Lyme Disease

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Lyme Disease is a tick-borne illness that causes signs and symptoms ranging from rash and flu-like fever and body aches to more serious ones including joint swelling, weakness, fatigue and temporary paralysis. It is caused by the bacterium Borrelia burgdorferi. Deer ticks, which feed on the blood of animals and humans, can harbor and spread the disease when feeding on a host.

You're more likely to get Lyme disease if you live or spend time in the grassy and heavily wooded areas where ticks carrying the disease breed. In the United States, this includes the Northwest, North Central and Northeastern states. Even in such areas, not all deer ticks are infected with the bacteria that cause Lyme disease, and only a small percentage of people or pets bitten by deer ticks actually become sick.

Still, it's important to take common-sense precautions in areas where this disease is prevalent. If treated with appropriate antibiotics in the early stages of the disease, you will most likely recover completely. However, some people have recurring or lingering symptoms long after the infection has cleared. Untreated, it can lead to arthritis and other serious health problems.

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Symptoms:
The signs and symptoms vary widely because this disease can affect various parts of the body. Not everyone with the disease will have all of the signs and symptoms. But in general, it can cause:

Rash A small, red bump may appear within a few days to a month, often at the site of the tick bite — often in your groin, belt area or behind your knee. It may be warm to the touch and mildly tender. Over the next few days, the redness expands, forming a rash that may be as small as a dime or as large as 12 inches across. It often resembles a bull's-eye, with a red ring surrounding a clear area and a red center. The rash, called erythema migrans, is one of the hallmarks of the disease, affecting about 70 percent to 80 percent of infected people. If you're allergic to tick saliva, redness may develop at the site of a tick bite. The redness usually fades within a week. This is not the same as erythema migrans, which tends to expand and get redder over time.

Flu-like symptoms A fever, chills, fatigue, body aches and a headache may accompany the rash.

Migratory joint pain If the infection is not treated, you may develop bouts of severe joint pain and swelling several weeks to months after you're infected. Your knees are especially likely to be affected, but the pain can shift from one joint to another.

Neurological problems In some cases, inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face, numbness or weakness in your limbs, and impaired muscle movement may occur weeks, months or even years after an untreated infection. Memory loss, difficulty concentrating, and changes in mood or sleep habits also can be symptoms of the late-stage of the disease.

Less common signs and symptoms Some people may experience heart problems — such as an irregular heartbeat — several weeks after infection, but this rarely lasts more than a few days or weeks. Eye inflammation, hepatitis and severe fatigue are possible as well.

Skin problems In Europe, people with advanced cases of the disease may develop skin nodules and patches of thinning skin on their hands, elbows or knees.

Causes:
In the United States, Lyme disease is caused by the bacterium Borrelia burgdorferi, which is carried primarily by deer ticks. The ticks are brown and often no bigger than the head of the pin, which can make them nearly impossible to spot.

Ticks feed on blood, latching onto a host and feeding until they're swollen to many times their normal size. During feeding, ticks that carry disease-producing bacteria can transmit the bacteria to a healthy host. Or they may pick up bacteria themselves if the host is infected. In areas where this disease is common, as many as 50 percent of deer ticks may carry Borrelia burgdorferi.

Deer ticks prefer the blood of mice, small birds and deer, but aren't averse to dining on humans, cats, dogs and horses. They live in low bushes and tall grasses of wooded areas, waiting for warmblooded animals to pass by and are most active in the summer.

To contract Lyme disease, you must be bitten by an infected deer tick. The bacteria enter your skin through the bite and eventually make their way into your bloodstream. Before bacteria can be transmitted, a deer tick must take a blood meal and that can take between 36 and 48 hours of feeding. Only ticks that are attached to your skin and are feeding can transmit the bacteria. An attached tick that has a swollen appearance may indicate that enough time has elapsed to transmit bacteria. Removing the tick as soon as possible may prevent infection.

Treatment:
Oral antibiotics — usually doxycycline for adults and children older than 8, or amoxicillin or cefuroxime axetil for adults, younger children and pregnant or breast-feeding women — are the standard treatment for early-stages of the disease. These drugs often clear the infection and prevent complications. A 14- to 21-day course of antibiotics is usually recommended, but some studies suggest that courses lasting 10 to 14 days are equally effective. In some cases, longer treatment has been linked to serious complications.

If the disease has progressed, your doctor may recommend treatment with an intravenous antibiotic for 14 to 28 days. This is usually effective, although it may take some time to recover. Intravenous antibiotics can cause various side effects, including a lower white blood cell count, gallstones and mild to severe diarrhea.

The Food and Drug Administration warns consumers and health care providers to avoid bismacine, an injectable compound prescribed by some alternative medicine practitioners to treat Lyme disease. Bismacine, also known as chromacine, contains high levels of the metal bismuth. Although bismuth is safely used in some oral medications for stomach ulcers, it's not approved for use in injectable form or as a treatment for Lyme disease. Bismacine can cause bismuth poisoning, which may lead to heart and kidney failure.

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...less medical jargon in a 'Quick Glance' format!