LYME DISEASE Lyme disease is an infectious disease caused by Borrellia burgdorferi bacteria, which is transmitted to humans by the bite of ticks that carry the bacteria. Usually, the tick must be attached for 36 to 48 hours before the bacteria can be transmitted to humans. Lyme disease is not transmissible between people, by other animals, or through food. Birds, small mammals and deer carry B. burgdorferi infected ticks but are immune to disease. Lyme disease is the most common disease spread by ticks in the Northern Hemisphere, most frequently occurs in the spring and early summer when tick nymphs are most active, and is primarily localized to specific regions of the US (see map).

The most effective way to prevent Lyme disease is to avoid tick bites particular during “Lyme Season”, spring and early summer. Preventive measures include wearing long pants, long-sleeve shirts, socks and head covering when outside, using DEET insect repellent, avoiding areas likely to harbor ticks, checking for ticks daily, bathing promptly after potential exposure, clearing brush and leaf litter, monitoring household pets for ticks, and applying lawn pesticide each spring. Ticks, if found, can be removed using tweezers taking care to avoid twisting or crushing the body of the tick or removing the head from the tick’s body. Alternatively, the tick may be killed first by using a product to rapidly freeze the tick to prevent it from injecting bacteria into the skin prior to removing.

Early signs and symptoms of Lyme disease include fever, chills, headache, stiff neck, fatigue, aching muscles and joints, and swollen lymph glands. A rash termed erythema migrans (EM) occurs in 70% to 80% of cases within 3 to 30 days at the site of the initiating tick bite, may grow to a foot or more in diameter, may clear as it grows to produce a characteristic “bulls-eye” appearance, and while warm to the touch, is seldom painful (see figure for example EM rashes). You should seek medical attention if you observe any of these symptoms following a tick bite, or live in a Lyme disease area, or have recently traveled in a Lyme disease area (see map above).

Patients treated early in the disease with appropriate antibiotics usually recover rapidly and experience no Lyme-associated sequelae. Effective antibiotics are readily available, inexpensive, and well-tolerated. However, if untreated or inadequately treated, early Lyme disease may transit to serious debilitating chronic disease manifesting severe headaches, EM rashes on other areas of the body, severe joint pain and swelling, particularly the knees and other large joints (“Lyme Arthritis”), loss of muscle tone or droop on one or both sides of the face, intermittent pain in tendons, muscles, joints, and bones, heart palpitations or an irregular heart beat (“Lyme Carditis”), episodic dizziness or shortness of breath, inflammation of the brain and spinal cord, nerve pain, shooting pains, numbness, or tingling in the hands or feet, problems with short-term memory. Early treatment is critical to avoiding these devastating sequelae and early diagnosis is essential to administration of appropriate early treatment.