Take care: Uptick in Lyme disease likely

Lyme Disease Incidence by County of Residence, U.S., 2002

RISK ZONES Ticks carrying Lyme disease may spread to new areas this year. More than 23,700 U.S. Lyme disease cases were reported in 2002, the most recent year for complete data. Map source: Centers for Disease Control and Prevention

Populations of the ticks that spread Lyme disease are expected to increase in the
Northeast U.S. and spread out across the Midwest and South this summer, experts say. Lyme disease is also appearing in parts of Canada, Europe, and Asia. So if you venture off pavement into tall grass or the woods in infected zones, be sure to take precautions, even if you've had Lyme disease before. "It's not like chicken pox or measles, where you get it once and you can't get it again," says Phillip Baker, Ph.D., program officer for Lyme disease at the National Institute of Allergy and Infectious Diseases in Bethesda, Md.

If diagnosed and treated promptly, Lyme disease can usually be cured with a course of antibiotics. A quick diagnosis may be difficult, however, since the disease has highly variable symptoms. About 20 percent of victims never develop the best-known early symptom, the bull's-eye rash. Other early symptoms can include headache, chills and fever, acute joint pain, and sore muscles.

A small number of patients who get the correct diagnosis and treatment can have a recurrence of symptoms after a year or more. "It's hard to tell whether they're suffering from an old infection that wasn't cleared, one that's reactivated, or a new infection," Baker says. If tests reveal the bacterium, repeated courses of intravenous antibiotics might help such chronic Lyme disease patients. In some cases there are symptoms with no trace of the bacterium, possibly because the infection provoked an autoimmune response in which the body attacks its own tissues in the joints and nerves.

Prevention is best. Avoid tick bites by taking the following steps:

* Don't sit on logs or lean against trees, where ticks may be hiding.

* Keep backyards and recreation areas as clear and dry as possible.

* Wear long pants and shoes in the woods. Tuck pant legs into your socks.

* Use deet-based insect repellents or spray clothes--never skin--with a permethrin insecticide.