Lyme Disease: Symptoms, Treatment, Prevention

Overview

Lyme disease is an infectious condition transmitted to humans through bites of lxodes ticks, also known as deer ticks, or black-legged ticks on the West Coast of the United States. The bacterium causing the disease is Borrelia burgdorferi. The common sign of the disease is an expanding area of redness on the skin appearing at the site of the tick bite.

In the United States, recent estimates suggest that approximately 300,000 people may get Lyme disease each year. In 2017, reported proportion of cases was 1 person out of 17. Luckily enough, noticing the early signs of Lyme disease and getting timely treatment can greatly reduce the severity and length of symptoms. Even when the infection is found much later, antibiotic treatment is still effective for most people.

Cause

Lyme disease results from the spread of Borrelia burgdorferi bacteria living inside infected ticks. The ticks may become infected after feeding on infected deer or mice. Most people get Lyme from the bite of the nymphal, or immature, form of the tick. They are about the size of a poppy seed. Because they are so tiny and their bite is painless, many people do not even realize they have been bitten.

Once a tick has attached, if undisturbed it may feed for several days. The longer it stays attached, the more likely it will transmit the Lyme and other pathogens into your blood.

Lyme disease can affect people of all ages. But studies indicate that it is most common in children, older adults, and others such as firefighters and park rangers who spend time in outdoor activities and have higher exposure to ticks.

Symptoms

Lyme disease signs and symptoms vary depending on the different stages of infection.

At the early stage, which is about 3 to 30 days after a tick bite, general symptoms include:

  • Erythema migrans (EM) rash

This may be the most common sign of an early infection, occurring in nearly 70-80% of infected people. The rash may feel warm to the touch but is rarely painful or itchy. Sometimes it may enlarge to a “bull’s-eye” appearance.

  • Other symptoms.

Fever, chills, fatigue, headaches, neck stiffness and swollen lymph nodes can accompany the EM rash.

If untreated, new signs and symptoms of Lyme infection might appear in the following weeks to months. These later signs and symptoms include:

  • Joint pain and swelling in one or more joints
  • Severe headaches and neck stiffness
  • EM rash on other parts of your body
  • Brain disorders involving memory, mood, and sleep
  • Numbness or weakness in your limbs
  • Impaired muscle movement

In several weeks after the infection, less commonly seen signs and symptoms of Lyme disease are:

  • Disturbances in heart rhythm
  • Eye inflammation
  • Liver inflammation
  • Severe fatigue

Diagnosis

Doctors will begin the diagnosis with the assessment of your medical history and a physical exam. Several weeks after the initial infection, a two-staged blood test may be the most accurate way to detect Lyme disease. The two stages are:

  • Enzyme-linked immunosorbent assay (ELISA) test.

This test is to looks for certain antibodies that are the immune system’s response to the bacterium infection. But it can sometimes provide false-positive results, so it’s not the sole basis for diagnosis.

This test might not be positive during the early stage of Lyme disease, but the rash is distinctive enough to make the diagnosis without further testing in people who live in areas infested with ticks that transmit Lyme disease.

  • Western blot to confirm a positive ELISA test by checking the presence of antibodies to specific B. burgdorferi proteins

Another test, Polymerase chain reaction (PCR), can also be helpful in evaluating people with persistent Lyme arthritis or nervous system symptoms.

Treatment

Early treatment is important for Lyme disease. It is a simple 2 to 3 weeks of oral antibiotics to eliminate all traces of infection. However, patients with arthritis may need longer treatment (four weeks) with oral antibiotics. Medications used to treat Lyme disease include:

If problems in central nervous system occur, your doctor might recommend treatment with an intravenous antibiotic for 14 to 28 days. This is effective in eliminating infection, although it may take you some time to recover from your symptoms.

Prevention

Avoiding bites from ticks is the most direct way to prevent Lyme disease. Ticks can’t fly or jump, but instead live in shrubs and bushes, and grab onto someone when they pass by. So, you can take the following steps:

  • Wear long pants and long-sleeve shirts when in the outdoors
  • Use insect repellents with a 20 percent or higher concentration of DEET to your skin
  • Make your yard unfriendly to ticks by clearing wooded areas, keeping underbrush to a minimum, and putting woodpiles in areas with lots of sun
  • Check your clothing, yourself, your children and your pets for ticks
  • Avoid the thought that you are immune to ticks after getting Lyme disease once
  • Remove a tick as soon as possible with tweezers upon finding it

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.