Lyme Disease
Lyme disease is a bacterial infection transmitted through the bite of an infected blacklegged tick, requiring prompt treatment to prevent long-term complications.
What is Lyme disease?
Lyme disease is a bacterial infection transmitted by the bite of an infected tick. Early symptoms often include a rash, fever, headache, and fatigue. If left untreated, the infection can spread to the joints, heart, and nervous system. Prompt treatment is essential for a quick recovery.
Causes and Risk Factors
In the United States, Lyme disease is usually caused by the bacterium Borrelia burgdorferi, which is spread by blacklegged (deer) ticks. These ticks are primarily found in the:
- Northeast
- Mid-Atlantic
- Upper Midwest
- Pacific coast (especially northern California)
Ticks can attach to any part of the body, often in hard-to-see areas like the groin, armpits, and scalp. Typically, a tick must be attached for more than 24 hours to transmit the bacterium. While most bites occur during warmer months (April–September), they can happen at any time if temperatures are high enough.
Symptoms
Early symptoms appear 3 to 30 days after a bite and include:
- Erythema migrans (EM): A red rash that often expands over several days. It may feel warm and sometimes resembles a "bull's-eye."
- Fever and chills
- Headache and fatigue
- Muscle and joint aches
- Swollen lymph nodes
If untreated, the infection may cause:
- Severe headaches and neck stiffness
- Additional EM rashes
- Facial palsy (drooping on one or both sides of the face)
- Arthritis with severe joint pain and swelling
- Heart palpitations or irregular heartbeat (Lyme carditis)
- Dizziness or shortness of breath
- Inflammation of the brain and spinal cord
- Nerve pain, numbness, or tingling in the hands or feet
Diagnosis and Treatment
Diagnosis is based on symptoms, potential exposure to ticks, and lab tests. Because antibodies can take weeks to develop, initial tests may be negative even if an infection is present, necessitating follow-up testing.
Lyme disease is treated with antibiotics. Some patients may experience post-treatment Lyme disease syndrome (PTLDS), characterized by lingering pain, fatigue, or difficulty thinking. There is no proven treatment for PTLDS, but symptoms can be managed with guidance from a healthcare provider.
Prevention
To reduce the risk of Lyme disease:
- Avoid wooded, brushy, or grassy areas; walk in the center of trails.
- Use EPA-registered insect repellents containing DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol.
- Treat clothing and gear with 0.5% permethrin.
- Wear light-colored, protective clothing (long sleeves and pants tucked into socks).
- Perform daily tick checks on yourself, children, and pets.
- Shower and dry clothes at high temperatures after outdoor activities.