Lyme disease: what is it, how is it treated?
December 13, 2013
FORT LEE, Va. -- FORT LEE, Va. -- Lyme disease became apparent in 1975 when mothers of a group of children who all lived in Lyme, Conn., made researchers aware that their children were all diagnosed with rheumatoid arthritis. This unusual grouping of illness that appeared "rheumatoid" eventually led researchers to the identification of the bacterial cause of the children's condition, what was then called "Lyme disease" in 1982.
This disease is caused by a bacterium called Borrelia burgdorferi. According to the Centers for Disease Control and Prevention, this bacterium is transmitted to humans through the bite of infected black legged ticks. Certain ticks, found on deer, harbor the bacterium in their stomachs. Lyme disease is spread by these ticks when they bite the skin, which permits the bacterium to enter the body. A human is not immediately infected with the bacterium. The CDC states in most cases, the tick must be attached for 36-48 hours or more before the Lyme disease bacterium can be transmitted. The disease is not contagious from one person to another.
Most humans are infected from bites of immature ticks, called nymphs. Nymphs are tiny, (less than 2mm) and are difficult to see. They are often found in hard to see areas such as the groin, armpits and scalp. Adult ticks can also transmit Lyme disease bacteria, but are much larger and are likely to be discovered and removed before transmission can occur.
The bacteria enter the skin at the site of the tick bite. Within days to weeks of the bite, the local skin surrounding the area develops an expanding ring of redness. There may be an outer ring of brighter redness with central clearing, resembling a bull's-eye or target appearance. This classic initial rash is called "erythema migrans." Multiple secondary lesions may occur that are a reaction to the infection and are not due to multiple tick bites.
Lyme disease is diagnosed by the patient's history, clinical findings and blood testing, particularly the western blot assay. It is important to tell your provider if you have had a tick bite.
Most Lyme disease is curable with antibiotics. Early illness is usually treated with oral medications, such as doxycycline, amoxicillin or Ceftin. Therefore, if a person finds the classic bull's-eye rash developing in an area of a tick bite, they should seek medical attention as soon as possible. Generally, antibiotic treatment resolves the rash within one-two weeks.
If left untreated, the rash can resolve in about a month. Weeks to months after the initial redness of the skin, the bacterium and its effects can spread throughout the body, causing fatigue, muscle and joint stiffness, swollen glands, and headache, resembling symptoms of a viral infection. If not treated, later it can produce abnormalities in the joints, heart and nervous system.
How can the disease be prevented? Because it is transmitted by ticks attaching to the body, it is important to avoid them. The CDC suggests spraying insect repellant containing 20-30 percent DEET onto exposed skin, clothing, and gear, avoiding wooded and bushy areas with tall grass and leaf litter, and walk in the center of trails. Other suggestions include taking a bath or shower as soon as possible after being outdoors to wash off ticks or easily find ticks that may be crawling, conduct a full body tick check, and examine your children, pets, and your gear. It is suggested to tumble clothes in the dryer on high heat to help kill any remaining ticks.
If a tick is found, it can be removed gently with tweezers by grasping the tick as close to the skin's surface as possible. Pulling upward with a steady even pressure, avoiding twisting or jerking should remove the tick easily. After removing the tick, clean the bite area thoroughly with rubbing alcohol, iodine, or soap and water. Follow up with your provider if you have any questions or concerns.