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 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.
Symptoms Of Post Treatment Lyme Disease
- Include severe fatigue, musculoskeletal pain, & cognitive problems
- Can significantly impact patients health and quality of life
- Can be debilitating and prolonged
Our research indicates the chronic symptom burden related to PTLD is significant. Although often invisible to others, the negative impact on quality of life and daily functioning is substantial for PTLD sufferers.
The chronic symptom burden related to Lyme disease is considerable, as shown on the left side of the graph above, and statistically significantly greater than the aches and pains of daily living experienced by the control group, on the right.
The Trouble In Treating Lyme Disease
Lyme disease is one of the most underdiagnosed and misdiagnosed conditions today. Doctors focus on treating your symptoms rather than addressing the root cause. Unless you have a noticeable bullseye rash or find a tick on your body, your doctor may not even think to test you for Lyme disease. This is especially true since the symptoms of Lyme disease mimic those of many other ailments.
Even when doctors do test for Lyme disease, the results arent always accurate. The current two-step testing process is only accurate a small percentage of the time. Rather than send you to a Lyme-literate specialist for a second opinion, doctors again focus on treating your symptoms.
The longer you go without being accurately diagnosed and treated, the more chronic and painful your symptoms become. They can become so severe that they interfere with your ability to function at work, home, and socially.
IV Infusion therapies as a Lyme disease treatment are showing promise in the treatment and elimination of Lyme bacteria and can be given at any stage of the disease.
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Complementary And Alternative Therapies
You should never treat Lyme disease with complementary therapies alone. Only proper antibiotic treatment can cure the disease and avoid complications.
Newsletters and Internet sites have cropped up in recent years advertising untested treatments to people with symptoms of post-Lyme disease syndrome or so-called “chronic Lyme disease” who are frustrated with standard medical treatment. Some remedies may be dangerous and ineffective. Always tell all of your doctors about the herbs and supplements you are using or considering using.
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.
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What Is The Treatment For Lyme Disease
The first-line standard of care treatment for adults with Lyme disease is doxycycline, a tetracycline antibiotic. Other antibiotics that have activity against borrelia include the penicillin-like antibiotic, amoxicillin, and the second generation cephalosporin, Ceftin. The mainstay of treatment is with oral antibiotics, but intravenous antibiotics are sometimes indicated for more difficult to treat cases of neurologic-Lyme disease, such as meningitis, and cases of late Lyme arthritis.
For Depression And Anxiety
Both psychotherapy and pharmacotherapy have proven benefits for improving mood. Psychotherapy has many different types such as supportive, dynamic, cognitive behavioral, dialectical behavior therapy, transference focused psychotherapy each of which offers benefit. Pharmacotherapy also has many different types. For depression the first-line options usually are SSRIs, SNRIs, Tricyclics or other agents with more unique modes of action.
A few noteworthy tips on anti-depressant agents:
- Most anti-depressant agents also help in reducing anxiety. However the opposite isn’t necessarily true. Specific anti-anxiety agents such as clonazepam or diazepam may not necessarily help fight depression.
- Most anti-depressants take three to eight weeks before an effect is seen. Therefore, it is unwise to stop an anti-depressant after only three or four weeks, as staying on it another two to three weeks may lead to a good response.
- Dosage makes a difference. Some anti-depressants work fine at low doses some medications however are effective only at higher doses. Some medications are more effective as the dose is increased. Other antidepressants may have a therapeutic range one has to achieve at least a certain dosage .
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Stage : Early Localized Disease
Symptoms of Lyme disease usually start 3 to 30 days after the tick bite. One of the earliest signs of the disease is a bulls-eye rash.
The rash occurs at the site of the tick bite, usually, but not always, as a central red spot surrounded by a clear spot with an area of redness at the edge. It may be warm to the touch, but its not painful and doesnt itch. This rash will gradually fade in most people.
The formal name for this rash is erythema migrans.
Some people with lighter skin have a rash thats solid red. Some people with darker skin may have a rash that resembles a bruise.
The rash can occur with or without systemic viral or flu-like symptoms.
Other symptoms commonly seen in this stage of Lyme disease include:
Youll have a general feeling of being unwell. A rash may appear in areas other than the tick bite.
This stage of the disease is primarily characterized by evidence of systemic infection, which means infection has spread throughout the body, including to other organs.
Symptoms can include:
- disturbances in heart rhythm, which can be caused by Lyme carditis
- neurologic conditions, such as numbness, tingling, facial and cranial nerve palsies, and meningitis
The symptoms of stages 1 and 2 can overlap.
Two Standards Of Care For Lyme Disease Treatment
There is significant controversy in science, medicine, and public policy regarding Lyme disease. Two medical societies hold widely divergent views on the best approach to diagnosing and treating Lyme disease. The conflict makes it difficult for patients to be properly diagnosed and receive treatment.
One medical society, the Infectious Diseases Society of America , regards Lyme disease as hard to catch and easy to cure with a short course of antibiotics. IDSA claims that spirochetal infection cannot persist in the body after a short course of antibiotics. The group also denies the existence of chronic Lyme disease.
In contrast, the International Lyme and Associated Diseases Society , regards Lyme disease as often difficult to diagnose and treat, resulting in persistent infection in many patients. ILADS recommends individualized treatment based on the severity of symptoms, the presence of tick-borne coinfections and patient response to treatment.
LDo believes that patients and their doctors should make Lyme disease treatment decisions together. This requires that patients be given sufficient information about the risks and benefits of different treatment options. Then, patient and health care provider can collaborate to reach an informed decision, based on the patients circumstances, beliefs and preferences.
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Why This Case Was Significantly Important As An Emerging Infection
Lyme borreliosis is the most common tick-borne disease of pronounced public health importance in countries with moderate climate in the Northern Hemisphere.1 Its increasing incidence1,2 may be a consequence of a range of environmental factors, together with changing human behavior.3 Unfortunately, LB has become a misdiagnosis also for non-specific chronic symptoms such as arthralgias, myalgias, headache, and fatiguesymptoms frequently present in the general population. The diagnosis of LB is too often based on erroneous interpretations of microbiological test results, whereas patients with typical clinical signs may stay undiagnosed and untreated.
Linda K. Bockenstedt, in, 2017
Where Are Ticks Found
Ticks are found throughout the UK and in other parts of Europe and North America. There are a high number of ticks in the Scottish Highlands.
They 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.
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What Are The Signs And Symptoms Of Lyme Disease
Early symptoms usually appear within 3 to 30 days after the bite of an infected tick. In 60-80 percent of cases, a circular bulls 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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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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How To Prevent Lyme Disease
People with pets should:
- Use reliable tick-preventive products. Speak with your veterinarian about what tick preventive product is right for your pet.
- Work with your veterinarian to decide whether to vaccinate your dog against Lyme disease. Your veterinarians advice may depend on where you live, your pet’s lifestyle and overall health, and other factors.
- When possible, avoid areas where ticks might be found. These include tall grasses, marshes and wooded areas.
- Check for ticks on both yourself and your animals once indoors.
- Clear shrubbery next to homes.
- Keep lawns well maintained.
As noted above, there are preventive Lyme disease vaccines available for dogs, but they aren’t necessarily recommended for every dog. Consult your veterinarian to see if the vaccination makes sense for your pets. If your veterinarian does recommend that your dog be vaccinated against Lyme disease, the typical protocol will involve an initial vaccination followed by a booster 2-4 weeks later and annual boosters after that.
How Is Lyme Disease Treated
Antibiotics, usually doxycycline or amoxicillin, are effective treatments for Lyme disease. How long your treatment lasts depends on the stage of infection. In general, its true that the sooner youre treated, the quicker and more complete the recovery.
Pregnant people should receive treatment for Lyme disease as well. There is, however, no evidence that a fetus can get the infection from its parent. Theres also no strong evidence that miscarriages are more likely after Lyme disease.
What should I do if a tick bites me?
If a tick bites you, the best way to remove it is by taking the following steps:
- Tug gently but firmly with blunt tweezers near the “head” of the tick at the level of your skin until it releases its hold on your skin.
- Avoid crushing the tick’s body or handling the tick with bare fingers because you could expose yourself to the bacteria in the tick.
- Wash the bite area thoroughly with soap and water.
- Don’t use kerosene, petroleum jelly or hot cigarette butts to remove the tick.
- Don’t squeeze the tick’s body with your fingers or tweezers.
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Late Or Chronic Lyme Disease Treatment
Experts agree that the earlier you are treated the better, since early treatment is often successful. Unfortunately, a substantial portion of patients treated with short-term antibiotics continue to have significant symptoms. The quality of life of patients with chronic Lyme disease is similar to that of patients with congestive heart failure. Doctors dont agree about the cause of these ongoing symptoms. The primary cause of this debate is flawed diagnostic testing. There is currently no test that can determine whether a patient has active infection or whether the infection has been eradicated by treatment.
The IDSA thinks Lyme disease symptoms after treatment represent a possibly autoimmune, post-Lyme syndrome that is not responsive to antibiotics. The IDSA essentially regards Lyme disease as an acute infection like strep throat that can be treated with a short course of antibiotics. The IDSA guidelines are now eight years old and do not reflect recent science.
ILADS physicians believe that ongoing symptoms probably reflect active infection, which should be treated until the symptoms have resolved. These physicians use treatment approaches employed for persistent infections like tuberculosis, including a combination of drugs and longer treatment durations. The ILADS guidelines have just recently been updated using a rigorous review of the medical literature.
What Are The Side Effects Of Lyme Disease Treatments
Antibiotics, like all medications, have the potential for side effects. Any antibiotic can cause skin rashes, and if an itchy red rash develops while on antibiotics, a patient should see their physician. Sometimes symptoms worsen for the first few days on an antibiotic. This is called a Herxheimer reaction and occurs when the antibiotics start to kill the bacteria. In the first 24 to 48 hours, dead bacterial products stimulate the immune system to release inflammatory cytokines and chemokines that can cause increased fever and achiness. This should be transient and last no more than a day or two after the initiation of antibiotics.
The most common side effect of the penicillin antibiotics is diarrhea, and occasionally even serious cases caused by the bacteria Clostridium difficile. This bacterial overgrowth condition occurs because antibiotics kill the good bacteria in our gut. It can be helpful to use probiotics to restore the good bacteria and microbiome balance.
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Can Lyme Disease Be Prevented Or Avoided
The best way to prevent Lyme disease is to avoid being bitten by ticks. When you are outdoors, follow these guidelines:
- Avoid areas that are wooded, brushy, or have tall grass.
- Walk in the center of trails.
- Use an insect repellent with at least 20% DEET. It can be put on clothing or sparingly on the skin. Dont apply it to the face or hands of children.
- Treat clothing, tents, or other gear with repellents containing 0.5% permethrin.
- Wear light-colored clothing. This makes it easier to see and remove ticks from your clothes.
- Wear a long-sleeved shirt and long pants. Tuck your pant legs into your socks or boots for added protection.
After you get home, check everything and everyone for ticks.
- Bathe or shower as soon as you can to wash off any ticks that have not attached to you.
- Check your entire body for ticks. Use a mirror for places you cant see. Check your children and your pets. Common tick locations include the back of the knees, groin area, underarms, ears, scalp, and the back of the neck.
- Check any gear you used, including coats, backpacks, or tents.
Tumble dry clothes or blankets on high heat in the dryer for 10 to 15 minutes. This should kill any ticks. If clothes are dirty, wash them in hot water and dry on high heat for 60 minutes.
Diagnosis And Treatment Of Lyme Disease
- Robert L. BrattonCorrespondenceIndividual reprints of this article are not available. Address correspondence to Robert L. Bratton, MD, Department of Family Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259Affiliations
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Postlyme Disease Symptoms And Syndrome
The outcome of treatment in most patients with erythema migrans is excellent. Studies show, however, that when questioned at 6 months or more aftertreatment of erythema migrans, approximately 10% of patients will report purely subjective symptoms such as fatigue or musculoskeletal pains.17 These subjective symptoms are typically mild and may wax and wane in intensity. Patients who have them are referred to as having postLyme disease symptoms or syndrome, depending on the symptom duration and severity. The cause of these symptoms is currently unknown. Carefully done microbiologic evaluations in the United States have failed to find evidence of either persistentB. burgdorferi infection or a coinfection with a secondIxodes-transmitted pathogen. In patients with persistent symptoms attributed to Lyme disease, longer-term antibiotic treatment has been shown to have no additional beneficial effects on health-related quality of life beyond those with shorter-term treatment.A4 Furthermore, retreatment has provided either no measurable benefit or a benefit so modest or ambiguous that it was outweighed by the risks associated with the antibiotic therapy.17b Therefore, symptomatic treatment is recommended for such patients.