The increasing number of cases of Lyme disease has resulted in frequent questions about the prevention, diagnosis, and treatment of this disease. The following information and guidelines may be helpful. EPIDEMIOLOGIC CONSIDERATIONS Lyme disease is caused by infection with the spirochete Borrelia burgdorferi. The organism is carried by a small tick, usually nymphal Ixodes dammini on the East Coast and Ixodes pacificus in the West. The disease is clustered in specific areas, with most cases reported in the Northeast, Wisconsin, Minnesota, and California. For patients who do not live in or have not traveled in those areas, the chances of acquiring Lyme disease are very small. However, at least some endemic cases have been reported from 46 states and Canada. Dogs can be infected with this spirochete and can develop symptoms of arthritis. PREVENTION Tick bites can be decreased by wearing clothing with long sleeves and long pants. Permethrin sprayed on clothing is effective in decreasing tick attachment. Tick repellents such as DEET are effective, but they require repeated application every 1 to 2 hours,1 and they have some negative side effects. For example, seizures have been reported coincidently with the application of DEET.2 If used, DEET should be applied sparingly only to exposed skin and should not be used on children's faces or hands. It should not be applied to irritated or abraded skin and should be washed off after coming indoors. Daily inspection and prompt removal of ticks should help prevent infection because prolonged attachment appears to be required for an infected tick to transmit spirochetes.
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A 1991 study studied this question.