Last fall, we attended a lunchtime lecture at the University of Vermont College of Medicine given by Dr. Christina Nelson, a medical epidemiologist at the Division of Vector-Borne Diseases at the Centers for Disease Control and Prevention (CDC) in Fort Collins, Colorado. She was speaking about Lyme disease pathophysiology and prevention. At the end of her talk, Dr. Nelson described a program called Lyme Corps, a CDC-sponsored, interdisciplinary program consisting of medical students, public health students, and residents from the University of Vermont. We were immediately interested in joining the effort. Here’s why:
Molly Markowitz ‘18: I grew up in a community in Maine where there is a high incidence of Lyme disease. I have known many individuals who have been affected by this disease and when I volunteered in my local pediatrician’s office three years ago, I got to see first-hand how families can be impacted by this tick-borne illness. I decided to participate in Lyme Corps because I wanted to help teach both my community here in Vermont and back in Maine more about this condition through increased awareness and prevention.
Catherine Hayes ‘18: I also grew up in Maine, and was always acutely aware of the risk posed by ticks when I ventured out into the woods. In Vermont, Lyme disease has only recently gained a foothold, so there is less vigilance about ticks and tick-borne illness. I was excited about the opportunity to collaborate with students from other disciplines to spread the word about Lyme disease and give people as much information as possible to be safe and healthy.
As medical students, there is some straightforward and important information we can relay to patients to help combat misinformation and confusion about Lyme disease.
What is Lyme disease?
Lyme disease is an infection that can be transmitted to people through the bite of an Ixodes scapularis tick (the blacklegged or deer tick) that is infected with the bacteria Borrelia burgdorferi. If the tick is attached for at least 24 hours, the bacteria can be transferred to the person and they can become infected.
There are three stages of Lyme disease. Most people are diagnosed and treated during early infection; however, if left untreated, the infection can progress and cause additional manifestations.
Early Stage: 7-14 days after tick bite
Erythema migrans rash (see Figure 1) develops at the site of the tick bite. Frequently the rash has a classic bull’s-eye appearance, but it can also appear homogenous. Flu-like symptoms may also occur including headache, fever, and muscle pain.
Intermediate Stage: Days-Weeks after tick bite
Patients may develop multiple erythema migrans rashes, facial palsy (paralysis or weakness of the muscles in the face), meningitis (inflammation of the membranes surrounding the brain and spinal cord), or heart block due to carditis (inflammation of the heart and its surrounding tissues).
Late Stage: Months-Years
Late manifestations include intermittent bouts of arthritis. Patients may also experience
joint swelling, shooting pain, numbness, and tingling in hands and feet.
Lyme disease is on the rise in Vermont
According to the Vermont Department of Health the number of cases reported has steadily increased since 2005 (Figure 2). It is important to let patients in Vermont know that they can be at risk for Lyme disease and that proper precautions should be taken.
How can we prevent tick bites?
There are some easy steps we can all take to protect ourselves from being bitten by ticks while still enjoying time outdoors:
- Avoid Ticks
When outdoors, walk in the center of trails and avoid wooded areas.
- Repel Ticks
Use 20 to30 percent DEET on skin and clothing.
Treat clothing/gear with permethrin.
Wear clothing that covers your skin.
- Remove Ticks
Bathe or shower within two hours of spending time outside.
Conduct a full body tick check using a mirror.
Inspect pets and gear for ticks.
Run your clothing in the dryer for five to 10 minutes on high heat after coming indoors – this should kill any ticks that are on your clothing.
If you would like more information about Lyme disease, please visit the following websites:
Or, get in touch with any Lyme Corps member!
Figure 3: From Left to Right: Shari Levine (Vermont Department of Health), Dwight Parker ‘16, Molly Markowitz ‘18, Catherine Hayes ‘18, Caitlin Loretan (UVM Public Health), Elizabeth Russo (UVM Public Health), Lyndelle Lebruin (UVM Public Health), Jenna Paige (Vermont Department of Health), Erica Berl (DVM, MPH, Vermont Department of Health)
Not Pictured: Jo Conant (UVMMC Pathology Resident), Christina Nelson (MD, MPH, Vector-Borne Disease Branch, CDC)
Information in this article was taken from the following sources: