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  • AT Hiker's Ability to Recognize Lyme Disease by Visual Stimulus Photographs

    Lyme disease is the most common vector-borne infectious disease in North America. With nearly 2500 Appalachian Trail (AT) hikers entering the endemic area for up to 6 months, exposure to the disease is likely. The characteristic exanthem of erythema migrans (EM) should be a trigger for seeking medical treatment, and itís significance in this relatively isolated environment is critical. Objective: Determine AT hikers ability to recognize EM as a surrogate marker for Lyme disease. Methods: Hikers were administered a photographic stimulus in this IRB approved, non-validated study. Historical hiking data, basic demographics, and self-reported treatment/diagnosis were collected. Results: 379 responses were collected by 4 researchers at three geographically separate locations at or proximate to the AT from June 2011 to May 2012. 54% (206/379) respondents were able to recognize the photographs of EM/Lyme disease, 46% could not. Of those who did recognize EM, 23 (6%) had seen it either on themselves or another hiker while on the AT. 37 hikers stated that they had been diagnosed with Lyme disease while hiking, and of these 89% were treated with antibiotics. 13 out of 37 (35%) hikers diagnosed with Lyme disease had visualized an embedded tick. 9% of all respondents reported they had been diagnosed with Lyme disease by a healthcare practitioner, whether from EM, symptomatology, or by titer. Conclusions: This study suggests that hikers are poorly able to recognize the characteristic exanthem of Lyme disease but have a high exposure risk.

    Comments 3 Comments
    1. plherrin's Avatar
      plherrin -
      Do you know where this was published?
    1. Ruski's Avatar
      Ruski -
      Quote Originally Posted by plherrin View Post
      Do you know where this was published?
      I'm not sure where this was published but there are many articles out there on risks of Lyme and Rocky Mountain Spotted Fever. Memorize the signs and symptoms if you are doing the AT. Get yourself some antibiotics for the trail: Doxycycline; This stuff is awesome and kills the tick diseases no problem. I went to my doc and told him about my upcoming 6 month hike, the risks of Lyme disease, the risk of Deer Tick Paralysis, and my desire to be prepared for it. He prescribed me the antibiotics with no problems. He simply billed the insurance company for Acne treatment. It is very commonly given for acne treatment, malaria prophylaxis, and much more.
      With all that said, I will be hiking with a small bottle of Doxycycline- 1 months supply. It cost me $10 with my insurance and weighs only 1 oz (for all you ounce wienies)
      Hope that helps!
    1. Dogwood's Avatar
      Dogwood -
      It's good getting this information out there. I would however like to see a simple brief laymen's written definition of what this means, characteristic exanthem of erythema migrans (EM), at the introduction with a few different corresponding photographs, namely also a picture of the "Bulls Eye Rash" that is said to often be a symptom of Lyme Disease during the early stages.

      I'll post this here.