Lyme Disease

Lyme disease is a bacterial infection caused by the bacteria borrelia burgdorferi. Of the many animal species that carry these bacteria, deer is the most important in terms of human infection. Humans contract the infection through the bite of the deer tick – Ixodes.

Illness starts with rash, fever, fatigue, malaise, headache and muscle pain. If untreated, in a few weeks to months one can develop neurological, cardiac and joint symptoms.

Where does it occur?

Lyme disease is most commonly seen in the cooler regions of Europe, Asia and America. This illness is NOT seen in the tropics.

How is it transmitted?

It is transmitted through the bite of infected ticks, commonly deer ticks. In animal experiments it appears the tick has to be attached to the body for at least 24 hours to transmit the bacteria.

Is it contagious from person to person?

It is not contagious from person to person.

What is the risk for travelers?

In general the risk for travelers is low. Individuals engaged in prolonged outdoor activities like hiking and camping in countries where the disease is prevalent are at most risk.

How soon after exposure will one develop symptoms?

One generally develops symptoms 1-2 weeks after exposure.

What are the signs and symptoms?

Greater than 90% of the time a red rash (erythema chronicum migrans) develops at the site of the bite which expands in a blotchy manner with a clear area in the center. This is accompanied by fever, headache, muscle aches, joint aches, fatigue and swollen lymph nodes.

If the illness is not diagnosed and treated at this stage, within weeks to months, one can develop other organ involvement with associated symptoms.  These include:

Neurological involvement with meningitis – headache, stiff neck, nausea, vomiting. Weakness of the facial muscles with one sided droop, unsteady gait, paralysis, confusion etc can also be seen.

Cardiac involvement includes disturbances in heart rhythm, heart failure with findings of shortness of breath, swollen legs etc.

The other major organ system that is involved is the musculoskeletal system with swollen & painful joints; primarily large joints like knee.

Are there any lab tests to diagnose the illness?

Blood Antibody tests are notoriously problematic and needs to be interpreted with extreme caution, especially in the first few months of the infection. Isolation of the bacteria by PCR from joint or spinal fluid is diagnostic of the infection.

Is there any treatment?

Antibiotics are most effective in the early stages of the infection when the rash is present. They are also used with active neurological, cardiac and joint infections. Doxycycline, Penicillin G, Ceftriaxone etc for 2-4 weeks is the standard practice of treatment depending on the site and chronicity of the infection. Consult with your physician for chronic problems.

What preventive measures can be taken?

Minimize outdoor activity in high risk areas if possible

Use insect repellant when outdoors

Wear long sleeve shirts, pants and socks

Check your body for any ticks each day and remove any you find - with tweezers using gentle and firm pressure so as not to break off the stinger in the skin.

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