While most tick bites are harmless, several species can transmit life-threatening diseases. Two of these well-known diseases are Rocky Mountain Spotted Fever and Lyme disease. Ticks can also transmit other infections including tularemia (a plague-like disease in rodents that can be transmitted to humans), relapsing fever, ehrlichiosis (which quickly causes fever, rash, nausea, vomiting, and weight loss), babesiosis, deer tick virus, and others.
Lyme disease (LD) is a multi-stage, multi-system bacterial infection caused by the spirochete Borrelia burgdorferi, a spiral shaped bacterium that is most commonly transmitted by a tick bite. The disease takes its name from Lyme, Connecticut, where the illness was first identified in the United States in 1975.
According to the Centers for Disease Control and Prevention (CDC), Lyme disease continues to be a rapidly emerging infectious disease. It's the leading cause of all insect-borne illnesses in the U.S..
Ixodes scapularis (northeastern and north-central U.S., black-legged deer tick)
Ixodes pacificus (Pacific coastal U.S., Western black-legged tick)
Ticks prefer to live in wooded areas, low-growing grasslands, and yards.
Lyme disease is a year-round problem, although April through October is considered tick season. Ticks tend to be very active in the spring and early summer. Although cases of Lyme disease have been reported in nearly all states in the U.S., it commonly appears to be confined to specific areas in the U.S.. It has been found in large areas in Europe and Asia, too.
The list of possible symptoms is long, and symptoms can affect every part of the body. The following are the most common symptoms of Lyme disease. However, each individual may experience symptoms differently.
For most people, the primary and first symptom is a red rash that:
Can appear 3 to 30 days after infection, or not at all.
Can last up to several weeks.
Can be very small or very large (up to 12 inches across) and looks like a "bulls-eye."
Can look a lot like such skin problems such as hives, eczema, sunburn, poison ivy, and flea bites.
Can itch or feel hot, or may not be felt at all.
Can go away and then come back several weeks later.
Several days or weeks after a bite from an infected tick, the person usually experiences flu-like symptoms such as:
Aches and pains in muscles and joints
Low-grade fever and chills
Fatigue (extreme tiredness)
After several months, arthritis-like symptoms may develop, including painful and swollen joints.
Other possible symptoms may include:
Neurological symptoms (nerve system changes)
Poor motor coordination
Some people may develop post-Lyme disease syndrome (PLDS), a condition also known as chronic Lyme disease. PLDS is characterized by ongoing muscle, bone, and nerve pain, fatigue, and memory impairment.
Lyme disease is difficult to diagnose because symptoms are not consistent and may look a lot like other conditions. The primary symptom is a rash, but it may not be present in all cases.
Diagnosis for Lyme disease is a clinical one and must be made by a doctor experienced in recognizing LD. Diagnosis is usually based on symptoms and a history of a tick bite. Testing is generally done to rule out other conditions. Blood and lab tests may be done, but these tests are not absolutely reliable for diagnosing LD.
Research is underway to develop and improve methods for diagnosing LD.
The symptoms of Lyme disease may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
Specific treatment for Lyme disease will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the symptoms
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Lyme disease is usually treated with antibiotics. If diagnosed at an early stage, treatment is usually given for 3 weeks.
Treatment will also be considered based on these and other factors:
If you are bitten by a tick that tests positive for spirochetes.
If you are bitten by a tick and have any of the symptoms.
If you are bitten by a tick and are pregnant.
If you are bitten by a tick and live in a high-risk area.
Relapse and incomplete treatment responses occur. Complications of untreated early-stage disease include: joint disease, neurologic disease, and heart problems. Sometimes these complications lead to chronic debilitating conditions and repeated hospitalizations.
There is no vaccine to help prevent LD. Some general guidelines for preventing LD include:
Dress appropriately by wearing:
Socks and closed-toe shoes
Long pants with legs tucked into socks
Frequently check for ticks on:
All parts of the body that bend: behind the knees, between fingers and toes, and underarms.
Other areas where ticks are commonly found: belly button, in and behind the ears, neck, hairline, and top of the head.
Areas of pressure points, including:
Where underwear elastic touches the skin
Where bands from pants or skirts touch the skin
Anywhere else where clothing presses on the skin
Visually check all other areas of the body and run fingers gently over skin.
Shower after all outdoor activities are over for the day.
When a tick is found, remove it carefully and do not squeeze the body. Remember that any method of removal could cause transmission of the bacteria.
Ticks can be tested for spirochetes, so place the removed tick in a glass, plastic vial, or plastic storage bag with a moistened cotton swab.
Consider using repellents:
Products that contain DEET are tick repellents, but do not kill the tick and are not 100 percent effective in discouraging a tick from biting you.
Products that contain permethrin are known to kill ticks; however, they should not be sprayed on the skin but on clothing.
Check pets and children for ticks.
The following related clinical trials and research studies are currently seeking participants at Massachusetts General Hospital. Search for clinical trials and studies in another area of interest.
Chadi El Saleeby, MD, a Pediatric Infectious Disease specialist at MassGeneral Hospital for Children (MGHfC) discusses effective Lyme disease prevention and treatment methods.
Mark Pasternack, MD, Chief of Pediatric Infectious Disease at MassGeneral Hospital for Children, answers parents' questions about how to protect kids from Lyme disease and what to do if a child is bitten by a tick.
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