A short time ago a close friend sent an email saying his daughter was diagnosed with Lyme disease. He was very concerned about the effects on her, the treatments and the possible outcome. I wanted to learn more about the disease and thought this information might be useful to other Scouters- especially those who camp in the northeastern US.
In short Lyme disease is caused by a bacterium spread by the bite of a tick. Early symptoms include fatigue, fever and headaches. Because these symptoms are similar to many other medical problems, Lyme disease often goes undiagnosed. The untreated infection can then spread to other parts of the body- the heart, the joints and the central nervous system. Properly diagnosed within a few weeks of infection, successful treatment with antibiotics usually results in a positive outcome.
Transmission of the Disease
The disease is spread through the bite of the blacklegged tick. In the northeast and mid-Atlantic states this is the deer tick. In the northwest the disease is transmitted by the western blacklegged tick. Lyme disease is a highly concentrated disease. 94% of cases occur in 12 states- Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Hampshire, New York, Pennsylvania, Virginia and Wisconsin. Ticks can attach themselves to almost any part of the body but they are most often missed when they are in the scalp, groin or armpits. If you are in tick infested areas check yourself thoroughly- generally the tick needs to be attached to your body for 36 to 48 hours before the Lyme disease bacteria is transmitted. There is no evidence that Lyme disease is:
- transmitted through blood transfusions (people with known cases of Lyme disease should not volunteer to give blood, however)
- by coming in contact with cats or dogs that have Lyme disease
- by eating venison or squirrel
- by air, food or water
- by mosquitos, fleas or flies
Symptoms of Lyme Disease
Early local symptoms occurring in the first 30 days after the tick bite include a red expanding rash, fever, chills, joint pain and fatigue. In 70% to 80% of cases the “bull’s-eye” rash occurs. It can expand to 12 inches in diameter and is generally warm but not itchy. Over the next several weeks additional symptoms may occur- Bell’s Palsy (loss of muscle control in the face), swelling of larger joints (like knees and elbows), heart palpitations, and dizziness. What can be confusing is that symptoms may improve even without treatment. Untreated, however, symptoms often worsen. 60% of untreated patients have joint problems similar to arthritis. 5% of untreated patients have neurological problems like tingling in the hands and feet and some short term memory loss.
Treatment for Lyme Disease
Once diagnosed the treatment is fairly straight forward. If treated early an oral treatment by one of several antibiotics usually allows patients to have a quick and complete recovery. Some patients with more advanced symptoms may require an intravenous treatment. In 10% to 20% of cases the patients symptoms persist after antibiotic treatment. These patients have PTLDS- Post-treatment Lyme Disease Syndrome.
The specific cause of PTLDS is unknown. Many believe the symptoms are left over damage to tissues and the immune system. Some believe that the ongoing symptoms are caused by an ongoing infection but there seems to be no evidence of this. Studies show that ongoing antibiotic treatments show no improvement in symptoms. Some doctors will prescribe treatment similar to that of fibromyalgia or chronic fatigue syndrome. You can help yourself by eating well and exercising, keeping a positive attitude and working with your doctor to make sure Lyme disease is your only medical problem.
Lyme disease is a difficult disease to diagnose. The best treatment is prevention. When you have been in the woods or outdoors, check yourself thoroughly for ticks even if you are not in high risk areas. Look for early symptom, especially the “bull’s-eye” rash. If symptoms persist let your doctor know that you have been in tick infested areas so he can include Lyme disease in his diagnosis arena. A related article for ticks is at the bottom of the page. For more detailed information about Lyme disease go to the Centers for Disease Control site and search for Lyme disease.