May is Lyme Disease Awareness Month. Named for its high occurrence in Lyme, Connecticut, Lyme disease is a tick-transmitted illness with multiple manifestations.
LYME DISEASE SYMPTOMS:
Lyme disease has early and late symptoms. The early symptoms include:
- A characteristic rash called erythema migrans. This is a red, round rash that starts small and expands to about six inches. It lasts up to two weeks
- Fever
- Headache
- Stiff neck
- Drooping of one side of the face
- Facial palsy
Late symptoms occur months later. They include:
- Joint pain
- Neurologic problems
CAUSES:
A tick called Ixodes transmits a spirochete called Borrelia burgdorferi. The tick must stay on the skin for at least thirty-six hours for the spirochete to be transmitted. The illness is most common in northeastern United States but can occur anywhere.
CONTAGION:
Not contagious from person to person
DIAGNOSIS:
Mostly done by clinical symptoms. However, this leads to over-diagnosis since the symptoms may mimic so many other illnesses. A blood test can be helpful in diagnosis. There are no definitive confirmatory tests at this point.
TREATMENT:
- Antibiotics including doxycycline, amoxicillin, erythromycin and cefuroxime (Ceftin) for early symptoms. Late symptoms are treated with intravenous antibiotics such as ceftriaxone (Rocephin).
OUTCOME:
Excellent with treatment. Left untreated, this can lead to neurologic problems.
DISCUSSION:
Lyme Disease is an illness contracted by a long exposure to a tick on the body. Any history of tick bite followed one to two weeks later by a rash is suggestive of the disease, especially if the rash is the expanding rash called erythema migrans. Blood tests for Lyme disease are not very accurate so clinical symptoms with a history of a tick bite are usually all that is done to diagnosis this illness. Unfortunately this may lead to over-diagnosis and over-treatment with antibiotics. So the best way to eradicate Lyme disease is through prevention. Prevention includes:
- Wearing protective clothing when entering tick-infested areas
- Using insect repellent
- Looking for and removing ticks quickly while in infested areas
- Vaccination
The Lyme Disease vaccine (Lymerix) is an effective vaccine and should be given to individuals over fifteen years of age who live in endemic areas and participate in activities that put them at high risk. These include:
- Camping
- Hiking
- Working in wooded areas
ONE DOCTOR’S OPINION:
Lyme disease is not a common illness, but with the long-term complications of arthritis and neurologic problems if left undiagnosed, it should always be considered after a tick bite. Preventative antibiotics should not be used after a tick bite because the over-use of antibiotics can cause problems and the likelihood of contracting Lyme disease is low. The vaccine is not recommended for everyone since the illness is so rare and is treatable once diagnosed. Prevention, vaccination when appropriate, and awareness of the possibility of Lyme disease after a tick bite are the best way to combat this illness.
Written by Dr. Michael Bornstein, who has over 28 years of experience as a pediatrician.
Disclaimer: The contents of this article, including text and images, are for informational purposes only and do not constitute a medical service. Always seek the advice of a physician or other qualified health professional for medical advice, diagnosis, and treatment.
FOLLOW US