Text_Files/Lyme_Disease.txt

LYME DISEASE (cont.) 
Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
LYME DISEASE 
 
Lyme disease is caused by a bacterium, Borrelia 
burgdorferi.  In New England it is transmitted by 
a certain type of tick, commonly called the deer 
tick or black -legged tick (scientific name: 
Ixodes 
scapularis).  Lyme disease may cause sympt oms 
affecting the skin, nervous system, heart and/or 
joints of an individual.  The NH Department of 
Health & Health Services made Lyme disease 
reportable in October 1990.  During recent years, 
the incidence of Lyme disease has increased in 
New Hampshire. 
 
Who gets this disease? 
The bacterium that causes Lyme disease is 
transmitted within the natural cycle of the deer 
tick, which feed on animals such as mice, 
opossums, dogs and deer.  Certain stages of the 
tick – especially the nymph and adult – can feed 
on a human; if the tick is infected with the 
bacteria it can cause infection in people.  Cases of 
Lyme disease have also been reported in domestic 
animals.  There is no evidence that Lyme disease 
is transmitted from person to person.  For 
example, a person ca nnot get infected from 
touching, kissing, or having sex with a person 
who has Lyme disease.  Lyme disease acquired 
during pregnancy may lead to infection of the 
placenta and possible stillbirth.  However, no 
negative effects on the fetus have been found 
when the mother receives appropriate antibiotic 
treatment.  There are no reports of Lyme disease 
transmission from breast milk.   
 
People who spend time in wooded or grassy areas, 
including areas around the home, are at greater 
risk of Lyme disease.  Althoug h persons of all 
ages and gender are susceptible to Lyme disease, 
it is most common among children aged 5- 9 and 
adults aged 55-59.  Most cases of Lyme disease 
occur between April and October. Current data 
indicates that it is possible for someone to get 
Lyme disease more than once. 
 
What are the symptoms? 
The illness usually occurs during the summer 
months and generally starts as a large circular 
reddish expanding rash around or near the site of 
the tick bite.  (NOTE: In some cases, a rash may 
not occur).  Multiple rash sites may occur.  
During the rash stage, or occasionally prior to the 
rash, other symptoms such as fever, headache, 
fatigue, stiff neck and muscle and/or joint pain 
may be present.  These may last for several 
weeks.  If left untreated – within a few weeks to 
months after the rash onset – complications such 
as meningitis and heart abnormalities may occur 
and other body systems may be affected.  
Swelling and pain in the large joints may recur 
over many months or years. 
 
How soon do symptoms appear? 
Symptoms usually begin within a month of a tick 
bite, generally 3-32 days. 
 
What is the treatment? 
Current therapy includes the use of antibiotics.  
Early diagnosis improves the outcome of 
treatment. 
 
How can the spread of this disease be 
prevented? 
Special precautions to prevent exposure to ticks 
should be used.  Apply insect repellent containing 
greater than 20% DEET, on clothes and exposed 
skin.  Clothes (especially pants, socks, and shoes) 
may be treated with permethrin, which kills ticks 
on contact.  Permethrin can also be used on tents 
and some camping gear.  Do not use permethrin 
directly on skin .  Always follow the 
manufacturer’s instructions when applying any 
repellents.  Long pants and long sleeves help keep 
ticks off skin.  Pant legs may be tucked into socks 
or boots and shirt into pants to keep ticks on the 
outside of clothing.  After being outdoors, wash 
and dry clothing at a high temperature to kill any 


LYME DISEASE (cont.) 
Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
ticks that may remain on clothing.  Perform tick 
checks after being outdoors.  Early removal of 
ticks can reduce the risk of infection. If a tick is 
attached to the skin for less than 24 hours, the 
chance of getting Lyme disease is extremely 
small.  Landscaping to reduce tick habitats and 
prevent deer and rodents around the home may be 
helpful. 
 
How should a tick be removed? 
To remove an attached tick, grasp it with one of 
the tick -removal tools found in stores or fine -
tipped tweezers as close as possible to the 
attachment site (i.e., skin) and pull upward and 
out with a firm and steady pressure. 
 
Do not handle the tick with bare hands , if using 
your fingers to remove a tick be sure to use a 
disposable towel when removing the tick.  Be 
careful not to squeeze, crush, or puncture the body 
of the tick, which may contain infectious fluids.  
After re moving the tick, thoroughly cleanse the 
area with an antiseptic.  Seek medical attention if 
there is a concern about incomplete tick removal. 
 
Do not attempt to remove ticks by using Vaseline, 
lit cigarettes, or other home remedies; doing so 
may actually increase the chances of contracting a 
tick-borne disease. 
 
Who should be excluded? 
Exclusion is not necessary since the disease is not 
spread from person-to-person. 
 
Reportable? 
Yes.  Lyme disease is reportable by New 
Hampshire law to the Division of Public  Health 
Services, Bureau of Infectious Disease Control  at 
(603) 271-4496.