Lyme Disease

Introduction:

Lyme disease, otherwise called Lyme borreliosis, is a vector-borne disease caused by the bacteria Borrelia. It was first reported in the town of Old Lyme, Connecticut in 1975, hence the name. If left untreated, this disease can affect various tissues in the body and cause various symptoms, which can last for several months or even years. Laboratory testing is useful when used properly and with validated methods. Most people with Lyme disease can get better after taking antibiotics for a few weeks. Using insect repellent, removing ticks as soon as possible, using pesticides, and other measures can help avoid Lyme disease.

What Causes Lyme Disease?

The four main species that cause this disease are Borrelia burgdorferi, mayonii, afzelii, and garinii. It is spread to humans by the bite of an infected deer tick (black-legged tick). 7 to 14 days after the tick bite, an erythema migrans (EM) rash appears on the skin. The tick deposits the bacteria when it bites humans and animals. People with pets who spend a lot of time in the woods are more susceptible.

What Are the Stages of Lyme Disease?

Lyme disease usually occurs in three stages:

• Stage 1 - Early localized stage.

• Stage 2 - Early disseminated stage.

• Stage 3 - Late disseminated stage.

What Is the Pathophysiology of Lyme Disease?

In Lyme disease, the first and most common sign is a rash called erythema migrans. This rash is found in 70 to 80 percent of cases and occurs at the spot where the tick bit, starting as a red area on the skin that expands and can be at least 50 millimeters (mm) wide. The rash might look uniformly red or have a target-like appearance. It usually shows up about one to two weeks after the tick bite. If left untreated, Lyme disease can lead to other issues, such as arthritis in about 30 percent of cases, neurological problems in 10 to 15 percent, or heart problems in 1 to 2 percent.

What Are the Symptoms of Lyme Disease?

The symptoms vary depending on the stage of the disease.

1) Early Localized Stage (Acute): The symptoms start a couple of weeks after the tick bite.

• Red solid rash or bulls-eye rash (erythema migrans) after 30 days at the site of the bite or other areas.

• Malaise.

• Fever.

• Chills.

• Headache.

• Swelling of the lymph node near the bite.

2) Early Disseminated Stage: Occurs a few weeks after the tick bite.

• Two or three erythema migrans other than the site of the bite.

• Migrating pain in the joints.

• Facial palsy.

• Neck stiffness.

• Tingling sensation in hands and legs.

• More than one enlarged lymph node.

• Shortness of breath.

• Sore throat.

• Fever more than 101 degrees Fahrenheit.

• Vision changes.

• Fatigue.

• Abnormal pulse.

3) Late Disseminated Stage: This stage occurs after some weeks to years when the infection is left untreated.

• Pain or swelling (arthritis) of one or two joints.

• Confusion.

• Dizziness.

• Heart rhythm problem.

• Heart palpitations.

• Short-term memory loss.

• Concentration problems.

• Nerve pain.

• Numbness in hands and legs.

What Are the Risk Factors?

The factors that increase the risk of getting infected with Lyme disease are:

• Spending more time in wooded or grassy areas.

• Wearing clothes that do not cover the body completely.

• Failure to remove the ticks properly.

• Letting dogs and other pets wander in the open.

How Is Lyme Disease Diagnosed?

The signs and symptoms that are seen in this disease are not very specific, as such symptoms can be seen with other diseases. So if the doctor suspects this illness, one might take a complete history which might include the time spent by the patient outside in summer. After performing physical examinations, the doctor might suggest the following tests:

1. ELISA (Enzyme-Linked Immunosorbent Assay) Test - This detects the presence of antibodies against Borrelia bacteria. As this test can provide false positives, and the antibodies might not be detected during the early stages, it is not used exclusively for diagnosing this condition.

1. Western Blot Test - This test is done if the ELISA test is positive. The western blot test detects antibodies to many proteins of Borrelia bacteria.

How Is Lyme Disease Treated?

Lyme disease is treated with the help of antibiotics. The sooner the treatment is started, the quicker will be the recovery. The antibiotics used are:

• Oral Antibiotics - Doxycycline, Amoxicillin, or Cefuroxime is used for 14 to 21 days during the early stage of this disease.

• Intravenous Antibiotics - Antibiotics are given intravenously if the central nervous system is affected.

What Are the Complications of Lyme Disease?

If left untreated, Lyme disease can lead to the following complications:

• Lyme Arthritis (joint inflammation).

• Facial palsy.

• Neuropathy - Nerve pain.

• Memory problems.

• Heart arrhythmias.

When to See a Doctor?

Not all tick bites lead to Lyme disease, but it is only caused when an infected tick bites the individual. The risk increases when the tick remains attached to the skin longer (more than 36 to 48 hours). Get immediate medical help if one develops any of the above symptoms after a tick bite, as the treatment is more effective when started early.

What to Look for When a Tick Bites?

Tick bites are usually painless and go unnoticed as they are the size of a poppy seed. So whenever one goes out camping or spends time walking in woods or tall grass areas, check oneself and the pets and clothes for ticks. Examine carefully under the shower after taking off one’s clothes.

How to Remove a Tick Properly?

As soon as a tick is spotted, carefully remove it with a fine-tipped tweezer, which will be available in a pharmacy. With the help of the tweezer, grab the tick as close to the skin as possible, and while applying a steady pressure pull the tick upwards. Remove all the parts of the tick left under the skin and wipe the area with rubbing alcohol or soap and water. Place the removed tick in soapy water or alcohol, stick it to a tape, or flush it down the toilet.

What Measures Should Be Taken to Prevent Tick Bites?

The following tips can help avoid tick bites:

• To repel ticks, consider spraying clothing with permethrin, an insecticide commonly available in lawn and garden stores. Insect repellents containing DEET (diethyltoluamide) can also be applied to clothing or directly to the skin. Carefully read the labels and avoid excessive use, as it may be harmful.

• Reduce skin exposure to ticks and insect repellents by wearing long pants and long-sleeved shirts that fit tightly at the ankles and wrists.

• Discuss tick prevention for pets with a veterinarian, as pets may bring ticks indoors.

• Stick to the center of trails to avoid picking up ticks from grass and brush.

• After outdoor activities in areas with a risk of ticks, always perform a tick check and then shower, using a washcloth to scrub.

• Eliminate any ticks on clothing by placing them in the dryer for 15 minutes, which will dehydrate and kill them.

• Wear a full-sleeved shirt, tuck pant legs into socks, wear a hat and gloves, and opt for closed-toe shoes when going out in wooded or grassy areas.

• Opt for light-colored clothing to make it easier to spot ticks.

• Check the clothes, pets, and children for ticks after one spends time in wooded or grassy areas.

What Is the Prognosis for Individuals With Lyme Disease?

Most individuals who contract Lyme disease and receive early treatment will recover well. Treatment can effectively cure Lyme disease, but there may still be some lingering long-term effects. If Lyme disease is left untreated, it could potentially lead to other serious complications, although fatalities are rare.

Conclusion:

The borrelia bacteria are the source of Lyme disease. Typically, a tick harboring the Lyme disease bacteria will bite a human and transmit the illness. If one spends time in areas where ticks thrive, such as grassy, brushy, or forested areas, one runs the risk of contracting Lyme disease. Lyme disease risk can be decreased in these places by taking safety precautions.