Wednesday, September 21, 2022

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The Numbers On Chronic Lyme

Lyme Disease Signs and Symptoms (2 of 5) | Johns Hopkins Medicine

Because Lyme disease is commonly missed or misdiagnosed, statistics vary on how many Lyme patients go on to experience chronic symptoms. The following research nonetheless paints a basic picture of the problem.

  • An estimated 5-20% of patients may have chronic symptoms after getting Lyme disease, according to the Columbia University Irving Medical Center.
  • The treatment failure rate for chronic Lyme disease patients was estimated at 26-50% in 2004, compared to 16-39% for early Lyme patients, according to Lymedisease.org.
  • Up to 15-40% of late-stage Lyme patients develop neurological disorders, which are responsible for many common symptoms of chronic Lyme disease.

Experts dont know for sure why some people experience persistent symptoms, even with treatment. However, some believe the Lyme infection may trigger an auto-immune response that manifests in the chronic symptoms detailed below.

How Is Lyme Disease Treated

With early-stage Lyme disease, youâll take antibiotics for about 10 days to 3 weeks. The most common ones are amoxicillin, cefuroxime, and doxycycline. The antibiotics will almost always cure your infection. If they donât, you might get other antibiotics either by mouth or as a shot.

If you donât treat your Lyme infection, you might need oral antibiotics for symptoms like weakened face muscles and irregular heartbeat. You may need antibiotics if you have meningitis, inflammation in your brain and spinal cord, or more severe heart problems.

If your Lyme is late stage, the doctor might give you antibiotics either by mouth or as a shot. If it causes arthritis, youâll get arthritis treatment.

Thereâs no therapy for post-treatment Lyme disease syndrome.

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Disclaimer: The above material is provided for information purposes only. The material is not nor should be considered, or used as a substitute for, medical advice, diagnosis, or treatment, nor does it necessarily represent endorsement by or an official position of Global Lyme Alliance, Inc. or any of its directors, officers, advisors or volunteers. Advice on the testing, treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patients medical history. Global Lyme Alliance, Inc. makes no warranties of any kind regarding this Website, including as to the accuracy, completeness, currency or reliability of any information contained herein, and all such warranties are expressly disclaimed.

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What Precautions Can I Take Against Tick Bites

  • Avoid wooded, brushy, and grassy areas, especially in May, June, and July.
  • Wear light-colored clothing so that you can see ticks that get on you.
  • Wear long pants and long-sleeved shirts, and shoes that cover the entire foot.
  • Tuck pant legs into socks or shoes, and tuck shirts into pants.
  • Wear a hat for extra protection.
  • Spray insect repellent containing DEET on clothes and uncovered skin.
  • Walk in the center of trails to avoid brush and grass.
  • Remove your clothing, and wash and dry them at high temperatures after being outdoors.
  • Do a careful body check for ticks after outdoor activities.

Unexplained Pain And Other Sensations

Signs and Symptoms

Some people with Lyme may have sharp rib and chest pains that send them to the emergency room, suspecting a heart problem 00090-7/abstract%20″ rel=”nofollow”> 27).

When no problem is found, after the usual testing, the ER diagnosis is noted as an unidentified musculoskeletal cause.

You can also have strange sensations like skin tingling or crawling, or numbness or itchiness 00090-7/abstract%20″ rel=”nofollow”> 27).

Other symptoms have to do with cranial nerves.

  • Ear-ringing . Tinnitus can be a nuisance, especially at bedtime when it seems to get louder as youre trying to fall asleep. About 10 percent of people with Lyme experience this (
  • Hearing loss. One study reported that 15 percent of Lyme patients experienced loss of hearing .
  • Jaw pain or toothaches that are not related to actual tooth decay or infection.

Summary:

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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.

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.

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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.

Summary:

Pull the tick out with tweezers and save it in a resealable container for identification.

Stage : Late Disseminated Lyme Disease

Long Haul Lyme Disease Risk Found: Even in Early Treated Patients | Johns Hopkins Rheumatology

Late disseminated Lyme disease occurs when the infection hasnt been treated in stages 1 and 2. Stage 3 can occur months or years after the tick bite.

This stage is characterized by:

  • arthritis of one or more large joints
  • brain disorders, such as encephalopathy, which can cause short-term memory loss, difficulty concentrating, mental fogginess, problems with following conversations, and sleep disturbance
  • numbness in the arms, legs, hands, or feet
  • farming
  • park or wildlife management

The majority of tick bites happen in the summer when ticks are the most active and people spend more time outside. However, its also possible to get Lyme disease from tick bites in early fall, and even in late winter if the weather is unseasonably warm.

Lyme disease prevention mostly involves decreasing your risk of experiencing a tick bite.

Take the following steps to prevent tick bites:

Contact a doctor if and whenever a tick bites you or your loved ones.

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Implementation Of Federal Framework And Action Plan

Recommendation 1

  • Focus on implementing the action items that are still in the early stages of implementation, or for which more needs to be done to achieve full implementation.

PHAC has made clear progress on implementing many of the action items described in the Federal Framework and Action Plan. However, there are number of areas where progress on action items has been limited or where further work is warranted . PHAC’s abilities to complete some Framework activities have been delayed due to competing pressures and priorities resulting from the response to COVID-19. In this context, PHAC should focus on fully implementing outstanding action items as soon as possible.

Who Gets Lyme Disease

Anyone bitten by an infected deer tick can get Lyme disease. Most U.S. cases of Lyme disease happen in Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin. But Lyme disease is also found in other parts of the U.S., Europe, and Asia.

Other things that might increase a person’s risk include:

  • spending a lot of time outdoors in tall grass, brush, shrubs, or wooded areas
  • having pets that may carry ticks indoors
  • activities such as yardwork, hiking, camping, fishing, or hunting in tick-infested areas

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Early Symptoms Of Lyme Disease

More than 30,000 cases of Lyme disease are reported to the Centers for Disease Control each year. The risk of Lyme disease is greatest in the spring and summer when the disease is commonly transmitted through tick bites.

Preventing tick bites is key to fending off an infection, but if you do get bit, look out for these early symptoms of Lyme disease:

What Are The First Signs And Symptoms Of Lyme Disease

Early disseminated Lyme disease

In the first early localized stage of Lyme disease the skin at the site of the tick bite becomes infected with Borrelia burgdorferi bacteria which can cause an expanding round or oval red skin lesion called erythema migrans. This may or may not be associated with flu-like symptoms within days to a month after the tick bite such as achiness, chills, fever, sweats, fatigue, malaise, headache, stiff neck, muscle soreness, joint pain, swollen lymph nodes, and sore throat. The combination of the skin lesion and flu-like symptoms are the primary manifestations of acute stage Lyme disease. Acute Lyme disease is not associated with typical cold-like symptoms of runny nose, prominent cough, or prominent diarrhea.

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Lyme Disease: Symptoms And Stages

Symptoms of early-stage Lyme disease include:

  • muscle and joint aches
  • fatigue
  • swollen lymph nodes

Another common symptom of Lyme disease is a rash . As many as 80% of infected people may develop a rash, and roughly 20% of the time the rash has a characteristic bull’s-eye appearance.

When left untreated, infection can spread to joints, the heart, and the nervous system.

Later-stage symptoms may not appear until weeks or months after a tick bite occurs. They include:

  • heart-rhythm irregularities
  • arthritis
  • nervous system abnormalities

Permanent damage to the joints or the nervous system can develop in patients with late Lyme disease. It is rarely, if ever, fatal.

What Is The Outlook For Someone With Lyme Disease

Most of the people who get Lyme disease and are treated early will be fine.

Post-Lyme Syndrome

Even after proper treatment, some patients may experience lingering fatigue, achiness or headaches. This does not signify ongoing infection and will not respond to additional antibiotics. The majority of people in this group will have symptoms resolve over the next one to six months.

Chronic Lyme Syndrome

Chronic Lyme syndrome is a term used by some that includes the symptoms of Post-Lyme syndrome outlined above. This is a controversial topic with no accepted etiology and no proven cause or association.

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What Blacklegged Ticks Look Like

Blacklegged ticks are small and hard to see. They attach themselves to humans and animals and feed on their blood. They can range in size depending on how long they have been feeding.

You can find out if its a blacklegged tick by:

Adult female blacklegged tick at various stages of feeding. Photo: Government of Canada

Lyme Disease Signs And Symptoms

A young man’s Lyme disease progresses quickly

Most symptoms of Lyme disease in humans usually appear between three and 30 days after a bite from an infected blacklegged tick.

You should contact your local public health unit or speak to a health care professional right away if you have been somewhere that ticks might live and experience any of the following symptoms:

  • rash
  • a bulls-eye rash (a red patch on the skin that is usually round or oval and more than 5 cm that spreads outwards and is getting bigger
  • a bruise-like rash
  • another type of unusual rash
  • muscle aches and joint pains
  • fatigue
  • swollen lymph nodes
  • spasms, numbness or tingling
  • facial paralysis

If not treated, Lyme disease can make you feel tired and weak and, if it gets really bad, it can even harm your heart, nerves, liver and joints. Symptoms from untreated Lyme disease can last years and include recurring arthritis and neurological problems, numbness, paralysis and, in very rare cases, death.

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How To Avoid Getting A Tick Bite

You might be at risk if you live, work in, or visit a wooded area, or an area with tall grasses and bushes .

You may also be at risk if you are involved in outdoor activities such as hiking, camping and gardening.

You may be bitten by a tick and not even know it.

Heres what you can do to avoid getting a tick bite.

Pearls And Other Issues

Based on the geographic distribution of the shared vector Ixodes scapularis, co-infections with Lyme disease and human granulocytic anaplasmosis and/or babesiosis can occur. Co-infected patients may be more severely ill at presentation, have a persistent fever longer than 48 hours after initiating antibiotic therapy for Lyme disease, or present with anemia, leukopenia, and/or thrombocytopenia. When co-infection is suspected or confirmed, treatment with an appropriate antimicrobial regimen for each infection is necessary for resolution of illness.

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Stage : Later Symptoms

  • shooting pains, numbness or tingling in the hands or feet
  • heart palpitations

These symptoms may go away without treatment within a few weeks or months. However, some people develop chronic Lyme disease and have lasting symptoms.

Around of people who do not receive treatment for the disease develop recurrent episodes of arthritis with severe swelling, especially in the large joints.

How Can Lyme Disease Be Prevented

Lyme Disease: 10 Lyme Disease Symptoms

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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Complications Of Untreated Lyme Disease

If unchecked, the Lyme disease infection can spread to other bodily systems, causing significant damage. Untreated, complications of this condition can be very severe:

  • Arthritis:Prolonged infection with Lyme disease leads to chronic joint inflammation and swelling, usually in the knees . These symptoms tend to arise within two years of infection, with periods of flare-ups and remissions. This arthritis is relatively difficult to manage, though antibiotics and steroids may be attempted.
  • Lyme carditis:If the bacteria reach the heart tissues, they can cause inflammation and lead to heart block. The electrical signals being sent between the upper and lower chambers of the heart are interrupted, impairing the coordination of the heartbeat. Though disruptive, this is rarely fatal.
  • Lyme neuroborreliosis:Inflammation of multiple nerves, including those in the spine and brain, is the chief characteristic of this condition. This can also affect the meningesthe layer of tissue surrounding the brain and spineleading to meningitis, among other conditions. Antibiotic therapy, if applied promptly, tends to be effective as a treatment.

Even in cases where Lyme disease has progressed, antibiotic regimensespecially drugs like doxycyclineare generally successful in resolving problems.

Understanding The Findings In This Report

While the Federal Framework on Lyme Disease and Action Plan clearly define activities expected to be achieved in the period of 2017 to 2022, the Framework does not include ways to measure success. In order to assess success in a consistent manner, OAE developed an evaluation rubric that provides standardized descriptions to assess the extent to which progress was made, and identify remaining opportunities for improvement . Effectiveness was assessed on the basis of reach to target populations, use of products and tools, quality of products and tools, and impacts of these products and tools in terms of awareness and behaviour change. These characteristics of success are based on similar approaches used in previous evaluations of health programs with a knowledge translation component. Reference 17 The rubric was used to guide analysis, conclusions, and associated recommendations.

Surveillance

Key takeaways

Implementation: What has been done?

Rubric Score: Progress Made, Further Work Warranted

Since 2017, PHAC has supported and directly implemented surveillance activities for Lyme and other tick-borne diseases, building on efforts that predate the Framework. Nonetheless, work still needs to be done to complete some of the commitments in the Action Plan accompanying the Federal Framework.

The Federal Framework commits to 4 actions related to ticks and tick-borne disease surveillance. These were:

  • Perform an analysis of the costs associated with Lyme disease and
  • Reach
    Quality

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