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Lyme disease is a infectious disease caused by the Borrelia bacteria. The bacteria are spread by ticks, and the most common symptom of the infection is an area of redness on the skin. The area, also called erythema migrans, is usually located where the tick bites, and it appears one week after the bite. Interestingly, the rash caused by the disease is neither painful nor itchy. Instead, the disease causes other symptoms like fever, headache, and tiredness.
The disease is called Lyme disease because it was first diagnosed as a separate condition in Old Lyme, Connecticut. Before then, it was often misdiagnosed for other conditions like rheumatoid arthritis.
Unlike several other conditions that develop exclusively from within the body like arthritis and never related issues, Lyme disease is caused by an external agent—a tick. The insect is from the genus Ixodes. There are different species of this tick, and the time it takes them to spread the bacteria varies from species to species. They are also known as deer ticks.
Additionally, these species are often found in different locations, so the specific type of tick can be guessed with some accuracy based on where the individual was bitten. In the United States, the species present is known to spread the bacteria after attaching to the individual for 36 hours. If it is removed within under 36 hours, the individual will not get the disease.
In Europe, the tick is known to spread the disease more quickly, and the same goes for Asia.
Lyme’s disease can only be spread by a tick bite. This means that an infected individual cannot infect a healthy person by personal contact, exchange of bodily fluids, or sexual intercourse. However, since the tick can stay attached for a long period, contact with an infected person who still has the tick attached to them can expose a healthy individual to the disease. If the tick transfers from the host to the healthy individual, they too can contact the disease.
The most prominent symptom of Lyme disease is the area of redness that appears after the person has been bitten. Since this area does not appear until about a week after the bite, it may take a while for the person to notice. It often takes even longer before any action is taken because the spot starts small and spreads.
The area of redness caused by the tick’s bite and subsequent bacterial infection does not present any symptoms. In other words, they do not give the infected individual any discomfort like pain and itchiness. Instead, the individual feels general symptoms like
As the red rash spreads on the skin, so also the symptoms of the disease become more severe. Eventually, they advance from headaches and fever to more severe ones like
Symptoms like shooting pains and joint pains are often felt in individuals who have been treated and cured of the disease. These symptoms often linger for up to six months after recovery.
The prevalence of Lyme’s disease is seasonal, and sources indicate that the infections are most common in the spring and early summer. It is the most common disease in the northern hemisphere spread by ticks. It is estimated that between 300,000 to 600,000 people suffer from Lyme’s disease every year in the US and Europe.
Besides the prevalence of the disease itself, there is also a prevalence of symptoms in individuals who have suffered it. Some of the symptoms of Lyme disease linger long after treatment (more below) for months. This is seen in 10% to 20% of individuals who suffer the condition. This means that about one to two in ten people who suffer Lyme’s disease will feel symptoms for months after the disease has been cured.
Since the major source of Lyme disease is the deer tick, the risk factors of the disease are spending time in areas where you’re likely to come across the tick. This includes places like grassy and heavily wooded areas. In the United States, they are very prevalent in the northeast and Midwest in heavily wooded areas. Another risk factor is wearing clothes that can expose the skin since the tick needs to attach and bite to be able to spread the infection.
The delayed onset of Lyme disease makes it difficult to catch in the early days. Because the rash doesn’t develop until after a week, the lack of symptoms doesn’t lead the infected individual to suspect anything.
Another factor that makes the diagnosis difficult is that the early symptoms that do develop (rash, fever and headaches) are common in a host of other diseases. This is partly why it was often misdiagnosed in the beginning.
Blood tests can detect the presence of the Borrelia bacteria, but only after a few weeks. In the early days, it has not spread enough through the blood stream to be detected in tests. During this time, tests like Enzyme-linked immunosorbent assay (ELISA) test and the Western blot test may be used.
Before blood tests, a complete history and examination is usually done to narrow down the possibilities. During the history, enquiries are made on possible exposure to infected deer ticks. The physical examination usually involves checking for the rash on the body surface.
The disease can be diagnosed on history and examination alone. If an individual has been in an area where they might have been exposed to an infected tick, and they have an erythema migrans rash, the diagnosis of Lyme disease is confirmed, and lab tests are not necessary.
The age-old saying “prevention is better than cure” is very true when dealing with Lyme disease. Preventing the disease will not only save individuals from the discomfort of infection, but also from the side effects that linger after the disease has been cured. The best way to prevent it is to limit exposure.
This can be done by spending as little time at likely tick habitats as possible, and covering the skin when you do have to spend time there. Additionally, taking precautions when entering and leaving these places can prevent the disease.
One such precaution is soaking or spraying items like clothes, shoes and camping gear after a trip in likely habitats. There are also tick repellants. After leaving the area, clothes and gear should be checked for ticks, and whatever ticks found should be removed as quickly as possible, and removed at once.
The treatment of Lyme disease is quite straightforward after the correct diagnosis has been made. It is mostly via antibiotics. However, the treatment modalities may vary depending on the stage of the disease. Drugs like doxycycline and amoxicillin are used in the treatment.
The symptoms of the disease are also treated as they present. For example, facial palsy is treated with physiotherapy, and arthritis is treated by reducing strenuous activity.
The rates of full recovery of Lyme disease in individuals who received the prescribed antibiotics is about 84% to 90% in the US and is said to be higher in Europe.
“Signs and Symptoms of Lyme Disease”. cdc.gov. 11 January 2013. Archived from the original on 16 January 2013. Retrieved 2 March 2015.
] Aucott JN (June 2015). “Posttreatment Lyme disease syndrome”. Infectious Disease Clinics of North America. 29(2): 309–323. doi:10.1016/j.idc.2015.02.012.PMID 25999226.
Johnson RC (1996). “Borrelia”. In Baron S, et al. (eds.).Baron’s Medical Microbiology (4th ed.). Univ of Texas Medical Branch. ISBN 978-0-9631172-1-2.PMID 21413339. Archived from the original on 7 February 2009.
Steere, AC; Strle, F; Wormser, GP; Hu, LT; Branda, JA; Hovius, JW; Li, X; Mead, PS (15 December 2016). “Lyme borreliosis”. Nature Reviews. Disease Primers. 2: 16090.doi:10.1038/nrdp.2016.90. PMC 5539539.PMID 27976670
Summer and spring prevalence: Shapiro ED (May 2014). “Clinical practice. Lyme disease” (PDF). The New England Journal of Medicine. 370 (18): 1724–1731.doi:10.1056/NEJMcp1314325. PMC 4487875. PMID 24785207. Archived from the original (PDF) on 19 October 2016.
Recovery rate in America and Europe: Wormser GP, Ramanathan R, Nowakowski J, McKenna D, Holmgren D, Visintainer P, Dornbush R, Singh B, Nadelman RB (May 2003). “Duration of antibiotic therapy for early Lyme disease. A randomized, double-blind, placebo-controlled trial”. Annals of Internal Medicine. 138(9): 697–704. doi:10.7326/0003-4819-138-9-200305060-00005.PMID 12729423.
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