Frequently Asked Questions About Lyme Disease
ILADEF is devoted to training doctors and other medical professionals in the diagnosis and treatment of Lyme. ILADEF, and our sister organization ILADS, also believes that increasing the public’s awareness of Lyme and its effects is one of the most important steps we can take to reducing the incidence of Lyme and other tick-borne diseases.
The information below is for educational purposes only. It is not intended to replace or supersede patient care by a healthcare provider. If you suspect the presence of a tick-borne illness, you should consult a healthcare provider who is familiar with the diagnosis and treatment of tick-borne diseases. Our provider search can help you find doctors in your area.
Why Isnt A Test Result Enough To Tell Me If I Have Lyme
Common tests for Lyme disease include ELISAs and Western blots. Both tests work by detecting the patients antibodies reacting to the Borrelia burgdorferi bacteria. Many factors affect that response and the tests ability to measure it, and can produce both false positive and false negative results. Although the CDC recommends a two-step testing process, consisting of an ELISA as a first test, followed by a Western Blot only if the ELISA is positive or uncertain, i.e. no further testing if the first step is negative, this testing scheme is insensitive. Additionally, positive results might reflect an old, rather than current infection. This is why testing is only one part of the information that contributes to making the diagnosis.
Where Is Lyme Disease A Problem
Since 1975 when it was first noted, thousands of cases have been reported in the USA. Lyme disease is less common in the UK. 730 cases were confirmed in 2015 in England and Wales. Not all are reported so the total number of cases each year is unknown. However, it is estimated to be 2,000 to 3,000. This is because many cases are not formally diagnosed and clear away without any treatment. Many people affected are forestry workers and other outdoor workers but visitors and holidaymakers to countryside areas where ticks are found are at risk.
Over half of infections acquired in the UK are known to have been caught in the southern counties of England. Areas where it is most common tend to be centres of outdoor activity – in particular, the New Forest, Thetford Forest, the South Downs, Exmoor, the Lake District, the North York moors and the Scottish Highlands. Up to a fifth of Lyme disease is caught while abroad – in particular, the USA, France, Germany, Austria, Scandinavia and eastern and central Europe.
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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.
What Is The Outcome
If you are treated with antibiotic medication in stage one of the disease, you have a very good chance of a complete cure with no further problems.
If you are not treated in stage one, you may go on to develop some symptoms of stage two or three. However, these are often mild and transient symptoms such as a skin rash or mild joint pains. Some people develop more severe symptoms if they progress to stage two or three. Treatment with antibiotics during stage two or three is also usually curative. However, a prolonged course of antibiotics may be needed. It may be difficult to treat post-Lyme syndrome, as it is not yet known what causes these ongoing symptoms. However, most eventually clear up with time.
Infection with Lyme disease does not produce lifelong immunity so you will need to continue with tick bite prevention measures to reduce the risk of further infection.
Further reading and references
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What Are The Symptoms Of Lyme Disease
Early symptoms of Lyme disease start between 3 to 30 days after an infected tick bites you. The symptoms can include:
- A red rash called erythema migrans . Most people with Lyme disease get this rash. It gets bigger over several days and may feel warm. It is usually not painful or itchy. As it starts to get better, parts of it may fade. Sometimes this makes the rash look like a “bull’s-eye.”
- Muscle and joint aches
- Swollen lymph nodes
If the infection is not treated, it can spread to your joints, heart, and nervous system. The symptoms may include:
- Severe headaches and neck stiffness
- Additional EM rashes on other areas of your body
- Facial palsy, which is a weakness in your facial muscles. It can cause drooping on one or both sides of your face.
- Arthritis with severe joint pain and swelling, especially in your knees and other large joints
- Pain that comes and goes in your tendons, muscles, joints, and bones
- Heart palpitations, which are feelings that your heart is skipping a beat, fluttering, pounding, or beating too hard or too fast
- Shooting pains, numbness, or tingling in the hands or feet
When Should You See A Doctor If You Think You Have Lyme
The rash is a pretty good indication that you may have been bitten. Take a photo of the rash and see your doctor. At this stage, treatment with antibiotics will probably work.
If you don’t have the rash but have symptoms like fatigue, fever, and headache but no respiratory symptoms like a cough, you may want to talk to your doctor.
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What Can A Workplace Or Home Do To Reduce The Presence Of Ticks
Keep the lawn and yard well maintained to prevent ticks from living near the home or workplace.
- Keep the grass mowed. Trim trees and shrubs.
- Remove leaf litter, brush, and weeds at the edge of the lawn, and around stonewalls and woodpiles.
- Clean up and seal stonewalls and small openings around the home to help discourage rodents.
- Keep stacked firewood piles and bird feeders away from buildings.
- Keep any pets, particularly dogs, out of the woods and talk to your veterinarian about tick repellents for your pets.
- Move children’s swing sets and sandboxes away from the woodland’s edge and use a woodchip or mulch foundation.
- Consider using hard landscape items such as woodchips, mulch, stones, gravel, tile, or metals.
- Create a border or barrier between the lawn, woods, or stonewalls to discourage deer and rodent activity.
- Widen woodland trails.
Lyme Disease: Signs And Symptoms
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This publication is available at https://www.gov.uk/government/publications/lyme-disease-signs-and-symptoms/lyme-disease-signs-and-symptoms
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How Is Lyme Disease Spread
Not all deer ticks are infected with the bacteria that cause Lyme disease. Ticks can become infected if they feed on animals such as mice and other mammals that are infected. The disease can be spread when an infected tick bites a person and stays attached for a period of time. In general, the tick must be attached for 36 to 48 hours or more. Lyme disease does not spread from one person to another. Transfer of the bacteria from an infected pregnant woman to her fetus is extremely rare.
What Are The Complications Of Lyme Disease
Lyme disease affects people differently. Relapse and incomplete treatment responses happen. Relapse and incomplete treatment responses happen. Complications of untreated early-stage disease include:
Frequent hospitalizations to manage the disease
Some of these complications result in chronic, debilitating conditions.
Some people may develop post-Lyme disease syndrome . A condition also known as chronic Lyme disease includes PLDS, but also other syndromes. Usually, these are characterized by persistent musculoskeletal and peripheral nerve pain, fatigue, and memory impairment.
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What Is Borrelia Mayonii
Borrelia mayonii are a type of bacteria recently found in North America that can cause Lyme disease. These bacteria are different from the three types of bacteria that cause most cases of Lyme disease worldwide.
- Borrelia burgdorferi
- B. afzelii
- B. garinii
B. mayonii is the only species besides B. burgdorferi shown to cause Lyme disease in North America.
How Do People Get Lyme Disease
Most people get Lyme from the bite of the nymphal, or immature, form of the tick. Nymphs are about the size of a poppy seed. Because they are so tiny and their bite is painless, many people do not even realize they have been bitten.
Once a tick has attached, if undisturbed it may feed for several days. The longer it stays attached, the more likely it will transmit the Lyme and other pathogens into your bloodstream. Refer to tick section.
If pregnant women are infected, they sometimes pass Lyme disease to their unborn children and, while not common, stillbirth has occurred. Some doctors believe other types of human-to-human transmission are possible but little is known for certain.
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Who Gets Lyme Disease
Lyme disease can affect people of any age. People who spend time outdoors in activities such as camping, hiking, golfing, or working or playing in grassy and wooded environments are at increased risk of exposure. The chances of being bitten by a deer tick are greater during times of the year when ticks are most active. Ticks can be active any time the temperature is above 45° F. Young deer ticks, called nymphs, are active from mid-May to mid-August and are about the size of poppy seeds. Adult ticks are most active from March to mid-May and from mid-August to November and are about the size of sesame seeds. Both nymphs and adults can spread Lyme disease. Infected deer ticks can be found throughout New York State.
How Can I Get Lyme Disease
Most commonly Lyme Disease is acquired from the bite of an infected black-legged tick. In the United States, two types of black-legged ticks, Ixodes scapularis in the Northeast and upper Midwest and Ixodes pacificus in the West, transmit Lyme disease, caused by Borrelia burgdorferisensu stricto. Black-legged ticks in other parts of the world transmit B. burgdorferi and several other Borrelia species.
Black-legged ticks are also known to transmit Borellia miyamotoi and Borrelia mayonii, two bacteria that cause Lyme-like illnesses. The lone star tick, Amblyomma americanum is the vector or STARI, a Lyme-like illness of uncertain cause.
Ixodes ticks vary in size from a poppy-seed size nymphal tick to a sesame-seed size adult tick. Ticks can carry other infectious agents besides the bacterium that causes Lyme disease, including Ehrlichia, Anaplasma, Babesia, and possibly Bartonella. Infections involving multiple pathogens can be more difficult to diagnose and treat.
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What Tests Are Used To Diagnose B Mayonii
Your healthcare provider may order a blood test to look for infection. Limited available information suggests that patients with B. mayonii infection develop antibodies that are similar to those of patients infected with B. burgdorferi. Therefore, Lyme disease serologic testing may help in diagnosing patients with B. mayonii. In some cases, B. mayonii bacteria may also be seen on a blood smear. Infection with B. mayonii can be specifically identified by Lyme disease molecular tests at Mayo Clinic. Lyme disease, including infection with B. mayonii, can be diagnosed without testing when patients have signs and symptoms consistent with Lyme disease and a history of possible exposure to blacklegged ticks.
How Can Lyme Disease Be Prevented
In areas where ticks are found, people should know about the risk of Lyme disease and should take precautions to protect themselves. Be aware of the signs and symptoms of Lyme disease so it can be detected and treated promptly. PHAC states that removing ticks within 24 to 36 hours after the tick bite usually prevents infection.
PHAC has also prepared a Lyme disease tool kit which provides material to raise awareness and educate.
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Can Lyme Disease Be Prevented
To prevent Lyme disease, you should lower your risk of getting a tick bite:
- Avoid areas where ticks live, such as grassy, brushy, or wooded areas. If you are hiking, walk in the center of the trail to avoid brush and grass.
- Use an insect repellent with DEET
- Treat your clothing and gear with a repellant containing 0.5% permethrin
- Wear light-colored protective clothing, so you can easily see any ticks that get on you
- Wear a long-sleeve shirt and long pants. Also tuck your shirt into your pants and your pant legs into your socks.
- Check yourself, your children, and your pets daily for ticks. Carefully remove any ticks you find.
- Take a shower and wash and dry your clothes at high temperatures after being outdoors
Centers for Disease Control and Prevention
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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How To Spot And Remove Ticks
Once youve come in from outside, one of the best ways to check yourself for ticks is to take a shower and bath.
Other than that, do your best to check your clothes, especially the folds of your clothes, knowing that ticks can be very small and hard to spot. Running your hands through your hair is also a good idea.
Who Is At Risk For Lyme Disease
Anyone can get a tick bite. But people who spend lots of time outdoors in wooded, grassy areas are at a higher risk. This includes campers, hikers, and people who work in gardens and parks.
Most tick bites happen in the summer months when ticks are most active and people spend more time outdoors. But you can get bitten in the warmer months of early fall, or even late winter if temperatures are unusually high. And if there is a mild winter, ticks may come out earlier than usual.
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Who’s At Risk And Where Are Ticks Found
The risk of getting Lyme disease is higher:
- for people who spend time in woodland or moorland areas
- from March to October because more people take part in outdoor activities
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.
It’s thought only a small proportion of ticks carry the bacteria that cause Lyme disease. Being bitten doesn’t mean you’ll definitely be infected. However, it’s important to be aware of the risk and speak to a GP if you start to feel unwell.
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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What Is Lyme Disease
Lyme disease is a bacterial infection you get from the bite of an infected tick. At first, Lyme disease usually causes symptoms such as a rash, fever, headache, and fatigue. But if it is not treated early, the infection can spread to your joints, heart, and nervous system. Prompt treatment can help you recover quickly.
What Causes Lyme Disease
Lyme disease is caused by bacteria. In the United States, this is usually a bacterium called Borrelia burgdorferi. It spreads to humans through the bite of an infected tick. The ticks that spread it are blacklegged ticks . They are usually found in the:
- Upper Midwest
- Pacific coast, especially northern California
These ticks can attach to any part your body. But they are often found in hard-to-see areas such as your groin, armpits, and scalp. Usually the tick must be attached to you for 36 to 48 hours or more to spread the bacterium to you.
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Early Symptoms Of Lyme Disease
Early symptoms will typically develop 1 to 4 weeks after being bitten, however, they can appear anytime between 3 to 30 days after exposure.
Many people with early-stage Lyme disease develop a distinctive circular red rash usually, but not always, at the site of the tick bite.
The rash is often described as looking like a bulls-eye on a dart board and is known as erythema migrans. The affected area of skin will be red and the edges may feel slightly raised.
The size of the rash can vary significantly and it may expand over several days or weeks. Typically, its around 15cm across but it can be much larger or smaller than this.
Some people may develop several rashes on different parts of their body. However, around one in every 3 people with Lyme disease do not report seeing a rash.
As well as a rash, people with early Lyme disease may experience any of the following:
- flu-like symptoms such as fever and sweats, chills, fatigue, neck pain or stiffness, headaches, joint or muscle pains
- paralysis of the facial muscles, typically only on one side of the face
- nerve pains, which may be shooting, sharp or prickly and which follow the course of the nerve