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Lyme disease, also known as Lyme borreliosis, is a vector-borne disease caused by Borrelia bacteria, which are spread by ticks in the genus Ixodes. The most common sign of infection is an expanding red rash, known as erythema migrans (EM), which appears at the site of the tick bite about a week afterwards.
What is Chronic Lyme Disease?
Chronic Lyme disease is a term used by some for a condition in a person who had Lyme disease and the symptoms of PTLDS. Some people consider chronic Lyme disease to be the same as PTLDS. However, some people receive a chronic Lyme disease diagnosis without a Lyme disease diagnosis. Sometimes, extended treatment with antibiotics helps. This term may be why some people think a Lyme disease infection can occur without being bitten by a tick. There isn't enough proof that mosquitoes can transmit Lyme disease. Many researchers dislike using the term “chronic Lyme disease.”
Who is at Risk for Lyme Disease?
Anyone can get a tick bite. But people who spend lots of time outdoors in wooded, grassy areas are at a higher risk. This includes campers, hikers, and people who work in gardens and parks. Most tick bites happen in the summer months when ticks are most active and people spend more time outdoors. But you can get bitten in the warmer months of early fall, or even late winter if temperatures are unusually high. And if there is a mild winter, ticks may come out earlier than usual.
Is Lyme Disease Contagious?
There is no evidence that Lyme disease is contagious between people. Also, according to the CDC, there are no reports of Lyme disease being transmitted through breast milk. Lyme disease is an infection caused by bacteria transmitted by black-legged deer ticks. These bacteria are found in bodily fluids, but there’s no evidence that Lyme disease can be transmitted to another person through sneezing, coughing, or kissing. There is also no evidence that Lyme disease can be sexually transmitted or transmitted through a blood transfusion.
Is Lyme Disease Curable?
Most cases of Lyme disease can be cured with a 2- to 4-week course of oral antibiotics, patients can sometimes have symptoms of pain, fatigue, or difficulty thinking that lasts for more than 6 months after they finish treatment. This condition is called Post-Treatment Lyme Disease Syndrome (PTLDS).
Which Organism Spreads Lyme Disease Through a Bite?
Lyme disease is an infection caused by the bacteria Borrelia burgdorferi and is spread to humans through the bite of infected blacklegged ticks (or deer ticks).
Is Lyme Disease a Virus?
Lyme disease is a bacterial infection spread to humans by infected ticks. It's also known as Lyme borreliosis. Ticks are tiny spider-like creatures found in woodland and moorland areas. They feed on the blood of birds and mammals, including humans.
How Do You Get Lyme Disease?
Lyme disease is transmitted by the bite of an infected deer tick, which also is known as the black-legged tick. (Not all ticks carry the bacterium, and a bite does not always result in the development of Lyme disease. However, since it is impossible to tell by sight which ticks are infected, it is important to avoid tick bites whenever possible.) Immature deer ticks can be very small, about the size of the head of a pin; adult deer ticks are slightly larger. Both can be infected with and transmit Lyme disease. Deer ticks acquire the bacteria by feeding primarily on small mammals infected with the bacteria, particularly the white-footed mouse. (Domestic animals can become infected with the Lyme disease bacteria and some may develop arthritis, e.g., dogs, cattle and horses.)
Is There a Test for Lyme Disease?
A doctor will test your blood for antibodies that are trying to fight the bacteria in your blood. One of these tests is called the ELISA test, and you'll often have a second test called the Western blot test to confirm you have Lyme disease. To treat Lyme disease, you may need to take antibiotics for up to a month.
Can Lyme Disease Kill You?
Most of the people who get Lyme disease and receive treatment early will be fine. Treatment can cure Lyme disease but you might still have some long-term effects. Untreated Lyme disease may contribute to other serious problems but it’s rarely fatal.
Can You Get Lyme Disease Twice?
The answer is yes, you can. Even if you’ve already had Lyme disease (and received treatment for it), you can get it again if you’re bitten by an infected tick carrying Lyme bacteria. Protecting yourself from tick bites is one of the best ways to prevent Lyme disease—regardless of whether you’ve had it before.
Is Lyme Disease an Autoimmune Disease?
While not classified as an autoimmune disease, research indicates that Lyme disease may trigger an autoimmune response and/or its symptoms may mimic an autoimmune disease. Lyme disease is caused by the bacteria Borrelia burgdorferi and Borrelia mayonii, transmitted through the bite of an infected blacklegged tick.
3 Stages of Lyme Disease
Stage 1
Early symptoms of Lyme disease usually happen within 3 to 30 days after a tick bite. This stage of disease has a limited set of symptoms. This is called early localized disease.
Stage 2
Without treatment, Lyme disease can get worse. The symptoms often show up within 3 to 10 weeks after a tick bite. Stage 2 is often more serious and widespread. It is called early disseminated disease.
Stage 3
In the third stage, you may have symptoms from the earlier stages and other symptoms. This stage is called late disseminated disease.
- A reddish rash or skin lesion known as erythema migraines (EM). The rash starts as a small red spot at the site of the tick bite anywhere from one week after to four weeks after the bite. The spot expands over a period of days or weeks, forming a circular, triangular or oval-shaped rash. The rash may look like a bull’s eye because it appears as a red ring that surrounds a clear center area. The rash can range in size from that of a dime to the entire width of a person's back. As infection spreads, several EM rashes (lesions) can appear at different sites on your body.
- Fever.
- Headache.
- Stiff neck.
- Body and joint aches.
- Fatigue.
- Swollen lymph nodes (swollen glands).
Signs and symptoms of the second stage of Lyme disease (the early disseminated stage) may include:
- Multiple areas of rash.
- Paralysis of facial muscles (Bell's palsy).
- Heart block or an interruption of the electrical system of the heart.
- Areas of numbness or abnormal feelings (neuropathy).
Signs and symptoms of untreated late Lyme disease, which may happen from months to a year after infection, may include:
- Recurring episodes of swollen joints (arthritis). This typically affects large joints like the knee.
- Difficulty concentrating, known as “brain fog.” This is a form of encephalopathy or damage to the brain.
- Damage to nerves all over your body, including your skin, muscles and organs (polyneuropathy).
Complications of Untreated Lyme Disease
If unchecked, the Lyme disease infection can spread to other bodily systems, causing significant damage. Untreated, complications of this condition can be very severe:
1. Arthritis: Prolonged infection with Lyme disease leads to chronic joint inflammation and swelling, usually in the knees (though other joints can be affected). These symptoms tend to arise within two years of infection, with periods of flare-ups and remissions. This arthritis is relatively difficult to manage, though antibiotics and steroids may be attempted.
2. Lyme carditis: If the bacteria reach the heart tissues, they can cause inflammation and lead to “heart block.” The electrical signals being sent between the upper and lower chambers of the heart are interrupted, impairing the coordination of the heartbeat. Though disruptive, this is rarely fatal.
3. Lyme neuroborreliosis: Inflammation of multiple nerves, including those in the spine and brain, is the chief characteristic of this condition. This can also affect the meninges—the layer of tissue surrounding the brain and spine—leading to meningitis, among other conditions. Antibiotic therapy, if applied promptly, tends to be effective as a treatment.
Even in cases where Lyme disease has progressed, antibiotic regimens—especially drugs like doxycycline—are generally successful in resolving problems.
Some see relapses of their condition despite treatment, something that’s commonly termed “chronic Lyme disease.” Clinically referred to as post-treatment Lyme disease syndrome (PTLDS), this is the persistence of fatigue, nerve and skeletal pain, and cognitive difficulties more than six months after treatment has ended.
There’s some debate about why PTLDS occurs in some but not others. Some believe it’s an autoimmune response triggered by the original infection. In addition, there is no consensus on treatment for this condition. Studies have shown that antibiotic treatments don’t help those with this condition.
Steps for Tick Removal
If a tick does bite you, a loved one, or a pet, there are a few key steps to take to remove the tick while minimizing the risk of infection. You want to remove the tick as soon as possible using fine-pointed tweezers or specialized tick-removal tweezers, using these steps:
1. Grasp the tick at the place of attachment, getting the tweezers as close to the skin as possible.
2. Pull the tick out gently and in a steady, upward motion with even pressure. Do not squeeze, jerk, or twist.
3. Don’t touch the tick with bare hands.
4. Wash your hands with soap and water. Apply rubbing alcohol or antiseptic to the bite.
5. If possible, bring the tick to a local health department to help determine what kind of tick it is. You can place it in a zippered plastic bag with a moist cotton ball.
6. If you notice a rash, take a photo and document your Lyme symptoms and seek medical attention as soon as possible.
7. If you suspect you’ve been exposed to an infected tick and are suffering from Lyme disease symptoms, our at-home Lyme Disease Test can help you learn if you may have a Lyme infection. (Note that this test should not be taken if you have the bulls-eye rash, since this is a clear physical sign of Lyme disease and you should speak with a healthcare provider right away.)
1. To repel ticks, you may want to spray your clothing with permethrin, an insecticide commonly found in lawn and garden stores. Insect repellents that contain a chemical called DEET can also be applied to clothing or directly onto your skin. Read the labels carefully. Don’t overuse it. Too much may be harmful.
2. Minimize skin exposure to both ticks and insect repellents by wearing long pants and long-sleeved shirts that fit tightly at the ankles and wrists.
3. Wear a hat, tuck your pant legs into socks and wear shoes that leave no part of your feet exposed.
4. Wear light-colored clothing to make it easier to detect ticks.
5. Walk in the center of trails to avoid picking up ticks from overhanging grass and brush.
6. After outdoor activities in an "at risk" area, always do a tick check and then shower, scrubbing with a washcloth.
7. Get rid of any ticks on your clothes by putting them in the dryer for 15 minutes. This will kill any ticks attached to the clothes by drying them out.
8. Pets may bring ticks into your home. Discuss ways to prevent ticks on your pet with your veterinarian.
When to See a Doctor
A person should see their doctor if they get a tick bite as deer ticks and black-legged ticks can carry Lyme disease. If a person is unsure about the type of tick that bit them, they can bring it with them in a sealed container.
The symptoms of Lyme disease can take some time to develop. Sometimes, a person may not notice the tick, and it will fall off their body before they have any symptoms.
It is also possible that a doctor will instruct a person to wait a month before undergoing a test for Lyme disease.
During this time, a person should look for early signs of Lyme disease. These include:
- headaches
- itching
- stiffness in the neck
- a red, growing bull’s-eye rash at the site of the bite
- swollen lymph nodes
- fatigue, chills, or a general feeling of illness called malaise
- dizziness
- muscle or joint pain
- joint swelling
People should see a doctor about these early symptoms of Lyme disease. It is possible that starting antibiotics at this stage could reduce the risk of chronic symptoms developing.
The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 (in the United States) immediately.
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