Lyme disease is transmitted through a bite from a specific type of tick. The animals that most often carry these insects are
white-footed field mice, deer, raccoons, opossums, skunks, weasels, foxes, shrews, moles, chipmunks, squirrels, and horses.
In the early stages of Lyme disease, the patient may have symptoms such as a stiff neck, chills, fever, swollen lymph nodes, headaches, fatigue, muscle aches, and joint pain.
The patient can also have a large, expanding skin rash around the area of the tick bite. In more advanced disease, nerve problems and arthritis, especially in the knees, may appear.
There are other symptoms that can point to Lyme disease. After several weeks of being infected with Lyme disease, some 60 percent of people not treated with antibiotics develop attacks of painful and swollen joints that last a few days to a few months.
The disease can also affect the nervous system, causing symptoms such as meningitis, temporary paralysis of facial muscles, pain or weakness in the limbs, or poor coordination. A smaller number of patients have irregular heartbeat, eye inflammation and severe fatigue.
Lyme disease can vary from patient to patient. The disease may be hard to diagnose because its many symptoms are similar to symptoms of other conditions.
Although a tick bite is an important clue for diagnosis, many patients don't remember that they have been bitten by a tick. This is not surprising because the tick is tiny, and a tick bite is usually painless.
The easiest way for a doctor to diagnose Lyme disease is to see the unique bull's-eye rash. If there is no visible rash (in 25 percent of infected people), the doctor might order a blood test to look for antibodies against the bacteria.
These tests are ELISA which measures the levels of antibodies against the Lyme disease bacteria that are present in the body, and Western blot which identifies antibodies directed against a panel of proteins found on the Lyme bacteria. The test is ordered when the ELISA result is either positive or uncertain.
How is Lyme disease treated?
In its early stages, Lyme disease can be effectively treated with antibiotics. In general, the sooner such therapy is begun following infection, the quicker and more complete the recovery is.
Antibiotics, such as doxycycline or amoxicillin taken orally for two to four weeks, can speed the healing of the rash and can usually prevent subsequent symptoms such as arthritis or neurological problems.
Most people with Lyme disease respond well to antibiotic therapy and recover fully. Some people may have persistent symptoms or symptoms that recur, making further antibiotic treatment necessary.
If left untreated, Lyme disease can cause permanent damage to the heart, nervous system, and joints.
A successful treatment is no guarantee that the disease will be prevented in the future. It can strike more than once in the same individual if he is bitten by another tick and infected again with the Lyme disease bacterium.
The antibody test usually remains positive for months to several years after the infection. If you have been bitten by a tick see your doctor immediately so that a proper diagnose can be made.
Abraham Eisenstein, M.D. ■