Treatment Of Lyme Disease
Early diagnosis and proper antibiotic treatment of Lyme disease is important and can help prevent late Lyme disease. The following treatment regimens reflect CDCs interpretation of the most current data for four important manifestations of Lyme disease. These regimens are consistent with guidanceexternal icon published by the by the Infectious Disease Society of America, American Academy of Neurology, and American College of Rheumatology.
Some patients report persistent symptoms of pain, fatigue, or difficulty thinking even after treatment for Lyme disease. The state of the science relating to persistent symptoms associated with Lyme disease is limited, emerging, and unsettled.
Additional researchexternal icon is needed to better understand how to treat, manage, and support people with persistent symptoms associated with Lyme disease. In light of these research gaps, recommendations for treatment of persistent symptoms in people previously treated for Lyme disease are not provided here.
If you are interested in information on chronic Lyme diseaseexternal icon, see NIHs website.
Links with this icon indicate that you are leaving the CDC website.
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 what’s 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 don’t prescribe antibiotics. Each child is different, but it’s 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.
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.
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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Positive Elisa On Serum
RIPL will automatically proceed to do IgM and IgG immunoblot tests after a positive or indeterminate ELISA test and will provide an overall interpretation of the ELISA and immunoblot in the light of the clinical details provided on the request form.
Please provide clinical details to allow the interpretation of serological results. These are needed for interpretation because borrelia-specific antibodies may persist for several years in patients who have had Lyme disease in the past, long after the bacteria have been cleared from the body. Therefore, detection of borrelia specific antibodies in someone with no evidence of current clinical symptoms or recent tick exposure argues against active Lyme disease infection. After successful treatment of Lyme disease antibody concentrations may slowly fall over time.
Borrelia species are notifiable organisms. The numbers of positive results from laboratory confirmed cases in RIPL are reported to UKHSA and analysed for inclusion in UKHSA Health Protection Reports as part of Lyme disease epidemiology and surveillance.
Late Lyme Disease Symptoms
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Is It Lyme Disease Or Is It The Flu
While there are some similarities between early Lyme disease symptoms and the flu, theyre very different illnesses. Flu symptoms in babies and toddlers include fever, cough, sore throat, runny nose, muscle aches, fatigue, nausea, vomiting and diarrhea.
Lyme disease symptoms include joint pain, swollen lymph nodes and headache in addition to fever, chills and nausea. Lyme is also most common during the spring and summer months, when the flu is usually uncommon. Additionally, many people who get Lyme disease also have a noticeable bulls eye rash.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.
How Can Lyme Disease Be Prevented
Unfortunately, there is currently no vaccine for Lyme disease. But you can avoid Lyme disease by avoiding tick bites, checking for ticks, and removing ticks promptly, before they become lodged in the skin. Some tips:
Avoid tick playgrounds: Ticks like low-level shrubs and grasses, particularly at the edges of wooded areas. If youre hiking, try to stay in the center of the trail and avoid bushwhacking. Walk on cleared paths or pavement through wooded areas and fields when possible.
Dress appropriately: Long pants with legs tucked into socks and closed-toed shoes will help keep ticks away from skin. Light-colored clothing helps make ticks visible.
Insect repellant: Products that contain DEET repel ticks but do not kill them and are not 100 percent effective. Use a brand of insect repellent that is designated as child-safe if your child is 1 year or older. For infants, check with your pediatrician about what brands are safe to use. You can also treat clothing with a product that contains permethrin, which is known to kill ticks on contact.
Shower after outdoor activities are done for the day. It may take four to six hours for ticks to attach firmly to skin. Showering will help remove unattached ticks.
- all parts of the body that bend: behind the knees, between fingers and toes, underarms and groin
- other areas where ticks are commonly found: belly button, in and behind the ears, neck, hairline, and top of the head
- anywhere clothing presses on the skin
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How Long Does It Take To Show Signs Of Lyme Disease
Lyme disease is characterized by various symptoms. The discomforts are very varied and affect many organs. If a person becomes infected with the Borrelia burgdorferi bacterium by means of a tick bite, a reddish and annular lesion on the skin may appear after several days or weeks this would be the first manifestation.
In the first month of exposure to the tick, which in most cases the patient does not remember, early localized infection occurs, which is usually manifested by nonspecific flu-like symptoms and the appearance of migratory erythema, which is a papule or macula that extends painlessly to take the form of a target with the clearer center. Since a quarter of patients do not have migratory erythema, it is not uncommon for this first stage to go unnoticed and doctors receive a patient with symptoms of an early disseminated infection , after weeks or months of exposure. This stage could be initiated, for example, as a general condition with intense discomfort, diffuse pains, headache, asthenia or new cutaneous symptoms: annular lesions smaller than migratory erythema, or the rare presence of lymphocytoma cutis .
Considering the inconstancy and clinical variability of borreliosis in this phase, it has been called the great imitator.
In any case, and if we exclude the almost constant fatigue/lethargy, it seems that the most relevant and frequent presentation symptoms are neurological, followed by the musculoskeletal and dermatological signs.
Investigation Of Suspected Lyme Disease
Erythema migrans is a clinical diagnosis and does not require confirmation by laboratory testing. Lyme disease is not a notifiable disease so there is no statutory requirement to notify clinically suspected cases to the local Health Protection Team.
The 2018 NICE Lyme disease guideline provides detailed advice about when a diagnosis of Lyme disease should be suspected and about which tests to use and when.
The NICE Lyme disease guideline also contains a useful summary diagram of the routine serological testing recommendations for Lyme disease.
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Other Lyme Disease Tests
Three other tests that may be used to diagnose Lyme disease are polymerase chain reaction , antigen detection and culture testing. They are called direct tests because they detect the bacteria, not just your immune response to it.
PCR multiplies a key portion of DNA from the Lyme bacteria so that it can be detected. While PCR is highly accurate when the Lyme DNA is detected, it produces many false negatives. This is because the Lyme bacteria are sparse and may not be in the sample tested.
Antigen detection tests look for a unique Lyme protein in fluid . Sometimes people whose indirect tests are negative are positive on this test.
Culture is the gold standard test for identifying bacteria. The lab takes a sample of blood or other fluid from the patient and attempts to grow Lyme spirochetes in a special medium.
Although culture tests are generally accepted as proof of infection, the CDC has advised caution on the only commercially available culture test developed by Advanced Laboratory Services. LDo recognizes that the test is new and requires further validation in other studies. However, we believe that informed patients should be able to choose the test if they prefer. Choice is particularly important given the low quality of Lyme disease tests generally.
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 there’s 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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Management Of Individuals Without Symptoms Following A Tick Bite
Diagnostic testing is not recommended for individuals who do not develop any symptoms suggestive of Lyme disease after a tick bite.
Some commercial companies offer services to test removed ticks for the presence of the bacteria that cause Lyme disease. UKHSA does not provide such tick-testing services. The results of such tests should not be used to inform diagnosis or treatment. A positive result does not mean that the infected tick will have passed on the bacteria there are many factors that determine whether Lyme disease results from the bite of an infected tick. A negative result may not be technically valid and could give false assurance, as it does not exclude the possibility that another tick elsewhere on the body has been missed by the patient.
UKHSA runs a tick surveillance scheme and is happy to receive ticks for species identification and to monitor tick distribution.
What Is Lyme Disease
Lyme disease is a multistage, multisystem bacterial infection caused by the Borrelia burgdorferi bacterium. It is transmitted by the bite of blacklegged tick .
Blacklegged ticks can be as small as a poppy seed, making it extremely difficult to spot them on the body. Blacklegged ticks are very common in certain areas in the United States including:
- The northeast
- The mid-Atlantic states
- The north central states of Wisconsin and Minnesota
- Northern California
Lyme disease was first reported in the U.S. in 1977, in Old Lyme, CT, giving the disease its name. Blacklegged ticks are most often found in wooded and grassy areas, but can be transported by animals to other areas.
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Serological Testing Of Csf For The Diagnosis Of Neurological Lyme Disease
Serological testing for neurological Lyme disease is based on demonstrating intrathecal synthesis of Borrelia-specific antibodies in CSF. For laboratory testing for neurological Lyme disease, IgG ViraChip® serology assays are performed on CSF and paired serum and the results compared.
CSF samples must be tested in parallel with a contemporaneous serum sample and albumin and total IgG levels compared between the 2 sample types to produce a meaningful result.
For necessary sample types and volumes see Sample types for Lyme disease testing.
Investigation Of Suspected Neurological Lyme Disease
The diagnosis of neurological Lyme disease can only be confirmed by examination of the CSF and a paired serum sample. A definite diagnosis is based on the presence of a pleocytosis in the CSF, demonstration of intrathecal synthesis of specific antibodies to Borrelia species in CSF by comparison to serum and the presence of neurological symptoms. It is not possible to confirm intrathecal synthesis and hence definite neurological Lyme disease without a paired serum .
In 2018 RIPL introduced a service for the detection of intrathecal synthesis of Borrelia-specific antibodies which is summarised in this flow diagram. An accessible text version of this flowchart is available below.
Clinicians may ask for guidance on laboratory testing of CSF from RIPL if required.
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How Prevalent Is Ld In Canada
Black-legged tick populations are well established in parts of British Columbia, Manitoba, Ontario, Quebec, New Brunswick and Nova Scotia, and may be expanding. Migratory birds can bring infected ticks into nonendemic areas, and people may also become infected while travelling to other endemic areas in North America and Europe. In 2009, LD became a nationally reportable disease. The number of reported cases has increased from 128 in 2009 to an estimated 500 in 2013.
What Are The Symptoms Of Lyme Disease In A Child
Symptoms can occur a bit differently in each child. They usually appear within 3 to 30 days after a tick bite. Lyme disease has early and late-stage symptoms. Early stage Lyme disease is more easily cured with antibiotics than late-stage disease. Most cases of late-stage disease occur when early stage disease is not treated.
One of the most common symptoms is a ring-shaped rash that looks like a bull’s-eye. It may be pink in the center and have a darker red ring around it. The rash does not occur in every case of Lyme. If it does occur, the rash may:
- Appear several days after infection
- Last up to several weeks
- Be very small or very large, up to 12 inches across
- Look like other skin problems such as hives, eczema, sunburn, poison ivy, or flea bites
- Itch or feel hot, or not be felt at all
- Go away and come back several weeks later
Several days or weeks after a bite from an infected tick, your child may have multiple ring-shaped rashes on the body and flu-like symptoms such as:
Months to a few years after a bite, these symptoms may occur:
- Inflammation of the joints
- Nervous system symptoms such as numbness in the arms and legs, tingling and pain, and trouble with speech, memory, and concentration
The symptoms of Lyme disease can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.
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What Do The Results Mean
The Centers for Disease Control and Prevention recommends a two-test process of your sample:
- If your first test result is negative for Lyme disease, you donât need any more testing.
- If your first result is positive for Lyme disease, your blood will get a second test.
- If both results are positive for Lyme disease and you also have symptoms of infection, you probably have Lyme disease.
Positive results donât always mean a Lyme disease diagnosis. In some cases, you can have a positive result but not have an infection. Positive results may also mean you have an autoimmune disease, such as lupus or rheumatoid arthritis.
If your lumbar puncture results are positive, it may mean you have Lyme disease, but you might need more tests to confirm a diagnosis.
If your health care provider thinks you have Lyme disease, he or she will prescribe antibiotic treatment. Most people who are treated with antibiotics in the early stage of disease will make a complete recovery.
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What To Do If You Find A Tick
If you see a tick, try to remove it from your childs body. If the tick was on the body for less than 36 hours, it may help prevent infection.
To safely remove a tick:
- Use fine-tipped tweezers to grasp the tick at its head or mouth, close to the skin.
- Pull firmly on the tick until it releases the skin. Try to ease out any parts that get stuck in the skin.
- Wash the bite area with rubbing alcohol or soap and water and apply an antiseptic lotion or cream.
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