There were 1,487 confirmed cases of Lyme disease in Wisconsin last year and state health officials urge everyone to take precautions against tick bites.  People are more likely to be exposed to ticks between May and August when more time is spent outdoors. 

Lyme disease is caused by a bacteria carried by deer ticks which are found in many parts of Wisconsin, including the eastern part of the state.    Early symptoms usually start within a month of exposure and often (but not always) include a "bulls-eye" rash near the site of the tick bite.  The rash expands in size over a period of days or weeks.  During the rash stage, other symptoms such as fever, headache, fatigue, stiff neck, muscle and/or joint pain may be present.  Antibiotics are used to treat Lyme disease and are more effective with early treatment.  If left untreated, complications such as meningitis, facial palsy, heart abnormalities, and arthritis can occur within a few weeks to months after infection.

Deer ticks are often hard to see and range in size from a poppy seed to a sesame seed but get much larger after feeding on its host.  It is important to check often for ticks, paying special attention to the head, scalp, armpit, groin, and area behind the knee.  A tick must be attached for at least 24 hours to transmit Lyme disease.  If an attached tick is removed promptly, there is a reduced chance for disease.  If you find a tick, remove it slowly and gently by using a pair of thin-bladed tweezers, grasping it as close to the skin as possible.  Do not use folk remedies like petroleum jelly, nail polish remover, or burning matches as these methods are neither safe nor effective. 

People can take steps to avoid tick bites and reduce the chance of getting Lyme disease:

• Avoid wooded and bushy areas with high grass and leaf litter.  If you are hiking in an area like this, try to stay in the middle of the trail.
• Use effective tick repellents and apply them according to label directions.  Repellents with 20-30% DEET can be used on exposed skin and clothing.  Permethrin repellents can also be used on clothing. 
• Wear clothes that will help shield you from ticks -- a long-sleeved shirt and long pants tucked into socks create a "tick barrier".  Ticks are easier to spot on light colored clothing.
• Carefully perform daily tick checks after being outdoors, even in your own yard.
• Also check your pets for ticks and prevent them from bringing ticks into the home.  There is a Lyme disease vaccine available for pets.

Past infection does provide some short-lived immunity but it is possible to get infected more than once.  There had been a vaccine against human Lyme disease but it is no longer marketed. 

More information about Lyme disease is available at:  http://dhs.wisconsin.gov/communicable/TickBorne/LymeDisease/links.htm       http://cdc.gov/ncidod/dvbid/lyme/index.htm       http://arthritis.webmd.com/slideshow-lyme-disease?ecd=wnl_lbt_061009         

It has been only several weeks since the H1N1 flu outbreak surfaced but, at times, it probably seems to be much longer.  The topic of this flu is in the news every day and some people are beginning to think "enough already!". 

While it is true that at this time, the outbreak is not as severe or deadly as initial data suggested, the potential was there and still lingers. The people who make the hard decisions must take a cautious approach and we should appreciate that they do.  No one has any immunity to this particular virus as it is a completely new combination of pig, bird, and human viruses and it could continue to mutate.  From the outset, no one knew how things would play out and they still don't know how events will unfold over the next few months.  Some experts are predicting that this virus will be back stronger in the fall and history suggests they may be correct.  But we are fortunate that there have been so many advances in surveillance, communication, and technology that if history is repeated, an outbreak or pandemic can be controlled as much as possible.  Perhaps increased knowledge will help make a pandemic of the future less devastating than a pandemic of the past. 

Who among us can really predict the future?  We must be prepared for any scenario and all levels of government have been doing just that.  The actions taken in response to this newest threat are a result of years of planning and coordination.  But again, the uncertainty involved makes it difficult to implement the "perfect" response plan if there is such a thing.  And, of course, every event serves as a learning experience which could lead to a different response in the future.

The best thing people can do is stay informed and practice good hygiene and daily health habits.  There is absolutely no need to be fearful but everyone really should respect that there are germs "out there" and it is not known when they could evolve to the point of causing serious disruption to life as we know it.  It is recommended that all families be prepared as best they can for different types of emergencies. 

Check out the following websites to stay informed about this constantly changing situation.  And by all means, call us at the Health Department (414-371-2980) if you have additional questions. 

http://www.cdc.gov/H1N1flu          http://www.pandemic.wisconsin.gov         

State health officials are reminding all Wisconsin residents to use caution around wild animals to protect against rabies, a viral disease transmitted by bites from infected animals.  Bats and skunks are the most likely to carry the rabies virus, but dogs, cats, raccoons, and foxes can also transmit the disease.

The best method of prevention is to use caution around unfamiliar animals -- domestic or wild.  If you are bitten by an animal, wash the wound immediately with plenty of soap and water.  Contact your physician and local health department to report the bite.  If you can do so safely, capture and confine the animal so it can be tested for rabies.  Oftentimes, the animal is turned loose or destroyed and cannot be tested.  In such a situation, the person who was bitten (or exposed if young children are involved) must undergo anti-rabies shots which is a series of five shots plus one immune globulin shot at the time of the bite.  If the animal is available for testing or observation, no anti-rabies treatment is needed in the majority of cases.  However, since rabies is usually a fatal disease (there is only one known human survivor), it is not worth the risk of assuming the animal does not have rabies and treatment is not needed.  Every animal bite by an unfamiliar animal should be followed up appropriately.

To help avoid possible exposure to rabies:

• Avoid contact with wild animals.  Do not try to nurse a sick animal back to health.  Call an animal control official or a wildlife rehabilitator if you find a sick animal.
• Never touch unfamiliar or wild animals and teach children to do the same.  Stray cats and dogs may not be accustomed to being handled and are more likely to bite.
• Never adopt wild animals or bring them into your home.  Even baby animals can carry rabies.
• Walk your dog on a leash and do not let it roam freely where wild animals may be present.
• Secure trash cans and pet foods so they do not attract wild animals.
• Keep bats out of living areas by securing open or loose fitting doors, attics, unscreened windows, and chimneys. 
• Be sure to have your pets vaccinated against rabies and keep current with booster shots.

While human rabies cases in the U.S. are rare, they do occur and the results are usually fatal.  In Wisconsin, the most recent cases of human rabies were in 2000 and 2004 with both cases resulting from a bite from an infected bat.  For more information on rabies, visit these websites:

http://dhs.wisconsin.gov/communicable/factsheets/Rabies.htm           http://www.cdc.gov/rabies

Summer is almost here and outside activities beckon.  And the mosquitoes are just waiting for us!  Should we be concerned?

West Nile infection is caused by the West Nile virus and is spread to people by the bite of a mosquito infected with the virus.  The mosquito becomes infected by feeding on an infected bird.  The West Nile virus was first detected in the U.S. in 1999 and has since spread across the country.  The first human infections in Wisconsin were documented in 2002. 

About 80% of people infected by West Nile virus will not get sick.  Most of the remaining 20% will have a mild illness that can present with fever, headache, body aches, swollen lymph nodes, nausea and vomiting, or a rash on the chest, stomach, and back.  Less than 1% of infected people become seriously ill with symptoms that can include imflammation of the brain, paralysis, coma, and death.  People over the age of 50 are at greater risk of developing severe illness.  Symptoms typically occur 3-14 days after a bite by an infected mosquito.  There is no specific treatment for West Nile infection but treatment can be given to relieve symptoms.

While the risk of contracting severe illness from West Nile virus is low, the consequences for some people and their families are devastating.  Much can be done to prevent exposure and reduce risk of West Nile.

Personal protective measures include:

• Limit time spent outside at dawn and dusk when mosquitoes are most active.
• Wear protective clothing when outdoors.
• Use insect repellents containing an Environmental Protection Agency registered ingredient, such as DEET, on your skin and clothes.
• Do not use more than a 10 percent concentration of DEET on children.
• Make sure home window and door screens are in good repair.

Reducing mosquito populations will also reduce the number of mosquito bites.  Mosquitoes lay their eggs in standing water and removing such sites from your property will help reduce the number of mosquitoes.  Steps to take are:

• Landscape to prevent water from pooling in low-lying areas.
• Drain water from pool covers and change water in birdbaths at least every three days.
• Do not allow water to accumulate in ceramic pots, wheelbarrows, plastic containers.
• Clean roof gutters and downspouts for proper drainage.
• Trim tall grass, weeds, and vines since mosquitoes use these areas to rest during hot daylight hours. 

Birds also become sick from West Nile Virus and can die.  Oftentimes, this is the first clue that West Nile virus is present in an area and is an indication that people should take precautions to avoid mosquito bites.  State health officials have activated the statewide toll-free Dead Bird Reporting Hotline to track the virus.  Hotline staff can answer questions about dead birds and provide information on safe handling and disposal.  People should not use their bare hands to handle a dead bird.  The Hotline number is:  1-800-433-1610.

More information about West Nile virus is available at the following websites:

http://www.cdc.gov/ncidod/dvbid/westnile          http://www.nlm.nih.gov/medlineplus/westnilevirus.html     

http://dhfs.wisconsin.gov/communicable/WestNileVirus/Resources.htm