Amid reports at the national level and in Rhode Island of increases in Lyme disease diagnoses, state public health and environmental officials gathered on Tuesday to remind Rhode Islanders about the tick prevention measures that everyone should take when outdoors in the coming months.
Between 2016 and 2017, Rhode Island saw a 22% increase in the number of cases of Lyme disease reported by healthcare providers to the Rhode Island Department of Health (RIDOH) (927 cases in 2016, versus 1,132 cases in 2017). Rhode Island has the fourth highest rate of Lyme disease in the nation. In May, the Centers for Disease Control and Prevention (CDC) issued a report (https://www.cdc.gov/mmwr/volumes/67/wr/mm6717e1.htm) stating that the number of cases of diseases that are transmitted by ticks, mosquitoes, and other insects more than tripled between 2004 and 2016 (27,388 cases in 2004, versus 96,075 cases in 2016).
"While enjoying our beautiful parks, forests, and other outdoor spaces in the coming months, Rhode Islanders should reduce exposure to ticks, check their bodies for ticks, and remove ticks whenever they are found to help protect against Lyme disease," said Director of Health Nicole Alexander-Scott, MD, MPH. "Lyme disease is a common but frequently misunderstood illness that, if not diagnosed early and treated properly, can cause very serious health problems. But the first step is prevention. All Rhode Islanders can help keep themselves and their family members safe by being tick aware this year!"
Lyme disease is caused by a bacterium transmitted to humans through the bite of an infected tick. An infected tick usually needs to be attached to a person for at least 24 hours to transmit Lyme disease. The ticks that carry Lyme disease can be found in parks, playgrounds, and backyards, but they are most common in very grassy areas and the woods. Ticks can be as small as a poppy seed.
"Climate change – with its elevated temperatures and increased precipitation patterns – could make conditions more hospitable for ticks in the Northeast," said Department of Environmental Management Director Janet Coit. "That's why public education is so important—people need to know how to avoid contact with ticks, how to check their body and remove any ticks that are found, and the common symptoms of tick-borne diseases. The attractive, informative materials produced by RIDOH are a wonderful resource, and we're pleased to make them available for our park and campground visitors."
The prevention measures reiterated at the event at Scarborough State Beach Pavilion on Tuesday were repel, check, and remove.
Repel - Keep ticks off you, your children, and pets: - Avoid wooded and brushy areas with high grass and leaves. If you are going to be in a wooded area, walk in the center of the trail to avoid contact with overgrown grass, brush, and leaves at the edges of the trail. You can also spray your clothes with permethrin to keep ticks away. Make sure to not spray this on your skin. - Wear long pants and long-sleeve shirts when outside. - Tuck your pants into your socks so ticks do not crawl under your clothes. - Wear light colored clothing so you can see the ticks more easily.
Check - Check yourself, your children, and pets, for ticks: - Take a shower as soon as you come inside if you have been in grassy or wooded areas. - Do a full-body tick check using a mirror; parents should check their kids for ticks and pay special attention to the area in and around the ears, in the belly button, behind the knees, between the legs, around the waist, and in their hair. - Check your pets for ticks as well since they can bring ticks into the home.
Remove - Remove ticks from your body, as well as from children and pets, if you find them: - Use a set of tweezers to remove the tick. Grasp the tick as close to the skin as possible and pull straight up. - If you don't have tweezers, use your fingers with a tissue or rubber gloves.
Most people who get Lyme disease get a rash anywhere on their body, though it may not appear until long after the tick bite (70-80% of people with Lyme disease will develop a rash, according to CDC). At first, the rash looks like a red circle, but as the circle gets bigger, the middle changes color and seems to clear, so the rash looks like a target bull's-eye. Some people don't get a rash, but feel sick, with headaches, fever, body aches, and fatigue. Over time, they could have swelling and pain in their joints and a stiff, sore neck; or they could become forgetful or have trouble paying attention. A few people may even have heart problems. A healthcare provider can help evaluate symptoms that are related to Lyme disease for appropriate diagnosis and treatment options.
Public health officials state that the recent increases in Lyme diagnoses could be attributable to many factors. These factors include increased testing because of increased awareness about Lyme disease, more accurate case reporting by healthcare providers, and an expansion of the areas where people are at higher risk for tick exposure. An additional, possible contributor could be an increase in the number of ticks in Rhode Island, due to a variety of environmental factors, such as increased temperatures and rainfall.
Rhode Island's Lyme disease prevention work is part of larger efforts toward building greater community resilience, which will help communities prepare for, respond to, and recover from the adverse health effects of climate change.
Other speakers at the event, in addition to Director Coit and Dr. Alexander-Scott, were Jeanine Silversmith from the Rhode Island Environmental Education Association, and Mary Lorusso-DiBara from the Lyme Newport Support Group.
Speakers at the event promoted RIDOH's Tick Free Rhode Island media campaign. The campaign, which includes ads on television, radio, and social media, features three new animated Tick Free Rhode Island videos (https://www.youtube.com/watch?v=qZGW-MaBM0E&list=PLJvP6pW6mcXqN6jlFtK9_NuIZnO4CqM6i). The videos show how to repel both ticks and mosquitoes, how to check for ticks, and how to properly remove a tick from the skin. To view the videos and get more information on Lyme disease and other tick-borne diseases visit www.health.ri.gov/ticks.