With tick season in full swing, we city dwellers need to be conscious of Borrelia burgdorferi, better known as the bacterium that causes Lyme disease. This bacterium is typically found in the deer tick, also known as the blacklegged tick.
Deer ticks are small and can be as tiny as a pencil tip or the size of a period at the end of a sentence. The CDC.gov site is a great resource for tick images and other information related to Lyme disease.
If you have been bitten by a tick, you should remove it with forceps, tweezers or protected fingers as close to the skin as possible and pull slowly and steadily straight up. Do not crush or squeeze the tick; doing so may spread infectious disease.
In a study, petroleum jelly, fingernail polish, a hot kitchen match and 70 percent isopropyl alcohol all failed to properly remove a tick. The National Institutes of Health recommend not removing a tick with oil.
When a tick is removed within 36 to 48 hours, the risk of infection is quite low. However, a patient can be given a prophylactic dose of the antibiotic doxycycline if a bullseye rash — a red outer ring and red spot in the center — has not occurred and it is within 72 hours of tick removal.
There are three stages of Lyme disease: early stage, where the bacteria are localized; early disseminated disease, where the bacteria have spread throughout the body; and late stage disseminated disease.
Symptoms for early localized stage and early disseminated disease include the bullseye rash, which occurs in about 80 percent of patients with or without systemic symptoms of fatigue, muscle pain and joint pain, headache, neck stiffness, swollen glands and fever.
Early disseminated disease may cause neurological symptoms such as meningitis, cranial neuropathy (Bell’s palsy) and motor or sensory radiculoneuropathy (nerve roots of spinal cord).
Late disseminated disease can cause Lyme arthritis, heart problems, facial paralysis, impaired memory, numbness, pain and decreased concentration.
How do we prevent Lyme? According to the Centers for Disease Control and Prevention, we should wear protective clothing and spray ourselves with insect repellent that includes at least 20 percent DEET.
Always check your skin and hair for ticks after walking through a woody or tall grassy area. Remember to check your pets; even if treated, they can carry ticks into the home.
Lyme disease often can be diagnosed within the clinical setting or with a blood test. However, testing immediately after being bitten by a tick is not useful, since the test will tend to be negative, regardless of infection.
It takes about one to two weeks for IgM antibodies to appear and two to six weeks for IgG antibodies. These antibodies sometimes remain elevated even after successful treatment with antibiotics.
Does chronic Lyme disease exist?
There has been a debate about whether there is something called “chronic Lyme” disease. In one analysis, the authors note that the definition of chronic Lyme disease is obfuscated and that extended durations of antibiotics do not prevent or alleviate post-Lyme syndromes.
The authors do admit that there are prolonged neurologic symptoms in a subset population that may be debilitating even after the treatment of Lyme disease. They also suggest that there may be post-Lyme disease syndromes with joint pain, muscle pain, neck and back pain, fatigue and cognitive impairment.
Regardless, the lingering effects of Lyme can be debilitating. This may be a result of systemic inflammation, which can be improved significantly with dietary and other lifestyle modifications.
Prevention is key to helping stem Lyme disease. If this is not possible, contact your physician as soon as you notice a tick.