Health Watch/Portage Health/Dr. Stacey Carpenter, Family Medicine

Lyme disease is the most common tick-borne disease in the United States. In Michigan, there is an incident rate of about 1 per 100,000 residents. The incidence of Lyme disease is 30 times higher in our closely neighboring state, Wisconsin.

Lyme disease has been in the news more than usual this year, as the population of ticks is thought to be expanding in some areas of Michigan. I have recently been seeing an increase of patients with complaints of tick bites, and questions regarding Lyme disease.

The disease is spread only by blacklegged ticks, formerly known as deer ticks (Ixodes species), that are infected with the disease. These ticks are brown in color and the size of a poppy/sesame seed, or the tip of a pencil. Infected ticks have to be attached to their host (deer, human, etc.) and feed for the disease to be transmitted to the host. Typically the tick would have to be attached for 24 hours, and feed for an additional 36-to-48 hours before disease transmission occurs. Ticks will become engorged, or full of blood, after they have fed.

Initial symptoms of Lyme disease include rash and/or flu-like symptoms. The rash can occur several days after the tick bite, but can appear up to one month after. The rash is normally described as a “bull’s eye” rash, because it is often salmon/red in color with a central clearing. Flu-like symptoms consist of fever, chills, fatigue, weakness, headache, and muscle/joint pain. If the disease progresses without treatment there can be neurological, joint, heart or brain involvement.

The number one way to prevent Lyme disease is to prevent tick bites. I don’t expect residents of the Keweenaw to avoid our densely wooded areas where the ticks are found. Instead, take precaution. Try to stay in the middle of trails, dress accordingly, and do your due diligence after leaving the woods to check for ticks.

Dressing accordingly includes close-toed shoes or boots, a long-sleeved shirt tucked into your pants, and pants tucked into socks. Light-colored clothing will also make the ticks easier to spot. Insect repellant should be worn. While in the woods, check yourself frequently for ticks. Once out of the woods, examine yourself and your clothing closely. Ticks prefer warm moist areas such as armpit, groin and the back of knees, but often can be found on the scalp as well. It’s important to bathe as soon as you can after leaving the woods, hopefully ticks will be washed away before they have a chance to attach.

If a tick is attached, care should be taken to remove it. Do not try to burn, twist or smother the tick.

Use pointed tweezers (not your hands) to grasp the tick as close to the skin surface as possible. Do not crush the body of the tick.

Pull the tick straight out with slow, steady pressure.

Wash the area where the tick was, and your hands, with soap and water immediately after removal.

If part of the tick remains in the skin, medical attention is not required as the remaining parts are usually expelled on their own. Do not attempt to remove the remaining parts.

After removing the tick, pay attention to the skin where it attached. Also, remember only the smaller, blacklegged species of ticks can cause Lyme disease. Medical attention should be sought if a person experiences a rash or flu-like symptoms.

Editor’s note:?Dr. Stacey Carpenter is the director of the Portage Health Continuing Medical Education program. She practices Family Medicine at Portage Health’s main campus in Hancock. Learn more about Dr. Carpenter at