What Is The Treatment For Lyme Disease

What Causes Lyme Disease

People get Lyme disease when they are bitten by an infected tick. Ticks live in areas with a lot of plant life, such as wooded areas or fields. They sit near the top of grassy plants and low bushes. They wait there for people or animals to brush up against them. Ticks can crawl on your clothes or body for up to several hours or more before attaching to the skin.

Ticks can attach to any part of your body. They are usually found in hard-to-see areas, including the armpits, groin, or scalp. An infected tick needs to be attached to your skin for 36 to 48 hours before it passes the bacteria on to you.

People who spend time in outdoor areas where ticks are common are at higher risk of getting tick-borne diseases.

Why Are Antibiotics The First Line Of Treatment For Lyme Disease

The use of antibiotics is critical for treating Lyme disease. Without antibiotic treatment, the Lyme disease causing bacteria can evade the host immune system, disseminate through the blood stream, and persist in the body. Antibiotics go into the bacteria preferentially and either stop the multiplication of the bacteria or disrupt the cell wall of the bacteria and kill the bacteria . By stopping the growth or killing the bacteria the human host immune response is given a leg up to eradicate the residual infection. Without antibiotics, the infection in Lyme disease can evade the host immune system and more readily persist.

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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Lyme Disease: Symptoms Causes & Treatment

Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi, which is transmitted through tick bites. The infection resulting from these bites causes swelling, joint pain, rash, and flu-like symptoms. The disease can affect the nervous system, as well, causing headaches, dizziness, and other symptoms.

Lyme disease is spread by the deer tick in the northeastern United States and the western black-legged tick in the Pacific Northwest. These ticks are typically found in wooded areas where deer are present. The tick carries the B. burgdorferi bacterium, which it passes to humans when it bites them.

In the United States, Lyme disease is the most common disease borne from an arthropod , up from sixth place in 2015. The Centers for Disease Control and Prevention received about 42,000 case reports in 2017, but they estimate the true case count could be as high as 300,000 annually, based on medical claims databases. Most reported cases are concentrated in the northeast part of the country: Maine, Vermont, Pennsylvania, New Hampshire, and Rhode Island have the highest incidence of Lyme disease. The disease is named after Lyme, Connecticut, where the disease was first identified in the 1970s. Of reported cases, Lyme disease is most common in 5- to 9-year old boys. Men are more commonly affected than women until age 70, when confirmed cases in women slightly outnumber men.

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What To Expect From A Lyme

ACUTE / EARLY STAGE A patient with acute Lyme disease is likely to be prescribed antibiotics for a minimum of 6 weeks, and is carefully monitored. This is worlds best practice according to the International Lyme and Associated Disease Societys treatment guidelines. If treated early and appropriately, these patients might not suffer any further symptoms.

The University of New Haven states that in vitro studies indicate Doxycycline must be taken to prevent Chronic Lyme disease. Below is a Lyme treatment example from Dr Eva Sapi:

Start at 100mg Doxycycline twice daily, and slowly increase to 200mg twice daily for severe reactions refer to experienced Lyme Specialist. Bicillin is recommended for pregnant women.

It is essential that you also take a good probiotic each day 2 hours after the antibiotics, for the length of the antibiotics, and for an extra two weeks.

Note: While theres been recent evidence to the contrary, some doctors will prefer that children under 12 should not have Doxycycline. If the child has a rash and/or symptoms, a two tiered approach is recommended: Clarithromycin and Amoxycillin with dosage adjusted for body weight, for children under 8, please assess with your doctor. Probiotics are recommended.

Just one of the complications for late stage patients is that Borreliosis is a very unusual infective disease presenting as the cell wall spirochaete, intracellular and then cystic form simultaneously .

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What Are The Risk Factors For Post Treatment Lyme Disease

Risk factors for Post Treatment Lyme Disease include:

• Delay in diagnosis
• Increased severity of initial illness
• Presence of neurologic symptoms

Increased severity of initial illness, the presence of neurologic symptoms, and initial misdiagnosis increase the risk of Post Treatment Lyme Disease. PTLD is especially common in people that have had neurologic involvement. The rates of Post Treatment Lyme Disease after neurologic involvement may be as high as 20% or even higher. Other risk factors being investigated are genetic predispositions and immunologic variables.

In addition to Borrelia burgdorferi, the bacteria that causes Lyme disease, there are several other tick-borne co-infections that may also contribute to more prolonged and complicated illness.

Diagnosis And Management Of Lyme Disease

WILLIAM F. WRIGHT, DO, MPH DAVID J. RIEDEL, MD ROHIT TALWANI, MD and BRUCE L. GILLIAM, MD, University of Maryland, Baltimore, Maryland

Am Fam Physician. 2012 Jun 1 85:1086-1093.

Patient information: See related handout on Lyme disease, written by the authors of this article.

• References

Lyme disease is the most common tick-borne illness in the United States. It is caused by the bacterium Borrelia burgdorferi, and is transmitted primarily by the deer tick . Following its discovery in children and adults in Lyme, Conn., in 1977,1 its incidence has increased steadily in the United States.2

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Erythema migrans rash following a tick bite is the only clinical manifestation sufficient to make the diagnosis of Lyme disease in the absence of laboratory confirmation.

A = consistent, good-quality patient-oriented evidence B = inconsistent or limited-quality patient-oriented evidence C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series. For information about the SORT evidence rating system, go to .

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Erythema migrans rash following a tick bite is the only clinical manifestation sufficient to make the diagnosis of Lyme disease in the absence of laboratory confirmation.

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What Should I Do If I Am Bitten By A Tick

If you experience a tick bite, 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 the skin.
• Avoid crushing the tick’s body or handling the tick with bare fingers as you could exposure yourself to the bacteria in the tick.
• Wash the bite area thoroughly with soap and water.
• DO NOT use kerosene, petroleum jelly , or hot cigarette butts to remove the tick.
• DO NOT squeeze the tick’s body with your fingers or tweezers.

The Chance Of Getting Lyme Disease

Not all ticks in England carry the bacteria that causes Lyme disease.

But it’s still important to be aware of ticks and to safely remove them as soon as possible, just in case.

Ticks that may cause Lyme disease are found all over the UK, but high-risk places include grassy and wooded areas in southern and northern England and the Scottish Highlands.

Ticks are tiny spider-like creatures that live in woods, areas with long grass, and sometimes in urban parks and gardens. They’re found all over the UK.

Ticks do not jump or fly. They attach to the skin of animals or humans that brush past them.

Once a tick bites into the skin, it feeds on blood for a few days before dropping off.

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Azlocillin Comes Out On Top

The drug, which is not on the market, was tested in mouse models of Lyme disease at seven-day, 14-day and 21-day intervals and found to eliminate the infection. For the first time, azlocillin was also shown to be effective in killing drug-tolerant forms of B. burgdorferi in lab dishes, indicating that it may work as a therapy for lingering symptoms of Lyme disease.

Pothineni and Rajadas have patented the compound for the treatment of Lyme disease and are working with a company to develop an oral form of the drug. Researchers plan to conduct a clinical trial.

Rajadas is also a professor of bioengineering and therapeutic sciences at the University of California-San Francisco.

Other Stanford co-authors are Hari-Hara S. K. Potula, PhD, senior research scientist postdoctoral scholars Aditya Ambati, PhD, and Venkata Mallajosyula, PhD senior research scientist Mohammed Inayathullah, PhD and intern Mohamed Sohail Ahmed.

A researcher at Loyola College in India also contributed to the work.

The study was funded by the Bay Area Lyme Foundation and Laurel STEM Fund.

• Tracie White

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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Chronic Lyme Disease Symptom Severity

In LDos chronic Lyme disease survey, over 75% of patients reported at least one symptom as severe or very severe and 63% reported two or more such symptoms. Find out more about LDo peer-reviewed published surveys. The chart below shows the severity of ten common chronic Lyme symptoms.

The survey also found that patients with chronic Lyme disease have high disability and unemployment rates. Over 40% of patients with chronic Lyme disease reported that they currently are unable to work because of Lyme disease and 24% report that they have received disability at some point in their illness.

What Is Chronic Lyme Disease

Lyme disease is an infection caused by the bacterium Borrelia burgdorferi. In the majority of cases, it is successfully treated with oral antibiotics. In some patients, symptoms, such as fatigue, pain and joint and muscle aches, persist even after treatment, a condition termed Post Treatment Lyme Disease Syndrome .

The term chronic Lyme disease has been used to describe people with different illnesses. While the term is sometimes used to describe illness in patients with Lyme disease, it has also been used to describe symptoms in people who have no clinical or diagnostic evidence of a current or past infection with B. burgdorferi . Because of the confusion in how the term CLD is employed, and the lack of a clearly defined clinical definition, many experts in this field do not support its use.

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What To Expect At Home

Home care for dogs with Lyme disease is relatively straightforward. Doxycycline is usually given by mouth twice daily for at least 30 days. Improvement in the dogs symptoms should be noted within 24-48 hours. If the dogs condition fails to improve in 72 hours or worsens at any time, call your veterinarian.

Questions To Ask Your Doctor

• I found a tick embedded in my skin, but I cant get it out. What should I do?
• Ive been bitten by a tick. Do I need to be seen?
• Do I need a blood test to confirm Lyme disease?
• Which antibiotic is best for me?
• How long will I have to take the antibiotic?
• What tick or insect repellent should I use for me or my child?
• How long will the symptoms last?
• What should I do if I still dont feel well a long time after I was bitten?

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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

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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History And Physical Examination

The clinical diagnosis of Lyme disease can be straightforward in patients with a history of tick exposure and the characteristic finding of an erythema migrans rash.12 The CDC has defined erythema migrans rash as an expanding red macule or papule that must reach at least 5 cm in size .11 According to the Infectious Diseases Society of America guidelines, erythema migrans rash is the only clinical manifestation sufficient to make the diagnosis of Lyme disease in the absence of laboratory confirmation.20 Although one study concluded that primary care physicians in a Lyme diseaseendemic area of France correctly identified erythema migrans in 72 percent of patients,22 the study was limited by lack of complete clinical information for the participants.

A number of conditions resemble erythema migrans however, the rapid and prolonged expansion of an erythematous lesion is unique to erythema migrans.11 Lesions most often occur at anatomic sites that are unusual for cellulitis and other conditions that mimic erythema migrans therefore, a complete skin examination should be performed before excluding erythema migrans.20

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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For Memory Concentration And Focus

Improving memory is a challenge. In Lyme disease, short-term memory problems and word-retrieval problems are common. These often improve substantially with appropriate antibiotic therapy. Over time, most patients regain their cognitive function.

When memory is a problem, consider that this could due to a primary problem with attention or with mood. An individual who can’t focus won’t be able to remember because he/she didn’t “attend” to the item in the first place. This happens to all of us when we hear someone’s name at a party if we don’t focus on the name and perhaps make a mental association to the name to enhance memory storage, we will forget that name within minutes. Patients with depression often experience problems with memory and verbal fluency when the depression is resolved, the memory and verbal fluency typically resolve as well.

• Medications: Attention can be improved with certain medications, such as bupropion , atomoxetine , modafinil , or stimulants . Medications that temporarily slow cognitive decline in Alzheimer’s disease or memantine ) have not been studied in Lyme disease.
• There is some evidence that online brain training programs can enhance concentration or processing speed.
• Neurofeedback may be helpful in improving attention, as well as in improving sleep and reducing pain. This has been studied for migraines, fibromyalgia, and ADHD.