Summary about Disease
Borrelia burgdorferi* infection, commonly known as Lyme disease, is a bacterial infection primarily transmitted to humans through the bite of infected blacklegged ticks (also known as deer ticks). The disease can affect multiple body systems, including the skin, joints, heart, and nervous system. Early diagnosis and treatment are crucial to prevent severe and chronic complications.
Symptoms
Early-stage (3-30 days after tick bite):
Erythema migrans (EM) rash: A characteristic "bullseye" rash that expands from the site of the tick bite.
Fever
Chills
Fatigue
Headache
Muscle and joint aches
Swollen lymph nodes
Late-stage (weeks to months after bite):
Severe joint pain and swelling (Lyme arthritis), particularly in the knees
Neurological problems:
Facial palsy (Bell's palsy)
Numbness or weakness in limbs
Meningitis (inflammation of the membranes surrounding the brain and spinal cord)
Impaired muscle movement
Heart problems (Lyme carditis):
Irregular heartbeat (arrhythmia)
Eye inflammation
Liver inflammation (hepatitis)
Severe fatigue
Causes
Lyme disease is caused by the bacterium Borrelia burgdorferi*.
Transmission occurs through the bite of infected blacklegged ticks (deer ticks). These ticks acquire the bacteria by feeding on infected animals, such as mice and deer.
The tick must usually be attached for at least 36-48 hours to transmit the bacteria.
Medicine Used
Antibiotics: The primary treatment for Lyme disease is antibiotics.
Early-stage: Oral antibiotics like doxycycline, amoxicillin, or cefuroxime axetil are typically prescribed for 10-21 days.
Late-stage: Intravenous antibiotics like ceftriaxone or penicillin may be necessary for more severe cases, especially those involving neurological or cardiac complications. The duration of treatment varies depending on the severity and location of the infection.
Is Communicable
Lyme disease is not communicable from person to person. It can only be transmitted through the bite of an infected tick.
Precautions
Avoid tick-infested areas: Stay on cleared trails when hiking and avoid wooded, brushy areas with high grass.
Use insect repellent: Apply insect repellent containing DEET, picaridin, or IR3535 to skin and clothing. Follow product instructions carefully.
Wear protective clothing: Wear long sleeves, long pants tucked into socks or boots, and light-colored clothing to make ticks easier to spot.
Check for ticks: Thoroughly check yourself, your children, and pets for ticks after spending time outdoors. Pay close attention to areas like the hairline, ears, armpits, groin, and behind the knees.
Remove ticks promptly and properly: Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible. Pull upward with steady, even pressure. Do not twist or jerk the tick, as this can cause the mouthparts to break off and remain in the skin. After removing the tick, clean the bite area and your hands with rubbing alcohol or soap and water.
Shower soon after being outdoors: Showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease.
Tick-proof your yard: Clear brush and leaf litter around your house, mow the lawn frequently, and create a barrier of wood chips or gravel between your lawn and wooded areas.
How long does an outbreak last?
An "outbreak" is not quite the right term for Lyme disease. Lyme disease is endemic to certain areas meaning it is consistently present. If untreated, the effects of a Borrelia burgdorferi* infection can last for months, years, or even a lifetime. With prompt antibiotic treatment, the acute infection can be cleared within a few weeks. However, some individuals may experience post-treatment Lyme disease syndrome (PTLDS), where symptoms like fatigue, pain, and cognitive difficulties persist for months after treatment.
How is it diagnosed?
Diagnosis is based on a combination of factors:
Symptoms: Presence of the characteristic EM rash or other symptoms consistent with Lyme disease.
Tick exposure: History of tick bite or living in an area known to have Lyme disease.
Blood tests:
ELISA (enzyme-linked immunosorbent assay): This is the first test usually performed. If positive or equivocal, it's followed by a confirmatory test.
Western blot: This test is used to confirm a positive or equivocal ELISA result. It detects antibodies to specific proteins of Borrelia burgdorferi.
Important Note: Blood tests may be negative in the early stages of the infection because it takes time for the body to produce antibodies.
Timeline of Symptoms
Days 3-30 (Early Localized):
Erythema migrans (EM) rash (classic bullseye rash) at the site of the tick bite (not always present)
Flu-like symptoms: fever, chills, fatigue, headache, muscle aches, joint pain, swollen lymph nodes
Weeks to Months (Early Disseminated):
Multiple EM rashes (smaller and less distinct than the initial rash)
Severe headache and neck stiffness
Facial palsy (Bell's palsy)
Pain, weakness, or numbness in the arms or legs
Heart problems (Lyme carditis): irregular heartbeat, chest pain, shortness of breath
Months to Years (Late Disseminated):
Lyme arthritis: severe joint pain and swelling, particularly in the knees
Neurological problems: chronic encephalitis (inflammation of the brain), memory loss, difficulty concentrating, sleep disturbances
Skin changes: acrodermatitis chronica atrophicans (ACA) – a bluish-red discoloration and thinning of the skin, usually on the extremities
Important Considerations
Early diagnosis and treatment are essential to prevent long-term complications.
Not everyone who is bitten by an infected tick will develop Lyme disease. The risk of infection depends on the length of time the tick is attached and the prevalence of Borrelia burgdorferi in the tick population.
Post-treatment Lyme disease syndrome (PTLDS): Some individuals may experience persistent symptoms such as fatigue, pain, and cognitive difficulties after antibiotic treatment. The cause of PTLDS is not fully understood, and treatment is focused on managing symptoms.
Co-infections: Ticks can transmit other diseases besides Lyme disease, such as anaplasmosis, babesiosis, and Powassan virus. Patients should be aware of the possibility of co-infections and discuss any unusual symptoms with their doctor.
Consult a healthcare professional for diagnosis and treatment if you suspect you may have Lyme disease.