By Lisa Belanger, Director of Health Services

With the arrival of spring, Ken and Ethan are eagerly anticipating the end of the semester and are talking about getting outside to enjoy the beautiful Maine summer. Ethan is thinking about putting in a week or two of hiking along the Appalachian Trail in Maine and New Hampshire. Ken is planning to work as a lifeguard at a state park on the coast of Maine. As both of them share their respective plans, what important health-related details should they be sure not to miss?

The answer: Beware of the Bugs!

Here’s a short summary of the illnesses caused by three of the primary insect villains in Maine:

Bug #1- Deer Tick: Maine has high rates of tick-borne diseases across the state. The deer tick, also known as the black-legged tick, is well known as a vector for lyme disease. Less well known but equally important are the following infections that are also transmitted by the deer tick, including anaplasmosis, babesiosis, borrelia miyamotoi and powassan virus, a potentially deadly form of encephalitis. One tick bite can transmit multiple diseases at one time. Disease transmission times range from up to 72 hours after tick attachment for lyme disease to as little as 15 minutes for powassan virus. The initial signs and symptoms for a tick-borne disease typically include flu-like symptoms like fever, headache, chills and body pains. Most, but not all people who are infected with lyme disease will also develop a classic “bull’s eye” rash at the site of the bite.

Remedy –
Apply EPA-approved skin repellents that include at least 20% DEET. Other EPA-approved non-DEET repellents include picaridin oil of lemon eucalyptus and IR3535.
Avoid wooded and brushy areas with high grass and leaf litter. Walk in the center of trails. Wear long-sleeved, light-colored clothing. Tuck your pant legs into your socks and your shirt into your pants.

Check your clothing and gear for ticks and do a full-body tick check when coming back indoors. Pay special attention to under the arms, behind the knees, between the legs, in and around the ears, in the belly button, around the waist and in the hair.
Take a shower within two hours after spending time outdoors, which will wash off any unattached ticks.

Remove attached ticks as soon as possible pulling upward with steady, even pressure.
Contact your health care provider promptly if you have a history of tick bite and suspect you have a tick-borne disease. He/she will use a combination of clinical symptoms and laboratory testing to reach a diagnosis.

Bug #2– Mosquito: Although it is currently uncommon, mosquitoes in Maine can carry viruses that can cause several illnesses. These include West Nile virus (WNV), Eastern Equine Encephalitis (EEE) and Jamestown Canyon Virus (JCV). Some people infected with WNV and EEE will not show any signs or symptoms. It is not known how many people with JCV do not show any signs or symptoms. For most people, the initial signs and symptoms of all three diseases is similar and can include fever, chills, muscle/joint pain, headache and fatigue. Some people with WNV can also develop a rash. All three diseases can potentially become severe and cause encephalitis (brain swelling) resulting in neurological impairment or death. Symptoms of severe illness can include altered mental status, seizures, tremors, disorientation, vision loss and coma.

Remedy –
· Use repellents that contain 20% DEET or greater on skin to prevent mosquito bites for several hours. Other EPA-approved repellents for use on skin include picaridin, IR3535 and oil of lemon eucalyptus.
· Use permethrin on clothing and gear. Treated clothing lasts for several washes and is very effective at preventing mosquito bites. Permethrin is NOT approved for use on skin.
· Mosquitoes need standing water to breed. To reduce breeding sites, remove any sources of standing water including unused pools, old tires, uncovered trash bins, buckets, clogged gutters and flower pots.
· Cut back or remove dense brush in your yard. Keep your grass mowed short.
· Consult your health care provider if you develop significant illness after being bitten by mosquitos.

Bug #3- Browntail Moth– This is an invasive species found primarily along the coast of Maine and Cape Cod. Caterpillars are the most active from April to late June. They have tiny poisonous hairs that cause a skin rash similar to poison ivy either from direct contact with the caterpillar or indirectly from contact with its airborne hairs. The rash results from both a chemical reaction to a toxin in the hairs and a physical irritation as the barbed hairs become embedded in the skin. Most people affected by the hairs develop a localized rash that will last for a few hours up to several days but on some sensitive individuals the rash can be severe and last for several weeks. Inhaling the hairs can be serious and potentially cause respiratory distress.

Remedy –
· Avoid places heavily infested by caterpillars.
· Rake, mow, weed whack etc. when foliage is wet to prevent the hairs from becoming airborne. Also wear a respirator, goggles and coveralls.
· Dry laundry inside during June and July to avoid the hairs imbedding on clothing.
· If exposed, start by taking a shower or cool bath and wash all clothing you were wearing outdoors. A mild rash may be treated with over-the-counter remedies such as 1% hydrocortisone, calamine lotion or diphenhydramine cream. Consult your health care provider if you develop a severe rash or have trouble breathing.


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