Last modified: Tuesday, June 9, 2009 2:19 AM EDT A greatly magnified look at the striking, adult female deer tick that transmits Lyme disease. It feeds on white-tail deer, mice, chipmunks, birds and dogs. Photo courtesy of the URI Tick Encounter Resource Center Tick, tick, tick BY SUSAN LaHOUD SUN CHRONICLE STAFF SEEKONK - For the first time in the 25 years that she's lived in this town, Cindy had deer visit her porch over the winter. They left hoof prints in the ice, droppings on her walk, and ate her arborvitae and yew bushes. It's made her nervous because less than 10 months ago, she was diagnosed with Lyme disease, which is transmitted by deer ticks. What Cindy (who didn't want her last name used) didn't know is that she likely had Lyme disease for 17 years before suffering symptoms so severe, she had a near-death episode. Her husband was recently diagnosed with the disease, as was her neighbor's daughter, husband and mother. She was among 20 people who attended a recent tick prevention session at the Seekonk Public Library led by a member of the Tick Encounter Resource Center, an outreach program of the University of Rhode Island's Center for Vector-Borne Disease. Many of the attendees either had been diagnosed with the disease or knew of people or pets that had. Cindy said if more people knew of the serious symptoms of Lyme disease and problems in getting a proper diagnosis and treatment, even more would have come to the session to find out how to prevent the disease. She worries about the children across the street from her who roll in the leaves, and feels youngsters should be educated in the schools about tick-borne diseases and precautions. That, in turn, might lead to more adults being educated about the problem. Serious problems Lyme disease can cause serious joint, heart or central nervous system problems if it is not recognized early and appropriately treated. Most people suffer fever, aches and flu-like symptoms and then experience a raised red rash that grows bigger than a 50-cent piece over one to two weeks after they've been bitten by a deer tick. In some cases there will be a bull's-eye centered rash. According to the state Department of Public Health, the number of cases of Lyme disease has been in the rise, doubling in this area since 2001. In 2005, Massachusetts had the fourth highest incidence rate (number of new cases per 100,000 people) nationwide with 36.4 cases per 100,000 - almost 4.5 times higher than the national rate. It is considered endemic in the state. Southeastern Massachusetts is one of the areas with the highest incidence rates. There were 239 confirmed cases in Bristol County in 2007, up from 194 in 2006. In Norfolk County there were 382 cases, up from 285 in 2006, according to the DPH. Attleboro's public health nurse, Jacqueline O'Brien, said she has seen an increase in cases of vector-borne diseases, including Lyme, over the past year. There are more cases as more people have become exposed to ticks. Tick densities are higher than they were 20 years ago, according to URI entomologist Thomas Mather. They have moved into rural, suburban and even semi-urban landscapes in Southeastern U.S. over the years as people have moved from the cities to suburbs and semi-urban areas, and as development has moved up against forests, or incorporated them within housing developments. The striking red-and-black tick that transmits Lyme disease feeds on white-tail deer, mice, chipmunks, birds and dogs. Ticks become infected when they feed on reservoir animals. In most settings, mice are the primary culprits for producing infected ticks, according to the URI center. Deer are important to ticks as reproductive hosts. The mammals sweep through the environment with hundreds of ticks attached to them, according to the documentary "Hidden In The Leaves." (The film, which features Mather, can be viewed on YouTube as well as the center's Web site, www.tickencounter.org.) The ticks detach and form eggs moving from larval to nymphal stages, which prefer to feed on small rodents. Summer, typically June and July, is when the poppy-seed sized nymphal ticks are active, climbing up people's legs. Each female tick can lay 1,500 eggs, and while a good frost kills mosquitoes, ticks overwinter in leaves. Forests and humidity help them to thrive. Mather said he conducts a five-step assessment in determining whether a yard is at risk for ticks: Rodent habitats: wood piles, especially if they're close to mulch piles. Stonewalls act as condos for mice. Bird feeders can be attractive to deer and to rodents. High humidity area: Shade with leaf piles. Evidence of deer. Risk for human exposure. Whether there are pets that go into the yard and then back into the home. Some steps to take to get rid of tick risks: Let more sunlight into the yard; rake up leaves. Use approved pesticides on the perimeters of yards. Install deer fencing around the yard. Use permethrin on clothes or buy clothes pre-treated with permethrin. (Products containing just DEET do not repel ticks.) After being outside, check for ticks, especially on the back of knees, around waistbands, under armpits or any other place where clothing restricts. Remove ticks with tweezers; don't wash them off. (If you have a question about whether it's a deer tick, put it in a sandwich bag with a slightly moistened napkin and if symptoms develop, you may want to have it tested. Don't put the tick in alcohol.) There are at least a couple of labs that conduct testing. Use spot-on products to treat pets, like Frontline or Advantix. There is also a Lyme disease vaccine for dogs, but not humans. While it may seem like work, becoming infected is far worse, said Erin Rainone, outreach coordinator for the URI program who spoke at the Seekonk Library. She said the good thing about permethrin is that it not only repels, but kills ticks. Studies have shown that even if shoes are treated, it provides 71 percent more protection than those that are not, Rainone noted. Yard treatments are typically required two or three times a year and typically should not include treating grass, she said. Some products, like Repel or Sawyer, include permethrin and can be sprayed on clothes to protect against ticks. If you find a tick, keep it, unless it's a dog tick, she said. Remember that an adult deer tick needs 24 hours to infect; nymphs, 18 to 20 hours. Ticks can be tested. UMass Extension, in cooperation with researchers at UMass Amherst, will assess specimens to determine whether they are black legged ticks (deer ticks). The test can detect the Lyme disease pathogen from a single tick. There is a fee of $40 per sample. If the test is positive, those results will be helpful to your doctor, Rainone said. SUSAN LaHOUD can be reached at 508-236-0398 or at slahoud@thesunchronicle.com.