Limiting Lyme disease: How you can protect yourself and your family

Long sleeves and pant legs tucked into boots can help prevent ticks from biting. (PHOTO BY DAN CAMERON)

Sixteen of every 100,000 New Yorkers were infected with Lyme disease in 2015, the latest year for which statistics are available. In 2015, 95 percent of Lyme diagnoses came from 14 states, including New York.

Lyme disease is caused by bacteria that are transmitted to humans through the bite of an infected tick, called Ixodes scapularis but better known as a deer tick because of its habit of parasitizing the white-tailed deer. Ticks acquire Lyme disease microbes by feeding on infected mice and other small rodents. They may also spread other organisms.

Prevention advice

  1. Ticks do not jump or fly or drop from trees. They start from the ground and crawl upward until they find a place to attach. Tuck pants legs into socks, to keep ticks on the outside, where they may be seen or brushed off.
  2. Use repellents on your skin (that contain DEET) and your clothes (that contain permethrin.) Be sure to spray shoes and the insides of pants and shorts, too.
  3. Ticks may live where yards border wooded areas. They like shady areas and leaves with high humidity. Keeping leaves raked and shrubs and low branches trimmed can ruin their habitat. You may also consider pesticide treatment along the yard’s perimeter.
  4. Check for ticks daily – especially the scalp, ears, underarms, belly button, waist and back, behind knees and the pelvic area – and remove any promptly (See “The right way to remove a tick,” below.)) The smallest deer ticks may resemble poppy seeds.
  5. Throw clothing in a hot dryer for 10 minutes to kill ticks. Washing clothes even in hot water does not kill ticks.

 The right way to remove a tick

An adult tick on a blade of grass.

“Take tweezers and grab the tick at the very bottom, close to the skin, and gently pull up,” says Jana Shaw, MD, an associate professor of pediatrics and public health and preventive medicine at Upstate.

She says not to try choking or burning the ticks, or other home remedies, because they are not effective — and stressing a tick can make it expel bacteria into your skin.

“Just a gentle pull with the tweezers — and cleaning the skin with alcohol afterwards — is ll that is needed.”

Dispose of a live tick by submerging it in alcohol, placing it in a sealed bag or container, wrapping it tightly in tape or flushing it down the toilet. Never crush a tick with your fingers.

— Sources: Centers for Disease Control and Prevention, Cornell Cooperative Extension, Tick Encounter Resource Center from the University of Rhode Island and Upstate Medical University

What happens when Lyme attacks the heart

BY AMBER SMITH

Every time he stood, he would feel dizzy.

Hamza Murtaza, 25, is a fourth-year medical student at Upstate Medical University who wrote about his personal experience with a complication of Lyme disease. (PHOTO BY ROBERT MESCAVAGE)

But since he was fasting for Ramadan in the summer of 2015, Upstate medical student Hamza Murtaza figured he was just lightheaded from not eating.

He was also tired, and he had abdominal pain. When he felt his pulse, it was an abnormally slow 30 to 40 beats per minute.

“It got to the point where I walked from my apartment to the library, and I had to stop two or three times,” Murtaza says. “I wasn’t winded or short of breath. I was just tired.”

Murtaza, 25, took a detour to the student health center at Upstate. Among the tests he submitted to was an electrocardiogram, which showed the electrical functioning of his heart.

Murtaza had complete heart block. The impulses from his heartbeat were not working properly. That’s why his heart rate was so low and why he was getting dizzy.

He was promptly admitted to Upstate University Hospital. A temporary pacemaker was installed. As doctors set about trying to determine what caused Murtaza’s heart problems, Murtaza started thinking.

He’d been married early that summer, and for a quick honeymoon, he and his wife traveled to Maine for a long weekend at Acadia National Park. One morning, he awoke with joint pain and shoulder pain. He thought he had pulled a muscle or slept wrong. The pain went away, and he forgot about it. Then his right elbow started hurting. Then his left thumb started to hurt.

Looking back, Murtaza realized he had “migratory arthritis,” something that is sometimes seen in Lyme disease. He never noticed a rash. Nevertheless, the heart block he developed was blamed on a rare complication of Lyme called Lyme carditis.

Doctors put him on antibiotics for seven days in the intensive care unit, and he continued taking the medicine for two weeks after he was discharged. He eventually recovered.

Murtaza wrote about his experience in a poster presentation for this year’s Charles R. Ross Student Research Day at Upstate. “Of the 30,000 Lyme cases reported each year, only 1 percent present with meningitis or Lyme carditis,” says his poster. “My case elucidates the value of a complete history and demonstrates that a lack of the hallmark rash can often lead to the underestimation of symptoms.”

This happened between Murtaza’s first and second year of medical school. When classes resumed, he attended an infectious diseases lecture – and the professor discussed an interesting case of Lyme disease. Murtaza volunteered that he was the patient, providing a perspective not usually available in a medical class lecture.

This article appears in the summer 2017 issue of Upstate Health magazine.

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