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We hope Lyme was not a lemon.

In reminding our readers last month to be alert to the possibility of Lyme disease, we should perhaps have been more specific on a couple of points. In using repellents containing DEET, avoid products that contain more than 40 percent DEET, which is readily absorbed by the skin-and use it on clothing instead of skin. Clothing can also be sprayed with Permanone (permethrin). However, this product is available in only half the states-and not available in two states where Lyme is very common, New York and Massachusetts, whose pesticide regulations prohibit its sale.

Light-colored clothing is preferable, making it easier to spot ticks. Ticks on the skin are often very difficult to spot, both because they may be no bigger than the period at the end of this sentence and because they may have fallen off after biting. If you do find a tick attached to your skin, remove it immediately, pulling it off gently with a pair of tweezers. If you don't have tweezers at hand, use your fingers, but cover them with a tissue. If possible, save the tick and call your local health department for information on where to send it for testing. But don't worry if you don't find the tick on you until you get home-risk is minimal if the tick is removed within 24 hours.

The first warning sign in 60-to-80 percent of Lyme disease cases will be a rim of reddened, but painless, skin around a pale area where the bite occurred. This is the so-called "bulls-eye" rash. To qualify as the rash of Lyme, however, the ring of red must be at least two inches in diameter, and it can become much larger. Later, smaller rings can appear inside it, producing a target-like appearance.

Finally, remember that blood tests for Lyme are not very reliable. Therefore, your doctor will rely much more on your clinical condition and history of exposure in deciding whether and how to treat you.
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Title Annotation:Lyme disease prevention
Publication:Medical Update
Date:Aug 1, 1991
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