Lyme Disease

1 What is Lyme disease?

Lyme disease is a bacterial disease that is caused by a bacterium commonly known as spirochete.

In the US, the bacteria's actual name is Borrelia burgdorferi. In Europe, the bacterium that causes Lyme disease is called Borrelia garinii and Borrelia afzelii.

Some ticks, mainly found on deer, host the bacterium in their stomachs. Lyme disease is then spread by deer ticks when they bite the skin, which allows transmission of the bacterium through your skin to infect the body. This means that Lyme is a tick-borne illness.

Lyme disease

Is Lyme disease contagious?

No, the disease is not contagious, as it cannot be transmitted from one person to the other directly. Lyme disease can cause abnormalities of the skin, heart, joints and the nervous system.

Lyme disease key facts

Below are the key points you should know about Lyme disease:

  • Lyme disease can affect your heart, skin, joints, and the nervous system
  • Lyme disease is a bacterial infection caused by Borrelia burgdorferi and is spread through tick bites
  • Lyme disease occurs in 2 major phases, with the early stage starting as soon as one is bitten by an infected tick
  • Diagnosis of Lyme disease is based on the person's clinical signs plus the detection of antibodies which are produced against the bacteria
  • Lyme disease can be treated

2 What is chronic Lyme disease?

The term “chronic Lyme disease” is a term used to describe persistent Lyme symptoms such as:

  • Headache
  • Pain
  • Muscle or joint aches
  • Fatigue
  • Memory problems (short-term)

Many people confuse chronic Lyme disease with post-infectious Lyme disease. Post-infectious Lyme disease is used to describe a condition of persistent Lyme symptoms even after treatment with antibiotics.

Diagnosis of chronic Lyme disease is difficult, since symptoms may also be indicative of another condition.

In both cases, there is no evidence to show that people diagnosed with chronic Lyme disease can transmit the condition to others. 

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3 How do you get Lyme disease?

Lyme disease is mainly caused by Borrelia burgdorferi bacteria that are usually transmitted through the bite of an infected tick. If a tick happens to bite an animal with Borrelia burgdorferia bacteria, the becomes infected. The tick can then spread the bacteria to you through a bite.

Ticks are mainly found in areas with deep and overgrown vegetation where they have access to animals. These areas include grassy areas and woodlands.

Ticks don’t fly or jump. They climb on your skin or clothes if you happen to brush against something they are on. After climbing, they bite your skin and start feeding on your blood.

You are more likely to be infected if the tick stays attached to you for more than 24 hours. The ticks are usually very small and their bites not painful. You may therefore not realize when a tick bites you.

In case you find a tick attached to your skin and it looks swollen, then it may have fed long enough to spread the bacteria. You should remove the tick as soon as possible and seek medical advice.

It is also possible to spread Lyme disease during childbirth. This happens when infected blood from the mother passes through the placenta to the fetus. Once this happens, the child may be born with Lyme disease.

Once Borrelia burgdorferia bacteria get into your blood, they dig themselves into the deep tissues and organs. They then release toxins known as bacterial lipoproteins that are responsible for symptoms such as numbness, memory loss, and burning pain. The bacteria also release some antigens that cannot be distinguished from healthy cells. As a result, healthy tissues and organs become inflamed.

4 What are the symptoms of Lyme disease?

Symptoms of Lyme disease usually occur in stages and may vary differently in different individuals. 

Early signs and symptoms

A few days after a tick bite, you will have a red bump at the site of the tick bite. This bump will dissolve within a few days. A red bump is normal, and not necessarily a sign of Lyme disease.

However, early signs of Lyme disease may occur within a month after you have been infected.

Lyme disease rash

Within the early stages of Lyme disease, many people will develop a circular distinctive rash at the site of tick bite. The rash is likely to develop after 3 to 30 days of infection. This type of rash is commonly known as erythema migrans.

A Lyme disease rash usually appears as a bulls eye. The area of rash is red in color and its edges are slightly raised. The size of the rash may vary in stages and in different people. The rash may expand after several days or weeks spreading 15cm across. Some people may also develop many rashes on different body parts. Rash associated with Lyme disease is not painful or itchy. Lyme disease rash is one of the hallmarks of a Lyme disease.

Flu-like symptoms

Some people are likely to develop flu-like symptoms accompanying the rash. Such symptoms include fever, body pains (muscle and joints), chills, headache, and a feeling of tiredness.

Early signs of Lyme disease occur between 3 to 30 days after you had a tick bite that spread the infection. The incubation period can be very confusing if you don’t realize that you have a tick bite. 

Later signs and symptoms

If Lyme disease goes untreated, you are likely to experience serious complications after several weeks, months, or years of infection. 

Heart complications

Heart problems such as myocarditis (inflammation of the cardiac muscles), heart failure, heart block, and pericarditis (inflammation of the sac surrounding the heart) may occur as a result of untreated Lyme disease.

Inflammatory arthritis

Severe joint swelling and pain is likely to occur with Lyme disease. This pain can shift from one joint to another affecting your joint movements.

Meningitis

This is a condition characterized by inflammation of the membranes surrounding the spinal cord and brain. Meningitis can cause severe headache, neck stiffness, and increased sensitivity to light.

Neurological problems

These are problems that affects the nervous system.

They include:

  • Memory problems, causing difficulty in concentrating
  • Limb pain and numbness
  • Paralysis of the facial muscles

Diffuse rashes

Rather than a single rash, you can have several rashes appearing on different body parts.

Less common signs of Lyme disease

After some weeks of infection, some people may develop some signs and symptoms such as:

Some of the signs and symptoms of Lyme disease listed above may improve with treatment. However, they can persist if treatment is started late. This could lead to symptoms related to those of chronic fatigue syndrome or fibromyalgia. This condition is known as chronic Lyme disease, or post-infectious Lyme disease. This happens due to over activity of the immune system.

Note that the common symptoms of Lyme disease in women are the same as those in men.

5 Lyme disease diagnosis

To diagnose Lyme disease, a test is performed to check for any antibodies that have been produced to fight Lyme disease bacteria. The main procedure recommended for this test is the ELISA test. An immunoblot test is then performed to confirm the results of ELISA test.

In early stages after you got a tick bite, the results may be normal. Even if you are treated with antibodies during early stages of Lyme disease, your body cannot produce enough antibodies to be detected by the ELISA test.

In Lyme disease-endemic areas such as the US, your doctor may be able to detect Phase 2 of Lyme disease even without lab tests.

Other tests that can be used to diagnose Lyme disease include:

  • Brain magnetic resonance imaging (MRI)
  • Electrocardiogram
  • An echocardiogram to examine the heart
  • Spinal tap, or a puncture that is made on the lumbar to examine the spinal fluid

6 Is Lyme disease curable?

Yes, Lyme disease can be cured with antibiotic treatment. However, a debate has emerged in the scientific community about people with chronic Lyme disease. The type of antibiotics used to treat this condition depend on the stage of the illness and the part of the body affected.

For example, a single dosage of doxycycline antibiotic may be prescribed to a person immediately after a tick bite, and when all of the following conditions are present:

  • The tick is suspected to have been attached to the person’s body for about 24 to 36 hours
  • A person has been found with a tick that can carry Lyme-causing bacteria attached to his or her body. This is after the doctor has examined and identified the tick
  • The person is able to begin a dose of antibiotics in a period of 72 hours after the tick is removed
  • The person is not pregnant
  • The person is not breastfeeding
  • The person is more than 8 years old
  • If the local rate of the ticks carrying Lyme disease-causing bacteria is more than 20%

A dose ranging from 10 days to 4 weeks of antibiotics is given upon a positive diagnosis. This may depend on the patient’s choice of drug. The choice of antibiotic to be used depends on the phase of the disease and also the severity of symptoms.

Common choices of antibiotics include amoxicillin, doxycycline, ceftriaxone, and cefuroxime. Pain medication such as ibuprofen is sometimes given to relieve symptoms of Lyme disease such as joint stiffness.

7 Risk factors

Where you live can increase or reduce your chances of getting Lyme disease.

The major risk factors for Lyme disease include:

  • Having exposed skin: Ticks will easily attach to bare skin. If you are living in an area where ticks are common, you should protect yourself by wearing long pants and long sleeves. You should also not allow your pets to wander in tall grasses and weeds as they may carry ticks.
  • Wooded and grassy areas: Spending a lot of your time in woody and grassy areas can also increase your chances of getting Lyme disease. Ticks usually stay in grassy or wooded areas. 
  • Not removing ticks properly and immediately: The bacteria from an infected tick can enter your bloodstream if the tick stays on your skin for more than 24 hours. If you remove the tick properly before 24 hours, your risk of getting Lyme disease is minimized.

8 Can you prevent Lyme disease?

Currently, there is no vaccine that is available to prevent Lyme disease. The best way you can prevent this condition is by being aware of the risk factors and taking sensible precautions.

Below are some simple measures you can take to reduce the risk of getting Lyme disease:

  1. Make sure you or your children do not bring ticks in the house that are attached to clothing.
  2. Always stay on clear paths, and avoid grassy or woody areas when walking out.
  3. Wear light-colored clothes when going outside to help you spot ticks.
  4. Wear the best clothes for your outing in tick infested areas. For example, tight-fitting pants and a long sleeved shirt.
  5. Apply insect repellent on an exposed skin.
  6. Inspect your skin regularly for ticks if you are outside often. Remove any ticks you find immediately to prevent Lyme infection.
  7. Make sure your pets are tick-free. Speak to your veterinarian about tick-preventing medication for your dogs and cats.
  8. Check your children’s neck, head, scalp, and any areas they cannot see.
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