Lyme disease is constantly making the news thanks to the alarming explosion of cases. Transmitted by ticks this disease affects an estimated 300,000 people per year in the United States.
What are the dangers of Lyme disease?
It can easily be treated with antibiotics if caught early; however, if not diagnosed quickly, it can cause severe damage to the joints, heart, and nervous system. It is essential to be aware of the signs and symptoms of Lyme disease so treatment can be started as soon as possible.
What are the stages of Lyme disease?
Lyme disease has four stages:
- Initial infection stage. This stage is easy to treat with a short course of antibiotics.
- Middle stage. Lyme disease here can cause neurological and cardiac symptoms.
- Late stage. This stage can trigger autoimmune arthritis.
- Post-Lyme syndrome. This syndrome refers to when symptoms of fatigue and "brain fog" continue for months or even years after eradication of the bacteria that caused the disease.
What are the symptoms of Lyme disease?
It's important to catch Lyme disease as early as possible to reduce the risk of complications. So, just what can someone expect from the initial infection stage?...
An Embedded Tick
How does the initial infection happen?
Lyme disease can only be transmitted if an infected deer tick bites and remains embedded in the skin for at least 36 hours.
When do people most commonly catch Lyme disease?
Lyme is often transmitted in the spring and early summer by tick nymphs that are only around 2 mm in diameter and are practically impossible to see.
What areas are more likely to have Lyme-carrying ticks?
While Lyme is considered a serious problem in the northeastern United States, a number of cases have also been reported from the northwestern region of the country. However, no one should assume they won't get bit by an infected tick anywhere else, as there are increasing numbers of cases across the United States.
What should someone do if they spot a tick?
Those who find a tick during their daily tick-check shouldn't panic; the best course of action is to remove the rick as quickly as possible. Remember, Lyme disease can only be transmitted if the tick bites for more than 36 hours.
- Grasp the tick as close to the skin as possible with a pair of tweezers.
- Pull gently straight upwards. (The goal is to remove the tick without leaving its mouth parts embedded in the skin.)
- Dispose of the tick by putting it in rubbing alcohol or flushing it down the toilet.
- Wash hands and the site of the bite with warm water and soap.
What happens if part of the tick remains embedded?
If the tick's mouth parts break off and remain embedded in the skin, the following may help:
- Attempt to remove the rest of the tick with tweezers.
- If this method fails, disinfect the area with alcohol or vinegar.
- Then, apply antibiotic ointment twice a day until the skin heals.
Should the tick be tested?
It is not necessary to keep the tick or to take it somewhere for testing. Even if a tick tests positive for Lyme, it does not mean the person acquired Lyme disease from it. Furthermore, the tests aren't too terribly accurate, so a negative test result is also meaningless.
What should someone do post-tick removal?
There are a few steps someone should follow after removing the tick.
- Check the bite site twice a day.
- During this time, watch for signs of a rash or an infection.
- Monitor health carefully for the next two to three weeks.
- If symptoms develop during this period, seek medical care and tell them about the tick bite.
What is the first major symptom of developing Lyme disease?
After someone is bitten by a tick, what should they be on the lookout for to see if they have Lyme disease?...
One of the first symptoms that will appear with Lyme disease? A large, circular rash.
When will the rash appear?
Around 70 to 80% of infected individuals will develop a rash at the site of the tick bite about a week after infection.
What will the rash feel like?
The rash will likely not itch or feel painful.
What will the rash look like?
It will look like a red ring that spreads outwards from the bite site; it is often described as a "bull's eye" rash for this reason.
Does everyone with Lyme disease get a rash?
Not everyone develops a rash. Additionally, if the tick bite occurred on the scalp, the rash might not be visible.
If no rash is present, it's still possible to notice other physical symptoms, like the following...
Fever & Fatigue
When does this symptom emerge?
Within one to three weeks after infection, a low-grade fever, headache, and fatigue will develop and persist for a few days. Many people compare these symptoms to catching a cold.
Why does Lyme disease cause fever and fatigue?
These symptoms are caused by the immune system's reaction to the invading organism.
What can treat these early symptoms?
Some people recover from this phase without any treatment and don't go on to develop further symptoms. Unfortunately, that isn't the case for everyone. In this case, a 10-day course of antibiotics will help.
Diagnosis is tricky.
Most Lyme diagnostic tests involve measuring levels of anti-Lyme antibodies in the blood. Unfortunately, this testing method is faulty.
Why is that, though?
It's because the presence of antibodies doesn't necessarily mean that someone has a disease, merely that the body mounted an immune response against the disease. Therefore, antibody testing can lead to both false negatives and false positives.
- False negatives. During the initial phase of infection, some people have undetectable levels of antibodies in their blood. That means, despite being infected, they might test negatively for Lyme.
- False positives. Additionally, individuals who have been exposed to Lyme disease in the past can have antibodies in the blood. Therefore, they can test positively even if they are not currently infected.
Antibiotics will likely be administered.
Most physicians in Lyme-ridden areas will administer antibiotics regardless of test results if the characteristic rash appears or a tick bite plus symptoms are reported.
What happens if left untreated?
The Borrelia burgdorferi bacteria—which causes Lyme—tries to evade the immune system by hiding inside certain tissues and cells. If it manages to hide—and antibiotics aren't administered early—the condition can progress into the middle phase of infection.
The middle stage of infection: What happens?
What can someone expect if Lyme progresses?...
Severe Headaches & Neck Stiffness
When do new symptoms emerge?
After the short period of feeling flu-ish, symptoms of untreated Lyme usually go away. Then, perhaps weeks or even months later, additional symptoms may manifest.
What new symptoms mark this next stage?
The following symptoms may develop:
- Severe headache
- Sensitivity to light
- Neck stiffness without fever
Why does Lyme cause these symptoms?
These symptoms are caused by the bacteria invading the nervous system. When this invasion occurs, wild pain signals can be sent to the brain, causing these uncomfortable sensations.
How is Lyme diagnosed at this stage?
Doctors can use a spinal tap and find the bacteria in the resulting fluid.
What is treatment at this stage like?
Lyme disease can be successfully treated with antibiotics during the middle stage of infection. However, a longer course is necessary than during the initial phase.
How long will treatment last?
Instead of a 2-week course, a 4-week course is generally required.
What if severe symptoms emerge?
If severe neurological or cardiac symptoms are manifesting, the doctor may recommend a powerful intravenous course of antibiotics. This method may quickly knock out the bacteria to prevent them from causing irreversible damage to the nervous system, joints, and heart.
What happens if left untreated?
If someone still does not receive treatment for Lyme, what other symptoms can develop?...
Facial palsy is another symptom Lyme disease can cause in this stage. With this condition, one side of the face becomes temporarily paralyzed. As a result, appears to droop due to damage to the nerves.
Why does Lyme cause this symptom?
It is a result of Lyme bacteria invading the nervous system.
How common is this symptom?
This condition affects up to 50% of infected, untreated individuals. It is more common among children than adults.
How long does facial palsy last?
Facial palsy will eventually go away, but it won't be quick.
- 4 months: It typically takes this long before recovery begins.
- 18 months: It can take up to this long to completely recover from this symptom.
Will antibiotics help?
Treatment with antibiotics against Lyme-causing bacteria does not affect the recovery time from facial palsy. Still, an estimated 99.2% of affected patients will completely recover on their own.
Don't avoid seeking help.
Avoiding a trip to the doctor can mean the following painful symptom develops...
Shooting Pains (Radiculopathy)
One fairly common manifestation of Lyme is radiculopathy, or shooting pains.
What does this symptom feel like?
The infected individual experiences severe, shooting pains at random intervals. These pains can occur in the arms and legs as the infected nerves fire off at random. Some individuals experience numbness instead of shooting pains when inflamed neurons temporarily stop working.
Where do the pains appear?
Radiculopathy usually but not always primarily affects the limb located closest to the site of the tick bite. Infected individuals also often experience somewhat random aches and pains in the following body parts during this stage of the infection:
How long does radiculopathy last?
After treatment, most patients recover completely from radiculopathy and the random aches and pains within a few weeks. However, a few patients develop neuropathy in the most strongly affected limb and continue to experience numbness and strange sensations for many months after the successful treatment of their Lyme disease.
There are more symptoms to come.
Other easily spotted signs of Lyme disease may also develop during this time...
Bull's eye rashes make new appearances.
Bull's eye rashes may appear at random sites on the body during this time.
What do these rashes look and feel like?
They will look like a typical rash but with an expanding red ring. The initial rash will not be painful or itchy, but after expanding slowly for a few days, the rash will disappear... only to reappear somewhere else.
Lymphocytoma may occur, too.
Although rare in the United States, cases of Lyme disease in Europe frequently cause what is called lymphocytoma.
What does this rash look like?
In this condition, a dark purple lump develops on the ear lobe, nipple, or scrotum.
One rash can even permanently damage the skin.
Additionally in Europe, Lyme has caused acrodermatitis chronica atrophicans (ACA).
What does this rash look like?
This condition refers to a red patch that develops on the back of one of the hands or sometimes on a foot. The skin lesion can remain for months before resolving.
What are the complications of ACA?
ACA can leave behind a thin, wrinkled, hairless patch of skin. This skin looks different and has a different texture than the surrounding area.
Rashes are no fun, but the following sign of Lyme is particularly alarming...
Irregular Heart Beat
Around 5% of untreated individuals will develop Lyme carditis during the middle phase of infection.
How does Lyme cause this symptom?
This symptom occurs when Lyme-causing bacteria enter heart tissues. There, the bacteria damage the electrical system that controls the beating of the heart. This damage can result in the heart alternating between beating too quickly and too slowly.
What additional symptoms may occur?
Affected individuals usually notice these symptoms:
- Heart palpitations
- Shortness of breath
- Chest pain
Will this symptom go away?
After treatment, most cases of Lyme carditis will resolve.
Still, in some cases, the heart is irreversibly damaged by the bacteria. In these cases, the condition may progress to congestive heart failure despite the successful treatment of the Lyme disease.
What happens during the late stage of infection?
The initial and middle stages of Lyme are no fun, but they look positively tame compared to the final stage of this disease...
Swollen, Painful Knees
Why does Lyme cause this symptom?
As the immune system tries to fight off the invading bacteria, it begins to inflict damage on tissues of the body. One common manifestation of this autoimmune-like attack? Swollen, painful knees.
Are only the knees affected?
No, it can also affect other joints, like the hip or shoulders.
Is only one joint affected?
No. The swelling and pain can be bilateral (affect both sides of the body), affect multiple joints, or only affect one joint.
When is this symptom common?
This condition most commonly manifests around six months after the initial infection.
Will antibiotics help?
For most people, joint swelling and pain rapidly resolve after treatment with antibiotics. Unfortunately, some people with a genetic predisposition to autoimmune diseases will continue to experience problems.
What complications can occur?
Even after the Lyme disease is successfully treated, the autoimmune attack on the joints continues and may develop into other conditions, including:
- Rheumatoid arthritis
- Other autoimmune diseases
The most severe symptom of all?
The most severe complication of Lyme disease just might be the following...
Encephalitis (Inflammation of the Brain)
In rare cases, prolonged Lyme infection can cause neurological symptoms that resemble encephalitis, or inflammation of the brain.
What symptoms can emerge?
The affected individual can experience a wide variety of symptoms, including:
- Cognitive impairment
- Memory problems
- Altered gait
- Balance issues
Psychological symptoms can occur, too.
Some lyme disease cases progress to schizophrenia-like symptoms or even overt psychosis, which can lead to:
- Panic attacks
- Delusional states
Why do these symptoms occur?
It is unclear if these symptoms are caused directly by bacterial damage to the brain or if they are caused by bacteria triggering an autoimmune attack on the brain. Although, most experts are leaning towards an autoimmune attack, since in many ways this condition resembles multiple sclerosis (an autoimmune disease). The fact that this condition doesn't respond to treatment with antibiotics also suggests autoimmune attacks are to blame,
What is post-Lyme syndrome like?
Even after Lyme is successfully treated, the disease can continue to plague sufferers in the form of post-Lyme syndrome...
Post-Lyme Syndrome: Fatigue, Aches, & Cognitive Impairment
What is post-Lyme syndrome?
After being treated for Lyme disease, some patients go on to develop post-Lyme syndrome.
How long does this syndrome last?
Despite being successfully treated, some patients continue to experience symptoms such as fatigue, aches and pains, and "brain fog" for up to six months later.
Why does post-Lyme happen?
Experts are not sure why this happens. Speculation that the bacteria hadn't actually been eradicated was laid to rest after several randomized and controlled trials showed that aggressive, prolonged antibiotic therapy did not change the progression or course of this syndrome.
There are precedents to experiencing a prolonged post-treatment recovery period; post-viral fatigue syndrome, which can develop after recovery from influenza or other common viral infections, is well-documented. The affected individual is fatigued and sometimes feels depressed for several months before spontaneously recovering.
How is post-Lyme treated?
Although there is no specific treatment for post-Lyme syndrome, doctors suggest treating it similarly to chronic fatigue syndrome. This method combines a gentle exercise program, resting when necessary, and accepting that there will be limitations on what one can do for several months.
What are the complications of post-Lyme syndrome?
Some doctors continue to offer aggressive, prolonged antibiotic therapy for this syndrome; however, it can cause serious harm to patients. Some patients have even died from these unnecessary treatments.
Does post-Lyme syndrome go away?
Post-Lyme syndrome will gradually resolve over time.
So, what should someone who suspects that they have Lyme disease do?
Don't Leave It To Chance
Lyme disease is caused by the Borrelia burgdorferi, which is transmitted by ticks.
Prevention is the best medicine.
The best approach? Avoid getting bitten in the first place. Great methods to reduce odds of tick bites include:
- Using insect repellant
- Wearing long pants tucked into socks
- Conducting daily tick checks
Seek treatment early, if possible.
Lyme disease is easily treated during the initial infection period. Therefore it is essential to be aware of the early symptoms, which include a very distinctive rash and mild flu-like symptoms.
Those who miss these first symptoms should know that Lyme disease can still be treated during the middle or late stage. This treatment typically occurs once symptoms like rashes, neurological manifestations, cardiac dysfunction, and swollen joints are noted.
Lyme disease can lead to other health problems.
Most cases treated during the middle and late stages of infection will completely clear up after two to four weeks of antibiotics. Still, unfortunately, Lyme disease seems to trigger the onset of autoimmune diseases in some cases.
In addition, some individuals are afflicted with post-Lyme syndrome, during which they spend months experiencing fatigue, "brain fog," and aches and pains before it finally resolves on its own.