Answers to Your Questions About Lyme Disease
powered byJotCast
Einstein Healthcare Network
3:45
The live chat will take place on Wednesday, May 17, 2017 from noon to 1 p.m. We hope you can join us. In the meantime, please feel free to post your questions ahead of time by using the box below. The chat will take place within this box. There won't be video or audio. Thanks.
cool 4
11:50
Thanks for joining us. The doctor is in the house. There are lots of questions lined up already. We'll get started in about 10 minutes.
12:00
Welcome. This is Dr. Fischer. Glad you're here and interested in this fascinating disease. Let's get started, shall we?
Christine
12:00
Do we need to worry about Powassan? I know it's rare, but I heard it's deadly and carried by deer ticks - and found in PA and NJ already this year.
Einstein Healthcare Network
12:00
Christine: Powassan virus is very rare – only 6-10 cases have been diagnosed per year in the entire country for the past few years, so it’s not something I would worry about very much. In any case, the only thing you can do to minimize your risk is to avoid tick bites or remove ticks promptly, which is what you should be doing anyway
Pat Holderbach
12:00
My son is moving to a heavily wooded area. I worry about him and his family developing Lyme Disease. What are the best precautions. He has a 10 month old baby, What is the best way to protect her? Can insect repellant be used on her?
Einstein Healthcare Network
12:01
Pat: The best precautions for avoiding Lyme disease are to avoid tall grass and shrubby areas when possible, use insect/tick repellents when spending time in tick-infested areas, wear solid-light-colored clothing so the ticks are more visible, tuck pants into socks, and do tick inspections within a day or two after possible tick exposures. DEET is not recommended for infants, but some of the other repellents are probably OK – check the labels.
Tom
12:01
I've had blood tests for Lyme disease several times over the years. Each time was negative. Does a negative titer for Lyme disease definitively rule it out?
Einstein Healthcare Network
12:01
Tom: if Lyme antibody tests are consistently negative, then Lyme disease is effectively ruled out. The testing is not extremely accurate, but the problem is mostly with positive tests in people without Lyme disease, rather than negative tests in people who do have it.
Dre
12:01
If you are actively being treated for Lyme disease, is there any serious complications if you get bitten again with a tick with Lyme?
Einstein Healthcare Network
12:01
Dre: Treatment for Lyme does not increase the risk of reactions from a new tick bite. It is possible, though, to get Lyme disease more than once.
Jay
12:01
Because it may become late-stage or chronic if Lyme disease is not diagnosed and treated early, is it advised to start antibiotic treatment right away if you suspect symptoms are from Lyme but not yet confirmed through blood work?
Einstein Healthcare Network
12:02
Jay: In general, starting treatment for Lyme disease is not an emergency, and if the diagnosis is uncertain than treatment should be deferred until test results are available.
Avery
12:02
If you witnessed a tick bite and a few days later develop fever or other subtle symptoms, is it advised to start treatment anyway prior to labs?
Jy
12:02
When do Lyme symptoms commonly appear after tick bite?
Einstein Healthcare Network
12:02
Avery and Jy: The incubation period for Lyme disease is 3 to 30 days, but most of the time symptoms will develop in 1-2 weeks. If symptoms suspicious for Lyme disease develop after a tick bite, treatment should be started; Blood tests will often not be positive in the first week or two (it takes time for the immune system to produce the antibodies that are detected by the test), so the diagnosis of early Lyme disease is clinical, not laboratory-based.
Gary
12:02
What other diseases do ticks transmit?
If you have had lyme disease already, I believe it shows up in your blood work. So how can you tell if you have it again besides the blood test?
Do other types of ticks in our area transmit disease? What are they and what are the symptons?
Einstein Healthcare Network
12:02
Gary: ticks transmit a host of other diseases. In the tropics, the worst vector for infections is the mosquito (malaria, dengue, Zika, yellow fever, Chikungunya virus) – but here in the temperate zone, the tick is our biggest problem. Rocky Mountain Spotted Fever, human anaplasmosis, babesiosis, Powassan encephalitis, and several other diseases can be transmitted by ticks. There’s even a weird syndrome in which a tick bite from the lonestar tick (Amblyomma americanum) can induce an anaphylactic allergy to red meat! Lonestar ticks and dog ticks can transmit infections, although not Lyme and not as frequently as deer ticks.
EHN Question
12:02
I hear that if you have Lyme disease, there’s always a rash shaped like a bull’s eye. Is that true?
Einstein Healthcare Network
12:03
The rash of Lyme disease, called erythema migrans, does NOT have to be a bull’s-eye – about half of the time, it just appears as a large red spot. It has to have a minimum size of 2 inches across, and usually is 6 to 12 inches in size.
EHN Question
12:03
Is Lyme disease only transmitted by ticks? Can I get it from fleas or mosquitos?
Can Lyme disease be transmitted through sexual contact? If so, what precautions should I take if I am diagnosed?
Einstein Healthcare Network
12:03
You cannot get Lyme disease from fleas or mosquitos or sexual contact – only from ticks.
EHN Question
12:04
What is the right way to remove a tick?
Einstein Healthcare Network
12:04
Coating the tick with petroleum jelly, butter, or kerosene – or holding a lighted match to the tick’s rear end – are NOT effective. Ticks should be removed with forceps (tweezers) by grasping them firmly as close to the skin as you can reach, and pulling out firmly until they let go. Often there will be a few mouth parts left behind imbedded in the skin. These should be left alone – attempting to remove them will only succeed in converting a small hole into a large hole in the skin
Pat Q
12:06
I'm a field biologist and cannot avoid ticks, mosquitos, chiggers, etc. My crew and I were always getting sick so I was given Lymerix in the late 1990s and seem to not have had any outbreaks since. Should I be considering any kind of booster or re-vaccination as I am finding tick infestation pretty heavy this year. And is Lymerix or other newer vaccine effective against Powassan virus? Unfortunately I'm heading out to field work right now and cannot stay to hear the response - but hope Einstein will post the responses on line so I can catch up after work. Thanks for the opportunity!
Einstein Healthcare Network
12:08
Lymerix has been off the market for years and there is presently no vaccine available for humans (there is a vaccine for dogs). All you can do is try to avoid ticks (treating clothing with permetherin, for example) and do regular tick inspections so you can remove them before they infect you.
MaryAnnette
12:09
Am I at risk of disease when I find a tic before it is attached? Can I get sick because it crawled on me?
Einstein Healthcare Network
12:10
MaryAnnette: you can't generally feel ticks when they walk on you or even when they bite you. But if they are not firmly attached, then they haven't yet bitten and you have nothing to fear. They typically wander around on your skin for several hours looking for a good place to bite before they actually dig in and start to feed. You have a 48 hour grace period in which to find them and remove them before you can get infected.
Jeff Brode
12:11
My understanding is that deer ticks that carry Lyme disease are considerably smaller than other varieties. Any best practice suggestions on identifying and removing (i.e. same as other with tweezers)? Thank you!
Einstein Healthcare Network
12:13
The deer tick nymphs are about 2mm in length. They can be identified by a uniformly black head part and a uniformly brownish red back part - but you may need a hand lens to see them well enough. Removal is the same with all ticks - tweezers.
Ruth
12:13
Do you have any information on the effectiveness of alternative formulations (essential oils, Etc) designed to ward off tick bites? Either way, products are known to do this and how exactly should they be used?
Einstein Healthcare Network
12:14
Ruth: the info about efficacy of tick repellents is not as good as we'd like. DEET is the gold standard, but many people are reluctant to use it for fear of toxicity. Picaridin and IR3535 have been shown to be effective; there are a number of natural oils that are available but the data on efficacy is limited. I would point out that a natural product is not automatically healthful - tobacco is an entirely natural product!
Shawna
12:15
Can you give us more information about the Powassan virus? I heard the symptoms appear within 15 minutes of getting bitten versus having 24 hours of a tick carrying Lyme disease.
Einstein Healthcare Network
12:16
Shawna: the incubation period for Powassan is at least several days, not 15 minutes. The incubation period for Lyme is also at least several days.
Sam at spicc99@yahoo.com
12:16
1. The ticks that cause Lyme disease are very small and hard to detect. Will taking a hot shower with plenty of soap right after being outdoors rid you of any ticks that latched on to you?
Einstein Healthcare Network
12:17
Sam: showering with soap may remove a few ticks if they are not yet imbedded, but cannot be considered as a reliable method - if it's not too hot for you to stand it, it's not too hot for them either. And they can be pretty firmly attached, so they don't necessarily wash off.
Doris Wyllner
12:17
Dr. can you loose your hair if you catch Lyme Disease? Thank you.
Load More Messages
Connecting...