House Calls / Dr. Michael Schwartz
Lyme disease is a complicated infection caused by the bacteria Borrelia burgdorferi. First identified in Lyme, Conn., in1975, the disease is transmitted to humans by the bite of an infected deer tick. These ticks are commonly found in the northeastern United States with Connecticut, New York, Massachusetts, New Jersey and Pennsylvania generally reporting the highest number of cases each year. In 2010, more than 30,000 cases of Lyme disease were either confirmed or suspected, with many more cases going undiagnosed. Lyme disease is fairly common and can lead to some very serious health issues.
The earliest sign and symptom of Lyme disease may be a rash. This rash usually occurs within two weeks of the tick bite and is referred to as a "target lesion" due to its unique appearance. In general, the rash may appear round or oval-shaped with a raised red center, with a ring of normal skin surrounding this area encircled by another red ring. This rash is seldom painful or itchy and usually appears at the site of the tick bite. Smaller, similar target lesions may appear in other places on the body indicating that the disease has spread. Interestingly, not all patients with Lyme disease have a rash. Furthermore, if a rash does occur, it is fairly common not to see it if it is located in an area not obviously noticed; (i.e. behind the leg or under the arm).
Following the rash, patients may develop fevers, chills, fatigue and joint pains. Although many of these symptoms are self-limiting, (resolve without any treatment), some will experience severe and debilitating effects of the disease. Ultimately, patients can develop neurologic symptoms such as headaches, numbness, dizziness or confusion. In addition, cardiac abnormalities may occur which include irregular heartbeats, lightheadedness and loss of consciousness. When severe symptoms do occur, hospitalization is commonly necessary. Fortunately, with antibiotic treatment, these symptoms generally improve quickly and without permanent damage to the brain or the heart.
If you discover a tick bite, remove the tick by placing tweezers below the tick body (as close to the skin as possible) and pulling gently in an upwards fashion. The application of cooking oils while you apply this pressure may in some cases simplify the tick removal. Do not squeeze the tick, burn the tick with a match or tear it off since tick parts are often embedded in the skin and may require a doctor to remove them. If a tick is embedded for less than 48 hours, the risk of Lyme disease is very low. Thus, removal of the tick as early as possible is probably the most important way to prevent the disease.
You can bring the tick to your local department of health to determine if it carries the Lyme disease bacteria. It takes only one to two days to analyze a live tick for the bacteria whereas it might take one to two weeks if the tick is dead.
Ticks live in wooded and grassy regions, so if you plan to be in these areas you should follow some simple suggestions to reduce your risk:
Wear long pants and long-sleeved shirts. Make sure to tuck your pants into your socks to create a barrier against the ticks;
Use insect sprays containing "DEET" to repel the ticks;
Check your entire body for ticks after coming inside. This should include a detailed search of the groin area, behind the knees and under the arms;
Exam your clothing as well. Ticks often climb on clothes and may pose a risk even after your outdoor activities;
Treat all pets with tick repellents to decrease the risk that the tick might be brought into the house;
If you find a tick and are unsure how long it has been on your body, promptly remove the tick and visit your doctor. A one- or two-day antibiotic course is all that is needed to prevent the onset of Lyme disease.
Lyme disease is not contagious. Only infected deer ticks can transmit this disease. In addition, dog ticks, wood ticks and the Lone Star tick do not carry the Lyme bacteria. If you discover a tick, visit your doctor. Although the results of the blood test used to determine if you have Lyme disease may take four weeks or more, your doctor will determine your risk and discuss the appropriate treatment course necessary.
Lyme disease may be a scary bug, but there is no need to get "ticked off" if you get a bite. Just remember that early detection and treatment will minimize your risk of contracting the disease.