What is Lyme Disease?
Lyme disease is an illness that is transmitted to humans by the bite of ticks that have been infected with a bacterial microorganism called Borrelia Burgdorferi (Bb). The symptoms of Lyme disease are often similar to those of arthritis. The disease is named after the small town of Lyme, Connecticut. In 1975, this community suffered an unusual amount of childhood arthritis cases, approximately 100 times greater than average, presumed to be juvenile rheumatoid arthritis. The outbreak was later attributed to an infection from the bite of deer ticks carrying Bb. Bb was not identified until 1982, when it was discovered by Swiss zoologist Willy Burgdorfer.
Lyme disease is delivered from one host to another, and is referred to as a “vector-borne” disease. An infected tick bites a host, such as a mouse or a person, and Bb is injected into the host’s bloodstream. Ticks bite to feed on the blood of their host, and may remain attached for 4-5 days. Not all deer ticks are infected, and not all hosts will become sick when bitten by an infected tick. The percentage of people who become sick from Lyme disease after being bitten by an infected tick is quite small. In areas where Lyme disease is common, it is estimated that up to 50% of all ticks carry Bb. The illness is not contagious, and cannot be “caught “ from another person.
Lyme disease is the most common of all vector-borne diseases in the United States, accounting for more than 90% of all cases. Over 99,000 cases were reported from 1982-1996, and there were 18,000 new ones in 2000. These numbers are a bit controversial, because there is no definitive test to positively identify Lyme disease, and its symptoms can mimic other diseases. In the U.S., most cases of Lyme disease are found in the Northeast (Connecticut, Massachusetts, Rhode Island, New York, and New Jersey), the Upper Midwest (Wisconsin and Minnesota), and in Northern California. However, it has been found in every state, and in Europe and Asia as well.
What Are the Symptoms of Lyme Disease?
Lyme disease is found in both an early, localized form, and in a chronic form. The ticks that transmit Lyme (several species of the genus Ixodes) go through three stages of development: larva, nymph, and adult. The larvae are generally not a problem for humans. They hatch in the spring from eggs laid on the ground, and feed on white-footed mice and deer, hence the name “deer ticks”. The nymphs cause most cases of Lyme disease. They are very small (1-2 mm in length), and are very hard to notice if they attach themselves to you. Some are smaller than the head of a pin. The adults are the most likely to carry Bb, but they are much easier to see than the nymphs. Generally, if a tick is discovered and removed within 48 hrs, it cannot transmit Bb. The chance of getting Lyme disease from a tick removed within this time period is only about 1%.
If a bitten person is infected, it will often first appear as a small red dot at the site of the bite, usually within 3-30 days after the bite. It may be warm and itchy. Then, in about 80% of cases, the hallmark sign of Lyme disease appears in most folks: a red, bulls-eye shaped rash known as erythema migrans. It starts as a red patch that expands outward, sometimes becoming as large as 10-20 inches in diameter. It often clears from the center out, giving it a bulls-eye appearance. Sometimes on folks with dark skin it may look like a bruise. Occasionally, a person who has been bitten will develop an allergic rash to the saliva of the tick, but this rash does not have the characteristic bulls-eye look, and does not indicate the transmission of Lyme disease. This allergic rash will usually appear sooner than three days, and disappear quickly.
Once Bb enters the bloodstream, it travels quickly and can be found in cerebrospinal fluid within 12 hours. Sometimes signs of infection will surface within 30 days, but Bb also has the ability to hide in the body in a latent state for long periods of time. Chronic Lyme disease patients may experience symptoms that come and go in recurring cycles. Some infected people may have Bb in their systems and never develop Lyme disease. But there is no immunity after the first attack. If you have Lyme disease once, you can get it again.
The initial phase of the infection is called the early, localized form, and in addition to the unique rash that usually develops, many subjects also come down with flu-like symptoms: chills and fever, muscle and joint pain, headache, fatigue, and swollen lymph nodes. The symptoms disappear after a period of weeks, but can resurface months or even years after the tick bite. Over time, the Bb spreads throughout the body via infected cells and bodily fluids. This, in contrast to the early, localized stage, is called “late, disseminated” or “chronic” Lyme disease. This is where many patients begin to develop more serious, long-term symptoms such as:
- Chronic fatigue
- Confusion and memory loss
- Mood swings
- Symptoms typical of meningitis (inflammation of brain membranes) such as: fever, stiff neck, intense headaches
- Symptoms typical of arthritis such as: painful and swollen joints, often starting in the knees and moving throughout the body
- Neurological problems such as unexplained pain, or “Bell’s Palsy” which is a condition of facial paralysis mostly on one side, but may be on both sides of the face.
- Less common serious complications may include hepatitis, heart arrhythmia, and eye problems such as swelling of the cornea, and eye muscles or nerves. Some patients may also experience severe, debilitating fatigue.
How is Lyme Disease Diagnosed?
Lyme is difficult to diagnose because many of its symptoms are also found with other illnesses such as Chronic Fatigue Syndrome or Multiple Sclerosis. There are lab tests that can be done, but these are not always definitive and often yield false or inconclusive results. The most common tests are theenzyme-linked immunosorbent assay (ELISA) test, which measures antibodies of Bb, and the western-blot test, which looks for proteins associated with Bb. Testing can be expensive and often is not covered under health insurance plans. Knowing of a tick bite and suspicious symptoms can be the best way to diagnose.
What Can Be Done to Prevent Lyme Disease?
The best advice is to avoid areas where ticks are likely to be found, or if that is not possible, to take necessary precautions. There are many common-sense steps that can be taken:
- Ticks are most active from late spring to late summer, so be even more aware of these pests during this peak season.
- If you live in area that has a high tick population, keep brush and leaves away from the house.
- Store woodpiles in sunny areas.
- Ticks like woods or areas of tall grasses. They attach themselves to trees, shrubs, and grass hoping to be able to find a host that passes closely to them.
- If you choose to be out in these areas during tick season (of if you are forced to work in this environment), do a “tick check” daily. Ticks especially like to latch on behind the knee, in the groin area, underarms, behind ears, and on the scalp. Children and pets should be checked frequently and thoroughly.
- Shake out clothing outside at the end of the day.
- Wear light-colored clothing so that ticks are more easily visible.
- Tuck pant legs into socks or boots.
- Use a repellent to keep ticks away. I do not recommend anything with DEET, as this is a toxic chemical to all of us, and particularly children and pets. The Centers for Disease Control (of all unlikely sources) states that oil of lemon eucalyptus, in similar concentrations, works just as well as DEET to ward off ticks. Citronella, oil of geranium, and cinnamon oil are effective as well.
- If you do find a tick, don’t panic. As long as you find and remove it carefully within 48 hrs, chances of Bb infection are minimal. Here are some recommendations for removing ticks:
- Using a tweezers, grasp the tick as close to the skin as possible
- Do not squeeze or crush the tick, as this can help the Bb to spread into the wound
- Pull straight back slowly, with steady pressure. The idea is to pull out as much of the creature as possible without breaking it off.
- Do not use anything like a lit match, alcohol, or vaseline to get the tick to “back out”
- Once the tick is removed, clean the wound with alcohol or peroxide, and apply an antibacterial ointment.
- If you wish, you may save the tick in a closed container to be analyzed for Bb or for species identification
- Best way to dispose of a tick is by flushing it down the toilet.
The most important thing to remember is to check regularly for ticks. Finding one is nothing to fear. It’s the ones you miss that may cause problems for you. Even then the risk of developing Lyme disease from a tick bite is small. This risk varies, of course, depending on the season and geographical area you are in. But caution is the key word here. While the risks may be small, the illness can be significant and cause serious chronic health issues.
What Treatments Are Available for Lyme Disease?
The typical allopathic treatment for Lyme disease is antibiotics. Doctors recommend that Lyme disease be treated as quickly as possible after discovery of the infection. Oral antibiotics are often prescribed for 21 days. In more extreme cases where symptoms have developed in the nervous system, intravenous antibiotics are sometimes recommended. Antibiotic therapy is controversial though, due to the fact that it is often over used, and Bb may develop immunity to the drugs. Bb also is found in several strains that can morph and change to outwit the antibiotics. These drugs are also only effective at killing Bb when it is active, and not when it is dormant. Use of antibiotics can also cause other health problems such as yeast infections and disruption of healthy flora and “friendly” bacteria in the body. Using a quality probiotic can help to restore this balance.
One herb that some people swear by is spilanthes. It is recommended as an antibacterial specifically for spirochetes (spiral-shaped bacteria) like Bb.