Lyme Disease and Tick Born Illnesses

Tickborne Diseases

Source: National Institute of Allergy and Infectious Disease

Tickborne diseases are becoming a serious problem in this country as people increasingly build homes in formerly uninhabited wilderness areas where ticks and their animal hosts live. Tickborne diseases can be caused by viruses, bacteria, or parasites. Most people become infected through tick bites during the spring and summer months.

Deer tick photo.

A deer tick, or blacklegged tick, Ixodes scapularis, on a blade of grass. Credit: CDC.

Rocky Mountain spotted fever, a bacterial disease transmitted by the dog tick, was first identified in 1896. It still exists, although now it can be easily treated. Since then, researchers have identified many new tickborne diseases.

Tickborne diseases can be found throughout the United States. For example, Lyme disease, first discovered in Connecticut in the early 1970s, has since spread to every state except Hawaii.

One of the newest tickborne diseases to be identified in the United States is called Southern tick-associated rash illness (STARI). This disease has a bull’s-eye rash similar to that found in Lyme disease, which is caused by bacteria transmitted by the deer tick. Although researchers know that the lone star tick transmits the infectious agent that causes STARI, they do not yet know what microbe (germ) causes it.

Ticks transmit ehrlichiosis and anaplasmosis, both bacterial diseases. Babesiosis is caused by parasites carried by deer ticks. These diseases are found in several states.

Tularemia, a less common tickborne bacterial disease, can be transmitted by ticks as well as other vectors (carriers) such as the deerfly. Public health experts are concerned that the bacterium that causes tularemia (Francisella tularensis) could be used as a weapon of bioterrorism.

Tickborne disease can usually be prevented by avoiding places where ticks often live, such as dense woods and brushy areas. Using insect repellents containing DEET (for the skin) or permethrin (for clothes), wearing long pants and socks, performing tick checks, and promptly removing ticks also will help prevent infection from tickborne microbes.

Scientists are searching for better ways to diagnose, treat, and prevent tickborne diseases. They are also looking for ways to control the tick populations that transmit microbes.

Lyme Disease

Source: State of RI Department of Health

Lyme Disease 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 look’s like a bull’s-eye.

Some people don’t 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:

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.

South County Internal Medicine provides Lyme treatment.  For information, call 401-789-0283.

 

 

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