Living with Lyme Disease
It’s summer time and the perfect excuse for a nature hike. But you might come back with more than some lovely memories. You could get a tick bite that will deliver a raging case of Lyme disease.
Lyme disease is caused by a bacteria Borrelia burgdorferi. The disease was first recognized in 1975 when large groups of children were diagnosed with juvenile rheumatoid arthritis in Lyme, Connecticut and two neighboring towns. It was discovered that bites from deer ticks infected with the bacterium were responsible for the illness. Wood ticks and dog ticks don’t carry the infection.
The ticks do not just live on deer but also on rodents, birds, and other host animals. Deer do not harbor the bacteria that cause Lyme disease, but certain other hosts such as white-footed mice do, and ticks pick up the bacteria by feeding on these infected hosts.
The life cycle and prevalence of deer ticks is strongly influenced by temperature. Deer ticks thrive when temperatures are above 45 degrees Fahrenheit and in areas with at least 85 percent humidity.
Lyme season typically peaks from May to July but with climate change the season can be expanded which means people need to be more educated about the dangers of these pests.
According to the Centers for Disease Control and Prevention, based on insurance records each year approximately 476,000 Americans are diagnosed and treated for Lyme disease.
The most common symptom of Lyme disease is a bull’s eye rash known as erythema migrans (EM) that appears as a small red spot at the site of the tick bite about 1 to 4 weeks after the bite. Eventually the rash can range from the size of a dime to the entire width of a person’s back. As the infection spreads, several rashes can occur on different sites on the body.
Other symptoms include a fever, headache, stiff neck, body and joint aches, fatigue or a fever with swollen glands that lasts from a few days to a few weeks. Left untreated, you may develop multiple areas of rash, paralysis of facial muscles (Bell’s palsy), heart block (which is the interruption of the electrical system of the heart), or areas of numbness or abnormal sensation (neuropathy).
Untreated late Lyme disease is most often associated with recurring episodes of swollen joints (arthritis) typical of large joints such as the knee. This can continue to occur months to a year after the initial infection. Additionally, some patients may develop problems with concentration such as “brain fog” (encephalopathy).
Lyme disease is often difficult to diagnose because tick bites are usually painless and symptoms mimic other diseases. If no rash is present, a doctor can take a full medical history and a careful physical examination as well as laboratory tests to confirm suspicions about having the disorder.
Risk factors for developing Lyme disease are spending time in grassy or woodsy areas, being exposed (not wearing long sleeve or long pants in these areas), and not removing ticks promptly or properly.
To diagnose Lyme disease, your doctor will perform tests such as enzyme-linked immunosorbent assay (ELISA) test, which is used most often to detect Lyme disease by detecting antibodies to the bacteria B. burgdorferi. Your physician may also perform a Western blot test if the ELISA test is positive. The Western blot test detects antibodies of several proteins of B. burgdorferi.
Antibiotics are used to treat Lyme disease and the sooner the better to conquer those symptoms. Oral antibiotics are the standard treatment for early-stage Lyme disease. These usually include doxycycline for adults and children older than 8, or amoxicillin or cefuroxime for adults, younger children, and pregnant or breast-feeding women. A 14 to 21 day course of antibiotics is usually recommended but studies recommending 10 to 14 days may be equally effective.
Intravenous antibiotics may be recommended if the infection involves the central nervous system. Your doctor may recommend treatment with an intravenous antibiotic for 14 to 28 days. This will work to eliminate the infection although it may take time to recover. Please note intravenous antibiotics may cause various side effects such as a lower white blood cell count, mild to severe diarrhea, or colonization or infection with other antibiotic-resistant organisms unrelated to Lyme.
Some helpful tips to avoid Lyme disease are to cover up with light colored long sleeve and long pants stuffed into your socks in areas known for deer ticks. Also spray yourself and your clothing with DEET-based sprays. Spray clothing before you put them on or buy clothes that are pretreated with permethrin. Some people even suggest throwing your clothing into the dryer after wearing them in a tick filled environment. Washing in the washing machine doesn’t necessarily kill ticks. Don’t forget to remove the tick with tweezers. Improper removal may result in further infection.
By taking certain precautions, you can stop Lyme disease in its tracks and continue to enjoy the great outdoors despite those pesky ticks. If you have any experience with Lyme disease don’t be afraid to let me know in the comments.
