What is Lyme Disease?
Lyme disease is an infection caused by the complex bacterium Borrealia burgdorferi and other less prevalent Borrealia species. It’s the #1 vector borne disease in the U.S., primarily spread via infected blacklegged (or deer) adult and nymph tick bites (Ixodes scapularis in the east and Ixodes pacificus in the west). The smaller nymphs infect most people while feeding in the spring and summer.
In the United States, there are about 30,000 annual cases of Lyme disease reported to the Centers for Disease Control and Prevention (CDC) and shown in the 2016 map. However, due to two studies conducted by the CDC in 2008 and from 2005-2010, the CDC estimates that there are actually around 300,000 cases each year!
Prevention of Lyme Disease
- Perform regular tick checks on your indoor/outdoor pets, children and yourself!
- Wear long sleeves and light colored clothing
- Tuck your pants into your socks
- Put your clothes into the dryer for 5-15 minutes to allow the heat to kill any ticks
- Use permetherin pesticide around the perimeter of your property
If you’ve been bitten by a tick and it is still attached, the CDC recommends removing it as quickly as possible using fine-tipped tweezers.
Then, a good idea is to place the tick in a zip-lock bag and mail it to The Tick Report Center at the University of Massachusetts. You may want to order a comprehensive package that includes 21 tests and is $200. A standard DNA test can be done for $50, within three business days, to determine if the tick is a host to Borrealia burgdorferi as well as other common disease causing bacteria and parasites.
Symptoms and Diagnosis of Lyme Disease
Lyme disease has three general categories: acute (tick bite), early disseminated and chronic.
There are many symptoms of chronic Lyme disease including, but not limited to: joint pain, fatigue, headache, upset stomach, facial paralysis (Bells Palsy), unexplained hair loss, heart palpitations, disturbed sleep, mood swings, vertigo and forgetfulness.
In chronic Lyme disease, symptoms may worsen for women during and around the time of menstruation.
Chronic Lyme disease can also include Multiple Systemic Infectious Disease Syndrome (MSIDS) where Lyme disease as well as other factors such as allergies, bacterial co-infections, viral infections, fungal infections and environmental toxins create a “symptom complex” and chronic illness.
The classic diagnosis of Lyme disease is the bullseye rash (also called erythema migrans or EM) and doesn’t require a positive blood test. However, over half of people with Lyme disease don’t get a rash and the rash may manifest in areas of the body not easily noticed. Some estimates are as low as 10% of people with Lyme actually present with the bullseye rash.
Diagnosis without the bullseye rash has proven to be more challenging. Older and more common diagnostic tests have been shown to be inaccurate more often than not.
Diagnosis may be determined via a Western Blot test through a reliable laboratory like IgeneX labs in California. And, more recently, the Ceres Antigen Urine test, which uses the Nanotrap technology to concentrate the Lyme antigens and then use ELISA or Western Blot.
Remember that testing negative for Borrealia burgdorferi doesn’t mean it’s not in your body.
Treatment of Lyme Disease
There are currently two sets of peer-reviewed treatment guidelines, supported by medical professional organizations, in the United States (U.S.).
The Infections Disease Society of America (IDSA) guidelines have been removed from the U.S. Department of Health and Human Services (DHHS) National Guidelines Clearinghouse (NGC) for being out of compliance as of March, 2016. Unfortunately, these are the guidelines many physicians are still using, while not presenting the more accurate standard of care treatment guidelines.
The International Lyme and Associated Diseases Society (ILADS) guidelines are current with the latest research. Recommendations for all Ixodes tick bites include a “preferred regimen of 100-200 mg of doxycycline, twice daily for 20 days.” The Lyme Action Network recommends antibiotic treatment to be at least 21-28 days. Additionally, “Patients receiving antibiotic prophylaxis should also be given information describing the symptoms and signs of a Clostridium difficile infection and the preventative effect of probiotics.” (2)
Recommendations for people who have a bullseye rash (EM) also include, “Clinicians should prescribe amoxicillin, cefuroxime or doxycycline as first-line agents for the treatment of EM.”
While these guidelines are key in treatment, it’s important to note that the optimal treatment for acute tick bites and persistent lyme disease have not yet been fully determined. Studies have also shown that the sooner treatment begins after a tick bite, the higher the success rate.
Trusted Lyme Disease Resources
- County-Scale Distribution of Ixodes scapularis and Ixodes pacificus (Acari: Ixodidae) in the Continental United States
- Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease.
- Horrowitz, Richard. How Can I Get Better?
- International Lyme and Associated Diseases Society (ILADS) Treatment Guidelines
- Lyme Action Network Treatment Issues and Guidelines
- Northeastern University Researchers investigate four promising new treatments for Lyme Disease
- Life after Lyme – Revive Your Inner Rock Star and Achieve Full Recovery