Lyme Disease on the Appalachian Trail

The follow excerpt is taken from Appalachian Trials: a psychological and emotional guide to thru-hiking the Appalchain Trail.  If you’re thinking of hiking the AT, I’ll go as far as to say, it’s a must read.

Deer Ticks are assholes.

I went into the Appalachian Trail with my share of premonitions. Most, turned out to be false.

The crazy hillbillies in the southern part of the trail, just turned out to be crazy nice.  Even if you can’t make out what they’re saying, it’s perfectly clear all they want to do is help.

That black bear that was going to leap out of tree for the sole purpose of eating my face– also turned out to be incorrect.  Black bears are big raccoons; they’re on a mission from God only to dig through trash.  They don’t seem to realize, or at the very least care about, their strength.  Watching a 300lb black bear scamper up a tree because it sees a 130lb female backpacker in the distance is one of life’s great mysteries.

My biggest fear going into the trail, however, turned out to be justified- Deer Ticks.  More specifically, the disease these micro-satans spread, Lyme Disease.

About Lyme Disease

Lyme Disease, caused by the bacterium Borrelia burgdorferi, is the most common vector-borne disease in the United States and is transmitted through the bite of one of the aforementioned micro-satans.  Symptoms include fever, headache, stiff joints, fatigue, depression, and the common “bulls-eye” rash. If left untreated, symptoms can increase in severity including permanent damage to joints, heart, and central nervous system, and eventually death.

Here’s why Lyme Disease is a big risk to Appalachian Trail thru-hikers– these early stage symptoms, minus depression, are also common symptoms of long distance backpacking.  If a hiker assumed they had Lyme Disease every time they experienced stiff joints or fatigue, they would be hypochondriacs.   Even the common bulls-eye rash, as it turns out, is not always the case.  An infected tick bite can result in a variety of different rash patterns, including no rash at all.  In other words, the only symptom of Lyme Disease that deviates from the normal side effects of backpacking isn’t even all that reliable

Yeah…..fuck is right.

Deer ticks can range in size from a “fleck of black pepper” (in the nymph stage) to roughly half the circumference of a dime (adult asshole).  If removed quickly (usually less than 24-48 hours), there is little risk of the disease being transmitted.  Finding a brownish half dime on your skin shouldn’t be all that challenging.  Here’s the problem- people are far more likely to contract the disease from the nymphs.  That’s right, the fleck of black pepper is the more dangerous of the two.  Furthermore, these bastards are programmed to find the dark, moist parts of your body- the difficult to check regions.  Pardon my bluntness- but examining your taint after a 20+ mile strenuous hike is as un-fun as it is uncomfortable as it is disgusting.

In just the narrow observation of my thru-hike, I heard of at least eight cases of people getting off the trail due to Lyme Disease.  Two people that I spent a significant time hiking with, Road Dog and Wildcat, didn’t find out that they contracted the disease until after getting off the trail (one is now symptom free, the other is still battling nerve damage, headaches, and blurred vision).  I can only imagine how many hikers received this bad news upon returning home (I was dealt a sweet dish of West Nile Virus instead).

The Data

The quantitative analysis backs up my qualitative claims.  In 2009, there were 29,959 reported cases of Lyme Disease (420,000 when including the estimated unreported cases as well).  That’s up 69% from 2000.  And to remove any sense of reassurance for the future, 2012 is projected to “the worst year for Lyme disease risk ever.

Granted, these numbers are national figures.  You’re likely wondering, “How does this pertain to the Appalachian Trail?”

Not that you need it, but here’s a map of the Appalachian Trail:

Now let’s look at a map of the reported cases of Lyme Disease (source: hvceo.org):

You’d think the trail was designed by deer ticks themselves.

———————————

The purpose of this post is not to dissuade you from hiking the Appalachian Trail.  All things considered the AT is still an education in living life the right way.  I just want you to be cognizant of the risks.  Ignorance is not bliss. Ignorance is Lyme Disease.  Lyme Disease can be a miserable bitch.  Knowledge is prevention.  Opt for knowledge.

Precautions

Before reaching the northern half of Virginia, get some Permethrin (a tick repellent for your clothes), which stays active even after a few washes (and up to six weeks).  Get a few bottles and have it sent every 4-5 weeks upon reaching the deer-tick heavy regions.  These containers are typically too big to carry, so spray the shit out of your clothes and then pass onto other thru-hikers.  You’re saving their life.  Be sure to remind them this when mom sends them cookies.

Wear pants and long-sleeves. This is more of a do as I say, not as I do sort of thing.  I wore pants while hiking for a total of 14 minutes in five months.  I’m a super sweaty bastard so pants in the Pennsylvania summer would have made as much sense as shorts in Antarctica.  Either way it’s up to you, but keep in mind that ticks can only suck what they can grab onto, and they’re not going to grab onto pants soaked in Permethrin.

DEET.  Sure DEET has been shown to cause neurotoxicity, kidney and liver problems, and birth defects, but damn is it good at keeping bugs away.  Of course, I am being facetious.  I used DEET a lot on the trail, and I can say that it does do a good job of making you less attractive to insects.  It also does a good job of making you feel like hot garbage.  The times where I applied multiple rounds of DEET in a day, or used it a few days in a row, I would always start to feel uneasy- slightly nauseous, a headache, and occasionally dizzy.  My DEET recommendation: use it sparingly.  If you are going to follow the above advice and wear pants/long-sleeves, apply DEET only on the days where you need a shorts/t-shirt reprieve.

Check yourself everyday: Because a tick has to be attached for 36 hours before the bacteria starts to spread into your blood stream, the single greatest precaution you can take against contracting Lyme Disease is to meticulously check yourself every day.  I know I already eluded to this being a pain in the ass.  It is.  But you know what’s even more of a pain in the ass?  Permanent nerve damage.

If you’re interested in furthering your Lyme Disease paranoia, the below documentary, Under Our Skin, will accomplish exactly that.  In all sincerity, I highly recommend this documentary.  Watch it.  Today.

(And seriously, check out Appalachian Trials.)

  • Zach thanks for this post. I was wondering how I was going to fight off the lil beggars for my trip. Would you recommending blousing your pants ( tucking them into your boots) on some parts of the trail?

    Looking forward to your book as always

    Adam

  •  Thanks for the comment Adam.

    I did see a lot of people blousing their pants (never head that expression – you learn something new every day) on the trail.  I’d say as long as you’ve sprayed your stuff, deer ticks will pretty much repel off. 

    I know this because…

    When in town, a fellow hiker picked a deer tick of her body, placed it on the cement, and then sprayed a circle around the tick.  The tick would avoid the permethrin at first, bouncing from one end of the circle to the next, and eventually got frustrated (if ticks can get frustrated) and walked right into.  Needless to say it died pretty quickly.  Seems like potent stuff.

  • Blousing is a military term and practice. That documentary did indeed make me paranoid.

  • Yeah I watched it last night with mom.  It made my WNV flare up.  Man do I hate deer ticks.

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  • Mimi

    thanks for this.  it was several weeks after my son finished his nobo thru-hike that he was diagnosed with lyme disease aftger experiencing joint pain.  he knew he’d had some ticks, but never experienced any of the typical symptoms, including the rash.  i’m grateful we recognized the joint pain for what it was and got his some antibiotics quickly.  being 18, he was invincible man,  but i do think he got a reality check on this that will serve him well in the future.  you can’t fool around with mother nature! 

  • Mimi- I’m sorry to hear that your son contracted Lyme, but am glad to see that he was able to nip the problem in the bud by taking antibiotics early on.  Thanks for sharing his story – just another example of why thru-hikers need to be careful on the trail.

  • I have heard not to put bug spray on my backpack or tent, but on the probass website listed that as one of permethrin’s uses. What do you think?

  • James

    When would you say it’s time to start checking myself thoroughly and treating my clothes with permethrin?

    I’m heading out March 15th; would it be worthwhile getting into the routine from the get go, or is it really only important in the height of summer and up in the northern states?

  • Good question James.  To be on the safe side, you might want to start doing it right off the bat.  Granted this is likely overkill- deer ticks won’t really be an issue until you get into Virginia, but it will help you to develop the routine.  You want to get to the point where checking yourself is as much of your nightly ritual as brushing your teeth or eating dinner. 

  • Might not be a bad idea as they could then make it into your pack when stowing your tent away in the morning.  I’d check with the manufacturer to see if that voids the warranty first though!  Good question Lori!  How’s your prep going?

  • Gig

    Hi, On which part of the trail do you recommend hiking in August and early September to avoid the deer ticks? Gig

  • Logan (Unitic)

    This is an excellent summary Zach, thank you!  I’m just coming out of the other side of an 18 month battle with chronic Lyme I contracted on a backpacking trip in Mammoth Cave NP in Kentucky in May of 2011.  I’m planning a SOBO thru-hike to begin in July of 2013 to try to raise awareness of the facts of Lyme disease.  I’d like to offer two enhancements to your post based on Lyme disease myths I discovered via personal experience (and you are correct, you DO NOT want this disease). 

    While there are states and months where the risk of exposure to Lyme is higher, it is very possible to contract it in any of the states along the AT in almost any month of the year.  There are more than 50 members of my local lyme support group here in Louisville, KY and the majority contracted it in this region (and the group just started in October of 2011).  The CDC reporting guidelines are so narrow, the myth that “Lyme doesn’t exist here” is so widespread, and the false negative rate for the current most common blood tests is so high (as much as 40-50%), that the reported statstistics of confirmed cases is drastically low and the geographic distribution of states considered endemic for Lyme is seriously flawed.     

    Also, the bacteria can be transmitted in less time than commonly thought.  I would not risk your health on the less than 24 hours standard.  I found and removed my little bastards in less than 12, and thought I was safe.  I never even considered the possiblity of Lyme because my belief that I had removed them in time.  By the time I was accurately diagnosed five months later the infection had spread throughout my body.  Then trying to find treatment in a state “where Lyme does not exist” was a nightmare in and of itself.  I have to travel to another state to see a specialist, and it’s taken me more than a year to recover as much as I have (I still have cognitive symptoms).

    I’ll be journaling about the facts of Lyme on my SOBO thruhike this year, trying to get this information out to as many as possible.  Thanks so much for all your great AT tips and inspiration.  Best,

    Logan (Unitic)   

  •  Ticks are out all year round… no matter where you live. Why? The bacteria acts as a antifreeze and keeps the ticks alive through winter. We have several lyme patients who were bit in winter and we have people finding them on their pets. Just do as he stated, wear permethrin on your clothes and a deet repellent on your skin. Check yourself often along the trail and try to stay on trails and don’t rub against any brush if possible. I am with the Kentuckiana Lyme Support Group if you need more information, we are on Facebook.

  • Pilgrim

    I was seriously interested in getting your book. I had it on my b-day list.

    It seems very informative and interesting. However the more I have checked it out the more I am not sure about it. It seems to be filled with a lot of (to me) very offensive language. Was that really needed to enhance the book?

  • Hey Pilgram,

    Thanks for writing in.

    The book’s author (the long-winded way of saying “me”) uses profanity in his normal vocabulary. One of the most consistent praises I’ve received regarding Appalachian Trials was how personable and informal the writing style is. In order for me to be authentically personable, I have to be authentically me, which may result in the occasional potty-mouth word, although never used in a derogatory or attacking manner, but instead as a point of emphasis.

    If you find that offensive, the book likely is not for you. However, I believe others find the book to be anything but.

    Happy hiking,
    Zach

  • Siarl Bychan

    Nerve damage is not pleasant or something you ever want if you can help it. I’m prepping to go on the AT as a thru hiker and have been dreaming of this all my life. I grew up in the VA Appalachians and I can hardly wait for the day to arrive for the hike. I will be doing the hike with peripheral neuropathy…nerve damage to the extremities. Once nerve damage occurs, it’s usually permanent. The sheath covering the nerve is gone. This allows the nerves to short out or send the wrong message to the brain. The nerves may not relay to the brain that you have actually been injured if you obtain cuts, abrasions, or puncture wounds. The feet and hands (if they are both affected) will burn as if they are on fire 24 hours a day. You can’t sleep for the burning. You can’t stand it for fabrics or anything to make contact with the skin on the affected area. What feels like electrical shocks can occur suddenly and shoot up the length of the affected muscles. Sometimes it will feel as if you were bitten when nothing actually did. Or needle sticks when there isn’t anything there. Nerve damage also affects circulation and feet and the affected area can swell. Loss of circulation and nerve damage also affects the bodies healing process for the affected area. For me, most of the above doesn’t happen due to taking the right medication. However, I still have a certain percentage of loss of sensation of feeling in my legs and feet. I received the nerve damage from another cause but it’s still the same never the less. So do be aware of the ticks. I don’t want sympathy because I’m actually very lucky. I can still walk and enjoy life and it’s just another experience in life. I’m still an avid hiker. I just don’t have to worry about tired feet anymore. LOL But you don’t want it if you can help it.

  • TH

    Unitic

    Your hike on the AT for Lyme disease is wonderful to follow. Thank you for doing this special hike. I can hear in your voice how difficult it is as you heal from Lyme disease.

    A few seed ticks got me in MA when I was on a long term section hike…in the Spring of the year…there was still ice on the ground. The North had an unusual hot spell. The bacteria went in my brain. Could not spell my last name or walk up my drive without help. To share how odd it was at one point I could not even match the right letter to the right addressed envelope or could not complete a verbal sentence. Thanks to my family Dr. he kept testing me since I backpack they found out it was Lyme. I was also tested for a brain tumor.

    I pushed hard to get back in walking shape and finished the hardest one mile of the AT last summer 2012 day packing. The only camping I do is in the dead of winter with SNOW on the ground. It is hard to find people to hike with in the winter;-) Was so proud I hiked up a mountain with my backpack on this Feb. …set the tent up and enjoyed four inches of snow fall to the ground. NO TICKO’s!!

    I am doing so much better. I started hiking the AT in the late 70’s. My section hiking last over 30 years. It hurts so bad to love the woods my whole life and know a walk in the woods today could cause such strange symptoms, I miss the freedom I enjoyed for so many years. To lay back in a pile of leaves and look up at the canopy of colors in the trees…ahhhh.

    . Permethrin is a wonderful spray for clothes and gear. USE IT hiker buds.
    If you do get it…or have it.

    Prayer, love, Acupuncture, essential oils, homeopathic, chiropractic, herbs, antibiotics, energy, rife, and biofeedback, ionic foot baths, change in diet have helped me heal. I still have days when some symptoms return. Esp. if I get the flu or cold.
    I had to learn to walk this path on my own…so many of the people close to me moved on. They said I was always the strong one…so I figure it must of hurt to see me in a different way. Wow. this is the first time I have ever shared my thoughts on the Internet. I just wanted to say THANKS for what you are doing and to let other hikers know they need to be careful. It is serious. Treehuggerva

  • john

    How do you go about checking yourself. I have been dreaming about this hike. Would be alone unless I pal up on the trail. I mean if you have a tent and get in the tent, then do you take all clothes off and look? But you’d also need a mirror to check behind and you can’t see everywhere. And in summer, when wearing shorts and a t-shirt to keep cool, then on skin deet alone is enough? I think even if I could do the hike at age 69 (with prostate issues), my biggest concern would be ticks, but I’m only reading stuff in drips and drabs. THANKS!

  • Ryan

    you make me raff. (like kim jung il.) good post; i’m one of those hillbillies and greatly revere those hikers. kudos.

  • I just saw this reply Treehuggerva. I hope you are still making good progress in your recovery. It’s amazing how devastating this disease can be. Strength and Courage my friend,
    Unitic

  • Wcarter

    I’m from Colorado and found myself on the Appalachian trail in Pennsylvania for a few days this week…I’ve never been so paranoid in my life. Every tickle was a tick looking to latch on! Great hike. Great trail.

  • Tracy bramwell

    I was hiking the A.T in Vermont in late July. I covered clothes and gear in Permethrin and put in Deet and still got lyme. The tick bit me under my arm. Wear long sleeves and pants! It’s worth it.

  • nochipforme

    Teasle. is a natural plant which when the roots are used as tea, heals lyme disease.