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| '''To go back to Lyme disease main page, click [[Lyme disease|here]]'''
| | {{CMG}}; {{AE}} {{Anmol}} |
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| {{CMG}}; {{AE}}{{Anmol}}
| | ==Tables== |
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| ==Overview== | | |+ |
| * [[Lyme disease]] is a condition commonly caused by bite of a [[tick]] infected with [[Borrelia burgdorferi]].
| | !Diagnosis |
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| ==What are the symptoms of Lyme disease?==
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| * It's important to know the symptoms of [[Lyme disease]] and to seek medical help if you think have [[Lyme disease]].
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| *'''Early signs and symptoms (3 to 30 days after [[tick]] bite):'''
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| **The first symptom is usually a red rash at the site of [[tick]] bite, which may look like a bull's eye. But not all people with Lyme disease have a [[rash]]. The rash is called [[erythema chronicum migrans]] or [[erythema migrans]] (EM).
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| ***EM occurs in approximately 70 to 80 percent of [[infected]] persons.
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| ***EM begins at the site of a [[tick]] bite after a delay of 3 to 30 days (average is about 7 days).
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| ***Em expands gradually over a period of days reaching up to 12 inches or more (30 cm) across.
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| ***EM may feel warm to the touch but is rarely [[itchy]] or [[painful]].
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| ***Sometimes, EM clears as it enlarges, resulting in a target or “bull’s-eye” appearance.
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| ***EM may appear on any area of the body but majority of times present in areas including [[axilla]], [[inguinal region]], [[popliteal fossa]], or along belt line.
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| **The rash may or may not be associated with flu-like symptoms including:
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| ***[[Fever (patient information)|Fever]] and/or [[chills]]
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| ***[[Headache (patient information)|Headache]]
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| ***[[Body aches]]
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| ***[[Arthralgia (patient information)|Joint aches]]
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| ***[[Headache (patient information)|Headaches]]
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| ***[[Neck stiffness/pain (patient information)|Stiff neck]]
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| ***[[Fatigue (patient information)|Fatigue]]
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| [[Image:Classic Lyme disease rash.jpg|thumb|250px|center|Classic Lyme disease rash - [https://www.cdc.gov/lyme/signs_symptoms/rashes.html Source: CDC.gov]]]
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| *Late Signs and Symptoms (days to months after tick bite):
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| **Severe [[Headache (patient information)|headaches]] and [[Neck stiffness/pain (patient information)|neck stiffness]]
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| ***Multiple [[erythema migrans]] rashes on other areas of the body.
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| ***[[Arthritis (patient information)|Arthritis]] with severe [[Arthralgia (patient information)|joint pain]] and [[Swelling (medical)|swelling]], particularly the [[knees]] and other large joints.
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| ***Facial palsy (loss of muscle tone or droop on one or both sides of the face).
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| ***Intermittent pain in [[tendons]], [[muscles]], [[Joints (anatomy)|joints]], and bones.
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| ***[[Heart palpitations]] or an irregular [[heart beat]] ([[Lyme carditis]]).
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| ***Episodes of [[Dizziness (patient information)|dizziness]] or [[Dyspnea (patient information)|shortness of breath]].
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| ***[[Inflammation]] of the [[brain]] and [[spinal cord]].
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| ***[[Nerve pain]].
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| ***Shooting [[pains]], [[numbness]], or [[tingling]] in the [[hands]] or [[feet]].
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| ***Problems with short-term [[memory]].
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| ===Notes===
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| *[[Fever]] and other flu-like symptoms may occur in the absence of [[rash]].
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| *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]].
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| *A [[rash]] with a very similar appearance to EM occurs with [[Southern tick-associated rash illness (patient information)|Southern Tick-associated Rash Illness]] (STARI), but is not Lyme disease.
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| *[[Ticks]] can spread other organisms that may cause a different type of [[rash]].
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| ==What causes Lyme disease?==
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| * [[Lyme disease]] is caused by a [[bacterial infection]] you get from bite of an infected [[tick]].
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| *The majority of [[Lyme disease]] in North America is caused by bite of [[Ixodes scapularis|black-legged tick]], or [[deer tick]] (''[[Ixodes scapularis]]'').
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| *Other ticks that transmit Lyme disease are [[Ixodes ricinus|sheep tick]], [[Ixodes ricinus|castor bean tick]], or [[Ixodes ricinus|European castor bean tick]] (''[[Ixodes ricinus]]'') in the Europe; [[Ixodes pacificus|Western black legged tick]] (''[[Ixodes pacificus]]'') in the Pacific region of North America; taiga tick (''Ixodes persulactus'') Europe, Central and Northern Asia, China, and Japan.
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| *Only 20% of individuals [[Infection|infected]] with [[Lyme disease]] by the [[Ixodes scapularis|deer tick]] are aware of having had any [[tick]] bite.
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| [[Image:Ixodes scapularis.png|center|200px|thumb|'''''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
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| ==Who is at highest risk?== | | ==References== |
| Individuals who spend time outdoors and/or have pets that go outdoors in [[Endemic (epidemiology)|endemic]] regions are at risk for [[tick-borne disease]].
| | {{reflist|2}} |
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| ===Exposure to ticks===
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| *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]].
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| *Individuals with outdoor occupations and who work outside with bare or exposed [[skin]] are at a high risk of contracting Lyme disease.
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| *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.
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| ===Endemic Regions===
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| *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.
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| *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]].
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| ===Seasonal Variation===
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| *The majority of [[Lyme disease]] cases are reported during the summer months of May to August.
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| *Case incidence increases in May, peaks in June and July, and tapers off in August.
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| ===Rarer forms of Transmission===
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| * Cases of [[blood transfusion]] and [[organ transplantation]] have been recorded as methods of [[Transmission (medicine)|transmission]] but this is a rare mode of transmission.
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| ==Diagnosis==
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| *Following points should be taken into consideration in order to make a diagnosis of [[Lyme disease]]:
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| **A history of exposure to potentially infected [[ticks]], especially in areas of the country known to have [[Lyme disease]].
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| **Symptoms, including physical findings such as the characteristic rash ([[erythema migrans]]).
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| **Results of blood tests that check for [[antibodies]] to the [[bacterium]] that causes [[Lyme disease]].
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| ==When to seek urgent medical care?==
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| *[[Lyme disease]] is rarely fatal.
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| ==Treatment options==
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| *According to CDC, patients treated with [[antibiotics]] in the early stages of the infection usually recover rapidly and completely.
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| *Antibiotics commonly used for oral treatment include [[doxycycline]], [[amoxicillin]], or [[Cefuroxime axetil (oral)|cefuroxime axetil]] ([[Ceftin]]).
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| *Patients with certain [[neurological]] or [[cardiac]] forms of illness may require [[Intravenous therapy|intravenous]] treatment with drugs such as [[Ceftriaxone Sodium Injection (patient information)|ceftriaxone]] or [[penicillin]].
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| ==Where to find medical care for Lyme disease?==
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| *In this section you can provide links for reputable places that the patient can find good treatment for there condition.
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| ==Prevention==
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| *Educate yourself about [[Lyme disease]], and try not to get bitten by ticks.
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| *More specifically:
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| **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 [[Tick|ticks]] in specific areas.)
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| **Wear light-colored clothing so that you can see ticks that get on you.
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| **Wear long pants and long-sleeved shirts.
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| **Wear shoes that cover the entire foot. Tuck pant legs into socks or shoes, and tuck shirts into pants.
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| **Wear a hat for extra protection.
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| **Spray insect repellent containing [[DEET]] on clothes and exposed skin other than the face, or treat clothes with [[Permethrin (patient information)|permethrin]], which kills [[ticks]] on contact.
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| **Walk in the center of trails to avoid brush and grass.
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| **Remove your clothing, and wash and dry them at high temperatures after being outdoors.
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| **Do a careful body check for ticks after outdoor activities.
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| *If a tick is attached to you, remove it!
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| **Using tweezers, grasp the [[tick]] close to the skin, pull straight back, and avoid crushing the tick's body.
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| **Save the [[tick]] for possible identification by a doctor or the local health department.
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| ==What to expect (Outlook/Prognosis)?==
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| *For early cases, prompt treatment is usually curative.
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| *However, the severity and treatment of Lyme disease may be complicated due to:
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| **Late diagnosis
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| **Failure of antibiotic treatment
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| **Coinfection with other tick-borne diseases including [[Ehrlichiosis (patient information)|Ehrlichiosis]] and [[Babesiosis (patient information)|Babesiosis]]
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| **[[Immune suppression]] in the patient
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| *Some patients with [[Lyme disease]] have [[Fatigue (patient information)|fatigue]], [[Arthralgia (patient information)|joint]] and/or [[Myalgia (patient information)|muscle pain]], and [[neurocognitive]] symptoms persisting for years despite [[antibiotic]] treatment.
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| *Patients with late stage [[Lyme disease]] have been shown to experience a level of physical disability similar to that seen in [[Congestive heart failure (patient information)|congestive heart failure]].
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| *Though rare, [[Lyme disease]] can be fatal.
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| ==Possible complications==
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| *Late [[Lyme disease]] can cause long-term [[Joint (anatomy)|joint]] [[inflammation]] ([[Lyme arthritis]]) and [[heart rhythm]] problems. [[Brain]] and [[nervous system]] problems are also possible, and may include:
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| **Decreased concentration
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| **Memory disturbances
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| **[[Nerve damage]]
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| **[[Numbness]]
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| **[[Pain(patient information)|Pain]]
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| **[[Paralysis]] of the face muscles
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| **Sleep disorders
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| **Vision problems
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| ==Sources==
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| * https://medlineplus.gov/lymedisease.html
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| * https://www.cdc.gov/lyme/index.html
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| * https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049298.htm
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