Lyme disease (patient information)

Jump to: navigation, search


To go back to Lyme disease main page, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S.[2]

Overview

What are the Symptoms of Lyme Disease?

  • It's important to know the symptoms of Lyme disease and to seek medical help if you think have Lyme disease.
  • Early signs and symptoms (3 to 30 days after tick bite):
    • The first symptom is usually a red rash at the site of tick bite, which may look like a bullseye, but not all people with Lyme disease have a rash. The rash is called erythema chronicum migrans or erythema migrans (EM).
      • EM occurs in approximately 70 to 80 percent of infected persons.
      • EM begins at the site of a tick bite after a delay of 3 to 30 days (average is about 7 days).
      • EM expands gradually over a period of days reaching up to 12 inches or more (30 cm) across.
      • EM may feel warm to the touch but is rarely itchy or painful.
      • Sometimes, EM clears as it enlarges, resulting in a target or bullseye appearance.
      • EM may appear on any area of the body but is usually present on areas including the axilla, inguinal region, popliteal fossa, or along belt line.
    • The rash may or may not be associated with flu-like symptoms including:
Classic Lyme disease rash - Source: CDC.gov

Notes

  • Fever and other flu-like symptoms may occur in the absence of rash.
  • A small bump or redness at the site of a tick bite that occurs immediately and resembles a mosquito bite, is common. This irritation generally goes away in 1-2 days and is not a sign of Lyme disease.
  • A rash with a very similar appearance to EM occurs with Southern Tick-associated Rash Illness (STARI), but is not Lyme disease.
  • Ticks can spread other organisms that may cause a different type of rash.

What Causes Lyme disease?

I. scapularis, the primary vector of Lyme disease in Eastern North America - Source: Gross L (2006) A New View on Lyme Disease: Rodents Hold the Key to Annual Risk. PLoS Biol 4(6): e182. https://doi.org/10.1371/journal.pbio.0040182

Who is at Highest Risk?

Individuals who spend time outdoors and/or have pets that go outdoors in endemic regions are at risk for tick-borne disease.

  • Exposure to ticks:
    • Individuals with frequent exposure to dogs and who reside near wooded areas or areas with high grass may also be at increased risk of tick-borne infection.
    • Individuals with outdoor occupations and who work outside with bare or exposed skin are at a high risk of contracting Lyme disease.
    • Failing to remove a tick as soon as you see it on your skin (the longer a tick is attached to your skin, the greater your risk of developing Lyme disease) also increases risk of developing Lyme disease.
  • Endemic Regions:
    • About 95% of all reported cases are confined to 14 states including Connecticut, Delaware, Maine, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin.
    • Any individual traveling or living within these five geographic areas including New England, Mid-Atlantic, East-North Central, South Atlantic, and West North-Central is at a heightened risk of exposure to Lyme disease.
  • Seasonal Variation:
    • The majority of Lyme disease cases are reported during the summer months of May to August.
    • Case incidence increases in May, peaks in June and July, and tapers off in August.

Diagnosis

The following points should be taken into consideration in order to make a diagnosis of Lyme disease:

When to Seek Urgent Medical Care?

You should seek medical care if:

  • You are bitten by a tick.
  • You have a rash similar to erythema migrans (even if you do not remember getting bitten by a tick).
  • After removal of a tick with the proper procedure.

Treatment Options

Where to find Medical Care for Lyme Disease?

Medical care for Lyme disease can be found here.

Prevention

  • Educate yourself about Lyme disease and try not to get bitten by ticks.
  • More specifically:
    • Avoid wooded, brushy, and grassy areas, especially in May, June, and July. (Contact the local health department or park/extension service for information on the prevalence of ticks in specific areas.)
    • Wear light-colored clothing so that you can see ticks that get on your clothes
    • Wear long pants and long-sleeved shirts.
    • Wear shoes that cover the entire foot. Tuck pant legs into socks or shoes and tuck shirts into pants.
    • Wear a hat for extra protection.
    • Spray insect repellent containing DEET on clothes and exposed skin other than the face, or treat clothes with permethrin, which kills ticks on contact.
    • Walk in the center of trails to avoid brush and grass.
    • Remove your clothing and wash and dry them at high temperatures after being outdoors.
    • Do a careful body check for ticks after outdoor activities.
  • If a tick is attached to you, remove it!
    • Using tweezers, grasp the tick close to the skin, pull straight back, and avoid crushing the tick's body.
    • Save the tick for possible identification by a doctor or the local health department.

What to expect Prognosis?

Possible complications

Sources


Linked-in.jpg