What Is Lyme Disease
Lyme disease is a bacterial infection. You get it when the blacklegged tick, also known as a deer tick, bites you and stays attached for 36 to 48 hours. If you remove the tick within 48 hours, you probably wonât get infected.
When you do get infected, the bacteria travel through your bloodstream and affect various tissues in your body. If you donât treat Lyme disease early on, it can turn into an inflammatory condition that affects multiple systems, starting with your skin, joints, and nervous system and moving to organs later on.
The chances you might get Lyme disease from a tick bite depend on the kind of tick, where you were when it bit you, and how long the tick was attached to you. Youâre most likely to get Lyme disease if you live in the Northeastern United States. The upper Midwest is also a hot spot. But the disease now affects people in all 50 states and the District of Columbia.
How You Get Lyme Disease
If a tick bites an animal carrying the bacteria that cause Lyme disease, the tick can become infected. The tick can then transfer the bacteria to a human by biting them.
Ticks can be found in any areas with deep or overgrown plants where they have access to animals to feed on.
They’re common in woodland and moorland areas, but can also be found in gardens or parks.
Ticks don’t jump or fly. They climb on to your clothes or skin if you brush against something they’re on. They then bite into the skin and start to feed on your blood.
Generally, you’re more likely to become infected if the tick is attached to your skin for more than 24 hours. Ticks are very small and their bites are not painful, so you may not realise you have one attached to your skin.
How Long Does Lyme Disease Last
Lyme disease symptoms can begin anywhere from three to 30 days after transmission of the infection from a tick. If treated early on with antibiotics, most people feel better within a few weeks, says Dr. Zemel.
According to the CDC, its not uncommon for people to experience lingering symptoms like fatigue and joint or muscle pain for a few weeks or months after treatment. Additional antibiotics wont help these symptoms, however, and most people improve on their own over time.
In a small percentage of cases, people continue to experience symptoms for more than six months after their recommended course of antibiotics is completed. This is sometimes referred to as chronic Lyme diseasebut that name is misleading, says Dr. Kuritzkes, because there is no evidence that the bacteria that causes Lyme disease is still present in the body. Instead, the CDC refers to this condition as post-treatment Lyme disease syndrome .
As with many other kinds of infectious diseases, some people are left with some debilitating symptoms that dont go away, says Dr. Kuritzkes. I like to compare it to polio: Some people who had polio are left paralyzed, but that doesnt mean they have chronic polio they have permanent damage from the infection, even after its gone away.
Its possible that Lyme infection leads to some damage that we dont fully understand yet, Dr. Kuritzkes adds. But we do know that long-term or repeated courses of antibiotics have no benefit in these cases.
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Antibiotics For Lyme Disease
How long to treat patients with Lyme remains an issue of controversy. With traditional antibiotic therapy, lasting 2-4 weeks, 10-20% of patients will have ongoing symptoms including fatigue, joint pain, insomnia and complaints of brain fog. Indefinite long-term treatment is advocated by ILADS , based on a patients symptoms. In contrast, IDSA only recommends 2-4 weeks’ treatment. The two groups are bitter adversaries.
A new study supports short-course treatmentbut is not entirely above criticism.
This study from the Netherlands, reported in the New England Journal of Medicine, was well designed, being randomized and double blind, and with a quasi-placebo group .
The upshot: There were no differences in the outcomes of the three treatment groupsbut some lingering questions remain. Notably, a large percentage of patients had side effects from the antibiotics, some quite serious.
Why is this important?
Lyme has been increasing, especially in the northeastern and upper Midwest portions of the U.S. The CDC now estimates there are about 300,000 cases of Lyme each year, with 30,000 reported cases.
But Lyme can be difficult to diagnose, and the assays miss a lot of patients . So if 20% of patients are left with persistent symptoms, that means that 60,000 people per year are being left with untreated problems that we just dont know what to do with. This study, along with others before it, suggests that longer antibiotics are not the answer.
The fine print:
Study Findings:
What To Expect At Home
Home care for dogs with Lyme disease is relatively straightforward. Doxycycline is usually given by mouth twice daily for at least 30 days. Improvement in the dogs symptoms should be noted within 24-48 hours. If the dogs condition fails to improve in 72 hours or worsens at any time, call your veterinarian.
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Who Gets Lyme Disease
Anyone bitten by an infected deer tick can get Lyme disease. Most U.S. cases of Lyme disease happen in Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin. But Lyme disease is found in other parts of the U.S., Europe, Asia, and Australia too.
The Chance Of Getting Lyme Disease
Not all ticks in England carry the bacteria that causes Lyme disease.
But it’s still important to be aware of ticks and to safely remove them as soon as possible, just in case.
Ticks that may cause Lyme disease are found all over the UK, but high-risk places include grassy and wooded areas in southern and northern England and the Scottish Highlands.
Ticks are tiny spider-like creatures that live in woods, areas with long grass, and sometimes in urban parks and gardens. They’re found all over the UK.
Ticks do not jump or fly. They attach to the skin of animals or humans that brush past them.
Once a tick bites into the skin, it feeds on blood for a few days before dropping off.
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Early Localized Lyme Disease Symptoms
The most telltale sign of Lyme is a rash , which occurs at the site of the tick bite. This rash occurs in 70 to 80% of patients.
On average, the rash shows up one week after the tick bite. But it can appear as early as 3 days or as late as 30 days after the bite.
The rash may feel warm but is usually not itchy or painful. The red patch will expand over several days and can grow as big as 12 inches across. The classic Lyme rash eventually takes on a bulls-eye shape with a red circle in the middle and an outer red ring.
Since the bulls-eye shape doesnt always appear, watch out for any circular or oval rash that gradually expands.
The 20% to 30% of people who dont develop a rash may notice other symptoms in the first month. These include chills, headache, low energy, sore muscles and joints, and swollen lymph nodes.
These initial symptoms and rash are the bodys first immune response to a foreign bacteria. This is why, beyond the typical rash, the symptoms are non-specific and can resemble any flu-like illness.
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Questions To Ask Your Veterinarian
If your dog has a positive Lyme test but no symptoms of the disease or protein in the urine, ask your veterinarian why he or she is recommending treatment. Experts currently recommend against antibiotic therapy under these circumstances because the dogs immune system is holding the bacteria in check and antibiotics are unable to eliminate the infection.
Dogs who have contracted Lyme disease do not develop prolonged, protective immunity and can be reinfected at a later date. Talk to your veterinarian about how best to prevent future infections. Options include measures to prevent the ticks that carry Lyme disease from biting your dog and Lyme vaccination.
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What Do I Do If I Find A Tick On My Skin
Dont panic. Use fine-tipped tweezers to grasp the tick as close to the skins surface as possible. Pull up with steady, even pressure. Be careful not to squeeze or twist the tick body. Sometimes parts of the tick remain in the skin. You can leave them alone or carefully remove them the same way you would a splinter. Do not use heat , petroleum jelly, or other methods to try to make the tick back out on its own. These methods are not effective.
Wash the area where the tick was attached thoroughly with soap and water. Keep an eye on the area for a few weeks and note any changes. Call your doctor if you develop a rash around the area where the tick was attached. Be sure to tell your doctor that you were bitten by a tick and when it happened.
What Are The Risk Factors For Post Treatment Lyme Disease
Risk factors for Post Treatment Lyme Disease include:
- Delay in diagnosis
- Increased severity of initial illness
- Presence of neurologic symptoms
Increased severity of initial illness, the presence of neurologic symptoms, and initial misdiagnosis increase the risk of Post Treatment Lyme Disease. PTLD is especially common in people that have had neurologic involvement. The rates of Post Treatment Lyme Disease after neurologic involvement may be as high as 20% or even higher. Other risk factors being investigated are genetic predispositions and immunologic variables.
In addition to Borrelia burgdorferi, the bacteria that causes Lyme disease, there are several other tick-borne co-infections that may also contribute to more prolonged and complicated illness.
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How Do You Get Lyme Disease
Deer ticks are the common carriers and are primarily found in woodland areas. Because the bite is painless, it is typical that you will not know that you have a deer tick bite unless you see it.
Apart from deer ticks, you can get Lyme disease from other animals and insects. Mosquitoes, mice, and birds can transmit the bacteria either by being infected or by carrying ticks that are infected.
- This tick-borne disease can affect all ages.
- Park rangers may be prone due to the nature of their work.
- Hikers in woodland areas are also more prone.
- Cases of Lyme disease typically rise during the late spring or early summer.
- Individuals living in states along the northeastern coast are the most at risk.
What Does The Lyme Multiplex Assay Measure
The Lyme Multiplex assay quantifies antibodies directed against specific proteins on the surface of B. burgdorferi at three different stages of the bacterial life cycle. This antibody profile can indicate whether an animal has been recently infected or is chronically infected with B. burgdorferi. It can also be used to monitor protective antibodies after vaccination.
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Living With Lyme Disease
Once antibiotics resolve the infection, you can support your recovery from Lyme disease as you would with any kind of arthritis or nerve injury. It is recommended that you:
- Eata healthy diet and limit your sugar intake.
- Getplenty of rest.
- Exerciseat least three times a week for at least 30 minutes each day.
- Reducestress.
- Useanti-inflammatory medication when necessary.
The damageLyme disease causes to your nerves or muscles would heal over a course ofmonths, Dr. Sullivan says. Identifying the infection and treating itappropriately so that the infection is cleared is the first step. And then thebody can start to heal.
What Do You Do If There’s A Tick Under Your Skin
Use a pair of fine-tipped tweezers to remove it as soon as possible. Pull upward with steady pressure. If parts of the tick are still in your skin, try to get those with the tweezers, too. After everything is out, clean the bite area with rubbing alcohol or soap and water.
You probably wonât get infected if you remove the tick within 36 to 48 hours.
How do you throw away a tick?
Put it in soapy water or alcohol, stick it to a piece of tape, or flush it down the toilet.
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What Can I Expect Long Term If My Child Has Lyme Disease
If Lyme disease is caught and treated early, most children will make a full recovery. Some children with Lyme disease go on to experience whats called a post-infectious syndrome with symptoms that may include feeling fatigue, joint aches and pains, headaches, difficulty sleeping, and problems concentrating. Since the infection itself is gone by this time, doctors generally dont prescribe antibiotics. Each child is different, but its not uncommon for symptoms of post-infectious syndrome to linger for months, or even years, and they can be made worse by stress or other illness. But most children do make a full recovery.
Blacklegged, or deer, ticks are very small, so it helps to know what to look for when doing a tick check. Adults are about the size of sesame seeds and in the nymph or larva stage, they can be as tiny as a poppy seeds.
Learn The Stages Of Lyme Disease
Lyme disease occurs in three stages: early localized, early disseminated and late disseminated. However the stages can overlap and not all patients go through all three. A bulls-eye rash is usually considered one of the first signs of infection, but many people develop a different kind of rash or none at all. In most cases, Lyme symptoms can start with a flu-like illness. If untreated, the symptoms can continue to worsen and turn into a long-lived debilitating illness.
Stage 1: Early Localized Disease
Symptoms with early localized Lyme disease may begin hours, a few days or even weeks after a tick bite. At this point, the
infection has not yet spread throughout the body. Lyme is the easiest to cure at this stage.
Symptoms may include:
- skin rash, which may or may not look like a bulls eye
- flu-like illness, including chills and fever
- fatigue
- muscle soreness and joint pain
- swollen lymph nodes
- sore throat
Stage 2: Early Disseminated Lyme
Early disseminated Lyme may occur several weeks or months after the tick bite. Bacteria are beginning to spread throughout the body. In addition to flu-like symptoms, this stage is often characterized by increase in symptoms such as:
- chills
- pain, weakness or numbness in the arms, legs
- vision changes
- heart problems, such as palpitations, chest pain
- rash may appear on body
- facial paralysis
Stage 3: Late Disseminated Lyme Disease
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Ongoing Symptoms Of Lyme Disease
A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.
These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.
It’s not clear why this happens to some people and not others. This means there’s also no agreed treatment.
Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.
The doctor may be able to offer you further support if needed, such as:
- referral for a care needs assessment
- telling your employer, school or higher education institution that you require a gradual return to activities
- communicating with children and families’ social care
Page last reviewed: 05 July 2021 Next review due: 05 July 2024
What Is Post Treatment Lyme Disease
Post Treatment Lyme Disease represents a research subset of patients who remain significantly ill 6 months or more following standard antibiotic therapy for Lyme disease. PTLD is characterized by a constellation of symptoms that includes severe fatigue, musculoskeletal pain, sleep disturbance, depression, and cognitive problems such as difficulty with short-term memory, speed of thinking, or multi-tasking. In the absence of a direct diagnostic biomarker blood test, PTLD has been difficult to define by physicians, and its existence has been controversial. However, our clinical research shows that meticulous patient evaluation when used alongside appropriate diagnostic testing can reliably identify patients with a history of previously treated Lyme disease who display the typical symptom patterns of PTLD.
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Why Are Antibiotics The First Line Of Treatment For Lyme Disease
The use of antibiotics is critical for treating Lyme disease. Without antibiotic treatment, the Lyme disease causing bacteria can evade the host immune system, disseminate through the blood stream, and persist in the body. Antibiotics go into the bacteria preferentially and either stop the multiplication of the bacteria or disrupt the cell wall of the bacteria and kill the bacteria . By stopping the growth or killing the bacteria the human host immune response is given a leg up to eradicate the residual infection. Without antibiotics, the infection in Lyme disease can evade the host immune system and more readily persist.
Cdc Supports The Development Of New Tests
New tests may be developed as alternatives to one or both steps of the two-step process. Before CDC will recommend new tests, they must be cleared by the Food and Drug Administration . For more details, see: Recommendations for Test Performance and Interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease.
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Hunting For Alternative Drug
Frustrated by the lack of treatment options for Lyme disease patients with lingering symptoms, Rajadas and his team began hunting for a better alternative in 2011. In 2016, they published a study in Drug Design, Development and Therapy that listed 20 chemical compounds, from about 4,000, that were most effective at killing the infection in mice. All 20 had been approved by the Food and Drug Administration for various uses. One, for instance, is used to treat alcohol abuse disorder.
Jayakumar Rajadas
In this most recent study, azlocillin, one of the top-20 contenders, was shown to eclipse a total of 7,450 compounds because it is more effective in killing B. burgdorferi and causes fewer side effects. Lyme disease affects more than 300,000 people annually, according to the Centers for Disease Control and Prevention. It can affect various organs, including the brain, skin, heart, joints and nervous system, and cause heart problems and arthritis if untreated. Symptoms include fever, headaches, chills, and muscle and joint pain.
Traditional antibiotics, such as doxycycline, are effective as an early course of treatment for the infection in the majority of patients, but it remains unclear why these drugs fail to treat 10% to 20% of patients, Rajadas said.