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Larry Langdon
/ Categories: Lyme Disease

What is Lyme Disease - Early signs and symptoms

What is Lyme Disease?

Lyme disease, also known as Lyme borreliosis, is the most common tick-borne infectious disease.  It is a potentially serious bacterial infection that is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected black-legged ticks also known as a deer tick.

When a person gets infected, the bacteria travels through the bloodstream and affects various parts of in your body.   Without treatment Lyme disease causes long-term infection characterized by inflammatory condition affecting multiple systems such as skin, joints, heart and nervous system.

Lyme disease can affect anyone who has been bitten by an infected tick. It’s the most common tick-borne illness in Europe and the United States.  Treatment with antibiotics usually cures Lyme disease, especially when started early.


Cause of Lyme disease

Lyme disease is caused by a spirochete, (a flexible spirally twisted bacterium) Borrelia burgdorferi (B burgdorferi) and is transmitted to humans through tick bites by infected pinhead-sized blacklegged ticks or deer ticks of genus Ixodes. 

Ticks pick up the bacteria after feeding on infected deer, birds, or mice infected with B burgdorferi.  The disease spreads to humans through the bite of an infected tick.


Transmission of Lyme Disease

The bacteria that cause Lyme disease enters the human body through the bite of an infected black-legged tick. These ticks can attach themselves to any part of the body, but often latch onto hard-to-see areas such as scalp, groins and armpits.

The infected adult or nymph tick, bores a tiny hole on the skin, inserts its mouth into the opening and attaches itself to the host. Typically the tick must be attached to the body for at least 36 to 48 hours or more to pass on the bacteria to humans.

Larger adult ticks may be noticeable and can be removed. However, young nymph ticks may not be noticeable and may remain undetected.


Risk factors for Lyme Disease?

Anyone can get a tick bite.   Most tick bites happen in the summer months when ticks are most active and people spend more time outdoors, in areas where Lyme disease is common.

People at a higher risk to tick exposure are more likely to get this illness.  Risk of Lyme disease increases for:

  • People who spend lots of time doing outdoor activities such as camping, walking, hunting or hiking in grassy, wooded areas.
  • People who work in gardens and parks.
  • People who have pets or domesticated animals that visit wooded areas.


Stages of Lyme disease

There are three stages of Lyme disease.

Stage 1 - Early localized Lyme disease

Early localized infection occurs when the infection has not yet spread throughout the body.   Only the site where the bacteria had first come in contact is affected.

Stage 2 - Early disseminated Lyme disease

Within a few days to weeks after the onset of local infection, the bacteria begins to spread throughout the body through the lymphatic system or bloodstream affecting different parts of the body.

Stage 3 - Late disseminated Lyme disease

The bacteria has spread throughout the body.  After several months or even years after the bite, untreated or inadequately treated Lyme disease affect many parts of the body, including the nerves, brain, eyes, joints and heart.


Signs and Symptoms of Lyme disease

The symptoms of Lyme disease vary in severity from person to person. Although Lyme disease may progress through three stages, the symptoms can overlap and may involve the skin, joints, heart or nervous system. Some people may present later stage symptoms without having symptoms of early Lyme disease.

The more common symptoms of Lyme disease include:

Symptoms of Stage 1 - Early localized Lyme disease

Early symptoms of Lyme disease begin between 3 to 30 days after an infected tick bite.  For the first few weeks, symptoms may include:

A red rash called erythema migrans (EM). About 70–80% of people with Lyme disease develop the EM rash often in the armpit, groin, back of knee, on the trunk or in children's hair, ears, or neck.   The rash appears about 3 to 30 days after the tick bite, as a small flat or slightly raised red spot at the site of the tick bite. It is usually circular or oval and gets bigger over several days ultimately reaching a diameter of about 12 inches. The rash may feel warm to touch, is usually neither itchy nor painful, and takes up to four weeks or longer to resolve without treatment.  As it starts to get better, it gradually lose its color in the center forming a bull's-eye appearance.  

Flu like symptoms. About 50% people who have Lyme disease develop symptoms similar to flu which may include:

  • Fever
  • Chills
  • General ill feeling
  • Headache
  • Joint pain
  • Muscle pain
  • Stiff neck
  • Fatigue
  • Swollen lymph nodes near the site of bite


Symptoms of Stage 2 - Early disseminated Lyme disease

A few weeks to months after the tick bite, untreated Lyme disease can lead to:

  • Several EM rashes at different sites on the body other than the original site of tick bite.
  • Fever
  • Arthritis that comes and goes
  • Muscle, tendon and bone pains
  • Joint pains
  • Headaches
  • Neck stiffness
  • Painful inflammation of brain and spinal cord (meningitis)
  • Numbness in arms or legs
  • Paralysis or weakness in the muscles of the face
  • Bell’s palsy which causes one half of the face to droop
  • Heart problems, such as chest pains, slow or irregular heartbeat
  • Shortness of breath and dizzy spells
  • Mood changes
  • Memory problems


Symptoms of Stage 3 - Late disseminated Lyme disease

Late disseminated Lyme disease can occur months or years after the infection, mostly in people who did not get early treatment. Lyme disease can cause long-term joint inflammation or Lyme arthritis, heart rhythm problems or Lyme carditis, brain and nervous system problems.   A person may have many symptoms of illness including:

  • Muscle and joint pain
  • Joint swelling
  • Arthritis
  • Abnormal muscle movement
  • Muscle weakness
  • Shooting pains, numbness or tingling in the hands or feet
  • Speech problems
  • Thinking (cognitive) problems
  • Decreased concentration
  • Memory disorders
  • Nerve damage
  • Nerve pain
  • Dementia
  • Heart palpitations or an irregular heart beat (Lyme Carditis)
  • Heart failure
  • Facial palsy (loss of muscle tone or droop on one or both sides of the face)
  • Sleep disturbances
  • Vision problems


Diagnosis of Lyme disease

Lyme disease is diagnosed based on:

  • Symptoms
  • Full body skin examination for erythema migrans (EM) rash
  • Physical findings such as  EM, facial palsy or arthritis
  • History of exposure to infected blacklegged ticks,
  • Laboratory tests - The most commonly used method for Lyme disease diagnosis is a two-stage blood test with ELISA and Western blot. The primary test is ELISA test which is an enzyme-linked immunosorbent assay that looks for certain antibodies produced by the immune system in response to Lyme disease infection. If the ELISA test is positive or equivocal, then the more specific Western immunoblot test is done to confirm ELISA results.
  • Other tests that may be done when the infection has spread include:
  • Electrocardiogram
  • Echocardiogram
  • MRI of the brain
  • Spinal tap




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