clear area. The rash varies in sizes. It can be as small as the tip of your thumb nail or as large as the surface of your back.
Other common signs and symptoms of Lyme disease are also present. These can be present with/without the EM rash. These signs and symptoms are headache, fever, stiff neck, body aches and fatigue. These are similar signs and symptoms to that of the flu but what is significant about Lyme disease signs and symptoms is that they do not just resolve like the common flu and they may occur off and on.
Lyme disease also leads to complications with arthritis. This is noticed a few months after being infected with Lyme disease. Whether being treated with antibiotics or not, an individual may experience some degree of arthritis. This causes the joints to be painful and swollen. The pain and swelling can jump around from joint to joint but the most common joint that is affected is the knee joint. About 50% of individuals who do not seek treatment for Lyme disease will go on to experience continuous attacks or flare ups of arthritis. Individuals who do not seek treatment, or are unaware they have Lyme disease, go on to develop arthritis that lasts a lifetime. This is about 10-20% of the population that is affected with Lyme disease that goes untreated and/or undiagnosed.
Lyme disease that goes untreated also leads to problems that develop within the nervous system. These problems consist of neck stiffness, severe headache also known as meningitis, temporary paralysis of facial muscles that is known as Bell’s palsy, numbness, pain and/or weakness in your arms/hands/legs/feet and poor motor coordination. As mentioned previously these develop in individuals who contract Lyme disease and do not seek treatment. There is no established time for when an individual with untreated Lyme disease will experience nervous system deficits. It may happen weeks, months or years after infection. The symptoms of Lyme disease are not constantly present – they occur on and off over time.
Other symptoms of Lyme disease are being unable to recall events, hard time focusing and changes in your behavior and sleep patterns. Heart problems also can occur from Lyme disease but at a very low rate. Less than 10% of individuals who are infected with Lyme disease experience heart problems. The symptoms of heart problems that are associated with Lyme disease or short lived as they only last at the longest a few weeks. The symptoms of these heart problems are abnormal rhythm of the heart, dizziness and difficulty catching your breath. These symptoms show several weeks after infection of Lyme disease.
Lyme disease is easiest to diagnose with the presence of the EM rash. As mentioned above though, an estimated 25% of individuals who have Lyme disease do not develop the EM rash which makes it difficult to diagnosis Lyme disease. This is because many of the signs and symptoms of Lyme disease are also signs and symptoms of other diseases. Many individuals do not remember being bitten by a tick since the tick is small and the bite is painless so recalling a recent tick bit is difficult.
Due to Lyme disease being difficult to diagnosis there are a few steps that a PCP (primary care provider) may take in diagnosing Lyme disease. The PCP will enquire about recent activity that may increase an individual’s chance of contracting Lyme disease and enquire about signs or symptoms that the patient has been experiencing that are significant to Lyme disease. If the PCP feels the individual may be potentially infected with Lyme disease he will then order a blood test that checks for Lyme disease.
Most people can be treated successfully with antibiotics. Typically the treatment is a 21 day course of an oral antibiotic. The sooner the treatment, the quicker and more complete the recovery is. If the Lyme disease is in an advanced stage IV antibiotics may be needed. It may also be treated with anti-inflammatory drugs if arthritis is present.
If a person is affected once by Lyme disease there is no guarantee that it will never happen again. A person can become re-infected with the Lyme disease bacterium.
Deer ticks are most common typically in May, June, and July but may be present at any time. Basic advice can be given to help prevent being exposed to a tick:
1. Wear long-sleeved shirts, socks, and closed shoes when outdoors.
2. Tuck pant legs into socks or boots and tuck loose shirts or jackets into pants.
3. Wear light-colored clothing so that ticks can be spotted easily.
4. Avoid overgrown grass and brush.
5. Apply insect repellent containing DEET.
6. Be sure to conduct daily tick checks by removing all clothing and inspecting skin in good light. Ticks tend to attach along hairlines and under arms but can attach anywhere on the body.
7. Don’t forget to also check pets when they come back in from outdoors. Pets can carry ticks into the house. These ticks could fall off the animal and attach themselves to people inside the house.
Many people have concerns about using Deet on themselves and/or their children. Using Deet can help reduce the risk of getting Lyme disease. The Center for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) recommend the use of Deet- based products on adults and children. Deet-based products in concentrations of 30% or less can be used on children as young as two months. For more information on Deet-based products you may visit this link: www.deet.com.
Parents in the community are encouraged to educate their children on ways they can protect themselves and their families from Lyme disease. We are inviting all local 4th and 5th graders to submit a colored picture displaying originality on ways of preventing Lyme disease. A winner will be chosen from each grade level and will win free passes to Laser Craze. All pictures can be sent to:
Town of North Andover
Board of Health
1600 Osgood Landing - Bldg. 20 2-36
North Andover, MA, 01845
ATTN: Bernadette Curran
The deadline to submit pictures is Monday, May 4th 2009. Please include child’s name and contact info on the back of the picture. Winners will be notified by phone and will have their picture displayed on the website by 5/8.
