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How Does Lyme Disease Spread

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Diagnosis Testing And Treatment

Lyme Disease Is Spreading

You may have heard that the blood test for Lyme disease is correctly positive only 65% of the time or less. This is misleading information. As with serologic tests for other infectious diseases, the accuracy of the test depends upon how long youve been infected. During the first few weeks of infection, such as when a patient has an erythema migrans rash, the test is expected to be negative.

Several weeks after infection, FDA cleared tests have very good sensitivity.

It is possible for someone who was infected with Lyme disease to test negative because:

  • Some people who receive antibiotics early in disease may not have a fully developed antibody response or may only develop an antibody response at levels too low to be detected by the test.
  • Antibodies against Lyme disease bacteria usually take a few weeks to develop, so tests performed before this time may be negative even if the person is infected. In this case, if the person is retested a few weeks later, they should have a positive test if they have Lyme disease. It is not until 4 to 6 weeks have passed that the test is likely to be positive. This does not mean that the test is bad, only that it needs to be used correctly.
  • If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately.

  • Telford SR, Wormser GP. Bartonella transmission by ticks not established.Emerg Infect Dis. 2010 Mar 16 379-84.
    • Report being bitten by a tick, or
    • Live in, or have recently visited, a tick-infested area.

    How Long Does It Take To Get Lyme Disease

    Black-legged ticks must be attached for at least 24 hours before they can transmit Lyme disease. Always check yourself for ticks after spending time outdoors in the warm weather. If you can remove the tick properly within a day of being bitten, youre unlikely to contract Lyme. The Lyme disease incubation period is between three to 30 days.

    Early Symptoms Of Lyme Disease

    The most common feature of localized Lyme disease is a slowly expanding skin lesion or rash known as erythema migrans . This rash usually develops 3 to 30 days after the disease-transmitting tick bite.

    Erythema migrans is the earliest sign of the disease in about 70 percent of Lyme disease cases reported to the Centers for Disease Control and Prevention .

    There are certain characteristics that can help identify erythema migrans:

    • It begins as a flat or slightly raised red spot at the site of the tick bite and can expand to become a round rash up to 73 centimeters across.
    • It can appear on any area of the body but most frequently shows up on the lower limbs, buttocks, and groin in adults, and on the head and neck in children.
    • A clear ring may appear around the center of the rash, giving it a bull’s-eye-like appearance .
    • It may be warm to the touch, though rarely painful or itchy.

    While the classic Lyme disease rash has a bull’s-eye shape, not all cases of erythema migrans look the same. The patient may develop a red, expanding lesion with a crusting of the skin at the center multiple red lesions red, oval-shaped plaques or a bluish rash, according to the CDC.

    In addition to erythema migrans, people with localized Lyme disease may experience flu-like symptoms, including fever and chills, headache, fatigue, muscle and joint pains, a general ill feeling , and swollen lymph glands.

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    Can Lyme Disease Be Transmitted From One Person To Another

    Lyme disease is the most common vector-borne disease in the United States. It is a bacterial infection spread by tick bites. Despite various claims, there is currently no evidence that Lyme disease can spread between people by blood transfusions, sexual intercourse or from mother to child.

    What is Lyme disease?Lyme disease is caused the bacterium Borrelia burgdorferi. The bacterium is spread by ticks when they bite humans. An infected bite often results in a bullseye rash, and then other symptoms include fevers and headaches. If treated with antibiotics early on, the bacteria can be eliminated within a few weeks. If the infection is not treated more severe symptoms like joint pain and problems with the nervous system can occur in some people.

    How do you get Lyme disease?B. burgdorferi is transmitted to humans through a group of ticks called Ixodes. B. burgdorferi is a member of a family of bacteria called spirochetes, which are characterised by their distinct wavelike body shapes. According to 9 out of 11 experts, tick bites are the only way you can get Lyme disease.

    What is the evidence for person-to-person transmission of Lyme disease?For obvious ethical reasons, scientists cannot do an experiment where we purposefully try to infect a person by different methods and see if it works. This means that the evidence we can get about Lyme disease transmission is indirect.

    History Of Lyme Disease


    Lyme disease gets its name from a small coastal town in Connecticut called Lyme. In 1975, a woman brought to the attention of Yale researchers an unusual cluster of more than 51 cases of mostly pediatric arthritis. In 1977, Dr. Allen Steere and Yale colleagues identified and named the 51 clusters Lyme arthritis.” In 1979, the name was changed to “Lyme disease,” when Steere and colleague Dr. Steven Malawista discovered additional symptoms linked to the disease such as possible neurological problems and severe fatigue. In 1982 the cause of the disease was discovered by Dr. Willy Burgdorfer. Dr. Burgdorfer published a paper on the infectious agent of Lyme disease and earned the right to have his name placed on the Lyme disease spirochete now known as Borrelia burgdorferi.

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    Whats The Most Common Way To Get Lyme

    Blacklegged deer ticks infected with Borrelia burgdorferi transmit the Lyme bacteria when they bite. The ticks, Ixodes scapularis , can also transmit other disease-causing bacteria, viruses, and parasites. These are called coinfections.

    A tick requires a blood meal at each stage of its life as larvae, nymphs, and adults. Ticks normally feed on animals, ground-feeding birds, or reptiles. Humans are a secondary blood source.

    Most bites to humans are from tick nymphs, which are the size of poppy seeds. Its hard to spot them, even on open skin. The prime seasons for human tick bites are late spring and summer.

    As an infected tick feeds on you, it injects spirochetes into your blood. has shown that the severity of infection varies, depending on whether the spirochetes are from the ticks salivary glands or the ticks midgut. In this animal research, infection required 14 times more midgut spirochetes than saliva spirochetes.

    Depending on the ticks bacterial virulence, you could be infected with Lyme within

    Lyme bacteria may be found in bodily fluids, such as:

    • saliva
    • urine
    • breast milk

    But theres no hard evidence that Lyme spreads from person to person via contact with bodily fluids. So dont worry about kissing someone with Lyme.

    What Should You Do If You Find A Tick

    • Don’t touch the tick with your bare hand.

    • Use a pair of tweezers to remove the tick. Grab the tick firmly by its mouth or head as close to your skin as possible.

    • Pull up slowly and steadily without twisting until it lets go. Don’t squeeze the tick, and don’t use petroleum jelly, solvents, knives, or a lit match to kill the tick.

    • Save the tick. Place it in a plastic container or bag so it can be tested for disease, if needed.

    • Wash the bite area well with soap and water and put an antiseptic lotion or cream on the site.

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    What You Need To Know About Lyme Disease

    • Lyme disease is an infection caused by the spiral-shaped bacteria Borrelia burgdorferi, which is most commonly transmitted by a tick bite.

    • There are over 300,000 estimated new cases of Lyme disease in the United States each year.

    • The symptoms of Lyme disease depend on the how long the infection has been present in the body. The first sign of Lyme disease is often an expanding round or oval red “bullseye” rash.

    • If left untreated, people may develop neurological symptoms and heart problems, and have an approximately 60 percent chance of developing Lyme arthritis.

    What To Do If You Get A Tick Bite

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    If you have a tick bite, remove the tick from your body as soon as possible. Use a pair of tweezers and remove the entire tick from your skin without crushing it. Once the tick is out, wash the site with soap and water.

    Keep an eye on the area for a rash that slowly expands, leaving a target-shaped mark. Also, watch for fevers, chills, headaches, or muscle pains, which are all early signs of Lyme disease. If you experience any of these symptoms within 30 days of the bite, you should contact a doctor.

    There are still some mysteries about Lyme disease, but fortunately, most cases can be treated with a two- to four-week course of oral antibiotics. If youre worried about contracting Lyme disease, take precautions to avoid ticks in the first place:

    • Wear fully covering clothing when going outside .
    • Walk in the middle of trails instead of on the sides near trees and brush.
    • Avoid tall grass or areas with shrubs.

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    What Is The Risk To Canadians

    The risk of getting a tick bite starts when the weather warms up in the spring, through until the fall. Ticks can also be active in the winter, if the winter is mild and there is not much snow. However, the greatest risk occurs during the spring and summer months.

    Blacklegged ticks are most often found in forests, wooded areas, shrubs, tall grass and leaf piles. Because tick populations are spreading, it is possible to be bitten outside of these areas.

    How To Avoid Tick Bites

    To reduce the chance of being bitten:

    • cover your skin while walking outdoors and tuck your trousers into your socks
    • use insect repellent on your clothes and skin products containing DEET are best
    • stay on clear paths whenever possible
    • wear light-coloured clothing so ticks are easier to see and brush off

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    Who Is At Risk

    Many occupations may be at risk, including forestry, farming, veterinarians, construction, landscaping, ground keepers, park or wildlife management, and anyone who either works outside or has contact with animals that may carry ticks

    Similarly, any person who spends a lot time outdoors , especially in grassy or wooded areas may also be at risk.

    Which Areas Are More Likely To Have It

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    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:

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    Later Symptoms Of Lyme Disease

    In early disseminated Lyme disease, which occurs weeks to months after the tick bite, other symptoms may develop, including:

    • Additional erythema migrans lesions
    • Nerve pain.
    • Facial or Bell’s palsy, a paralysis or weakness in the muscles on one side of the face.
    • Lyme carditis, in which Lyme disease bacteria enter the tissues of the heart and interfere with the normal process that coordinates the beating of the heart symptoms include palpitations, chest pain, or shortness of breath.

    Late disseminated Lyme disease, which develops months to years after the infection begins, may cause:

    • Arthritis with severe joint pain and swelling, especially in large joints such as the knees
    • Pain in the tendons, muscles, joints, and bones
    • Abnormal muscle movement

    No Forests No Deer No Lyme

    Lyme disease has existed in North America and Europe for a long time and must have affected American Indians and early colonists. But only recently has it become epidemic.

    One reason Lyme disease may have remained obscure in the United States for so long before beginning to spread in the late 20th century had to do with the extensive deforestation to create farmland that began after colonists arrived in North America. With the loss of forests, deer disappeared from most of the Northeast. The only known populations in the Northeast were in the Adirondacks and on Long Island. Without deer, deer ticks, also known as black-legged ticks, were rare, and the bacterium that causes Lyme disease was contained in isolated tick populations, primarily in northern Wisconsin and on Long Island.

    That changed when deer were reintroduced for hunting in the Northeast during the early 1900s and began to repopulate new forests.

    The infected deer ticks on Long Island were only about six miles from Lyme, Connecticut, separated by Long Island Sound. Once they reached the mainland deer have been seen swimming in Long Island Sound the infected ticks were able to find an unending supply of reproductive hosts.

    Scientists in the early 1980s identified the cause of Lyme disease as a previously unrecognized bacterium, Borrelia burgdorferi, carried by deer ticks and transmitted to humans through their bite.

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    Can You Get Lyme From Sexual Transmission

    Theres no direct evidence that Lyme is sexually transmitted by humans. Lyme experts are divided about the possibility.

    The evidence for sexual transmission that Ive seen is very weak and certainly not conclusive in any scientific sense, Dr. Elizabeth Maloney told Healthline. Maloney is president of the Partnership for Tick-Borne Diseases Education.

    Dr. Sam Donta, another Lyme researcher, agreed.

    On the other hand, Lyme researcher Dr. Raphael Stricker told Healthline, Theres no reason why the Lyme spirochete cant be sexually transmitted by human beings. How commonly it occurs, or how difficult it is, we dont know.

    Stricker has called for a Manhattan Project approach to Lyme, including more research.

    Indirect studies of human transmission are suggestive , but not definitive. A few animal studies of sexual transmission of the Lyme spirochete have shown that it does occur in some cases.

    Its not ethical to test sexual transmission by deliberately infecting humans, as was done with syphilis in the past.

    to the fetus. But if they receive adequate treatment for Lyme, adverse effects are unlikely.

    A 2009 study of 66 pregnant women found that untreated women had a significantly higher risk of adverse pregnancy outcomes.

    Infection from the mother to the fetus can occur within the first three months of pregnancy, according to Donta. If the mother is untreated, the infection would result in congenital abnormalities or miscarriage.

    What Are The Signs And Symptoms Of Lyme Disease

    How Has Lyme Disease Spread in the US?

    Early symptoms usually appear within 3 to 30 days after the bite of an infected tick. In 60-80 percent of cases, a circular bull’s eye rash about two inches in diameter, called erythema migrans, appears and expands around or near the site of the tick bite. Sometimes, multiple rash sites appear. One or more of the following symptoms usually mark the early stage of Lyme disease: chills and fever, headache, fatigue, stiff neck, muscle and/or joint pain, and swollen glands. If Lyme disease is unrecognized or untreated in the early stage, more severe symptoms may occur. As the disease progresses, severe fatigue, a stiff aching neck, and tingling or numbness in the arms and legs, or facial paralysis can occur. The most severe symptoms of Lyme disease may not appear until weeks, months or years after the tick bite. These can include severe headaches, painful arthritis, swelling of the joints, and heart and central nervous system problems.

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    What Tests Are Available For Lyme Disease

    When a person becomes infected, the body creates antibodies to protect itself from the bacteria. Certain blood tests are available to measure these antibodies. However, sometimes a “false negative” test can result if there are not enough antibodies in the blood for the tests to detect accurately. A doctor should also do a complete medical examination and gather information about your recent outdoor activities in order to make a clinical diagnosis for Lyme disease.

    Stage : Changing Skin

    In stage 3, few signs of Lyme disease appear on the skin. Most problems occur in the heart and nervous system, and these can be serious.

    Where you see signs on your skin: If you were in Europe when bit by a tick, you may see changes to your skin in this late stage. These changes usually appear on a hand or foot. Some people develop this change on both of their hands or feet. It can also occur on a knee, elbow, or elsewhere.

    What the skin looks like: The skin begins to swell, and you may notice some redness. These signs are caused by having a bacterial infection for a long time. The affected skin may also feel sore.

    In time, the skin starts to harden and shrink, causing deep lines to form. If you have hair in the area, it tends to fall out. The sweat glands can die, and the skin often becomes so thin that it tears easily. The medical name for this condition is acrodermatitischronical atrophicans.

    In stage 3, you may also see tumors on your skin. It is believed that the long-term infection and swelling in the lymph nodes can lead to a cancer known as cutaneous B-cell lymphoma.

    Skin starts to harden and shrink, causing deep lines to form

    The medical name for this condition is acrodermatitis chronical atrophicans. Swelling, hardened skin, and deep lines on the foot of someone who has had Lyme disease for years.

    When you see signs of changing skin and symptoms: These tend to occur months or years after you are bitten by a tick.

    • Arthritis

    • Dementia

    • Heart failure

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