Which Areas Are More Likely To Have It
The tick that causes Lyme disease has been moving from the Northeast and upper Midwest into the Southern and Western U.S., Mexico, and Canada. Cases in California and Florida are on the rise. After a drop between 2017 and 2018, the numbers jumped a little bit in 2019.
But most Lyme cases in 2019 were in 15 states: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New
Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, West Virginia, and Wisconsin. Washington, DC, is also a hotspot.
In 2019, Pennsylvania had the most Lyme infections, with 6,763. New York was next, with 2,847 cases.
In the Southern U.S., where itâs hotter, ticks stay under leaves so they don’t dry out. This means people donât get Lyme from Southern ticks very often because they don’t usually come out to bite.
Even though people only report about 30,000 cases of Lyme infection in the U.S. each year, there are actually around 476,000 a year. The same tick also can spread other diseases, including babesiosis, anaplasmosis, and Powassan virus. Those diseases are also on the rise in the U.S.
Whoâs likeliest to get Lyme disease?
Boys up to age 15 and men between the ages of 40 and 60 are the most likely to get Lyme disease. Thatâs because they tend to play outside and go camping, hunting, and hiking.
Why are there more ticks now than there used to be?
There are several reasons why Lyme is spreading. Some of these are:
How Long Does It Take The Tick To Transmit Lyme
Experts disagree about how long it takes a tick to transmit Lyme disease. The CDC says that in most cases, the tick must be attached more than 24 hours.
We think that gives people a false sense of security. In some research studies, 5-7% of nymphs transmitted the Lyme bacteria in less than 24 hours. One paper reported on a case of Lyme disease transmitted after six hours of tick attachment. The risk may be low the first day, but its not zero.
Furthermore, some studies show that only 30% of patients with Lyme disease recall a tick bite. If people dont even realize that they were bitten, how could they know how long the tick was attached?
The longer a tick stays on you, the more likely it will transmit disease. Its important to find and remove any tick as soon as possible.
When Should You See A Doctor If You Think You Have Lyme
The rash is a pretty good indication that you may have been bitten. Take a photo of the rash and see your doctor. At this stage, treatment with antibiotics will probably work.
If you don’t have the rash but have symptoms like fatigue, fever, and headache but no respiratory symptoms like a cough, you may want to talk to your doctor.
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Can Autism Be Misdiagnosed As Lyme Disease What Research Is There To Prove This Can A Child With Autism Be Successfully Treated For Lyme Disease
It would be extremely unusual to misdiagnose a child with autism as having Lyme disease. Lyme disease typically gets diagnosed when a child has joint and muscle pains, along with fatigue, positive blood tests, and central or peripheral nervous system involvement. Certainly a child with autism may also get Lyme disease and thus have two disorders. In that situation, treatment of Lyme disease should result in a resolution of the Lyme disease but it would not likely result in a change in the autism symptoms. The question of interest to us is whether there are cases of “regressive autism” that occur in older pre-school age children for example that has been induced by a central nervous system infection, such as with Borrelia burgdorferi. In such a situation, treatment with antibiotics may well result in an improvement in the developmental regression. This area however has not been adequately studied.
Can You Get Lyme Disease Without Noticing A Tick Bite
Hopefully this isn’t a stupid question. I live on the West Coast and have visited Mexico a number of times over the last 4 years and recently visited Costa Rica.
While in Costa Rica, we swam in some water holes and hiked through the jungle. I noticed numerous bug bites all over my body while in CR, most of which had a black head on them. I assume they were mosquito bites as they were very itchy however, I’ve never noticed a typical mosquito bite having small black heads on them. There were probably 20+ on my body.
I never noticed any ticks crawling on me or digging into my skin that I was aware of. I never experienced the bullseye rash. However, about a month after returning from CR I’ve been experiencing extreme fatigue, like I can’t even wake up for work in the morning despite 8-9 hours of sleep. Joint pain. I keep joking to my boyfriend that I have arthritis, but my finger joints and knee joints hurt for no reason. Extreme brain fog. Heart palpitations. The fatigue is the worst. I used to go to the gym 4-5 days a week and now I’m lucky if I can drag myself in there 1-2 times a week. Even after my workouts I feel mentally and physically drained.
I also have hypothyroidism, which can exhibit many of these symptoms. I just had my thyroid labs done last week and everything came back normal.
Could I have possibly been infected with Lyme Disease without noticing a tick?
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How Is Lyme Disease Transmitted
Ticks usually live in woods or tall grasslands in Canada, the United States, Europe, and Asia. Ticks can become infected with Borrelia burgdorferi by feeding on infected wild animals, and then can spread the bacteria when they feed on blood from the host. Ticks cannot fly – they hang onto small bushes or tall grasses and are usually found close to the ground. They wait for an animal or person to pass near them and when the animal or person makes contact, the ticks attach themselves to the skin to feed.
In North America, Lyme disease is transmitted mainly by two species of ticks:
- Blacklegged tick , Ixodes scapularis.
- Western blacklegged tick, Ixodes pacificus.
The Public Health Agency of Canada states that there no evidence that Lyme disease can spread from person-to-person. Pets, especially dogs, can get Lyme disease, but there is no evidence that pets can spread the infection directly to humans. They may, however, carry infected ticks into the home or yard which may increase the chance of transmission.
What Criteria Do Doctors Use To Choose Different Antibiotics
Partly, doctors rely on what medicines have been shown in published studies to be effective for Lyme disease. For neurologic Lyme disease, the best tested antibiotic is IV ceftriaxone . For early Lyme disease, the best tested antibiotics include oral doxycycline, cefuroxime and amoxacillin. Physicians however often use other antibiotics well. For example, because one mouse study and several in vitro studies indicate that the agent of Lyme disease can penetrate and lodge inside cells, some doctors prefer to use medications that have good intracellular penetration ). Other factors that go into the decision include whether the patient is allergic to a particular family of antibiotics or whether the patient can tolerate oral medications intolerance might suggest the use of intramuscular penicillin whereas if a person is allergic to penicillins or cephalosporins a doctor would want to avoid long-acting intramuscular penicillin-family medicines.
To our knowledge, having had a Lyme disease infection that has been treated does not have a negative impact on the ability to become pregnant.
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Can Lyme Disease Completely Be Cured
Taking oral antibiotics typically cures Lyme disease after two to four weeks. You may need to get antibiotics through the vein for four more weeks. However, theres no reason to think that Lyme disease stays in you forever after treatment.
A note from Cleveland Clinic
If youre going to spend time in an area that might have ticks, take measures to avoid being bitten. This includes wearing long-sleeved shirts and pants to make it harder for ticks to bite. If you feel sick after being in an area that probably has ticks, make an appointment with your healthcare provider. If your provider prescribes antibiotics, make sure you take all of them as instructed.
What Happens At Your Appointment
The GP will ask about your symptoms and consider any rash or recent tick bites you know about.
Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions and theres not always an obvious rash.
2 types of blood test are available to help confirm or rule out Lyme disease. But these tests are not always accurate in the early stages of the disease.
You may need to be retested if you still have Lyme disease symptoms after a negative result.
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What If Mouthparts Of The Tick Remain In The Skin
Do not attempt to remove the mouthparts if they are left in the skin after tick removal. As long as the body of the tick has been removed it can no longer transmit infection. The mouthparts will come out over time naturally. Trying to remove these mouthparts can cause more trauma and may cause a local skin infection.
Tick Attachment Times And Other Lyme Disease Myths
Dr. Laurie Radovsky is a family physician in St. Paul, MN. Board-certified in family medicine, she is a member of the Academy of Integrative Health and Medicine and the International Lyme and Associated Diseases Society.
MYTH: You can only have Lyme disease if you live in a few areas of the country.
TRUTH: Lyme disease has been reported in all states of the union. Some of this is due to residents acquiring the infection elsewhere, but the range of infected ticks is much larger than previously believed, and is growing. Ticks associated with carrying Lyme disease have now been identified in almost 50% of counties in the United States. Furthermore, migrating songbirds carry infected ticks, spreading them across their migration route.
MYTH: You can only get Lyme disease during the warmest months.
TRUTH: It is true that the greatest risk of getting bitten by a tick is between May, when nymphs hatch, and July. However, any time when the temperature is above freezing, ticks can be active. Ticks are active well into the fall, so deer hunters are at risk.
MYTH: You can only get Lyme disease if you go into the woods.
TRUTH: As human environments encroach on the wild, the interface between suburbs and the habitat of deer and other animals increases. As noted above, songbirds such as robins carry infected ticks and can deposit them in urban yards as they search for worms in lawns. Pets such as dogs and cats can also bring infected ticks into the home.
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Preventive Antibiotics After A Tick Bite
According to guidelines from the Infectious Diseases Society of America , people bitten by deer ticks should not routinely receive antibiotics to prevent the disease, especially if Lyme disease is not common in that area. In areas where Lyme disease is prevalent, a single dose of an antibiotic is commonly administered after a tick bite.
A single dose of the antibiotic doxycycline may be given if:
- At least 20% of ticks in the geographic area are infected with B. burgdorferi.
- The tick is still attached to the person and is positively identified as a species of Ixodes tick that carries the Lyme disease B. burgdorferi spirochete.
- Doxycycline treatment can be given within 72 hours of the tick bite.
- It is safe for the person to receive doxycycline.
In general, the risk of developing Lyme disease after being bitten by a tick is only 1% to 3%. However, if you have an attached tick or have removed it yourself, be sure to inform your health care provider. Also let your provider know if you develop a bull’s-eye rash or any flu-like symptoms in the first 30 days following a tick bite.
When To Call A Doctor
- A tick is attached to your body and you cant remove the entire tick.
- You have a circular red rash that expands over the course of several days, especially if you know you were recently exposed to ticks. You may also have flu-like symptoms, such as fatigue, headache, stiff neck, fever, chills, or body aches.
- You feel very tired or have joint pain , irregular heartbeats, severe headache, or neck pain.
- You are pregnant or breastfeeding and you think you may have been exposed to ticks.
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Where Do Ticks Typically Live
Ticks are typically found on the underside of low lying shrubs and brush, in areas between forests and open grass and especially in areas where there are deer. They tend to also be in higher numbers in old stone walls where mice nest. Ticks in their immature or nymphal form are carried by mice, and by deer as adults. When a human or animal goes past them, ticks latch on to the passerby and search for an area to attach and start feeding.
What Can Patients With Chronic Neuropsychiatric Symptoms From Lyme Disease Do To Get Proper Treatment If We Are In A So Called Non
Chronic neuropsychiatric Lyme disease is a confusing entity to treat. That is why it is best to consult with someone who has had considerable experience evaluating these patients. That specialist may then be able to guide you and your doctor regarding the next phase of treatment. For example, while one patient may need additional antibiotics, another may need symptomatic therapies focused more on the residual symptoms. If one lives in an area in which Lyme disease is not common, it can be helpful to ask your doctor whether he or she would consider it useful for you to consult with a doctor from another state who might be more familiar with the latest treatment strategies. Most doctors would appreciate the recommendation of a colleague with more extensive expertise. It helps both the treating doctor and the patient. Your doctor may also wish to call a specialist in another state who has more experience often informal professional to professional consultation is quite helpful. We wish to add however that we have seen many patients who have avoided going to regular doctors or regular psychiatrists because of a fear of being misunderstood. This can be risky because it delays help which that particular doctor may be able to provide. One does not necessarily need to be an expert on neuropsychiatric Lyme disease to treat depression or irritability related to Lyme disease.
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Summer is the season to head outdoors, but the looming threat of tick bites has many uneasy about a hike in the woods, with good reason. We are right smack in the middle of peak season for ticks, which means the chance of contracting Lyme disease from a single tick bite is relatively high, especially in the Northeast and Midwest, where 70 percent of the ballooning deer tick population is infected with the health-compromising disease.
Lyme disease is scary in part because the signs can be easy to miss, and undetected cases can progress from treatable to chronic without a patient ever seeing a tick. People on the lookout for the tell-tale bullseye to necessitate a trip to their health care provider may miss the critical treatment window. The reality is that 30 percent of people with Lyme disease never get that bullseye, and because the rash can move locations and is usually not itchy or painful, some people who have a skin reaction never notice it.
So how can you enjoy the outdoors with your family this summer and still avoid Lyme disease? Tick vigilance is a great first step long sleeves and pants, insect repellent containing DEET and Permethrin for clothes and shoes will go a long way in warding off these pesky parasites. Still, there is always a risk of picking up a tiny hitchhiker when you head outside, so its important to understand the symptoms of an infected bite.
How To Prevent Lyme Disease
If youâre a camper, hiker, or outdoor enthusiast, take these simple measures to help prevent tick bites and Lyme disease.
- Use a tick repellent containing 20%-30% DEET or 20% Picaridin. Re-apply as needed.
- Stay in the middle of trails when hiking and exploring.
- Wear appropriate protective clothing.
- Examine your clothes and pets after youâve been outside.
- Avoid tall grasses, shrubs, and leaf litter.
- Use a tarp when sitting on the ground.
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If The Tick Is Still Attached
Finding a tick on your skin can be quite difficult, Ostfeld says especially during the spring and early summer months when ticks are in their nymph stage, and so are roughly the size of a poppy seed. You have to closely examine your skin and then ask someone to scan the places you cant see in order to spot them. While adult ticks are a little larger, theyre still difficult to identify.
Running your hands over those parts of your body ticks tend to bite is another way to find them before theyve dropped off.
Seek Medical Care Early To Prevent Lyme Disease From Progressing
Its easy to get bit by a tick and not know it. Most people dont feel a tick on their skin or the bite. Checking your skin for ticks after spending time outdoors can help you find a tick and remove it.
Removing a tick can prevent Lyme disease. A tick must be attached to your skin for at least 36 hours to infect you with the bacteria that cause Lyme disease.
Its not always possible to find a tick, so its important to pay close attention to your skin. If you notice any signs of Lyme disease or develop a rash, get medical care right away. Ticks can cause other serious diseases, such as Rocky Mountain spotted fever.
Related AAD resources
ImagesImage 1: Centers for Disease Control and Prevention, Public Health Image Library, Last accessed May 11, 2017.
Images 2, 3, and 7: Used with permission of the Journal of the American Academy of Dermatology. J Am Acad Dermatol. 2011 64:619-36.
Image 6: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
ReferencesBhate C and Schwartz RA.
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Lyme disease: Part I. Advances and perspectives. J Am Acad Dermatol. 2011 64:619-36.
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Lyme disease: Part II. Management and prevention. J Am Acad Dermatol 2011 64:639-53.
Centers for Disease Control and Prevention:
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