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What Is Lyme Disease?

Lyme disease is an infection that is transmitted through the bite of a tick infected with a bacterium called Borrelia burgdorferi. Ticks typically get the bacterium by biting infected animals, like deer and mice. Although most people who get tick bites do not get Lyme disease, the condition is serious enough that every tick bite should be evaluated. The risk for contracting the disease increases the longer the tick is attached to the body.

Symptoms: Early Stage

Within 1-4 weeks of being bitten by an infected tick, most people will experience some symptoms of Lyme disease. A circular, expanding rash (called erythema migrans) at the site of the bite develops in about 70%-80% of cases. Some people report flu-like symptoms at this stage, including fever, chills, headaches, fatigue, swollen lymph nodes, joint pain, and muscle aches.

Symptoms: As the Infection Spreads

If the disease is not detected and treated in its early stages, it extends to more areas of the body, affecting the joints, heart, and nervous system (about 1-4 months after the initial bite). Additional rashes may occur, and there may be intermittent periods of pain and weakness in the arms or legs. Headaches, fainting, and poor memory are other symptoms at this stage, along with a rapid heartbeat and some loss of control of facial muscles.

Symptoms: Late-Stage Disease

This is the most serious stage of the disease, when treatment was either not successful or never started (usually occurring many months after the initial bite). Joint inflammation (arthritis), typically in the knees, becomes apparent, and may become chronic. The nervous system can develop facial-muscle paralysis (Bell's palsy), abnormal sensation due to disease of peripheral nerves (peripheral neuropathy), meningitis, and confusion. Heart problems are less common, but can include inflammation of the heart muscle.

Do All Ticks Transmit Lyme Disease?

No. In the northeastern and north-central U.S., the black-legged tick (or deer tick) transmits Lyme disease. In the Pacific coastal U.S., the disease is spread by the western black-legged tick. Other major tick species found in the U.S., including the lone star tick and the dog tick, have NOT been shown to transmit the Lyme disease bacterium. But beware: Lyme disease has been reported in all 50 states, as well as in Canada, Europe, Asia, Australia, and South America.


How Lyme Disease is NOT Spread

You can’t catch Lyme disease by being around an infected person. And although pets can become infected by a tick, they cannot transmit the disease to humans unless an infected tick falls off the animal and then bites a person. Insects such as mosquitoes, flies, or fleas cannot spread the disease to humans either. Only infected ticks have that honor.

Diagnosing Lyme Disease

The easiest way to diagnose the disease is through a "bull's-eye" rash at the site of a tick bite. But not everyone has the rash, and not everyone can recall being bitten. Blood tests (ELISA and Western Blot) can be taken 3-4 weeks after suspected contact, but can only suggest a prior infection, not the current disease status. Other tests, such as a spinal tap or skin biopsy, may be used to confirm a diagnosis or rule out other conditions.

Treating Lyme Disease

Most Lyme disease is curable with antibiotics, particularly when the infection is diagnosed and treated early. Doxycycline, amoxicillin, and cefuroxime are the drugs of choice most of the time for early illness. Later illness, such as nervous system disease, might require long-term, intravenous antibiotics, such as ceftriaxone. And nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, are used to treat achy joints.

Is There a Lyme Disease Vaccine?

Currently, there is no vaccine for Lyme disease. The one that did exist--LYMErix--is no longer available. Originally approved by the FDA in 1998 to help prevent the disease, the vaccine was pulled from the market by the manufacturer in 2002 due to poor sales. There was concern that the vaccine could trigger treatment-resistant Lyme arthritis, although the FDA never found evidence that the vaccine was dangerous.

Preventing Lyme Disease

Avoid tick bites whenever possible by staying clear of grassy or wooden areas, especially May to July. Cover your body head-to-toe when entering possible tick-infested areas. Apply an insect repellent containing DEET directly to your skin. Insect repellents containing permethrin can be applied to clothes to kill ticks on contact, but never apply to the skin. When coming in from outdoors inspect your body thoroughly for ticks; do the same for pets. Wash your skin and scalp to knock off any ticks that are only loosely attached.

How to Remove a Tick

If you have a tick, it is important to remove it properly. Using fine-tipped tweezers, grasp the part of the tick that's closest to your skin — you want to grab the head, not the belly filled with infected fluid. Slowly pull the tick straight out, without twisting it, so that the mouth is released too. Put the tick in a jar of rubbing alcohol so that it can be tested for Lyme disease. Wash the bite site with soap and warm water. If you cannot remove the entire tick from your skin, contact your doctor.