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Lyme Disease: Symptoms, Diagnosis and Treatment Information

  • Revised/Updated: 2019/07/01
  • Synopsis : Information on Lyme Disease a health condition contracted through the bite of infected Black Legged Ticks.

Untreated Lyme disease can spread to the nervous system and to the heart, as well as to the joints.

Lyme disease is transmitted to humans via black-legged ticks, also known as deer ticks.


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According to the U.S. Centers for Disease Control, there are more than 300,000 cases of Lyme disease in the U.S. each year. In 2013 most Lyme disease cases reported to the CDC were concentrated heavily in the Northeast and upper Midwest, with 96 percent of cases in 13 states. In fact, the disease gets its name from the northeastern town of Lyme, Connecticut, where it was first discovered.

The bacterium, 'Borrelia Burgdorferi,' causes Lyme disease, which is transmitted to people through the bite of infected Black-Legged Ticks. Symptoms of Lyme disease involve headaches, fevers, fatigue and a skin rash known as, 'Erythema Migrans.'

Untreated Lyme disease can spread to the nervous system and to the heart, as well as to the joints.

A diagnosis of Lyme disease is reached through lab testing, exhibited symptoms, and physical findings such as the characteristic rash associated with it, as well as potential exposure to ticks. Laboratory testing and results are most helpful when Lyme disease is in its later stages. In the majority of cases of Lyme disease, antibiotic treatment is successful. Prevention of Lyme disease involves taking steps such as using insect repellents, integrated pest management, and landscaping, as well as promptly removing ticks which can transmit additional diseases in addition to Lyme disease.

Transmission

Squirrels, Mice, and other small animals are carriers of Lyme disease; however, Lyme disease is transmitted to human beings through a specific species of ticks. The Black-Legged Tick, also known as the, 'Deer Tick,' found in the United States is a transmitter of Lyme disease in north-central and north-eastern areas. Along the Pacific coastal areas, the Western Black-Legged Tick is a transmitter of the disease. There are many additional species of ticks to be found in America; they haven't been found to transmit Lyme disease.

Symptoms

Picture of an adult Deer Tick with tick removal instructions using tweezers.
Picture of an adult Deer Tick with tick removal instructions using tweezers.

One of the first signs of a Lyme disease infection is usually a circular rash referred to as, 'Erythema Migrans,' which affects about seventy to eighty percent of the people who are infected after a delay of three to thirty days. The rash appears around the area of the tick bite, and expands over a period of days, potentially to a size of up to twelve inches across. An interesting feature of the rash is that the center of the rash might clear as it grows larger, making it resemble a bull's-eye. The person affected might go on to develop additional rashes on their body as days go by; the rashes may be warm, but are usually not painful. The person can also experience symptoms such as chills, fevers, fatigue, muscle and joint aches, and headaches. Sometimes these symptoms are the only ones a person will experience.

People who contact Lyme disease may experience it in different ways. Not everyone has all of the same symptoms, and the symptoms associated with Lyme disease occur with other diseases too. Lyme disease has the potential to infect many different parts of the human body, and to create various symptoms at different times. If you have been bitten by a tick and suspect that you may have Lyme disease it is important to contact a healthcare provider as soon as possible.

Early Signs and Symptoms (3 to 30 days after tick bite) may include; fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes.

Erythema migrans (EM) rash:

  • May appear on any area of the body
  • May feel warm to the touch but is rarely itchy or painful
  • Occurs in approximately 70 to 80 percent of infected persons
  • Sometimes clears as it enlarges, resulting in a target or "bull's-eye" appearance
  • Begins at the site of a tick bite after a delay of 3 to 30 days (average is about 7 days)
  • Expands gradually over a period of days reaching up to 12 inches or more (30 cm) across

The ticks which spread Lyme are typically no larger than a sesame seed, or the size of a period at the end of a sentence. It is thought that nymphs infect more humans than adult ticks because they are so hard to see. The ticks saliva contains an anesthetic like substance so you may not feel the bite. Picture Credit: Bay Area Lyme Foundation.
The ticks which spread Lyme are typically no larger than a sesame seed, or the size of a period at the end of a sentence. It is thought that nymphs infect more humans than adult ticks because they are so hard to see. The ticks saliva contains an anesthetic like substance so you may not feel the bite. Picture Credit: Bay Area Lyme Foundation.

Later Signs and Symptoms (days to months after tick bite)

  • Nerve pain
  • Problems with short-term memory
  • Severe headaches and neck stiffness
  • Inflammation of the brain and spinal cord
  • Episodes of dizziness or shortness of breath
  • Additional EM rashes on other areas of the body
  • Intermittent pain in tendons, muscles, joints, and bones
  • Shooting pains, numbness, or tingling in the hands or feet
  • Heart palpitations or an irregular heart beat - Lyme carditis
  • Facial palsy (loss of muscle tone or droop on one or both sides of the face)
  • Arthritis with severe joint pain and swelling, particularly the knees and other large joints.

Diagnosing Lyme Disease

A diagnosis of Lyme disease is made based upon the symptoms the patient presents, any objective physical findings such as the characteristic, 'bulls-eye,' rash in company with arthritis or facial palsy, as well as a potential exposure to a tick bite.

Blood Tests

Tests for antibodies in the blood by ELISA and Western blot is the most widely used method for Lyme diagnosis.

A two-tiered protocol is recommended by the Centers for Disease Control and Prevention (CDC): the sensitive ELISA test is performed first, and if it is positive or equivocal, then the more specific Western blot is run.

Treatment and Prognosis

People who receive recommended antibiotic treatment within several days of appearance of an initial EM rash have the best prospects.

Most cases of Lyme disease can be effectively treated with 2 to 4 weeks of antibiotics. Depending on the symptoms and when you were diagnosed, you may require a longer course or repeat treatment with antibiotics.

Some people experience symptoms that continue more than 6 months after treatment. Research continues into the causes of these persistent symptoms and possible treatment methods.


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