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Lyme Disease

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Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans by the bite of infected blacklegged ticks.

Blacklegged tick (Lyme disease)

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Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, the infection can spread to joints, the heart, and the nervous system.

Lyme disease is diagnosed based on symptoms, physical findings (such as a rash), and the possibility of exposure to infected ticks; laboratory testing is helpful in the later stages of disease.

Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, landscaping, and integrated pest management.

The ticks that transmit Lyme disease can occasionally transmit other tick-borne diseases as well.

What Does the Rash of Lyme Disease (Erythema Migrans) Look Like?

A key component of early diagnosis is recognition of the characteristic Lyme disease rash called erythema migrans (EM). This develops at the site of the tick bite in about 80% of Lyme disease patients about 3 to 30 days following the tick bite.

Rash of Lyme disease

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Typically, the rash expands over a period of several days, reaching up to 12 inches (30 cm) across. The center of the rash may clear as it enlarges, resulting in a bull's-eye appearance. It may be warm but is not usually painful.  Some patients develop additional EM lesions in other areas of the body after several days. Patients also experience symptoms of fatigue, chills, fever, headache, and muscle and joint aches, and swollen lymph nodes. In some cases, these may be the only symptoms of infection.

What Are the Symptoms of Lyme Disease?

Lyme disease can infect several parts of the body, producing different symptoms at different times. Not all patients with Lyme disease will have all symptoms, and many of the symptoms can occur with other diseases as well.  If you think you may have Lyme disease, it is important that you consult your doctor as soon as possible for proper diagnosis.

Most cases of Lyme disease can be cured with antibiotics, especially if treatment is begun early in the course of illness. However, a small percentage of people with Lyme disease have symptoms that last months to years after treatment with antibiotics. These symptoms can include muscle and joint pains, arthritis, cognitive defects, sleep disturbance, or fatigue. The cause of these symptoms is not known. There is some evidence that they result from an autoimmune response, in which a person's immune system continues to respond even after the infection has been cleared.

Treatment

The National Institutes of Health (NIH) has funded several studies on the treatment of Lyme disease. These studies have shown that most patients can be cured with a few weeks of antibiotics taken by mouth. Commonly used oral antibiotics include doxycycline, amoxicillin, or cefuroxime axetil.

People with certain neurological or cardiac forms of illness may require intravenous antibiotics such as ceftriaxone or penicillin.

People treated with antibiotics in the early stages of the infection usually recover rapidly and completely. People in later stages of disease may have persistent or recurrent symptoms. These patients may benefit from a second 4-week course of therapy. Longer courses of antibiotic treatment are not recommended.

Studies of women infected during pregnancy have found that there are no negative effects on the fetus if the mother receives appropriate antibiotic treatment for her Lyme disease. In general, treatment for pregnant women is similar to that for non-pregnant persons, although certain antibiotics are not used because they may affect the fetus. If in doubt, discuss treatment options with your health care provider.

How Can I Avoid Getting Lyme Disease?

Be careful in areas with a lot of ticks:

  • Ticks prefer wooded and bushy areas with high grass and a lot of leaf litter. These are areas to avoid.
  • Take extra precautions in May, June, and July. This is when ticks that transmit Lyme disease are most active.
  • If you do enter a tick area, walk in the center of the trail to avoid contact with overgrown grass, brush, and leaf litter.
  • Ask your local health department and park or extension service about tick-infested areas to avoid.

Keep ticks off your skin:

  • Use insect repellent with 20% - 30% DEET on adult skin and clothing to prevent tick bite.
  • Permethrin is another type of repellent. It can be purchased at outdoor equipment stores that carry camping or hunting gear. It kills ticks on contact. One application to pants, socks, and shoes typically stays effective through several washings. Permethrin should not be applied directly to skin. Learn more at the National Pesticide Information Center.
  • Wear long pants, long sleeves, and long socks to keep ticks off your skin. Wear light-colored clothing to help you spot ticks more easily. Tuck pant legs into socks or boots and tuck shirts into pants to help keep ticks on the outside of clothing. If you’ll be outside for an extended period of time, tape the area where your pants and socks meet to prevent ticks from crawling under your clothes.

Check your skin and clothes for ticks every day!

  • Remove ticks from your clothes before going indoors. To kill ticks that you may have missed, wash your clothes with hot water and dry them using high heat for at least one hour.
  • Perform daily tick checks after being outdoors, even in your own yard. Inspect all parts of your body carefully including your armpits, scalp, and groin. Remove ticks immediately using fine-tipped tweezers.
  • If a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is extremely small. But just to be safe, monitor your health closely after a tick bite and be alert for any signs and symptoms of tick-borne illness.

Vivacare public information from The Centers for Disease Control and Prevention

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Last updated January 21, 2010.

This information is for general educational uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician or other health care professional with any health-related questions or concerns.

Be sure to follow specific instructions given to you by your physician or health care professional.