Lyme disease is a bacterial infection caused by Borrelia burgdorferi that can result from the bite of an infected blacklegged tick or deer tick. Infected ticks are found mainly in the Northeast, upper Midwest, and along the Northwest coast. Ticks can be found throughout the year, but their peak activity occurs during June, July, and August when it is warm and moist.
Early symptoms of Lyme disease are usually mild and therefore easily missed. Symptoms include fever, headache, fatigue, swollen lymph nodes, and the characteristic bullseye skin rash called “erythema migrans” (EM). EM occurs in 70-80 percent of cases. EM begins within 3 to 30 days at the site of the tick bite. The average appearance of this rash occurs around seven days after the bite, and it can grow to around 12 inches or more. It may look like a “bullseye” and could feel warm to touch but is rarely itchy or painful.
In a small percentage of cases, symptoms can last for more than six months. This is referred to as Post-Treatment Lyme Disease Syndrome (PTLDS). Some patients may not experience symptoms for weeks or months after the initial bite. Symptoms of ‘late Lyme disease’ include arthritis and pain and swelling of joints, especially the knees.
Late Lyme disease signs and symptoms include those affecting the nervous system. Other rare symptoms include irregularities of heart rhythm and problems with memory, concentration, and sleep disturbances. Lyme disease is diagnosed based on symptoms as well as the potential for exposure to infected ticks.
What you can do:
If Lyme disease is suspected, ask patients detailed questions about their medical history and if they have spent time outdoors where Lyme disease is common. Patients should also be examined. Lab tests may be needed to help confirm the diagnosis of this disease. However, these tests are most accurate a few weeks after the patient is infected with Lyme disease because their bodies have had time to develop antibodies.
Always advise patients to prevent tick bites by:
- Staying on cleared, well-traveled paths when outdoors
- Wearing light colored clothing
- Wearing long sleeved shirts and long pants in wooded or grassy areas
- Tucking pants into socks
- Using an insect repellant that contains a 20 percent concentration of DEET
- Spraying insect repellent only when outdoors—Follow the directions on the spray container
- Checking clothes and uncovered skin frequently when outdoors
- Bathing or showering within two hours of coming indoors to wash off and more easily find ticks
- Checking their gear and pets for ticks
- Tumbling clothes in a hot dryer for one hour to kill remaining ticks
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