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Lyme disease is the most common tick-borne illness in North America and Europe. Lyme disease is caused by the bacterium Borrelia burgdorferi. Deer ticks, which feed on the blood of animals and humans, can harbor the bacteria and spread it when feeding.
You’re more likely to get Lyme disease if you live or spend time in grassy and heavily wooded areas where ticks carrying the disease thrive. It’s important to take common-sense precautions in areas where Lyme disease is prevalent.
Lyme disease is a bacterial infection that is transmitted mainly through Ixodes ticks, more commonly known as deer ticks, on the East Coast and black-legged ticks on the West Coast of the U.S.A. According to Lymedisease.org, the symptoms of Lyme disease—which include but are not limited to flu-like symptoms, a bull’s-eye shaped rash, and/or Bell’s palsy (drooping of the face)—are often misdiagnosed as other conditions, earning Lyme disease the title of “The Great Imitator.” According the Centers for Disease Control and Prevention (CDC), an estimated 300,000 new cases of Lyme disease are diagnosed across the country each year, more than the annually diagnosed number of breast cancer or HIV/AIDS cases.
In recent years, Lyme disease has appeared to be a growing threat to public health. According to the CDC, there were just over 10,000 confirmed cases of Lyme disease in 1995. In 2013, that number grew to over 25,000, with an additional 10,000 probable (yet unconfirmed) cases. A leading theory behind the increasing prevalence of Lyme disease revolves around forest fragmentation.
Forest fragmentation occurs when larger swaths of forest are broken up into small woodlots (less than one hectare each) in order to make room for agricultural fields or suburban developments. When larger forests are broken up, their ecosystems undergo significant change. Small woodlots cannot sustain large or mid-sized predators and therefore become ideal habitats for small mammals. Mice, especially, thrive in small woodlot areas. Small woodlots cannot sustain the natural predators of mice (long-tailed weasels, red and gray foxes, coyotes). Additionally, mice have proven to be able to adapt to life in small woodlot areas in ways that some other small mammals (chipmunks, squirrels) have not. Therefore, in many small woodlots (which accounts for much of the wooded areas in suburban and rural communities) mice are the most populous mammals.
Though deer and blacklegged tick bites are the main sites of Lyme disease transmission in humans, mice are the main carrier of Borrelia burgdorferi, the bacterium responsible for Lyme disease. Large populations of mice in small woodlot areas attract and sustain large tick populations, which feed on the infected mice. According to the National Science Foundation, small woodlot areas have approximately three times the number of ticks of larger forest fragments, and seven times the number of infected ticks. Though the mice are unaffected by Borrelia burgdorferi, ticks acquire and the bacteria while feeding on the mice and later transmit the bacteria to their human host.
Lyme disease is caused by an infection by the bacterium Borrelia burgdorferi, a cork-screw shaped microorganism that is most often transmitted through the bite of an infected Ixodes (deer) tick or black-legged tick. Borrelia burgdorferi does not produce an adverse reaction in all organisms. In fact, mice, the main carriers of B. burgdorferi, are not at all adversely affected by the bacterium. It is the adverse immunopathological response of the human body to B. burgdorferi that causes the symptoms associated with Lyme disease.
According to lymedisease.org, the majority of tick bites occur when the tick is in the nymphal, or immature, form, when the tick is approximately the size of a poppy seed. Lyme disease is not necessarily transmitted immediately after a tick bite. It may take several days or weeks for the transmission to occur. It is therefore crucial to check yourself and your children for ticks after being in an area where there may have been ticks.
Though many potential risk factors for Lyme disease are being researched, there are few factors that draw a conclusive correlation to the risk of developing the disease.
The following factors are known to increase your risk of developing Lyme disease:
Lyme disease is what is known as a clinical diagnosis, meaning that the diagnosis is made based on a patient’s medical history, symptoms, physical exam (which may demonstrate the characteristic bulls-eye rash), and a history of exposure to ticks or travel to a known region where there is a high occurrence of Lyme disease. There is no conclusive testing available to confirm a Lyme disease diagnosis. Most doctors choose to use a Lyme disease antibody test, which checks the blood for the presence of antibodies against the bacterium that causes Lyme disease. However, antibody tests cannot detect every strain of Lyme disease, they will not detect cases where the patient has the disease but is lacking the corresponding antibodies, and they will not detect the disease during the first four to six weeks of infection. Despite the tests’ limitations, the CDC still recommends the use of the two following tests:
Due to the wide-range of Lyme disease symptoms and the sometimes hard-to-detect factor of the tick bite, Lyme disease is often initially misdiagnosed as chronic fatigue syndrome, fibromyalgia, multiple sclerosis, or depression.
The symptoms of Lyme disease change with the stage of the disease. According to the Centers for Disease Control and Prevention, the stage-specific symptoms of Lyme disease are as follows:
**Later-stage patients may show symptoms of their current stage or any earlier stage
Stage 1: Early localized stage (3-30 days following tick bite)
Stage 2: Early disseminated stage (days to weeks following tick bite—usually one to four months)
Late disseminated stage (months to years following tick bite)
Stage 2 and stage 3 symptoms may be the first signs of Lyme disease in people who didn’t have a rash or other symptoms of early infection.
Late disseminated Lyme disease occurs when the infection hasn’t been treated in stage 1 and 2. Stage 3 can occur weeks, months or years after the tick bite. This stage is characterized by:
According to the CDC, 10-20% of Lyme disease patients will experience post-treatment Lyme disease syndrome, in which symptoms linger after treatment.
The prognosis for Lyme disease depends largely on the stage in which it is diagnosed. If Lyme disease is diagnosed in its early stages, antibiotic therapy can most likely cure the patient. However if it is caught at a progressed stage, when the infection has spread throughout the body, it is possible that antibiotic therapy would not be able to reverse damage done to bodily tissues and the patient would suffer from chronic symptoms. According to the CDC, an estimated 10-20% of Lyme disease patients experience lingering symptoms after their treatment is over, a condition known as post-treatment Lyme disease (PTLD). These symptoms may persist for up to 6 months after treatment and often include fatigue, pain, and muscle aches. Although the exact cause of PTLD is not known, it is believed that residual damages to the body and immune system may contribute to the symptoms. Similar chronic conditions follow treatment for Guillain-Barre syndrome, Reiter’s syndrome, and Strep throat. Although those receiving long-term antibiotics may not recover any faster than those who do not, symptoms will improve and resolve with time (up to 6 months).
The following tips can help making living with Lyme disease a little bit easier:
There is no universally accepted screening test for Lyme disease largely because there is no definitive diagnosis for Lyme disease. Patients who have been exposed to ticks and who show any number of the symptoms of Lyme disease may be recommended for diagnostic testing.
There is no way of knowing whether or not a tick is infected with Lyme disease. Your best chance at preventing Lyme disease is to prevent tick bites when in tick environments.
According to lymedisease.org, the following tips can decrease your risk of getting a tick bite:
Choosing a treatment plan for Lyme disease can be very difficult, especially with the conflicting opinions within the medical and scientific communities. Lymedisease.org reports that central to the divide in opinion are the Infectious Diseases Society of America (IDSA) and he International Lyme and Associated Diseases Society (ILADS). The IDSA claims that antibiotic treatment is capable of treating all cases of Lyme disease, but the challenge lays in detecting the disease. The ILADS recognizes the complexity of Lyme disease and contends that treatment for Lyme disease is more complicated than a simple antibiotic regimen.
Each case of Lyme disease should be treated with special attention to the case’s details, such as the stage of the disease upon diagnosis, the patient’s location (and subsequent risk of exposure to infected ticks), and the patient’s symptoms. Cases of Lyme disease that are caught early on will most likely be curable with antibiotic therapy. However, in cases that were diagnosed at later stages, treatment may need to include the management of post-Lyme syndrome symptoms. Because standard treatment available for post-Lyme syndrome symptoms does not address the cause of the symptoms, many patients choose to turn to alternative modes of treatment.
The following alternative treatments are available for patients with Lyme disease:
If you are caring for a loved one with Lyme disease, consider the following:
If you experience any of the following, contact a doctor immediately:
To find a general practitioner in your area, click here
To find a physician that is a member of the International Lyme and Associated Diseases Society, visit The International Lyme and Associated Diseases Society
For more information on Lyme disease, visit:
For more information on the effect of forest fragmentation on Lyme disease, visit:
For more statistics on Lyme disease, visit:
For more information on Borrelia burgdorferi, the bacterium responsible for Lyme disease, visit:
For more information on alternative therapies for Lyme disease treatment, visit:
You may want to ask your doctor the following questions:
What lifestyle changes should I make to accommodate my illness?
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