Lyme disease can be one of the easiest — and most difficult — diagnoses to make. There is much information and confusion about the diagnosis and the treatment, so it’s best for parents to learn as much as they can about the disease.
Lyme disease is a tick-borne disease that is transmitted when a mammal is bitten by an infected tick. The disease is named after the town of Lyme, CT, where it was first diagnosed about 30 years ago.
In our area, deer ticks can harbor and transmit the disease. While young ticks prefer to attach to small animals like mice, adult ticks like larger mammals like deer, hence, the name. Both young and adult ticks can transmit Lyme disease to humans. The more deer around the area, the more deer ticks there are, which leads to more Lyme disease. This is why there is very little Lyme disease on Staten Island — so far.
If you or your child are bitten by an infected tick, don’t worry, a bite results in Lyme disease less than one percent of the time. However, it is best to immediately remove the tick, since it needs to remain attached for at least 36 to 48 hours for transmission to occur. If you or your child are infected, the early signs and symptoms may be the classic red, expanding rash that looks like a bull’s eye and flu-like symptoms — fatigue, chills, fever, headache, muscle and joint aches, and swollen glands. This usually occurs about a week after the bite, but can occur from three to 30 days after.
If left untreated, the infection may spread and cause what is called early disseminated infection. Signs and symptoms may include a bull’s eye rash in other parts of the body, facial palsy or Bell’s palsy (paralysis of facial nerves), joint pain and swelling, muscle pain, heart problems, and even meningitis.
If still not treated after months, the late persistent stage may begin — which can lead to severe arthritis, as well as chronic neurological symptoms that can include numbness and tingling of hands and feet, and even inflammation of the brain.
If the patient has the signs and symptoms of early Lyme disease, it can usually be diagnosed without the use of blood tests, and treatment is a 14- to 21-day course of oral antibiotics.
If things are not clear-cut, then blood tests are done. This is where much confusion lies. Because we all have similar non-disease-causing bacteria that live normally in and on our bodies, there is much cross reaction with the Lyme tests.
Therefore, a two-prong approach is taken. First, a screening test is performed. This test can have a large amount of false positive results, so if it is positive, a confirmatory test is done. However, even this is not always correct. The less disease that is prevalent, the less accurate the confirmatory test is. So, testing should not be done unless there is a history of a tick bite or some signs and symptoms of Lyme disease infection — otherwise, many people will be treated with antibiotics unnecessarily.
Another area of confusion is in the treatment of late or neurologic Lyme disease. A two- to four-week course of intravenous antibiotics may be necessary. There is NO evidence that longer periods of treatment are warranted.
Many studies show that “chronic” Lyme disease does not exist, but “post-traumatic Lyme disease syndrome” does. This syndrome is most likely due to damage done by the infection, as well as damage done by our own immune systems. It is not caused by persistent Lyme bacteria — therefore, extended courses of antibiotics are not helpful, and may actually be harmful. Patients with this syndrome get better with time — but it may take months to years.
To keep your family safe from Lyme disease, remember that, while most tick bites don’t cause Lyme disease, in the case of a bite, the tick should be removed immediately to prevent transmission. If you notice the early signs and symptoms of the disease, see a doctor for diagnosis and treatment.