Phylogenetic Diversity And Human Disease Taxonomy And Disease
B. burgdorferi was thought to be the sole genospecies in the United States until 1995 when Marconi and associates isolated B. andersonii from cottontail rabbits and I. dentatus ticks. Subsequently, it became evident that enzootic cycles exist involving non-sensu stricto species and specialist ixodid ticks with strong, selective host preferences and little or no proclivity to bite humans. Perhaps the best characterized of these is B. bissettii , transmitted by I. pacificus, I. affinis and I. spinipalpis and recovered and/or detected by PCR throughout the United States in ticks and a variety of vertebrates and, in rare instances, humans . Molecular evidence for infection of humans by B. americana and B. andersonii, particularly in Southern states, also has been reported . Moreover, B. mayonii was recently isolated from a few human specimens in upper midwestern U.S. . However, in the United States, B. burgdorferi remains the primary agent of disease.
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.
How Is Lyme Disease Transmitted
Ticks usually live in woods or tall grasslands in Canada, the United States, Europe, and Asia. Ticks can become infected with Borrelia burgdorferi by feeding on infected wild animals, and then can spread the bacteria when they feed on blood from the host. Ticks cannot fly – they hang onto small bushes or tall grasses and are usually found close to the ground. They wait for an animal or person to pass near them and when the animal or person makes contact, the ticks attach themselves to the skin to feed.
In North America, Lyme disease is transmitted mainly by two species of ticks:
- Blacklegged tick , Ixodes scapularis.
- Western blacklegged tick, Ixodes pacificus.
The Public Health Agency of Canada states that there no evidence that Lyme disease can spread from person-to-person. Pets, especially dogs, can get Lyme disease, but there is no evidence that pets can spread the infection directly to humans. They may, however, carry infected ticks into the home or yard which may increase the chance of transmission.
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What Are The Symptoms Of Lyme Disease
Symptoms can start anywhere from 3 to 30 days after the bite. They may look different depending on the stage of your infection. In some cases, you wonât notice any symptoms until months after the bite.
Early symptoms include:
All of those symptoms are also common in the flu. In most Lyme infections, one of the first symptoms youâll notice is a rash.
Without treatment, symptoms can get worse. They might include:
- Severe headache or neck stiffness
- Rashes on other areas of your body
- Arthritis with joint pain and swelling, particularly in your knees
- âDroopingâ on one or both sides of your face
- Inflammation in your brain and spinal cord
- Shooting pains, numbness, or tingling in your hands or feet
What does the rash look like?
Some Lyme rashes look like a bull’s-eye with circles around the middle. But most are round, red, and at least 2 inches across.
The rash slowly gets bigger over several days. It can grow to about 12 inches across. It may feel warm to the touch, but itâs usually not itchy or painful. It can show up on any part of your body.
How small are ticks?
Ticks come in three sizes, depending on their life stage. They can be the size of a grain of sand, a poppy seed, or an apple seed.
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.
These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.
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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Late Persistent Lyme Disease
Late persistent Lyme disease usually occurs in those who did not receive early treatment. It’s the most severe stage and can occur months to years following the initial infection. Damage to the joints, nerves, and brain is possible if not treated.
Muscle and joint pain is the most common complaint of those in late-stage Lyme disease, affecting 80% of untreated people. Lyme arthritis, which occurs in 50% of cases, can cause swelling and pain, usually in one knee, but can be present in both knees or other large joints.
Various neurological symptoms can occur depending on the area of the nervous system affected. Some symptoms may be similar to stage 2 but can be more extensive, severe, or longer-lasting. If the infection has traveled to the brain, you may experience:
- Difficulty following conversations and processing information
- Mental fogginess
- Trouble sleeping
- Vertigo or dizziness
Oral antibiotics are typically used for Lyme arthritis, while intravenous antibiotics treat neurologic issues. The length of therapy can be two to four weeks, depending on the symptoms.
Early Lyme Disease Treatment
ILADS doctors are likely to recommend more aggressive and longer antibiotic treatment for patients. They may, for instance, treat high risk tick bites where the tick came from an endemic area, was attached a long time, and was removed improperly. They may treat a Lyme rash for a longer period of time than the IDSA recommends, to ensure that the disease does not progress. They are unlikely to withhold treatment pending laboratory test results.
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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
What’s The Best Way To Prevent A Tick Bite
Ticks can’t fly or jump. But they live in shrubs and bushes and can grab onto you when you pass by. To avoid getting bitten:
- Wear pants and socks in areas with lots of trees and when you touch fallen leaves.
- Wear a tick repellent on your skin and clothing that has DEET, lemon oil, or eucalyptus.
- For even more protection, use the chemical permethrin on clothing and camping gear.
- Shower within 2 hours after coming inside. Look for ticks on your skin, and wash ticks out of your hair.
- Put your clothing and any exposed gear into a hot dryer to kill whatever pests might be on them.
How do you know if you’ve been bitten?
Since ticks are so small, you’ve got to have pretty good eyes to see them.
If you have a small, red bump on your skin that looks like a mosquito bite, it could be a tick bite. If it goes away in a few days, itâs not a problem. Remember, a tick bite doesnât necessarily mean you have Lyme disease.
If you notice a rash in the shape of a bull’s-eye, you might have a tick bite. Talk to your doctor about treatment.
If you have an allergic reaction to ticks, you’ll notice a bite right away.
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Treatment For Neurological Lyme Disease
After defining the problem, she moves on to solutions. The next section deals with pharmaceutical approaches to Lyme disease in the brain, including an explanation of the blood-brain barrier and what drugs can effectively penetrate it. She discusses medications that reduce inflammation, as well as those to stabilize neurological function, balance mood and help people think more clearly.
Section 3 discusses natural approaches to Lyme disease in the brain: antimicrobials, such as Cats Claw and teasel root anti-inflammatories, such as curcumin and stephania root antioxidants, such as glutathione neurotransmitter support and essential oils such as peppermint and frankincense.
Section 4 deals with nutrition. Readers of her earlier book, The Lyme Diet, will find familiar themes: avoid gluten, dairy, sugar, caffeine, alcohol and additives such as MSG.
Ducharme explains about therapies to help the brain, including neurofeedback, Brainwave Entrainment, and hyperbaric oxygen. She covers sleep and exercise. She reviews different kinds of psychotherapy for patients with Lyme brain.
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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.
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What Do You Do If There’s A Tick Under Your Skin
Use a pair of fine-tipped tweezers to remove it as soon as possible. Pull upward with steady pressure. If parts of the tick are still in your skin, try to get those with the tweezers, too. After everything is out, clean the bite area with rubbing alcohol or soap and water.
You probably wonât get infected if you remove the tick within 36 to 48 hours.
How do you throw away a tick?
Put it in soapy water or alcohol, stick it to a piece of tape, or flush it down the toilet.
Early Disseminated Lyme Disease
If Lyme disease is left untreated, it may progress to early disseminated Lyme disease, which spreads from the bite location to other parts of the body. It may begin to affect the skin, nervous system, and heart. This stage can occur days to months following the initial infection.Neurologic symptoms occur in approximately 10% of untreated people.
Inflammation of the nervous system can cause:
- Facial paralysis
- Numbness, tingling, shooting pain, or weakness in the arms or legs
- Sensitivity to light
- Severe headache or neck stiffness
Lyme carditis, which affects approximately 5% of people in this stage, occurs when the infection reaches the heart tissue and slows down the heart rate too much. Some people may not have any symptoms, while others may experience severe effects requiring hospitalization.
- Shortness of breath
During this stage, you may develop multiple erythema migrans rashes on areas distant from the original bite. You may also experience headaches, muscle or joint pain, or extreme fatigue.
Early disseminated Lyme disease can be treated with oral or intravenous antibiotics for two or more weeks, depending on the severity of the symptoms.
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How Should A Tick Be Removed
Grasp the mouthparts with tweezers as close as possible to the attachment site. Be careful not to squeeze, crush or puncture the body of the tick, which may contain infectious fluids. Pull firmly and steadily upward to remove the tick. After removing the tick, thoroughly disinfect the bite site and wash hands. The NYSDOH has created a video on proper tick removal and a printable card with steps on how to remove ticks . See or call a doctor if there are concerns about incomplete tick removal. Do not attempt to remove ticks by using petroleum jelly, lit cigarettes or other home remedies because these may actually increase the chance of contracting a tick-borne disease.
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Symptoms Of Lyme Disease
People with Lyme disease may react to it differently. Symptoms can vary in severity.
Although Lyme disease is commonly divided into three stages early localized, early disseminated, and late disseminated symptoms can overlap. Some people will also present in a later stage of disease without having symptoms of earlier disease.
These are some of the more common symptoms of Lyme disease:
- a flat, circular rash that looks like a red oval or bulls-eye anywhere on your body
These symptoms may occur soon after the infection, or months or years later.
You may also notice some psychological symptoms in your child. According to a , some parents reported the following psychological issues in their child with Lyme disease:
- anger or aggression
If your child seems to be acting differently and cant explain why or what theyre feeling, its important to talk with their doctor, as these changes could be a sign of many conditions, including Lyme disease.
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Is Lyme Disease Curable
The tick-borne illness can be treated with antibiotics, and most people make a full recovery within weeks or months. So why is there so much confusion?
In much of the country, spring and summer mean warmer weather and spending more time outdoors. Unfortunately, it also means that the ticks that carry Lyme disease bacteria may be out in full force, especially in wooded or grassy areas.
About 30,000 cases of Lyme disease are reported each year to the U.S. Centers for Disease Control and Prevention, although experts estimate that 10 times that amount may actually be infected. Thats concerning, because if left untreated, Lyme disease can cause nerve damage, memory loss, dangerous inflammation around the heart, and other permanent health problems.
But the good news is that Lyme disease is also very treatableespecially when its diagnosed soon after symptoms begin. Lyme disease is always curable, Daniel Kuritzkes, MD, chief of the Division of Infectious Diseases at Brigham and Womens Hospital in Boston, tells Health. The medications we have are very effective at getting rid of the infection. Heres what else you need to know.
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Lyme Disease Surveillance In Canada
Lyme disease became a national notifiable disease in December 2009.
Canada continues to monitor the evolving geographic distribution and prevalence of infected ticks and cases of Lyme disease. Therefore, you must report clinically diagnosed or laboratory-confirmed cases to your provincial or territorial public health authorities.
Health professionals in Canada play a critical role in identifying and reporting cases of Lyme disease. See the surveillance section for more information on surveillance in Canada.
Consult the national case definition for additional information.
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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
What Is Real Bartonella
Several Bartonella species are known to infect humans. Bartonella henselae causes cat-scratch disease because the bacteria is transmitted to humans from a scratch of a cat.
As stated above, cat-scratch disease often causes enlarged lymph nodes , typically in the underarm, head/neck, or groin. This is photo of a 5-year old child with lymph node growth in the underarm due to cat-scratch disease:
Lymph node growth occurs in many different conditions, so this symptom alone cannot be used to diagnose cat-scratch disease.
The human body louse transmits Bartonella quintana to humans, causing Trench fever.The National Organization for Rare Disorders states that Trench fever is commonly found in homeless, alcoholic, and poverty-stricken populations where poor sanitation and poor hygiene often occurs.
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Unexplained Pain And Other Sensations
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.