This undated photo provided by the U.S. Centers for Disease Control and Prevention shows a black-legged tick, which is also known as a deer tick. Ticks will be more active than usual early in spring 2023, and that means Lyme disease and other tick-borne infections could spread earlier and in greater numbers than in a typical year. Ticks can transmit multiple diseases that sicken humans, and deer ticks, which spread Lyme, are a day-to-day fact of life in the warm months in New England and the Midwest. (CDC via AP, File)

As the weather warms, more Mahoning Valley residents will head outdoors to work in their yards, hike or bike on tree-lined trails or walk through parks.

But this year also is predicted to be an especially bad year for deer ticks, which potentially carry a crippling neurological disease.

Lyme disease affects an estimated 476,000 people each year in the United States. It is most common in New England, the mid-Atlantic states and the upper Midwest. More cases are cropping up in Ohio.

According to Lymedisease.org, an online resource that supports science-based advocacy, “Lyme disease can affect any organ of the body, and it is often misdiagnosed because it tends to mimic symptoms of other diseases. Lyme disease may be misdiagnosed as chronic fatigue syndrome, fibromyalgia, multiple sclerosis and even psychiatric illnesses like depression.”

When misdiagnosed, treatment of the underlying infection is delayed.

Dr. Munir Shah, an infectious disease specialist in Warren, said, “The mild winter we had means there will be an increase in ticks as well as mosquitoes this summer.”

Dr. Frank Migliore, a board-certified rheumatologist in Poland, said, “That’s been theorized, and it probably means they will be out and active earlier than usual.”

Sam Telford of Tufts University’s school of veterinary medicine said, “The best approach is to assume ticks will be very active. Every year should be considered a bad tick year.”

Researchers say it is hard to predict how the tick season will play out. This year’s mild winter and early snow melt, though, could mean more ticks earlier than usual and a wider spread of Lyme disease and other tick-borne diseases, scientists said.

In Connecticut, ticks are showing up in greater numbers this year, according to Goudarz Molaei, a tick expert for the state. Through late April, more than 700 ticks had been sent in for a testing program that normally would have gotten 200 to 300 by then. The state typically sees a lot of Lyme disease, which got its name from a Connecticut town.

“It’s going to be an above average year for tick activity and abundance,” Molaei said.

The same seems to be playing out in northeast Ohio.

OHIO AND TICKS

“Ohio is not one of the pivotal states with ticks that spread Lyme disease. However Pennsylvania and West Virginia are,” Migliore said.

Shah said, “While we have ticks in our area, the deer ticks are not as prevalent here as they are in western Pennsylvania. We see more tick bites in summer because they thrive in warm weather.”

“Lyme disease is spread by the deer tick, which transmits bacteria called Borrelia burgdorferito humans,” Migliore said. “The ticks get the bacteria from biting the white-footed mouse. The tick bites the mouse, and then the bacteria is transferred from mouse to humans.

“Adult ticks feed on deer too, so the more deer there are the greater the presence of ticks. A high population of deer helps to propagate the disease.”

There are three life stages of ticks — the larvae, the nymph and the adult stage. The majority of transmissions to humans is at the nymph stage. The nymphs are smaller than the adult ticks and more difficult to detect and they must be attached to a person for 36 to 48 hours before transmitting bacteria.

Migliore said, “Tick season begins in mid-May and peaks in June. Ticks are less active in July and August. Adult ticks are more active in October, November and December.

SYMPTOMS

Shah and Migliore say an infected bite first appears as a “bull’s-eye” rash. The symptoms can include fatigue, body aches, fever, lethargy, headaches, swollen lymph nodes and joint pain. Anyone with any of those symptoms should check for a tick which may be attached to your body.

“Sometimes people discover a tick before they start having symptoms,” Shah said.

If you find a tick on yourself or a family member, remove it quickly and correctly. “If the tick is removed within two hours of a bite, it does not transmit infection,” Shah said.

Remove a tick with fine-tipped tweezers as soon as it is noticed. Grasp it with tweezers as close to the victim’s skin as possible, and pull it straight out without twisting or squeezing the body of the tick.

Late stages of Lyme disease — manifesting weeks or months after the bite and after the tick has moved on — can include arthritis, bouts of joint swelling, nervous system abnormalities, meningitis, a stiff neck, numbness, fever, severe headache, irregular heart rhythm and facial paralysis.

This is why treatment needs to begin as early as possible.

The diagnosis of Lyme disease is based on a person’s blood work and his or her symptoms. The treatment for Lyme disease is taking an oral antibiotic for 14 days. Doxycycline is the main antibiotic used for treatment however amoxicillin is also used.

Migliore said that sometimes after the bacteria has been treated and cleared, patients will have persistent joint pain and swelling. The infection is gone but it has triggered inflammatory arthritis, which can last six to 12 months, and is treated with medication used for rheumatoid arthritis.

PROTECT AGAINST TICKS

The most common place to encounter ticks is in wooded areas, and Shah said if you spend time in a wooded area, it’s a good idea to take a shower within two hours and check yourself for ticks. Migliore suggests having someone check you over for ticks after being in a wooded area.

The Centers for Disease Control and Prevention recommends wearing light-colored clothing outdoors, on which it is easier to detect ticks. Clothing should also be treated with repellent containing DEET or permethrin. Long pants, tall socks and long-sleeved shirts should be worn.

Covering up prevents ticks from gaining easy access to skin.

It’s also important to be especially cautious in areas where ticks live, such as grassy and wooded areas. Checking your clothing after being outside is also key and limiting exposed skin also helps avoid bites.

Also, be mindful of pets. Even if a person doesn’t venture outdoors, the family dog may and can carry ticks into the house. The ticks then can end up on family members.

Prescription tick repellent products are available from veterinarians. There are topical solutions and collars that can keep ticks away, and there is a Lyme vaccine for dogs.

The Global Lyme Alliance, which funds research aimed at preventing, diagnosing, and treating tick-borne illnesses, notes that practicing tick-bite prevention habits is the best way to prevent Lyme disease. Through its “Be Tick AWARE” campaign, The GLA urges people to follow these simple steps to reduce their risk for Lyme disease:

• Avoid high tick-traffic areas, like tall grass and leaf piles;

• Wear proper clothing, including long pants, sleeves and socks. Avoid walking on the grass barefoot or in open sandals, even when grass has been cut short;

l• Apply tick repellent approved by the Environmental Protection Agency;

• Remove clothing upon entering your home, tossing clothing into the dryer at high temperatures for 10 to 15 minutes to kill live ticks. Putting clothes into the washer will not kill live ticks.