Lyme Disease

Lyme disease got its name after an outbreak of arthritis near Lyme, Connecticut in 1975. Since then Lyme disease has skyrocketed in parts of the country.

The Centers for Disease Control and Prevention (CDC) say there are three hot spots for Lyme disease in the United States:

• Northeast and mid-Atlantic states from Massachusetts to Maryland, spreading north and south along the coast and inland
• North-central states especially Wisconsin and Minnesota, spreading in all directions
• West coast particularly northern California, spreading north

The disease however is not isolated to these areas.

Cause

Blame a very small wood tick for a very big disease. Lyme disease is caused by two types of bacteria, Borrelia burgdorferi and another closely related bacterium, Borrelia mayonii. (Read about "Microorganisms") They are carried by various black-legged ticks. The main culprit in the Northeast and North-central states is the deer tick, which normally feeds on the white-footed mouse and the white tail deer. The mice and deer act as a reservoir for the bacteria, which the ticks pick up and pass on to their next host. The American Lyme Disease Foundation says studies show that it takes a tick 36 to 48 hours to pass the bacteria on to humans.

Diagnosis

In its early stages, Lyme disease is diagnosed by symptoms and evidence of a tick bite. According to the American Lyme Disease Foundation, blood tests aren't always reliable for Lyme disease especially early in the disease's progress. (Read about "Laboratory Testing") If you suspect you have been bitten by a tick, it is imperative that you share that with your doctor so he or she can make an informed diagnosis.

Symptoms

If caught in its earliest stages Lyme disease is almost always successfully treated, so it's important that symptoms not be ignored. The first sign, of course, is a tick that you find that has bitten you. But these ticks are tiny and often go unnoticed. They tend to hide in moist, hairy portions of the body such as armpits, the groin and the scalp.

The first sign most people see is an expanding rash called erythema migrans or EM. B. burgdorferi's is a bull's eye rash, it tends to be round and expand from a central spot sometimes with rings. The rash shows up in over 80 percent of the cases according to the Lyme Disease Foundation. It will show 3 to 30 days after the bite by an infected tick. CDC says the rash caused by B. mayonii tends to be more diffused.

The Arthritis Foundation says some of the other early symptoms of Lyme disease are flu like symptoms such as:

• fatigue
• chills and fever
• headache
• muscle and joint pain
• swollen lymph nodes
• nausea and vomiting

These signs don't necessarily mean you have Lyme disease but they are an important diagnostic tool for your doctor. If treated early with antibiotics, Lyme disease can be successfully treated so do not delay seeing your physician.

The National Institute of Neurological Disorders and Stroke (NINDS) says, if untreated in its early stages, Lyme disease can affect the brain and the rest of the nervous system. (Read about "The Brain" "Nervous System") Neurological complications most often occur in the second stage of Lyme disease, with numbness, pain, weakness, Bell's palsy (paralysis of the facial muscles), visual disturbances, and meningitis symptoms such as fever, stiff neck, and severe headache. (Read about "Bell's Palsy" "Encephalitis & Meningitis") Other problems, which may not appear until weeks, months, or years after a tick bite, include decreased concentration, irritability, memory and sleep disorders (Read about "Sleep") and nerve damage in the arms and legs. (Read about "Peripheral Neuropathy")

Treatments & complications

Treatment of early stage Lyme disease - that means in the first few weeks after infection - is pretty routine. Oral antibiotics (Read about "Antibiotics") almost always result in a successful treatment, according to the American Lyme Disease Foundation. Patients diagnosed with later stage Lyme disease also often respond to antibiotics. Some patients continue to have problems after being treated because of damage caused by the disease. There can also be heart problems including inflammation and heart rate irregularities. (Read about "Arrhythmia")

Arthritis may also develop if Lyme disease is not treated. (Read about "Arthritis and Rheumatic Diseases") According to the Arthritis Foundation, pain and swelling may occur in a few large joints. The most common joint to be affected by arthritis is the knee. (Read about "The Knee") The arthritis is often temporary, but some people with Lyme disease will develop chronic Lyme arthritis if untreated. According to the Food and Drug Administration (FDA) there is some evidence that these people are genetically (Read about "Genetics") predisposed to overreact to the Lyme bacterium, extending the normal inflammatory response to infection or injury. Lyme arthritis differs from rheumatoid arthritis (Read about "Rheumatoid Arthritis") in that it tends to come and go and affects two or three joints, rather than producing an all-over effect. FDA says new skin outbreaks, usually smaller than the first, may appear in the later stages too.

Prevention and control

The best thing of course is never to get the disease. You do that by avoiding ticks, where they live, and by being vigilant.

The first thing to do is don't give ticks an inviting place around your home. That means clearing brush, low hanging branches and tall grass from near your house, yard and garden. When you are outdoors, CDC says there are precautions to take:

• Wear shoes, socks and light colored clothing to spot ticks easily
• Tuck long pants into socks and your shirt into your pants
• Scan your clothing and exposed skin, especially if you are wearing shorts, frequently looking for ticks
• Careful use of an insect repellent is often recommended; ask your doctor about this, especially as far as children are concerned (For more on repellents, read about "Insect Bites")
• Wear a hat and a long sleeve shirt if possible
• Avoid sitting on the ground or stone walls
• Stay in the center of hiking trails avoiding tall grass and open fields
• Do a full body check at the end of the day for ticks, paying particular attention to scalp and other hairy portions of the body

Wash and dry the clothes you had on at high temperatures to kill any hidden ticks. Also, remember that a tick will climb up looking for exposed skin. That's why you need to keep them off your clothes.

Finding a tick

Finding a tick isn't a reason to panic. The National Institutes of Health (NIH) say studies show it takes 36 to 48 hours for the bacteria to be passed on; therefore if you are checking yourself and your family carefully everyday, you are going a long way to protecting them from Lyme disease. If you do find a tick, CDC says to use a pair of tweezers to grasp the tick as close to the skin as possible and pull back slowly and steadily. Avoid grabbing and crushing the tick by its body. Place the tick in a vial or jar of alcohol to kill it. Then, watch for other signs (see symptoms above).

NIH says the risk of developing Lyme disease from a tick bite is small, since not all ticks are carriers. According to NIH, most physicians prefer not to treat patients bitten by ticks with antibiotics unless they develop symptoms of Lyme disease. On the other hand, NIH says one-fourth of the people who become infected with Lyme disease do not develop the characteristic bull's eye rash, and many may not even recall having been bitten recently by a tick. So if you have concerns about Lyme disease, or if you do have suspicious symptoms, see your doctor immediately.

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