Lyme Disease

History and Facts

Lyme disease is the most common tick-born illness in North America and Europe, according to the Mayo Clinic.  Lyme is caused by a spirochete (spiral-shaped) bacterium called Borrelia burgdorferi and is found in deer ticks. The disease is transmitted to humans by an infected tick bite (not all deer ticks carry the bacteria, however).

The Lyme Disease Association states, “deer ticks feed once in each stage: larva, nymph and adult.  Each time they feed they can pass the disease to whatever animal they feed upon.”  Deer ticks can survive for two years even through freezing temperatures and can be active anytime of the year when temperatures are above freezing.

Prevention

Prevention is the best policy.  When you are in wooded or grassy areas, wear long pants and shirts with sleeves, tuck your pants into your socks and wear shoes.  Do the best you can to stay on a trail because ticks are most abundant in low brush and tall grass.  Use a bug spray with DEET to deter ticks (watch labels – DEET is not safe for everyone).  Clean up brush, leaves and garbage in your yard to minimize habitat for ticks and animals that ticks live on.  Also, keep woodpiles in sunny areas to help the wood stay dry; ticks need humidity to live.

When you return to your home after being in an area with ticks, check yourself, children and pets for ticks.  Be careful to check in hair, body creases and the bellybutton.  Wash your clothing right away.  Shower using a washcloth to scrub your skin.  This will help remove ticks that are not attached to your skin that may have been missed on visual inspection.  Deer ticks range in size from less than 2mm or the size of the poppy seed to the size of a sesame seed.

You can see this picture and read more about deer ticks on the MN Department of Health website.

The tick removal tips listed below are provided by the Centers for Disease Control:

  1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure.  Don’t twist or jerk the tick – this can cause the mouth-parts to break off and remain in the skin.  If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
  3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water. 

This is the only safe way to remove a tick and it is important to remove the tick as soon as possible to minimize the risk of being infected with Lyme disease. 

Signs and Symptoms

Early signs and symptoms can start a few days to a few weeks after the infectious tick bite.  One sign is a red bull’s eye rash.  According to the Lyme Disease Association, less than 50% of people will get a rash.  Other early symptoms include fatigue, chills, fever, diarrhea, headache, muscle and joint aches, swollen lymph nodes and stiff neck.  It is very important to get treatment in the early stage of Lyme disease because it is much easier to treat.  The bacteria that causes Lyme disease is spiral-shaped so it can burrow into any area of the body, making it difficult to eliminate. 

Symptoms by body system according to Lyme Disease Association:

  • Heart/Lungs: chest pain or rib soreness, shortness of breath, heart palpitations, or heart murmur.
  • Stomach/Intestines: nausea or vomiting, difficulty eating, change in bowel function (constipation, diarrhea), abdominal cramping, irritable bladder or bladder dysfunction.
  • Musculoskeletal: joint/muscle pain in feet, swelling in toes, balls of feet, ankle pain, burning in feet, shin splints, joint pain and /or swelling, stiffness of the joints, neck or back, muscle pain or cramps that may migrate, neck creaks and cracks, neck stiffness and TMJ.
  • Neurological: twitching of the face, eyelids or other muscles, headache, tingling, numbness, burning or stabbing sensations, facial paralysis (Bell’s palsy), dizziness, poor balance, increased motion sickness, light-headedness, wooziness, difficulty walking, tremor, confusion, difficulty in thinking or with concentration or reading, forgetfulness, poor short term memory, disorientation (getting lost, going to wrong place), difficulty with speech, double or blurry vision, eye pain, blindness, increased sensitivity to light or sound, ringing in ears, seizures, and low blood pressure. 
  • Neuropsychiatric: mood swings, violent outbursts, irritability, depression, disturbed sleep (too much, too little, early awakening), personality changes, obsessive compulsive disorder, paranoia, panic anxiety attack and hallucinations.
  • Reproductive: testicular pain/pelvic pain, menstrual irregularity, milk production (lactation), sexual dysfunction, loss of libido.
  • Other: fever, sweats, or chills, weight changes (loss or gain), fatigue, hair loss, swollen glands, sore throat, difficulty swallowing, swelling around the eyes.

Testing/diagnosis

Blood testing is done to screen for Lyme disease and it takes several days to get the results.  Unfortunately, the testing can result in false positive or false negative depending on the reference source.  Lyme literate doctors believe that patients should be diagnosed by symptoms and not testing alone.  Lyme disease has been known to be misdiagnosed as: Lupus, Fibromyalgia, RA, Chronic fatigue, MS, ALS, Parkinson’s disease and depression. 

Treatment

Lyme disease is treated with antibiotic therapy.  Doxycycline given orally, twice per day for 10-30 days, is the most common treatment for early stage Lyme disease.

Be your own advocate!  Seek a second or third opinion if you feel that your symptoms return after treatment and your doctor does not feel they should re-treat you or your doctor does not want to treat your current symptoms.  There are doctors who specialize in Lyme disease called Lyme literate doctors.  The medical community is divided on whether or not it is a chronic condition and if long term antibiotics are beneficial, therefore, treatments vary depending on your doctor.

During treatment, patients can experience a reaction (Jarisch-Herxheimer) that causes them to feel worse even though the bacteria are dying.  The reason is because dying bacteria release toxins into the body faster than the body can eliminate them.  This reaction is also common in the treatment of syphilis, another spirochete bacterium. 

When people are being treated for chronic Lyme disease and are on antibiotics for months or years at a time, the patient goes in and out of remission and can eventually be cured. 

On a personal note: I have been witness to what long-term antibiotic treatment can do and it has been positive.    

Under our Skin is a documentary about Lyme disease. If you have a few minutes, watch the trailor!

The author of this blog is Divine Home Care RN Case Manager for our Little Falls branch, Kristin Woodford