As the weather warms and we venture outside to seek relief from being housebound, it’s important to be on the lookout for ticks, particularly this year because the mild winter allowed ticks to thrive instead of being killed off.

The Department of Public Health’s Bureau of Infectious Disease and Laboratory Sciences states that black-legged (deer) ticks and dog ticks, found throughout Massachusetts, can spread a range of diseases, including Lyme disease, babesiosis and anaplasmosis, when they bite people.

Data from the U.S. Centers for Disease Control and Prevention ranked Massachusetts as the fourth-worst state for tick-borne diseases, according to an article last December in US News and World Report.

Ticks may be encountered year-round, but they are typically most active between April and September, with most tick-borne disease cases reported in June and July.

The fact that we’ve been cooped up for months due to COVID-19 hasn’t diminished the chance of getting Lyme disease. Many people are taking daily walks in the woods and spending more time in their yards, potentially exposing themselves and their pets to ticks. Those who live in the suburbs, where people, ticks, deer, and tick hosts such as mice and chipmunks are in close contact, can be at high risk of contracting Lyme disease.

Health issues such as Lyme disease can make people more vulnerable to COVID-19, according to Goudarz Molaei, director of the Connecticut Agricultural Experiment Station’s passive tick surveillance and testing program. There’s no evidence ticks can carry or transmit the virus that causes COVID-19, Molaei said, but a person who contracts a tick-borne illness and is then exposed to the coronavirus could have an especially difficult time recovering.

Symptoms
Typical Lyme disease symptoms include fever, headache, fatigue and a characteristic skin rash that looks like a bullseye. In most cases, symptoms of early Lyme disease begin to appear from three to 30 days after being bitten by an infected tick.

According to the CDC, most cases of Lyme disease can be cured with a two- to four-week course of oral antibiotics.

Some patients, however, can have symptoms of pain, fatigue or difficulty thinking that lasts for more than six months after they finish treatment. This condition is called Post-Treatment Lyme Disease Syndrome. Unfortunately, there is no proven treatment for PTLDS. Patients usually get better over time, but it can take many months to feel completely well.

If untreated, symptoms of late Lyme disease may occur from weeks to years after the initial infection.

Symptoms of untreated Lyme disease include:
• Severe headaches and neck stiffness
• Additional bullseye rashes on other areas of the body
• Facial palsy
• Arthritis with severe joint pain and swelling, particularly the knees and other large joints
• Intermittent pain in tendons, muscles, joints, and bones
• Heart palpitations or an irregular heartbeat
• Episodes of dizziness or shortness of breath
• Inflammation of the brain and spinal cord
• Nerve pain
• Shooting pains, numbness or tingling in the hands or feet

Research from the Johns Hopkins Bloomberg School of Public Health suggests that a prolonged illness associated with the disease in some patients is more widespread and serious than previously understood. The researchers found that Lyme disease costs the U.S. health care system between $712 million and $1.3 billion a year — or nearly $3,000 per patient on average.

Prevention
Steps to prevent Lyme disease include using insect repellent, wearing long sleeves and tucking long pants into socks when possible, wearing permethrin-treated clothing, checking for and removing ticks promptly by using tweezers and pulling them straight up and out starting as close to the skin as possible, noting the date of a tick bite, and alerting one’s primary care physician.

Saving the tick in a plastic bag or jar can also be helpful for identification, should illness appear.

The CDC suggests disposing of a live tick by putting it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet.

The CDC warns against using folklore remedies that wait for the tick to detach, or crushing them.

Communities can take steps to prevent ticks and tick-borne diseases by applying eco-friendly pesticides such as permethrin, reducing tick habitat, and combating climate change.

Educating employees about Lyme disease and prevention can reduce the chance of long-term health-related costs, loss of productivity, and ongoing debilitating illness.

For more information, including downloadable educational materials, visit mass.gov/tick-borne-diseases.

Written by Jayne Schmitz, MIIA Wellness Project Manager.