Lyme disease is a vector-borne illness spread through the bite of infected ticks. The main types of ticks that are commonly known to transmit Lyme disease include the blacklegged tick (also known as deer tick), which is native to the northeastern, mid-Atlantic and north-central United States, and the western blacklegged tick, which is native to the Pacific coast of the United States. In Northern, Western, and Eastern Europe, the primary ticks responsible for the spread of Lyme disease include the castor bean tick and the taiga tick.
Lyme disease in the United States is caused by Borrelia burgdorferi, a Gram-negative, microaerophilic bacteria of spirochete morphology. B. burgdorferi does not produce toxins, unlike most disease-causing bacteria, but instead interacts directly with the cells it infects. In 2013, B. mayonii was also discovered in North America, but is comparatively much less prevalent than B. burgdorferi. In both Europe and Asia, there are two bacteria attributed to Lyme disease, B. afzelii and B. garinii.
To prevent Lyme disease, the CDC recommends:
Avoiding areas likely to have ticks
Using insect repellent on skin and clothing
Showering as soon as possible after potentially being exposed to ticks
Inspecting your body for ticks and removing them promptly
Inspecting pets and equipment for ticks and removing them
Heat-treating clothing that may have been exposed to ticks by placing dry clothing in the dryer on high for 10 minutes, or by washing clothing and drying in a dryer until completely dry and warm
Lyme disease is diagnosed based on signs and symptoms, the possibility of exposure to infected ticks, and laboratory testing. Symptoms of Lyme disease vary depending on the length of infection.
Early-stage Lyme disease (<30 days) is characterized by:
- Fever
- Headache
- Fatigue
- Swollen lymph nodes
- Muscle and joint aches
- Bullseye skin rash called erythema migrans (EM)
Later-stage Lyme disease (>30 days) can be characterized by:
- Severe headaches and neck stiffness
- Joint pain and swelling
- Irregular heartbeat or palpitations
- EM on other areas of the body
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
- Nerve pain
- Shooting pains, numbness or tingling in the hands or feet
- Problems with short-term memory
- Facial palsy
Because symptoms of Lyme disease can be similar to other illnesses, laboratory tests are ordered to help ensure accurate diagnosis and appropriate treatment. The CDC recommends a two-tiered testing method for Lyme disease. Tests that detect IgG and IgM antibodies produced in response to the Lyme bacteria confirm whether a person has been exposed to certain species of Borrelia. An enzyme-linked immunosorbent assay (ELISA) test can detect if antibodies are present in the blood. And a Western Blot, or immunoblot, can detect specific proteins to confirm the ELISA diagnosis.
If detected early, Lyme disease can be successfully treated with a two- to three-week course of antibiotics, such as:
- Doxycycline
- Amoxicillin
- Ceftriaxone (when meningitis or neuritis is present)
Nonsteroidal anti-inflammatory drugs (NSAIDs) can also be prescribed for pain management.
Symptoms generally last for two to four weeks after beginning antibiotic treatment, although some symptoms may last longer. Early diagnosis and early treatment help to prevent complications that may develop due to later-stage Lyme infection.
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