Lyme Disease Symptoms And Treatment
In it's simplest terms, Lyme disease is a bacterial infection. However, controversy surrounds the diagnosis of the disease, the length of treatment, and a much-debated cluster of symptoms referred to as “chronic Lyme disease.”
First, a bit on what health care providers all agree on regarding the disease, and then a little more on some of the controversies...
What Is Not Disputed
Deer ticks and Western blacklegged ticks, both no bigger than a sesame seed, are the only species of tick that actually carry bacteria that cause Lyme disease. Typically, the tick picks up the disease from biting an infected animal, and then passes it on to humans with a subsequent feeding.
Is Lyme Disease Common In Virginia?
Lyme disease is most commonly reported in New England and the mid-Atlantic states. It has become increasingly common in Virginia. In fact, Virginia has experienced tremendous increases in the number of reported cases in the past several years. From 2009 to 2010, for instance, there was a 37% increase in diagnosis of the disease. The recent increase in Lyme disease has coincided with an alarmingly rapid spread of the disease southward and westward from northern regions of our state.
Lyme Disease Symptoms
The most common signs of early-stage Lyme disease are flu-like symptoms: muscle aches, joint pain, headache, fatigue, and fever. Occasionally, neurologic symptoms accompany the “achiness.” Lyme disease oftentimes causes a skin rash known as “erythema migrans,” which may start as a small red spot and grow larger, taking on the appearance of a bull’s-eye. Some of those infected have no symptoms at all, and up to 20% may not show the characteristic bull’s eye rash. The incubation period from infection to onset of the characteristic rash is typically 7 to 14 days; however, it may occur within as few as 3 days or as long as 1 month after contact with the tick. Lyme disease spreads from the site of the tick bite by skin, lymph nodes, and blood.
Musculoskeletal symptoms (present in 60% of those infected) include migratory joint or muscle pain, with or without joint swelling. Neurologic manifestations (present in 15% of cases) may include meningitis, temporary paralysis of some facial nerves, and “nerve pain.” Cardiac symptoms are less common (present in 8% of cases) but may include temporary heart arrhythmias.
What Happens When Lyme Disease Is Not Treated?
An infection that goes untreated for longer periods of time has many manifestations, including persistent pain and swelling of one or more joints. The joints primarily affected are the knees and hips. In these cases, Lyme disease may be responsible for substantial disability, but it is rarely fatal.
How Quickly Is Lyme Disease Transmitted?
It is important to note that the tick must be attached to skin for at least 36 hours in order for it to transmit the infection. Otherwise, the chances of transmission are near zero.
Lyme Disease Controversies
Now, for some of the controversies surrounding the disease... There is a simple blood test to check for Lyme disease. Unfortunately, the test is not perfect. Occasionally, false-negative or false-positive results can be misleading, especially early in the course of the disease. Frequently, your healthcare provider may not think it necessary to treat you for the disease, despite a marginally positive test. The symptoms you may experience are vague enough to encompass many different kinds of illnesses, many of which will not respond to typical treatment of Lyme disease.
Recommended treatment includes antibiotics like doxycycline or amoxicillin, both of which are generally effective in early disease. Depending on the severity and number of your symptoms, your health care provider may decide to treat you for anywhere from 14 to 28 days. And remember, these antibiotics are not without side effects! Nausea, vomiting, and hypersensitivity to sunlight are three of the more common symptoms experienced when taking these medications for extended periods.
Also, if you notice an engorged tick that you feel has been attached for more than 36 hours, and you come to see a provider within 3 days of removing the tick, you may be effectively treated with a single dose of antibiotic without testing for the disease. Recent studies show it is extremely effective if caught early enough. This does not mean, however, that you should come to expect a prophylactic dose of antibiotic each time you notice a tick bite.
And finally, a word on “chronic Lyme disease.” This term refers to people who have been treated for the disease in the past though some symptoms persist. In fact, up to one third of patients who have completed a course of antibiotic treatment continue to have temporary symptoms like severe fatigue, sleep disturbance, and cognitive difficulties. While it is undeniable these patients can have severe symptoms, the cause and long-term treatment is controversial. Significant research is currently underway to better delineate this phenomenon.
Early Treatment For Lyme Disease Is Important
In short, it is critically important to see your doctor if you think you may have Lyme disease. The earlier treatment begins, the quicker you feel back to your normal self!
Article Posted June 15, 2011