Lyme Disease (Lyme borreliosis)

Lyme Disease (Lyme borreliosis) is a bacterial infection that can cause fever, headache, fatigue, and a characteristic skin rash and, if left untreated, can spread to joints, the heart, and the nervous system

Symptoms

Most people who get Lyme disease get a rash around the tick bite though it may not appear until long after the tick bite. At first, the rash looks like a red circle, but as the circle gets bigger, the middle changes color, so the rash lookís like a bullís-eye.
Some people donít get a rash, but feel sick, like they have the flu. They could have swelling and pain in their joints and a stiff, sore neck. Their face could become numb or even paralyzed. They could become forgetful or have trouble paying attention. A few people even have heart problems.

How It Spreads

The Lyme disease bacterium, Borrelia burgdorferi, is spread through the bite of infected ticks. The blacklegged tick (or deer tick, Ixodes scapularis) spreads the disease in the northeastern, mid-Atlantic, and north-central United States, and the western blacklegged tick (Ixodes pacificus) spreads the disease on the Pacific Coast.

Ticks can attach to any part of the human body but are often found in hard-to-see areas such as the groin, armpits, and scalp. In most cases, the tick must be attached for 36-48 hours or more before the Lyme disease bacterium can be transmitted.

Most humans are infected through the bites of immature ticks called nymphs. Nymphs are tiny (less than 2 mm) and difficult to see; they feed during the spring and summer months. Adult ticks can also transmit Lyme disease bacteria, but they are much larger and may be more likely to be discovered and removed before they have had time to transmit the bacteria. Adult Ixodes ticks are most active during the cooler months of the year.

Prevention

Reducing exposure to ticks is the best defense against Lyme disease, Rocky Mountain spotted fever, and other tickborne infections. There are several steps you and your family can take to prevent and control Lyme disease:

Removing Ticks

Testing & Diagnosis

Lyme disease is diagnosed based on:

Laboratory blood tests are helpful if used correctly and performed with validated methods. Laboratory tests are not recommended for patients who do not have symptoms typical of Lyme disease.

Treatment

Patients treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Antibiotics commonly used for oral treatment include doxycycline, amoxicillin, or cefuroxime axetil. Patients with certain neurological or cardiac forms of illness may require intravenous treatment with drugs such as ceftriaxone or penicillin. For detailed recommendations on treatment, consult the 2006 Guidelines for treatment developed by the Infectious Diseases Society of America.

Approximately 10-20% of†patients (particularly those who were diagnosed later), following appropriate antibiotic treatment, may have persistent or recurrent symptoms and are considered to have Post-treatment Lyme disease syndrome†(PTLDS). The National Institutes of Health (NIH) has funded several studies on the treatment of Lyme disease which show that most patients recover when treated with a few weeks of antibiotics taken by mouth. For details on research into what is†sometimes referred to as†"chronic Lyme disease" and long-term treatment trials sponsored by NIH, visit the NIH Lyme Disease web site. Additional information on prolonged treatment for Lyme disease is also available.

Rhode Island Hospital in Providence provides special Lyme treatment clinics for adults and children, by healthcare provider referral only. For information, call 401-793-2928.

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