Lyme Disease

Mistaken for juvenile rheumatoid arthritis for decades, Lyme disease was only recognized as a separate condition in 1975 in Old Lyme, Connecticut, hence the name. It is an infectious disease transmitted to humans through Ixodes ticks, which carry the Borrelia bacteria. Every year, it affects hundreds of thousands of people in the United States, but experts believe that Lyme disease is one of the most neglected and misdiagnosed conditions and that the number of people who are affected by it is much larger. Although Lyme disease is not transmissible from humans to humans through food or physical contact, it can be very dangerous when not diagnosed and treated in time. The species of ticks responsible for spreading this disease – black legged or deer ticks – can be found throughout the Northern hemisphere, predominantly in the United States, Canada and Europe, which makes Lyme disease one of the most widespread infectious diseases in the world.


Overview & Facts About Lyme Disease

According to the Center For Disease Control and Prevention, Lyme Disease affects 300,000 Americans every year, whereas in Europe there are about 67,000 reported cases annually. Because the infection is spread by ticks, the highest incidence is in the spring and summer, when people are vulnerable to bites. Lyme disease has a favorable onset provided that it is treated quickly and the awareness campaigns initiated in the past decade have played a considerable role in reducing infection rates. However, the disease remains highly dangerous, as there is no approved vaccine for it and scientists are still working on this matter. These Lyme disease facts and statistics are important in order to understand the incidence and seriousness of the disease.

  • Ever since patients have learned to recognize the symptoms of Lyme disease, the number of diagnosed cases have increased by ¼.
  • There are more than 800 cases of Lyme disease diagnosed in the US every day.
  • At present, there is no test for determining whether Lyme disease has been cured and the bacteria that caused it was eradicated.
  • Almost half of Ixodes ticks carry the bacteria that causes Lyme disease
  • When diagnosed later than 3 weeks, Lyme disease results in long term health issues
  • Although the rash is the main symptom of the disease, almost half of the patients do not have a rash and do not even recall being bitten by a tick.


Causes of Lyme Disease

The only known cause of Lyme disease is a bite from the tick carrying the bacteria. Although apart from ticks there are a few other insects who have the Borrelia bacteria, the number of Lyme diseases caused by them is extremely small. Transmission is highly unlikely because even though scientists have found traces of Borrelia DNA is breast milk and semen, they could not find any live spirochetes.

In order for the Borrelia bacteria to enter the bloodstream, the patient must be bitten by the insect and it must stay attached between 36 and 48 hours. Typically, if the tick looks swollen, it means it has fed and has most likely managed to spread the infection. Not all ticks carry the bacteria that causes Lyme disease, but people who were bitten are still advised to seek medical attention immediately, even if they do not have symptoms for weeks.


Symptoms & Diagnosis of Lyme Disease

Lyme disease is commonly associated by the general population with a red, round signature rash at the place of the bite, but it’s very important to point out that this is just one of the many Lyme disease symptoms and patients may react differently to the bite. The full list of Lyme disease symptoms includes:

  • Rash. The Lyme disease rash is very recognizable compared to other insect bites because it is oval and has a distinct pattern: it consists of a red nucleus, then a clear circle and then another red circle surrounding it. This rash is not prominent and, unlike the rashes caused by spiders and mosquitoes, it doesn’t cause itchiness, this also being one of the reasons why so many bites go unnoticed. At first, the rash can become swollen, but it does reduce in size over time and it can even go away on its own without any sort of medical treatment.

Unfortunately, the rash is not a reliable diagnosis method because it can differ from patient to patient and sometimes it may not even be there. Up to 30% of diagnosed Lyme disease patients said that they do not recall having a rash of any type and up to 50% had not seen the tick that bit them. In some cases, albeit few, the rash can manifest in other forms, such as a raised bump or a clusters of blisters, making diagnosis more difficult.

Another important thing about the Lyme disease rash is that it does not appear immediately after the bite. The skin around the insect bite may look normal a few days after the bite, but the first sign of rash can appear even after 30 days, after the infection had already started to spread.

  • Flu-like symptoms. The early stages of Lyme disease can be misdiagnosed as the flu because patients report a lasting feeling of fatigue and exhaustion. Every few weeks, they can experience the urge to sleep and are not capable of working and staying focused, sometimes to the point where they can no longer function. According to a 2013 study, 75% of Lyme disease patients experienced fatigue as a symptom and reported sleeping more than usual.

Apart from fatigue, other flu-like symptoms that may appear in Lyme disease cases include headaches and fever. These usually set in seven days after the bite and are usually confused with the flu/common cold and treated with over-the-counter drugs. The presence of flu-like symptoms is of course very confusing for patients, but one way to differentiate Lyme-disease symptoms from the flu is again the pattern. If fever, headaches, dizziness and tiredness come and go, without following the track of the flu, they are most likely something else. A flu without a sore throat, running nose or cough requires medical investigation.

  • Joint soreness and stiffness. As the infection spreads through the muscle tissue, the patient will start to experience severe and transitory episodes of joint soreness and stiffness. This pain is not limited to the location of the bite and it may not occur in the same place at the same time. For example, the patient may be unable to move their neck and two weeks later have swollen knees. More often than not, they misinterpret the pain as a sign of aging or a side effect of sedentary lifestyle and fail to seek treatment.
  • Confusion and difficulty concentrating. Patients with Lyme disease can experience a number of disturbances in terms of focusing. Young people who carry the infection may start to have poor performance in school and may not be able to remember new information. In advanced stages, the symptoms may even resemble those of Alzheimer’s, as the patient has short term memory lapses and does not remember how they got in a certain place. At times, the patient may feel confused and unable to focus because Lyme disease also causes irregular sleep patterns.
  • Light sensitivity and blurry vision. Lyme disease also causes light sensitivity, including to artificial light, as well as vision changes.


Because the diversity and irregularity of Lyme disease symptoms, Lyme disease is one of the most undiagnosed conditions. Many people do not experience a rash and do not see the tick that bit them, which makes Lyme disease diagnosis easy to miss. What is more, the Lyme disease screening that is done at present does not have a high degree of accuracy and many patients receive a negative result. To increase the chance of an accurate diagnosis, patients are encouraged to take photos of their rashes as soon as they seem and go to a specialist for further investigation, even if the rash goes away. If the patient managed to remove the tick within the first 48 hours, the chances of infection are low, but a screening is still recommended.


Lyme Disease Treatment & Care

Lyme disease treatment includes the use of antibiotics of antibiotics amoxicillin and tetracycline for a period between 10 and 21 days. Other antibiotics such as cefuroxime and doxycycline may also be recommended. When diagnosed in the early states, Lyme disease treatment is successful the patient makes a full recovery.

Specialists do not recommend antibiotic treatment for more than 21 days, unless the patient experiences join pain again. In general, success is estimated based on the absence of symptoms, as currently there isn’t a test to check whether there are remaining traces of bacteria in the blood.


Lyme Disease Risk Factors & Prevention

A Lyme disease vaccine was launched on the market in 1998, but because of its cost and alleged side effects, it was withdrawn in 2002. Scientists are currently working on developing a new vaccine, but, until then, the population can only prevent Lyme disease by avoiding risk factors – namely, the tick bite:

  • Covering the body as much as possible when in a park, forest or any other area where ticks live; wearing long sleeved tops, long pants and socks. White clothes are preferable because the tick is easier to spot before it manages to bite.
  • Avoiding places with tall grass, wood and bushes
  • Sitting directly on the grass
  • Having a pet increases the risk of contracting Lyme disease, because animals may have ticks. Pets should be checked for ticks on a regular basis and administered preventive solutions.
  • Applying tick-repellant before spending time outside. The only chemical that successfully repels ticks is DEET. The other substance, Permethrin, only kills ticks, but does not repel them.
  • If the patient senses a tick on their body, they can attempt to remove it using tweezers. The tick should be removed from the base and its little pincers should not remain attached to the skin. After it was removed, the place where it bit should be thoroughly washed with water, soap and rubbing alcohol. However, ticks are much stronger than they seem and they can be difficult to remove completely and correctly, which is why specialists advise people to rush to the nearest hospital as soon as possible so a professional can remove the tick.
  • If the tick was successfully removed at home or another non-controlled environment, it should be killed and disposed of correctly, otherwise it will keep on moving and bite someone else. To dispose of a tick, you can either put in a glass of water with soap/alcohol or flush it down the toilet.
  • People who spend time in tick-friendly environments should shower as soon as they get home, as this allows them to closely inspect their skin, find ticks and remove them as soon as possible.
  • Not every tick carries the Borrelia bacteria and infection usually occurs if the tick managed to feed for more than 48 hours, but, to be safe, people who still have the bite checked even if they were able to remove the tick and they do not have any symptoms. After removing the tick and inspecting the place of the bite, your doctor may ask you to carefully monitor your health for the following weeks and report any symptom that may otherwise seem harmless, such as headaches, joint pain or fever.
  • When going on vacation, tourists should check the incidence of Lyme disease in that area, at the time of visit. If there are many reported cases, they should carry a DEET repellant in their luggage.

The most notable Lyme disease risk factors are contact with ticks in their habitats or pets, which can become their hosts.


Complications of Lyme Disease

Lyme disease is a serious infectious disease that can cause additional health problems if left untreated. Some of the most common Lyme disease complications include:

  • Long term neurological defects such as memory loss
  • Lyme arthritis, a chronic disease that causes the inflammation of the joints
  • Irregular heart rhythm and palpitations
  • Persistent hand and feet pain

Last updated on March 2nd, 2018

Chris Riley

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