Healthy Living

Lyme Disease: The Top 10 Questions

1 What is Lyme disease?

Lyme disease is a bacterial infection that spreads to humans by way of ticks. It is transmitted primarily by Ixodes ticks, also called deer ticks or black-legged ticks in the west. These tiny arachnids are usually found in wooded or grassy areas.

Lyme disease

This disease is caused by a spirochete, a cork-screw shaped bacterium called Borrelia burgdorferi. Lyme disease is often called “the great imitator” since its symptoms imitate many other conditions. It has the ability to affect any organ in the body including the nervous system, brain, heart, joints, and muscles.

Because the diagnosis of Lyme disease can be troublesome, people with the condition are frequently misdiagnosed with other conditions. These conditions include chronic fatigue symptoms, multiple sclerosis, fibromyalgia, and various psychiatric conditions such as depression. Being misdiagnosed with other diseases can delay the correct treatment and diagnosis as the underlying infection is left to progress unchecked.

Lyme disease can affect people of all ages. However, it most commonly affects older adults, children, and park rangers or firefighters who spend extended periods outdoors and have an increased exposure to ticks.

Lyme disease can often be treated effectively and successfully if it is detected early on. However, if it is not treated or treatment is delayed, there's a risk that the patient could develop severe and long-lasting symptoms.

2 How long does it take to know if you have Lyme disease?

It could take a bit of time before you know you have Lyme disease as it can be troublesome to diagnose. Firstly, people do not always know when they have been bitten by a tick. Thus, they may not seek the proper medical treatment until symptoms develop. In addition, the numerous symptoms for Lyme disease can imitate signs and symptoms of other conditions including the flu. Also, the ticks that can spread the disease are often small and difficult to see with the human eye.

Symptoms of Lyme disease can begin at any time between 3 and 30 days after an individual becomes infected. The incubation period can lead to some confusion about the symptoms. If people don’t remember being bitten, they may think that they have flu.

Diagnosis is difficult as blood tests may not always detect a positive case. It is recommended to undergo two types of blood tests; enzyme immunoassay (EI) and western blot. When both of these tests are positive, the physician can confirm a diagnosis of Lyme disease. The accuracy of the tests will depend on the stage of the disease at which a person is tested. In the few weeks after infection, any tests that are performed to check for the disease will likely be negative. Thus, the best time to test for Lyme disease is usually several weeks after the infection occurs. During this time, the tests can more accurately determine if infection is present.

3 Is there a cure for Lyme disease?

Yes, there is a cure for Lyme disease. It is often managed effectively when the disease is detected during its early stage.

Patients who were treated with the appropriate antibiotics in the earlier stages of Lyme disease normally recover quickly and completely. Also, those who are diagnosed during the earlier stages of the disease are prescribed oral medications for between 2 and 3 weeks. People with more severe symptoms, such as neurological impairment, may require intravenous antibiotics. The antibiotics that are commonly prescribed for oral treatment include amoxicillin, cefuroxime axetil, or doxycycline. On the other hand, patients with certain cardiac or neurological forms of illness may need intravenous treatment with medications like penicillin or ceftriaxone.

Treatment for more advanced Lyme disease may run anywhere from several weeks, a month, or possibly more.

A small number of people still have some symptoms after treatment. These may include muscle aches and fatigue. These continuing symptoms, known as post-treatment Lyme disease syndrome, have an unknown cause and antibiotic treatment doesn't help. Some experts believe that some people who get Lyme disease are prone to develop an autoimmune response that contributes to their symptoms. People with post-treatment Lyme disease are recommended to take medicines for fatigue and pain. Techniques to reduce stress, such as yoga or deep breathing, and talk therapy to manage symptoms is also recommended.

4 How long can you have Lyme disease and not know it?

People who were bitten by a tick may not actually know that they have been bitten. Thus, the tick could stay on their skin as long as it wants and would be able to transfer the infection. The initial symptoms of Lyme disease could also be misinterpreted as symptom of other conditions like flu.

The symptoms can begin at any time between 3 to 30 days following the tick bite. The incubation period can lead to confusion as the symptoms imitate symptoms of other conditions. If people don’t remember being bitten, they may think that they have the flu.

5 How is Lyme disease diagnosed?

Diagnosis can be difficult as blood tests may not always detect a positive result. Thus, it is recommended that the patient undergo two types of blood tests including enzyme immunoassay (EI) and western blot. When both of these tests are positive, the physician can confirm a diagnosis of Lyme disease.

The accuracy of the tests will depend on the stage of the disease at which a person is tested. In the few weeks’ after infection, the tests are expected to be negative. Thus, the best time to test for Lyme disease is several weeks after infection occurs as it is when the tests are most precise.

6 What happens if Lyme disease goes untreated?

Lyme disease that is left untreated can result in a wide range of symptoms depending on the stage of the infection. Some of the symptoms include:

Early Signs and Symptoms (3 to 30 days after tick bite):

The rash usually occurs in about 70-80% of infected people. It begins at the location of the tick bite after a delay of about three to 30 days (average is around 7 days). It spreads gradually within a few days, reaching up to 12 inches or more. Though the rash is rarely painful or itchy, it will likely be warm to the touch. Sometimes the rash clears as it spreads. This can result in a target or “bulls-eye” appearance. The rash can also appear on any area of the body.

Later Signs and Symptoms (days to months following tick bite):

  • Severe neck stiffness and headaches
  • Arthritis with swelling and severe joint pain
  • Additional EM rashes on other areas of the body
  • Facial palsy
  • Heart palpitations or an irregular heart beat (Lyme carditis)
  • Problems with short-term memory
  • Shooting pains, tingling, or numbness in the feet or hands
  • Inflammation of the brain and spinal cord
  • Episodes of dizziness
  • Nerve pain

It is recommended to seek medical attention if any of the above symptoms were observed and you have been bitten by a tick.

7 Can you get Lyme disease from a dog, fleas, or bed bugs?

Most people get Lyme disease from the bite of an immature form of the tick which is called nymph. These nymphs are around the size of a poppy seed (less than 2 mm) and are hard to see. The nymphs feed during the summer and spring months. Many individuals do not know they have been bitten because these ticks are so small and their bites are actually painless. Adult ticks can also pass on Lyme disease bacteria; however, they are far larger in size and are more likely to be discovered and be removed before transmission of bacteria takes place. These ticks are usually most active during the colder times of the year.

Borrelia burgdorferi, the Lyme disease bacterium, is spread through an infected ticks bite. Ticks can attach themselves to any area of the body and are often discovered in hard-to-see places such as the scalp, armpits, and groin. In most cases, the ticks have to be attached to their host for 36-48 hours or longer before the bacterium of Lyme disease can be transmitted.

Dogs and felines can contract Lyme disease but there is no evidence that indicates that either animal can pass the disease to humans directly. However, it is possible for pets to bring infected ticks into the yard or home.

8 What should you do if you were bitten by a tick?

The first thing to do is remove the tick properly.

Any inappropriate removal of the tick such as holding a hot match to it, squeezing it, or applying Vaseline or oil to it will only increase the chance of transmitting bugs. The tick must be removed with tweezers that are fine pointed, taking hold of the tick from the side where it meets the skin and then removing the tick from the skin by gently pulling in the opposite way from which the tick is embedded.

The longer the tick is embedded within the skin, the higher the risk is for transmission. Thus, it is possible to get this disease even if the tick has only been embedded for 24 hours or less.

When the tick is removed, it is recommended to save it in case you want to have it tested for Lyme or other pathogens. Also, the doctor may want to see the tick and check if it is the kind of tick that causes Lyme disease.

If a person is bitten by the type of tick that carries Lyme disease, also called deer tick, the physician will likely advise one of two approaches. One approach is to observe and treat if signs or symptoms of Lyme disease develop. The other approach is to treat with a preventive antibiotic immediately.

9 How soon after tick bite could you start to experience a rash or symptoms of Lyme disease?

Symptoms of Lyme disease can start at any time between 3 and 30 days after becoming infected. The incubation period can lead to some confusion about the symptoms. If people don’t recall being bitten, they may think that they have flu.

The symptom of Lyme disease that is most well-known is a rash which resembles a bull’s-eye. This rash is known as erythema migrans. It occurs in 70 to 80 percent of individuals infected by a tick bite. The area that is directly surrounding the tick bite may be red and raised and could look like an average bug bite.

In addition, the rash spreads in a circular pattern which is darker on the outer ring and lighter in the center. But, not everyone who becomes infected with Lyme disease gets the target-shaped rash.

Classic Signs of Early Lyme Disease:

  • Headache
  • Muscle aches
  • Fever
  • Fatigue

Other people with Lyme disease experience more advanced symptoms of the disease. A stiff neck and joint pain may occur in the early-symptom stage or several months after the tick bite. Severe headaches as well as shooting pain in the body may also occur. Dizziness and changes in heart rate are also advanced symptoms of Lyme disease.

10 Can a person get Lyme disease twice?

An individual can get a new case of Lyme disease if he/she has had the disease previously and has been treated with antibiotics and recovered.

If a person is exposed to the bacteria again through another tick bite, they will become re-infected and will again require treatment. If the individual develops symptoms after the initial treatment and recovery, he/she should see a doctor to verify if it is a new infection or a recurrence of symptoms from the previous infection. However, it can be troublesome to differentiate whether or not the symptoms are the result of the previous infection or a new one.

If a person has not been exposed again to tick bites, but is still displaying symptoms, then it might be a symptom recurrence which can be the result of another unrelated illness, a re-emergence of the first infection that had been treated only partially, or a Borrelia-triggered immune mediated symptom complex.

In most cases of Lyme disease, a single erythema migrans rash and fever can be a sign of a new acute infection. But, some patients do experience recurrent erythema migrans rashes, known as satellite rashes, which may come about later in the course of the disease.