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Lyme disease is caused by four different types of bacteria. Borrelia burgdorferi and Borrelia mayonii are the most common pathogens in the United States, while Borrelia afzelii and Borrelia garinii are the most common in Europe and Asia. Lyme disease, the most common tick-borne illness in these areas, is spread by the bite of an infected black-legged tick, also known as a deer tick.
If you live or spend time in grassy or heavily wooded areas where ticks carrying Lyme disease thrive, you are more likely to contract the disease. In tick-infested areas, it's critical to take common-sense precautions.
WHAT ARE THE SYMPTOMS OF LYME DISEASE?
Lyme disease has a wide range of signs and symptoms. They typically manifest in stages, but the stages can overlap.
Early signs and symptoms
A small, red bump, similar to a mosquito bite, frequently appears at the site of a tick bite or tick removal and resolves within a few days. This is a common occurrence and does not indicate Lyme disease.
However, these signs and symptoms can appear within a month of being infected:
Rash: An expanding red area that sometimes clears in the center, forming a bull's-eye pattern, may appear three to 30 days after an infected tick bite. The rash (erythema migrans) spreads slowly over days and can reach a diameter of 12 inches (30 centimeters). It is not usually itchy or painful, but it may feel warm to the touch.
The rash Erythema migrans is one of the hallmarks of Lyme disease, though it does not appear in every case. Some people get this rash in more than one location on their bodies.
Other symptoms: The rash may be accompanied by fever, chills, fatigue, body aches, headache, neck stiffness, and swollen lymph nodes.
Signs and symptoms that are less common
Some people develop the following symptoms several weeks after infection:
- Heart issues, such as an irregular heartbeat
- Inflammation of the eyes
- Inflammation of the liver (hepatitis)
- Extreme exhaustion
Signs and symptoms that develop later
If left untreated, new signs and symptoms of Lyme disease may appear in the coming weeks or months. These are some examples:
Erythema migrans: The rash could spread to other parts of your body.
Joint pain: Severe joint pain and swelling are most likely to affect your knees, but the pain can shift from joint to joint.
Neurological issues: You may develop inflammation of the membranes surrounding your brain (meningitis) weeks, months, or even years after infection, as well as temporary paralysis of one side of your face (Bell's palsy), numbness or weakness in your limbs, and impaired muscle movement.
WHAT ARE THE CAUSES OF LYME DISEASE?
Lyme disease is caused in the United States by the bacteria Borrelia burgdorferi and Borrelia mayonii, which are primarily transmitted by black-legged or deer ticks. Young brown ticks are frequently no bigger than a poppy seed, making them nearly impossible to detect.
To get Lyme disease, you must be bitten by an infected deer tick. The bacteria enter your skin via the bite and eventually enter your bloodstream.
In most cases, a deer tick must be attached for 36 to 48 hours in order to transmit Lyme disease. If you find a swollen attached tick, it may have fed long enough to transmit bacteria. Remove the tick as soon as possible to avoid infection.
WHAT ARE THE RISK FACTORS OF LYME DISEASE?
Your chances of contracting Lyme disease can be influenced by where you live or vacation. Your profession, as well as the outdoor activities you enjoy, can be affected. The following are the most common risk factors for Lyme disease:
- Spending time in the woods or on the grass: Deer ticks are mostly found in the heavily wooded areas of the Northeast and Midwest of the United States. Children who spend a lot of time outside in these areas are especially vulnerable. Adults who work outside are also at a higher risk.
- Having bare skin: Ticks are attracted to bare skin. If you live in a tick-infested area, protect yourself and your children by wearing long sleeves and pants. Allow your pets to roam freely in tall weeds and grasses.
- Not removing ticks as soon as possible or as thoroughly as possible: If a tick bite remains attached to your skin for 36 to 48 hours or longer, bacteria from the tick can enter your bloodstream. If you remove a tick within two days, your chances of contracting Lyme disease are slim.
WHAT ARE THE COMPLICATIONS OF LYME DISEASE?
Lyme disease, if left untreated, can lead to:
- Chronic joint inflammation (Lyme arthritis), particularly in the knee
- Neurological symptoms, like facial palsy and neuropathy
- Cognitive defects, such as impaired memory
- Irregular heart rhythm
HOW IS LYME DISEASE DIAGNOSED?
Many of the signs and symptoms of Lyme disease are also found in other conditions, making diagnosis difficult. Furthermore, ticks that transmit Lyme disease can spread other diseases as well.
If you don't have the typical Lyme disease rash, your doctor will likely ask about your medical history, including whether you've been outdoors during the summer, where Lyme disease is common, and will perform a physical exam.
Antibodies to the bacteria can be identified in lab tests, which can help confirm or rule out the diagnosis. These tests are most accurate a few weeks after an infection, when your body has had time to produce antibodies. They are as follows:
- Enzyme-linked immunosorbent assay (ELISA) test: The most commonly used Lyme disease test, ELISA, detects antibodies to Borrelia burgdorferi. However, because it can occasionally produce false-positive results, it is not used as the sole basis for diagnosis.
Although this test may not be positive in the early stages of Lyme disease, the rash is distinct enough to make the diagnosis without further testing in people who live in areas infested with ticks that transmit Lyme disease.
- Western blot test: If the ELISA test results are positive, this test is typically performed to confirm the diagnosis. The Western blot detects antibodies to several B. burgdorferi proteins in this two-step approach.
WHAT ARE THE TREATMENTS FOR LYME DISEASE?
Lyme disease is treated with antibiotics. In general, the earlier treatment begins, the faster and more complete the recovery.
Antibiotics
- Oral antibiotics: These are the standard treatments for Lyme disease in its early stages. Doxycycline is usually prescribed for adults and children over the age of eight, while amoxicillin or cefuroxime is prescribed for adults, younger children, and pregnant or breast-feeding women.
Antibiotic courses lasting 14 to 21 days are typically recommended, but some studies suggest that courses lasting 10 to 14 days are equally effective.
- Intravenous antibiotics: If the disease affects the central nervous system, your doctor may advise you to take an intravenous antibiotic for 14 to 28 days. This is effective at removing infection, but it may take some time for you to recover from your symptoms.
Intravenous antibiotics can cause a drop in white blood cell count, mild to severe diarrhea, and colonization or infection with antibiotic-resistant organisms unrelated to Lyme disease.
Following treatment, a small number of people continue to experience symptoms such as muscle aches and fatigue. The cause of these persistent symptoms, known as post-treatment Lyme disease syndrome, is unknown, and treating with additional antibiotics is ineffective.
Some experts believe that certain people who contract Lyme disease are predisposed to developing an autoimmune response, which contributes to their symptoms. More investigation is required.
Alternative medicine
The only proven treatment for Lyme disease is antibiotics. Some people with unexplained symptoms or chronic disease may believe they have Lyme disease even if it has not been diagnosed. People with Lyme disease or those who suspect they have Lyme disease can find relief through a variety of alternative treatments.
Unfortunately, these treatments have either not been tested or have not been proven effective by scientific evidence. They can be harmful, even lethal, in many cases. If you're thinking about trying alternative treatments for Lyme disease, consult your doctor first.
HOW CAN LYME DISEASE BE PREVENTED?
Avoiding areas where deer ticks live, especially wooded, bushy areas with long grass, is the best way to avoid Lyme disease. With a few simple precautions, you can reduce your risk of contracting Lyme disease:
- Cover up: Wear shoes, long pants tucked into socks, a long-sleeved shirt, a hat, and gloves when walking through wooded or grassy areas. Avoid walking through low bushes and long grass by staying on trails. Keep your dog on a leash at all times.
- Make use of insect repellents: Apply insect repellent with a DEET concentration of 20% or higher to your skin. Parents should apply repellent to their children's hands, eyes, and mouth while avoiding their hands, eyes, and mouth.
Keep in mind that chemical repellents can be toxic, so carefully follow the directions. Apply permethrin-containing products to clothing or purchase pretreated clothing.
- Make every effort to keep ticks out of your yard: Remove tick-infested brush and leaves. Maintain a regular lawn mowing schedule. Stack wood neatly in dry, sunny areas to deter tick-carrying rodents.
- Check your clothing, yourself, your children, and your pets for ticks: After spending time in wooded or grassy areas, be especially cautious. Deer ticks are often no bigger than the head of a pin, so unless you search thoroughly, you may miss them.
It's a good idea to shower as soon as you get inside. Ticks will frequently remain on your skin for several hours before attaching themselves. Unattached ticks may be removed by showering and using a washcloth.
- Don't assume you're immune: Lyme disease can be contracted more than once.
- Tweezers should be used to remove a tick as soon as possible: Grip the tick gently near its head or mouth. Pull carefully and steadily, rather than squeezing or crushing the tick. Once you've removed the entire tick, dispose of it by soaking it in alcohol or flushing it down the toilet, and treat the bite area with antiseptic.