What Is Chronic Lyme
According to the CDC and IDSA, most people who test positive for Lyme respond well to antibiotics, even if they aren’t diagnosed or treated until months or years after the initial infection. But some patients continue to suffer long after the standard antibiotic course.
Researchers have some ideas about the causes of this more difficult condition. Its possible that the bacteria or some of the toxins they produce are sometimes able to survive the treatment. Its also possible that the body suffers some sort of autoimmune response to the bacteria or the treatment itself. Or it could be that these illnesses are the result of multiple simultaneous infectionsnot just with Borrelia burgdorferi but with several other pathogens that the blacklegged tick is known to transmit.
But ultimately, doctors are divided over several basic questions: How common is this condition? Can it be treated with antibiotics? And what should it be called?
The CDC and IDSA refer to this as post-treatment-Lyme-disease syndrome, a condition for which no proven cause or treatment options exist. According to both, there’s no evidence that prolonged antibiotic therapy works against Lyme disease.
But other groups, including the International Lyme and Associated Diseases Society , call it chronic Lyme disease. They say it may stem from a failure to diagnose Lyme disease early on . They also say that long-term antibiotic therapy can work, though they say relapses are common and the road to recovery is bumpy.
Everything You Need To Know About Texas Ticks
There are many reasons we love living in Texas. The unfortunate reality, however, is that we share this great state with a small, but potentially dangerous pest: ticks. What types of ticks live in Texas? Where do they live? How can you prevent tick bites? Perhaps most importantly, how do you get rid of ticks? Read on to learn everything you need to know about Texas ticks.
Stopping The Saliva Preventing The Disease
Researchers explain that the black-legged tick species Ixodes scapularis transmits the Lyme disease pathogen Borrelia burgdorferi. This disease contains several proteins and the team focused their research on 19 different types.
Working with the University of Pennsylvania, they analyzed pieces of mRNA which produce all 19 of these tick saliva proteins. Scientists who created the COVID-19 vaccine used the same strategy to develop a formula that protects against the SARS-Cov-2 virus.
Using guinea pigs, the team discovered that vaccinated animals quickly developed redness at the bite site after encountering a disease-carrying tick. As long as researchers removed the ticks right after the redness started, none of the guinea pigs developed Lyme disease. Conversely, around half of the unvaccinated group of guinea pigs were infected with B. burgdorferi bacteria despite researchers removing the ticks.
Interestingly, the vaccine successfully protected immunized guinea pigs from a single tick bite, even if researchers left the tick on the animals skin. On the other hand, a single tick bite led to Lyme disease in 60 percent of the unvaccinated guinea pigs. The vaccine also prevented ticks from feeding aggressively on their hosts and caused them to dislodge from their skin quicker.
The vaccine does have its limits. Results show protection against Lyme disease dropped off when leaving three ticks attached to the vaccinated guinea pigs.
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What If A Tick Bites My Dog
The more ticks in your region, the likelier it is that your furry pal will bring them home.
Your dog is much more likely to be bitten by a tick than you are. And where Lyme disease is common, up to 25% of dogs have had it at some point.
About 10% of dogs with Lyme disease will get sick. 7-21 days after a tick bite, your dog might seem like theyâre walking on eggshells. They also might have a fever and enlarged lymph nodes. Plus, they might seem tired. Dogs also get antibiotics for Lyme.
What if my dog brings ticks into my home?
Use a tick control product on your pet to prevent Lyme disease. Also, have your dog vaccinated against Lyme.
Check your dogâs whole body each day for bumps. If you notice a swollen area, see if thereâs a tick there. If you find a tick, wear gloves while you use tweezers to separate it from your dog. Then, put it in soapy water or alcohol, or flush it down the toilet.
Use alcohol to clean the spot on your dog where the tick was attached. Keep an eye on that spot, and also on your dog to make sure theyâre behaving normally. If you notice any changes, check with your vet.
John Aucott, MD, assistant professor of medicine, Johns Hopkins University School of Medicine director, Johns Hopkins Lyme Disease Clinical Research Center.
Morbidity and Mortality Weekly Report: âVital Signs: Trends in Reported Vectorborne Disease Cases — United States and Territories, 2004-2016.â
American College of Rheumatology.
Living With Lyme Disease
Most people treated in the early stages of Lyme disease make a quick and complete recovery. Some may experience symptoms for a few weeks after treatment. If you were treated for Lyme disease but you still dont feel well, call your family doctor. He or she can make sure there isnt something else wrong. They can help you find ways to ease your symptoms. Some patients have found relief with treatments typically used for chronic fatigue syndrome or fibromyalgia.
Other things you can do to help manage Lyme disease include:
- Educate yourself.There is a lot of inaccurate information to be sorted through, especially on the internet. Ask your doctor if you have questions.
- Track your symptoms.Keep a diary of your sleep patterns, eating habits, exercise routines, and how youre feeling. You or your doctor may be able to make connections between them.
- Take care of yourself.Eat a healthy diet. Exercise as regularly as you can. Get plenty of rest.
Find support. It can be hard to not feel well and not know why. Some people may think your symptoms arent real. Talk to friends and family. If they cant offer support, talk with a counselor who can help you.
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Ticks As A Disease Vector
Ticks are carriers of several blood-borne diseases, the most serious of which is Lyme disease. According to the Texas Lyme Disease Association , since 2000, the number of reported cases in Texas has ranged between 50 and 100, with probable cases at twice that number. The TXLDA reports that it typically receives between 600 and 900 requests a year from Texans looking for medical care for Lyme disease symptoms.
Lyme disease is often misdiagnosed in Texas, according to the TXLDA, since many physicians believing there are few ticks in Texas and that Lyme disease does not exist. Classic symptoms of Lyme disease start with a flu-like feeling, followed by a rash that starts at the site of the tick bite. Without treatment, the disease continues to overtake the patient, with arthritis in the joints, severe headaches, facial droop and nerve pain. The impact of Lyme disease can be quite serious, leaving the affected person unable to work or carry out many regular activities.
In total, there are six tick-borne illnesses in Texas, each with similar symptoms but caused by different strains. The two most common are Lyme disease and Rocky Mountain Spotted Fever.
Tiny Deer Ticks Transmit Lyme Disease
Although the tick prefers certain creaturessuch as voles, white-footed mice, or deerupon which to feed during the various stages of its life cycle, it is quite willing to feed on people or dogs. Regardless of its stage of development , if the tick carries the bacteria in its body, people and dogs can become infected if bitten. Once a tick attaches, it takes 1-2 days for it to transmit the bacteria that cause Lyme disease, so prompt removal of ticks is important. Risk of transmission is highest during periods when the nymphs and adults are actively seeking hosts.
Lyme disease in dogs has been reported in every state in the United States, but certain geographical areas are much more likely to harbor bacteria-carrying ticks than others. Infection rates of ticks vary, but can be as high as 50%. Areas in the United States where it occurs most often include the northeast , upper Midwest, and Pacific coast. The disease is actually named after the town Lyme, Connecticut, where an early outbreak was first described. Lyme disease is also seen in Europe and Asia. The risk of Lyme disease being transmitted to people is increasing. In the last 20 years, the number of cases reported to the Centers for Disease Control has about doubled, to around 30,000/year. Although the rate of occurrence of the disease in a geographic area is similar in both animals and people, animals, especially dogs, are at significantly higher risk because of their greater exposure to ticks.
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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:
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
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What To Do If You Find A Tick
If you find a tick, use fine tweezers, grasp it close to the skin, try not to squeeze the tick bodywhich would help inject its contents into its victimand pull straight out. Twisting the tick while removing is not recommended. Clean the skin and your hands with soap and water or rubbing alcohol .
You can have a tick tested for pathogens at TickCheck or TickEncounter or other labs. The Bay Area Lyme Foundation offers advice on when, how, and where to have a tick tested. Even if it is not known whether the tick carries any pathogens, if it is an Ixodes tick and was attached for long enough to transmit pathogens , preventative treatment with antibiotics may be warranted, so call your doctor. There are varying opinions as to what that treatment should consist of, from a single dose of doxycycline to twenty days of doxycycline .
Early Symptoms And Signs Of Lyme Disease
You can expect a small, red bump on the site of your bite, or where you removed the tick from, and this will resolve within a day or two. This is to be expected after being bitten by any insect, and it in itself is not an indicator that you have Lyme disease.
However, if you have been infected, you can expect the following within a month or so:
- Flu-like symptoms. Early-stage Lyme disease can present as chills, fever, fatigue body aches, stiff neck, headache and other flu-like symptoms.
- Rash development. Between three and 30 days after an infected tick bites you, you may see a rash that looks like a bulls eye. This will expand over days, and it can grow to as many as 11 to 12 inches across. It is usually not painful or itchy.
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How Are Dogs Tested For Lyme Disease
Diagnosis is made by a combination of history, physical signs, and diagnostics. For dogs, the two blood tests for diagnosing Lyme disease are called the C6 Test and Quant C6 test. Veterinarians perform both.
The C6 test detects antibodies against a protein called C6. Presence of the antibodies suggests an active Lyme infection. The C6 antibodies can be detected three to five weeks after an infected tick bites a dog and may be found in the bloodstream even before the dog shows signs of illness.
The next step is to do a Quant C6 test. This, along with urinalysis will help determine if antibiotic treatment is necessary.
Key Points To Remember
- Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
- Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
- Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
- Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
- Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.
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Dna And Culture Tests
Although antibody tests are flawed and it is tempting to use additional diagnostic tests such as PCR or culture tests, these tests have not been validated, and they can give incorrect or misleading results. PCR is a very sensitive way to detect DNA however, in early stages of infection, PCR tests for B. burgdorferi DNA on skin samples detect only around 60 percent of infections. PCR tests on blood samples are very insensitive. In late-stage infection, PCR testing of synovial fluid and cerebrospinal fluid is more useful, and it can accurately identify Lyme cases . If symptoms suggest infection of the central nervous system, then a spinal tap should be done and both DNA and antibodies should be measured and compared to levels in the blood drawn on the same day . Scientists are developing different kinds of PCR tests that may be more accurate, like T2 magnetic resonance .
Culture tests are not a great optionon skin and blood samples, they detect only about half of early-stage Lyme infections and no late-stage infections .
Summary Symptoms And 3 Stages Of Lyme
This list of signs, symptoms, and stages of Lyme disease is not exhaustive. Ive talked to a lot of people with Lyme and many of our symptoms are similar. But others are different too.
My friend, if you are struggling with an illness and the doctors havent been able to help you, you may want to study the lists above to help rule out Lyme disease. This is especially true if you spend a lot of time outdoors or live or work in a tick-infested area.
And of course, if you know youve been bitten by a tick and arent feeling well, please get yourself checked out immediately. Keep in mind that anyone can get Lyme and no one is immune.
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What To Do If You Have A Blacklegged Tick Bite
Remove the tick by pulling it directly out with fine-tipped tweezers. Lift upward with slow and even pressure. Dont twist when removing it. Dont crush it or put soap or other substances on it. Dont apply heat to it.
Place the tick in a resealable container. See if you can identify what kind of a tick it is.
Immediately after removing the tick, wash your skin well with soap and water or with rubbing alcohol.
Not all ticks carry Lyme. The Lyme bacteria is transmitted only by blacklegged ticks in their nymph or adult stage.
Save the tick to show your doctor. The doctor will want to determine if its a blacklegged tick and if theres evidence of feeding. Ticks enlarge as they feed. Your risk of getting Lyme from an infected tick increases with the length of time that the tick fed on your blood.
Pull the tick out with tweezers and save it in a resealable container for identification.
When To See A Doctor
Anyone who develops a rash or fever in the weeks following a tick bite should contact their doctor.
It can help to make notes about the bite, such as when it occurred and any symptoms that appeared after the bite. Taking pictures of the bite or the tick itself may also assist a doctor with diagnosis.
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Yoga Meditation And A Drug To Treat Chronic Symptoms
Brian Fallon, MD, of Columbia University Irving Medical Center and the Research Foundation for Mental Hygiene, is leading two clinical studies on treatments for symptoms of PTLDS. In one study, treatment will consist of Kundalini yogabased techniques of breathing, stretching, and meditation. Mind-body practices like these are known to be helpful for pain, fatigue, and mental focus. A comparison group will practice other breathing and meditation techniques. This is an eight-week study that will be carried out online.
The second study will evaluate the effects of the drug disulfiram on fatigue and quality of life in people with PTLDS. In laboratory settings, disulfiram has been shown to kill dormant B. burdorferi that are resistant to antibiotics. Disulfiram is better known by its brand name, Antabuse. It is used to discourage alcohol consumption by causing an unpleasant reaction to alcohol. Our Q& A with Fallon provides additional information on these clinical studies.