Lyme Disease in Oregon and Washington

Lyme disease is caused by several members of the Borrelia bacteria genus (referred to as Borrelia burgdorferi sensu lato) which are transmitted by black legged ticks. While the highest rates of infection are on the East coast of the United States, both the Oregon Health Authority and the CDC acknowledge the disease is present in the Pacific Northwest and is growing. In May of 2015, Governor Kate Brown proclaimed the month of May Lyme and Tick-Borne Diseases Awareness Month in Oregon for the first time. On the East coast, the Deer Tick (Ixodes scapularis) is the primary vector of the disease. On the West coast, however, the Western Blacklegged Tick (Ixodes pacificus) is responsible for transmitting the Borrelia bacteria. The main hosts for the bacteria are deer and mice, however it is possible that other animals may also be carriers. While the CDC receives approximately 30,000 confirmed cases reported annually by state health departments, they estimate that upwards of 300,000 Americans are being infected each year, making this the most common vector-borne illness in the country. To put that number into perspective, it is six times the annual infection rate of HIV.

Western Blacklegged Tick Distribution

Image from the Oregon Health Authority

Signs & Symptoms of Lyme Disease

The diagnostic Bullseye rash of Lyme disease

The most telltale sign is a bullseye rash occurring 3-30 days after a tick bite.  The CDC considers this rash diagnostic for Lyme disease, and treatment should begin as soon as possible without the need for any testing.  Not everyone experiences or notices this rash, however.  Other signs and symptoms of Early Lyme Disease may include the following:

• Fever

• Headache

• Muscle & Joint Pains

• Fatigue

• Facial Paralysis

Symptoms of Late Lyme Disease include the following:

• Severe Headaches & Stiff Neck

• Joint Pain that wanders

• Shooting or Tingling Nerve Pain

• Numbness

• Brain Fog

• Lightheadedness

• Digestive Problems

• Mood Changes

• Vertigo

• Irregular Heartbeat

Lyme Coinfections

It is common for ticks to transmit other pathogenic organisms along with the bacteria that causes Lyme disease, leading to multiple simultaneous infections.  This can create a complicated symptom picture making it difficult for patients to be diagnosed and treated. Some other infections that may be present include Bartonella, Babesia, Anaplasma, Rickettsia, and Ehrlichia.  These infections sometimes have an overlap in symptoms with Lyme disease, however they also have their own characteristics that increase their suspicion. 

Lyme Disease Prevention

Whenever spending time in grassy or wooded areas where you may be likely to brush up against tall grass or foliage, the following recommendations may help prevent infection by a tick bite:

• Wear long pants and tuck them into your socks. Wear a hat and long sleeves.

• Apply tick-repellant. The CDC recommends repellants containing DEET or Picaridin. They also recommend products containing Oil of Lemon Eucalyptus as an effective natural alternative. Clothing and gear may be treated with 0.5% permethrin, but permethrin should never be directly applied to the human body.  Keep in mind natural products need to be reapplied more often than chemical repellants.

• Stick to trails and avoid walking through bushes and tall grass

• Change your clothing upon arrival at home, tossing worn clothing into a dryer on high for 10-15 minutes

• Perform tick-checks after activities outdoors, being sure to inspect your entire body including crevices, folds, and your hair

• Keep dogs on a leash and inspect your pets for ticks as they may transfer them to you

Removing a Tick

If you find a tick, remove it as quickly as possible using a pair of tweezers. The appropriate way is to grasp the tick around its head or mouth, close to where it is lodged in the skin.  The pressure of the tweezers here will cause the tick to loosen its grip.  Very carefully and steadily pull to remove the tick. Treat the area with antiseptic as you would any wound.  If you incorrectly grab the body of the tick with the tweezers instead of the head, the body might break off and you will be left with the tick’s head still lodged in the skin. If you experience any of the symptoms of Early Lyme disease after a tick bite, contact your healthcare provider.