Lyme Disease Causes, Symptoms, Treatment And Prevention
Lyme disease, also known as the Lyme infection is a bacterial disease transmitted by the tick (Ixodes), insect that carries a bacterium called Borrelia burgdorferi. The disease is found in North America and Europe, where it was initially described almost 100 years ago. Maximum prevalence of lyme disease is in the north-eastern states of America, half of the cases are concentrated in New York and Connecticut area.
American doctors have described the disease almoast 70 years ago. Most of those affected lived in the town of Lyme in Connecticut, hence the name “Lyme disease. “
- Fortunately, less than 5% (1 of 20) of tick bites cause Lyme infection
- Doctors have gained experience with the disease, from first cases until today. Thus, currently a treatment for Lyme disease exists.
B. burgdorferi is the bacterium that causes Lyme disease. The life cycle of this bacteria is very complex and a part of the like cycle taks place inside the tick. The rest of the life cycle, B. burgdorferi is parasitizing various mammals such as mice or deer. Humans are not part of the life cycle, but can become infected if they are bitten by a tick.
- Infection. Initial infection occurs without symptoms or with minimal manifestations, often going unnoticed. Some reports of flu-like symptoms or a characteristic rash are succeeding the tick bite.
- Flu Symptoms. These occur in the warm weather months, an atypical period for influenza.
- Rash. It is a red annular lesion that grows from day to day and is called erythema migrans. The center of infection control and prevention (CDC) defines the eruption as a red dot that increases over a few weeks to form a round lesion of at least 5 cm in diameter. A red point that appears within a few hours after the bite is usually the body reaction. The appearance of rash at the bite site is considered the primary lession. Multiple secondary lesions may occur in response to infection. All these lesions are characteristic for Lyme disease. The rash is oval or round (circular). As it grows, the rash can get red or pale in the center, sometimes looks like a “bullseye”, with red concentric circles alternating with healthy skin. Left untreated, the symptoms of primary infection disappear within a few weeks, but may reappear – skin eruption.
- Later, additional symptoms may occur as a result of damage to internal organs:
- Facial nerve paralysis causing facial muscles asymmetry (can resolves itself, even without treatment)
- Meningitis with headaches, fever and neck stiffness
- Nerve inflammation with dizziness and tingling sensation in the hands and feet
- Cerebral edema (encephalitis) causes learning difficulties, confusion and dementia
- Intermittent episodes of arthritis that last about a week and affect wrists or knees. May reappear for several months in a row and without treatment, persistent knee arthritis occurs. Lyme disease can occasionally manifest with acute arthritis of the knee, in the absence of a suggestive rash.
- Inflammation of the cardiac structures (carditis – inflammation of the heart) leads to cardiac rhythm disturbances.
Lyme disease diagnosis is based on a complete clinical examination and specific laboratory tests.
- Your doctor will ask if you were bitten by a tick and if you perform outdoor activities in areas that are endemic for ticks.
- Clinical signs are important, especially erythema migrans, as described above. If there is any doubt regarding the causal skin rash, the doctor can measure the erythema and then ask you to return to perform a second measurement after 2-3 days. Erythema migrans grows about 1 centimeter in size daily. There are specific clinical signs by which the physician can distinguish Lyme disease from other diseases.
- Blood tests for antibodies against the bacterium Borrelia burgdorferi detection. In the first weeks after infection the antibodies can be absent, so testing can be negative. There are two blood tests that can be used to detect Lyme disease, a screening test (ELISA Lyme), and if the result is positive, a second, specific test (called “Western blot”), confirms the infection. In countries where Lyme disease is very common, patients can have positive tests for Borrelia, without having the disease. Positivation of a simple screening test is not sufficient to establish the diagnosis of Lyme disease: a Western Blot test must be also positive. Once the tests for Lyme disease become positive, they remain positive for a very period of time, even after proper treatment. Thus, repeating the test after the treatment is not necessary or useful.
- Ticks can carry other organisms besides B. burgdorferi, which can cause diseases that can mimic Lyme disease. Therefore, liver function tests and blood counts are recommended.
- Patients who have headaches may require lumbar puncture to determine the degree of inflammation of the nervous system and to detect the possible presence of specific Lyme disease antibodies in the cerebrospinal fluid (CSF).
- An electrocardiogram (ECG) to identify potential cardiac complications.
- Magnetic resonance imaging (MRI) and computed tomography may be performed to rule out other diseases with similar manifestations of Lyme disease.
It is recommend that the early stages of Lyme disease are treated with antibiotics such as doxycycline, penicillin or erythromycin. Advanced stages of Lyme disease (patients with neurological, cardiac or joint complications) have to be treated during hospitalization with antibiotics administered intravenously.
There are three ways to prevent Lyme disease.
- Avoiding tick bites
-Do not venture into forests unprotected, especially during summer
-Wear socks that create barriers between the tick and the skin;
-Insert the bottom edge of the trousers inside the socks, and wear colorful clothes, allowing quick identification of insects on the fabric.
-Apply an insecticide, especially on the clothing and not on your skin. This product is not recommended for children as they can absorb the insecticide through the skin. Insecticide application reduces the chances of infection by reducing the risk of tick bites.
- Removing ticks. For transmitting Borellia the ticks needs 24-48 hours to stay attached to the skin surface. Thus, after carrying out your outside activities, inspect all exposed areas of your skin. If you notice an insect sting it is very important to be aware of the associated symptoms that may occur in the next three weeks.
– Ticks attach themselves to warm, moist areas: groin, armpits, neck and hair line implantation.
– If you find a tick, remove it quickly. This maneuver reduces the risk of contracting the infection.
– If you have a pair of tweezers, grasp the tick as close to the implantation site and pull it out slowly but firmly. If you do not have tweezers, grasp the tick’s body and take it out slowly.
– Disinfect the bite site with alcohol or other antiseptic solutions.
– If the tick does not come out easily, pull it out by twisting, pinching and pulling upward.
- Antibiotic treatment. Treatment of tick bites in the first 72 hours with a single dose of doxycycline prevents Lyme disease. It is recommended for those that are living in an endemic area and are bitten by a tick. It is advisable to ask your doctor before administering the dose of antibiotic.