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Where Can You Get Lyme Disease

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Can Lyme Disease Be Prevented

Do you know the signs of Lyme disease?

People aren’t able to become immune to Lyme disease. So even if you’ve had Lyme disease, you can get it again. No vaccine is available currently to prevent the disease.

The FDA approved a Lyme vaccine called LYMErix in 1998. The vaccine was not 100% effective, however. The FDA still recommended preventing the disease in other ways. In 2002, the company that made LYMErix said it would no longer offer the vaccine.

To help prevent Lyme disease, follow these guidelines.

How Long The Tick Is Attached

In general, it takes about 36 to 48 hours for Lyme bacteria to enter the bloodstream after a tick bite. So if you remove the tick within a day and a half, your risk of getting Lyme disease is substantially lowered. Using tweezers is thought to be the best approach for tick removal: carefully grab the tick near its head or mouth and do not squeeze or crush it, but instead pull gently and slowly in an upward direction.

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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.

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Does Bells Palsy From Lyme Go Away

About 5% of Lyme sufferers experience facial palsy. It can occur within a few weeks of a bite from an infected tick. This might look like Bells palsy, but it is not the same. Facial paralysis caused by Lyme infection should not be treated the same as Bells palsy. The bacterial infection of Lyme disease is treated with antibiotics. Facial paralysis caused by early onset Lyme can go away with quick diagnosis and treatment. It might take a few weeks or a few months to fully recover from facial palsy, even after treatment of Lyme is complete.

Be Aware Of Where Ticks Attach Themselves

Ticks and Lyme Disease

To avoid tick bites, it helps to know where ticks attach themselves in the body. That way, when youâre doing a self-inspection after returning from a hike or spending time outdoors, you can know what areas to focus on.

While ticks can attach to any part of the human body, they prefer hard-to-see areas like the scalp, armpits, and groin. Remember that for Lyme disease bacteria to be transmitted, the tick generally must be attached for 36-48 hours. Finding any ticks as soon as possible may help decrease your chances of Lyme disease after a tick bite because infected ticks are more likely to transmit Lyme bacteria the longer theyâre attached.

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Rocky Mountain Wood Ticks And Colorado Tick Fever

The mocha-colored Rocky Mountain wood tick lives in the northwestern United States and in Canada. Young Rocky Mountain wood ticks bite small rodents adult ticks are more likely to latch onto deer, dogs, livestock, and people. Before going on a walk in the woods or in a grassy area near the woods, use a safe insect repellent that contains DEET to prevent tick bites. The CDCs DEET information page shows which formulations are okay to spray directly on your skin.

The Rocky Mountain wood ticks bite can transmit diseases including a virus that causes Colorado tick fever, as well as Rocky Mountain spotted fever, tick paralysis, and tularemia. Colorado tick fever symptoms resemble the flu: They leave you tired, achy, and with chills, according to the CDC. The illness is usually short-lived, but there is no treatment. In rare cases, complications can develop, including hepatitis and pneumonia.

In What Parts Of The United States Are Lyme Disease Seen

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Lyme disease is the most commonly reported tick-borne illness in the United States. Infections predominantly occur in the Northeast and north-central portions of the United States . Ninety-three percent of infections reported to the Centers for Disease Control and Prevention from 1992 to 2006 were reported in 10 states: Connecticut, Delaware, Maryland, Massachusetts, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island, and Wisconsin. The Pacific Northwest states also have a moderate number of Lyme disease cases, but this region in not considered by the CDC to be endemic for the dis- ease. In addition to the United States, Lyme disease has also been reported in Europe and Asia. The geographic restriction of the disease is the result of the ecologic niche required for the vectors, the Black-legged tick and the Western Black-legged tick .

Figure 16-1. Distribution of reported cases of Lyme disease in the United States.

Figure 16-2. Erythema migrans rash.

The diagnosis of Lyme disease may be made clinically and confirmed serologically. If the patient presents with erythema migrans and a history of tick exposure, the diagnosis can be based solely on the clinical presentation. However, if the patient presents later in the course of illness, serologic testing is necessary.

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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

Complications Of Untreated Lyme Disease

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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.

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What Do Testing Kits Typically Include

Depending on the method of collection, testing kits may include:

  • a device to collect the blood, urine, or saliva sample
  • instructions
  • a container to ship the sample back to the lab
  • a shipping label

Some kits come with a bandage, wipes, and a biohazard bag. Kits may contain extras such as Styrofoam holders, labels, or tubes with varying solutions inside.

What Do The Test Results Mean

Because there are three tests that are typically conducted for the Lyme disease blood test, then results can vary based on the combination of test results received. When all three tests are positive, then Lyme disease is likely. These other result combinations are usually interpreted in the following ways.

Positive IgM, Negative IgG, Negative Western Blot.This usually indicates that the Lyme disease infection is in its early stages or that the blood test has produced a false positive result.

Negative IgM, Positive IgG, Positive Western Blot.This is usually interpreted as having a late-stage Lyme disease infection. It may also be an indication that someone had a previous infection that has been removed from the body.

All results negative.This is usually interpreted as there not being any infection present and that the symptoms are being caused by another issue. In some specific instances, however, it can also be seen as the antibody levels being too low to detect.

Once Lyme disease is confirmed, there will almost always be detectable levels of the bacteria which causes the disease in the IgG antibodies in their blood. This will mean that their IgG blood test results will have a standard deviation in what is considered as normal because of the presence of the disease, even if it has been effectively cured.

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Stage : Quickly Expanding Rash

After being bitten by a black-legged tick, a quickly growing rash can appear. This is the earliest stage of Lyme disease, known as stage 1.

Most people who develop a rash, get it within days or weeks of being bitten by a tick.

Where you see the rash: If you develop a rash, it appears near the tick bit you. For most people, that means the back, groin, armpit, or a lower leg. However, a tick can bite you anywhere.

What the rash can look like: You may see a spot or bump on the skin, which is the bite mark. Around or near the bite mark, a rash develops. Some people see the bulls-eye rash . You can also have one of the other rashes shown here.

Early rash caused by Lyme disease

Notice the bite mark in the center of this early rash, which will expand quickly.

Bull’s-eye rash on woman’s upper arm

This is another early sign of Lyme disease.

Lyme disease rash with lighter color on the outside

This rash has expanded, but you can still see the bite mark in the center.

Rash from Lyme disease has begun to clear

As the rash begins to clear, the redness fades.

If you develop a rash during this stage, you may notice that it:

  • Feels smooth and warm to the touch

  • Causes a burning sensation

  • Itches or feels painful

  • Has an outer edge that feels scaly or crusty

When the rash and symptoms begin: According to the Centers for Disease Control and Prevention , the rash begins 3 to 30 days after the tick bites you.

About 50% of people who have Lyme disease develop flu-like symptoms , which include:

What Tests Are Available For Lyme Disease

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When a person becomes infected, the body creates antibodies to protect itself from the bacteria. Certain blood tests are available to measure these antibodies. However, sometimes a “false negative” test can result if there are not enough antibodies in the blood for the tests to detect accurately. A doctor should also do a complete medical examination and gather information about your recent outdoor activities in order to make a clinical diagnosis for Lyme disease.

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Resources For Maine Residents

Public Law, Chapter 340, LD 597, 126th Maine State Legislature: An Act to Inform Persons of the Options for the Treatment of Lyme Disease

  • Acknowledges difficulty in diagnosing and treating Lyme disease
  • Information on risks of long term antibiotic therapy

Public Law, Chapter 235, LD 422, 127th Maine State Legislature: An Act to Improve Access to Treatments for Lyme Disease

  • Allows licensed physicians to prescribe long-term antibiotic therapy to eliminate infection or to control a patients symptoms

What If I Don’t Feel Better After Treatment

If you’re treated for Lyme disease and don’t feel better after you’ve finished your treatment, talk to your healthcare provider. He or she may recommend a longer course of antibiotics or may be able to prescribe another medication to help with symptoms like joint or muscle pain.

You might also want to seek a second opinion, especially if your Lyme disease diagnosis was not initially confirmed via a two-step blood test. If your body has not responded to antibiotics, it’s possible that something else besides the bacteria that causes Lyme disease is making you sick.

Even if you do recover completely from a Lyme disease diagnosis, your immune system may continue making antibodies to fight Lyme disease bacteria for months or even years after the infection is gone. Those antibodies won’t protect you from getting a second Lyme disease infection, however, so be sure to take steps to protect yourself from ticks in the future.

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Late Disseminated Lyme Disease

In the late disseminated stages of Lyme disease, symptoms become chronic and affect neurological functioning through ailments like encephalitis, encephalopathy, and polyneuropathy. Swelling in pain in your joints becomes severe. Rheumatoid arthritis may appear. The knees seem to be the most affected by swelling and pain.

Months to years after being infected with Lyme disease and going untreated, you may have the following additional symptoms: Intermittent fevers, chills, and sweats, chronic inflammation, numbness and tingling in the limbs, dizziness, and shortness of breath, tremors, respiratory infections, irregular heartbeat, anxiety and paranoia, rage, hallucinations, hearing sensitivity, and increased pain in the joints.

Managing your symptoms can become difficult the more chronic the disease.

Symptoms Of Late Stage Lyme Disease

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The CDC reports that late stage Lyme disease may appear days to months after the initial tick bite and may include but are not limited to:

  • Severe headaches and neck stiffness
  • Additional EM rashes in new places on the body
  • Facial palsy, also known as Bells palsy paralysis of one side of the face
  • Arthritis or joint pain and swelling, especially of large joints
  • Intermittent tendon, muscle, joint, nerve, or bone pain
  • Heart palpitations or arrhythmia
  • Dizziness or shortness of breath
  • Inflammation of the brain or spinal cord
  • Shooting pains, numbness, or tingling in the hands or feet

As mentioned above, late stage Lyme may also be characterized by the recurrence of early stage symptoms, such as fatigue.

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Key Points To Remember

  • Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
  • Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
  • Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
  • Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
  • Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.

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.

Links with this icon indicate that you are leaving the CDC website.

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Signs Of Lyme Disease That Appear On Your Skin

Signs of Lyme disease

If you see a rash or another sign of Lyme disease on your skin, see your primary doctor right away. When caught early and treated, Lyme disease can be cured with antibiotics and most people recover fully.

Lyme disease is caused by a bite from a black-legged tick. If you are bitten by this tick and develop Lyme disease, you may see a bulls-eye rash. Its a common sign of Lyme disease, but its not the only sign.

Lyme disease occurs in stages. Heres what you may see on your skin during each stage.

Racial Differences In Incidence

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Lyme disease is reported primarily in whites, although it occurs in individuals of all races. No genetic explanation is known for this the disparity most likely stems from social or environmental factors and possibly to the fact that erythema migrans is more difficult to diagnose in dark-skinned individuals.

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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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