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Wake County Lyme disease update

Release Date: March 17, 2010
Contact: Renee McCoy, 919-733-9190

RALEIGH – Wake County Human Services and N.C. Division of Public Health surveillance investigations have confirmed that two residents of Wake County were diagnosed in 2009 with laboratory-confirmed early Lyme disease, with no reported history of travel out of the county in the month before they became ill.

The significance of these cases is that the patients acquired Lyme disease in Wake County. According to the case definition for disease surveillance from the Centers for Disease Control, once it has been determined that at least two confirmed cases have been acquired in the county, then, the county is defined as endemic for Lyme disease for surveillance purposes. Four other counties, Wilkes, Wilson, Pitt, and Carteret, also reported one case each of Lyme disease in 2009 in patients who had not traveled out of their county in the month before becoming ill.

“We want to take this opportunity to continue to encourage clinicians in North Carolina to consider the diagnosis of Lyme disease, and to test and treat presumptively patients presenting with signs and symptoms compatible with Lyme disease, regardless of county of residence and of travel history,” said State Epidemiologist Dr. Megan Davies. 

Dr. Davies added that the most recognizable sign of early Lyme disease, although not always present, is a red or purplish skin lesion, called erythema migrans, that extends in size over time. Often, but not always, the center of the lesion can clear, giving a bull’s eye appearance.  Treatment with antibiotics is recommended when erythema migrans is present. In addition, using the appropriate laboratory tests to confirm Lyme disease is important because there is another rash illness, called Southern Tick Associated Rash Illness that resembles Lyme disease that can occur in the southeastern states. Antibiotic treatment should be given for erythema migrans regardless of testing.

Lyme disease is a tick-borne infection caused by the bacterium Borrelia burgdorferi, and may be transmitted to people in North Carolina by the bite of an infectious black-legged tick (Ixodes scapularis). It is the most common tick-borne illness reported in the United States. Between 1992 and 2006 more than 240,000 cases were reported to the CDC. The distribution of these cases is highly focused with more than 93 percent of reported cases occurring in 10 northeastern and northcentral states.

Because Lyme disease and other tick-borne diseases such as Rocky Mountain spotted fever and Ehrlichiosis can be acquired in our state, Dr. Davies urges residents to take the following steps to reduce the likelihood of infection with these diseases:

PERSONAL PROTECTION:

  • Use insect repellent containing 20%-30% DEET. Follow package instructions. Do not apply under clothing or to children under two months of age.
  • Apply permethrin to clothing per package instructions.
  • Wear light-colored clothing and tuck long pants into the socks to help keep them off of your skin. Also, wear close-toed shoes.
  • Do thorough tick checks of yourself, your children and pets. Completely remove any ticks found. Ticks attached to skin for less than 24 hours are unlikely to transmit Lyme disease.
  • Research has found that bathing within two hours after being exposed to tick habitat may also reduce the risk of Lyme disease transmission.

REMOVING A TICK:

  • Using tweezers, grasp the tick mouthparts as close to the skin as possible, and pull the tick out with steady pressure. Do not yank the tick out.
  • Wash the area with soap and water, then dry and apply a topical antiseptic.
  • Do not use a hot match, nail polish remover, petroleum jelly or other substances to remove ticks.
  • Mark the spot where the tick was removed and mark the date on your calendar. Watch during the next several weeks for early signs of illness.
  • Consider keeping the tick to be able to show your physician in the event that you start to become ill.
  • Contact your physician if you feel you are developing early symptoms of a tickborne illness.

LANDSCAPE MANAGEMENT:

  • Keep grass mowed. Remove leaf litter, brush, and tall weeds from around the home and at the lawn’s edge.
  • Use plantings that do not attract deer or exclude deer through various types of fencing.

PET MANAGEMENT:

  • Minimize time that dogs and cats spend outdoors and have access to areas with leaf litter, brush, and tall weeds. This may help reduce the number of ticks brought back into the home.
  • Check pets for ticks when they come indoors.
  • Check with your veterinarian regarding methods to prevent your pet from tick bites.