Lyme Disease

Lyme disease is something we all have heard of and probably already know is a disease transmitted by a tick. But what kind of tick, what it looks like, where it exist, how we get rid of one and knowing the signs and symptoms of Lyme disease are probably a bunch of questions that many of us can't answer.

The tick is the carrier of Borrelia burgdorferi, a spirochete organism that causes Lyme Disease. Image courtesy of University of Iowa.

Before you brush off this topic, let us warn you that the consequences of untreated Lyme disease are very severe and often irreversible. You can become infected without any knowledge that it occurred and the serious symptoms can begin to arise years later. Because of how insidious the symptoms can occur, it generally causes a lengthy delay in making the correct diagnosis by your medical professional, thus worsening the situation. Lyme disease is also the most common vector borne disease found in the U.S. It has been reported in 47 of the 50 states in all age categories and both sexes. So lets go over this disease that most of us are susceptible to if you spend any time around the vast expansive range that the Ixodid tick -- otherwise known as the deer tick -- calls home which, could include your back yard.

Most of us know or have heard of a poor soul who has had the unfortunate luck to contract Lyme disease that progressed to the neurological stages before being correctly diagnosed. Then you probably heard of the very lengthy and often less then desirable improvement that resulted after being diagnosed and treated. This, as most things, is easily preventable with a little knowledge and observation.

I was exposed to Lyme disease years ago while in medical school here in South Carolina. I made it a habit in the fall to deer hunt before morning classes and some afternoons when time permitted. I knew of the prevalence of the ticks in my area, looked for them and often found them and removed them quickly.

Menace to hunters? The Ixodid tick is the culprit for spreading Lyme Disease through the U.S. and world. The Image courtesy of University of Iowa

One instance was unusual though because I didn't find the little bugger for a few days before I could remove him. I didn't feel any different at the beginning, but then noticed I felt like I had a minor flu-like illness but nothing too bad. The clue to tip it off was the bull's-eye rash that appeared at the tick bite site. That gave it away. A short course of cheap antibiotics and all was fine. This occurred again some time later with the same sequence of events occurring and since then every year I have been the victim of many tick bites.

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The culprit/carrier in Lyme disease is the Ixodid tick. It is not the big fat juicy dog tick that we readily pick off our pets and squash beneath our feet but rather it is a tiny, often pinhead size, flat creature that does not swell up and is almost impossible to crush with your fingertips But remember, it lives just as readily in your back yard as it does in the surrounding woods, fields and forests. It easily hitches a ride to any unsuspecting passerby and then proceeds to crawl to the nearest exposed skin and begins the process of burrowing its head deep enough into your tissue to access blood which is its food. When it has had its fill in three to seven days, it backs out and drops off to find another victim when it gets hungry again.

Now, if that was all it did it wouldn't be so bad but unfortunately, the tick is the carrier of Borrelia burgdorferi, a spirochete organism that happily lives in these ticks and the white footed mouse. In short, adult ticks that are infected attach themselves to an uninfected mouse, which then becomes infected and becomes a host/carrier/incubator for Borrelia Burgdorferi. The next time an uninfected tick bites/feeds on the mouse, then it too becomes infected. Neither the mouse nor the tick is harmed by Borrelia so they can live perpetually with the infective organism. To contract Lyme disease, a tick has to bite us and infect us with the Borrelia organism, which usually requires the tick to be attached for 24 hours. This leaves us a window of opportunity to check for ticks and remove them before they become a problem. Note, it is estimated that 20 percent of the Ixodid ticks are infected with Borrelia.

A bull's eye rash, or "erythema migrans" is a symptom of a tick bite that contains the Borrelia organism. Image courtesy of DermNet.com.

Lyme disease has three stages.

The first stage occurs soon after being infected. Three days to one month after being bitten we may notice the expanding non-painful rash called "erythema migrans" which looks like a bull's eye -- a red ring with central clearing. This is a sign of the localized infection caused by the Borrelia organism. But note 25 percent of victims do not develop a rash at all.

Stage two occurs days to weeks later and is indicative of a disseminated infection via your blood stream. The symptoms listed below only last a few weeks then seem to vanish on their own. The major signs/problems that occur are recurrent rashes that are widely distributed, fatigue, migratory musculoskeletal pains, severe headaches and fever. But cardiac nervous system problems may also develop.

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Graph courtesy of the Center For Disease Control

Stage three occurs months to years later usually after a long period with out any symptoms at all. 60% of the victims now have chronic large joint arthritic pain but the very serious neurological problems now start to arise from severe dysfunction of the brain to the debilitating effects on the nervous system that controls our legs and arms. Our mood, sleep and memory can be significantly affected also. The symptoms are very similar to the end stages of Syphilis dramatized by the movie "Scarface".

Lyme disease can be diagnosed by blood work but be careful because the blood work m

ay be negative for the first several weeks of the infection. The clinical diagnosis can often be confused with "Fibromyalgia and Chronic Fatigue Syndrome".

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Reported Cases of Lyme Disease by Month of Illness Onset United States, 1992-2004. Graph courtesy of the Center For Disease Control

The good news is that Lyme disease is easily treated early on with a short, cheap course of an antibiotic called Doxycycline that can prescribed by your family doctor. For pregnant women and those who have allergies to that particular antibiotic class alternatives are available. Unfortunately though, if have progressed to stage three, things become much more complicated and drawn out and the success rate is not anywhere as good. You will have to take intravenous antibiotics for many weeks. No vaccine is available that we are aware of at this time.

We hope this has been informative and will help you in the future. As always enjoy the outdoors and be safe.

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