Lyme disease is transmitted by a tick that is infected by one of these four main species of bacteria: Borrelia burgdorferi, Borrelia mayonii, Borrelia afzelii and Borrelia garinii.
The disease can be found in the United States, Europe and Asia. It is rare but can be fatal.
After an infected tick bites you, a bull’s eye rash (also known as contact dermatitis) develops on your body, which can adversely affect your skin, joints, heart, and nervous system. Lyme disease occurs in phases, with the early phase starting at the site of the bite with an expanding ring of redness. These stages are known as: early localised, early disseminated, and late disseminated. Symptoms depend on which stage the disease is in.
You are most likely to contract Lyme disease if you live or spend time in overgrown, wooded areas where ticks carrying the disease thrive. It is not contagious.
What are its symptoms?
A red bump often appears at the site of a tick bite. This is normal; it disappears after a few days and does not indicate Lyme disease.
Lyme disease symptoms may occur within a month after you’ve been infected. These include:
- Rash (erythema migrans): From three to 30 days after an infected tick bite, an expanding red area might appear that sometimes clears in the centre, forming a bull’s-eye pattern. It expands slowly and can spread to 30cm across. It is not painful or itchy. Some people develop this rash at more than one place on their bodies.
- Flu-like symptoms: Fever, chills, fatigue, body aches and a headache.
If untreated, new signs and symptoms of Lyme infection might appear. These include:
- Joint pain and arthritis: Bouts of severe joint pain and swelling in your knees, but the pain can shift from one joint to another
- Back pain
- Neurological problems: Weeks, months or even years after infection, you might develop inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell's palsy), numbness or weakness in your limbs.
Several weeks after infection, some people develop:
- Heart problems, such as an irregular heartbeat. These rarely last more than a few days or weeks
- Eye inflammation
- Liver inflammation (hepatitis)
How is it diagnosed?
If you’ve been bitten by a tick and live in an area known to have Lyme disease, consult your doctor immediately so treatment can be started.
Lyme disease may be difficult to diagnose because many of its symptoms are similar to those of other disorders. Although a tick bite is an important clue, many patients don’t notice if a tick has bitten them.
The easiest way for a doctor to diagnose Lyme disease is to identify the rash. If there is no visible rash (as is reportedly the case in about a quarter of those infected), the doctor might order a blood test to look for antibodies against the bacteria. Unfortunately, the Lyme disease bacterium itself is difficult to isolate or culture from body tissues or fluids. These tests are:
- Enzyme-linked immunosorbent assay (ELISA): This measures the levels of antibodies against the Lyme disease bacteria present in the body. Antibodies are molecules made by the immune system to destroy specific microbial invaders.
- Western blot: This blood test identifies antibodies directed against a panel of proteins found on the Lyme bacteria. The test is ordered when the ELISA result is either positive or uncertain.
- Polymerase chain reaction (PCR): This is used to evaluate people with persistent Lyme arthritis or nervous system symptoms. It is performed on joint fluid or spinal fluid.
What are your treatment options?
Although rare, Lyme disease can be deadly and is best treated in the early stages. Early treatment is a 14-to-21-day course of oral antibiotics. However, improvement of symptoms occurs more slowly.
Medication used to treat Lyme disease include:
- Doxycycline: For adults and children older than eight years old
- Cefuroxime and amoxicillin: To treat adults, younger children, and women who are nursing or breastfeeding
It’s unknown why symptoms like joint pain continue after the bacteria have been destroyed. Some doctors believe that persistent symptoms occur in people who are prone to autoimmune disease.
Can it be prevented?
A Lyme disease vaccine is reportedly being developed but is not yet available. The only guaranteed prevention measure is to avoid exposure to infected ticks.
To prevent tick bites, follow these tips:
- Wear long sleeves and tightly woven clothes when walking in bush and wooded areas
- Tuck your shirt tucked into your pants, and tuck your pants into your boots/socks
- Where possible, keep grass trimmed
- Apply tick repellents to your clothing, shoes and socks before going out into tick-infested environments. (Read the container for possible side effects).
- Shower and shampoo your hair if you think you may have been exposed to ticks.
- Check your clothes for ticks and wash them immediately in order to remove any ticks.
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