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Lyme Disease Lyme Disease
by Kimberly Allen, RN Not only is Lyme disease the most common tick-borne illness in the US and Canada it is the “fastest growing... Lyme Disease

by Kimberly Allen, RN

Not only is Lyme disease the most common tick-borne illness in the US and Canada it is the “fastest growing infectious disease in the country.”  According to the CDC the number of reported cases of Lyme disease has more than doubled in the US since they first began recording them in 1991.  However, the CDC has also stated that they believe only approximately 10% of Lyme disease cases are actually reported.  This has lead many experts to estimate that over 200,000 people every year are infected with Lyme disease.  And that’s for Lyme disease only, not including other thick-borne diseases.
Lyme disease is caused by the Borrelia burgdorferi bacterium.  This bacterium is primarily found in deer ticks.  Deer ticks are very small, usually about the size of the head of a pin making them extremely difficult if not impossible to detect.  Though the tick carrying the Lyme disease causing bacterium is usually found on deer it can also be found on several smaller wildlife animals like field mice, weasels, and moles as well as chipmunks and squirrels.  They have also been found on raccoons, skunks and opossum’s, even horses.  The bacterium is transmitted when the tick bites you.  In most cases once the tick has bitten you it must remain attached for 36 to 48 hours in order to transmit the Lyme disease causing bacterium into your bloodstream.tickmap_lg
Lyme disease generally develops in three stages.  The first stage is known as “early localized disease”.  In this stage a small red bump appears where the tick bite occurred.  It then usually expands in to a rash called erythma migrans.  This telltale rash occurs in approximately 80% of Lyme disease cases and frequently resembles a”bull’s eye”.  This rash varies in size ranging from the size of a dime to one that covers your entire back.  Along with the rash most people also complain of flu like symptoms including fever, headache, and body aches as well as fatigue.  The second stage is called “early disseminated disease”.  In this stage there is heart and nervous system involvement.  This stage usually manifests a few weeks to months  after being bitten.  Symptoms of this stage include the development of meningitis with a severe headache and stiff neck, some people also experience temporary paralysis of their facial muscles, numbness and weakness in their extremities as well as pain and poor coordination.  These symptoms are sometimes accompanied by trouble concentrating and memory loss as well as changes in mood and/or sleeping habits.  Lyme disease can also cause inflammation of your heart leading to irregular heart rhythms and even heart failure.  Stage three is late disease is “late disease.”  In this stage you develop sensory and motor nerve damage as well as inflammation in your brain.  People in this stage also develop arthritis and develop pain, inflammation and deformities in their joints.  The knees are affected most often, however, it can move from one joint to another.  Approximately 20% of those with untreated Lyme disease will develop permanent arthritis.
If Lyme disease is detected in it’s early stages it can be treated effectively with antibiotics.  As with any infection the sooner treatment is started the sooner and more completely you’ll recover.  When caught early oral antibiotics like doxycycline or amoxicillin for up to a month usually heals the rash quickly and prevents the spread of the infection.  More advanced cases of Lyme disease require intravenous antibiotics.  The preferred antibiotics for people with late stage symptoms including Rocephen and Claforan as well as penicillin.  Most doctors recommend at least 2 weeks of intravenous therapy for advanced Lyme disease.
Because Lyme disease mimics a variety of other “common” illnesses and that it can vary significantly from person to person it is frequently mistaken as something else.  Frequently the person doesn’t even recall being bitten so they don’t consider Lyme disease.  If you’re someone that spends alot of time outdoors it’s important to remember if you develop flu like symptoms that don’t resolve check with your doctor, you don’t have to remember being bitten only that you have been outdoors in grassy and/or wooded areas.

Preventing tick-borne illness

The temperatures are warming up and summer is just around the corner.  More and more people are turning to outdoor activities like hiking and camping as well as gardening for enjoyment and relaxation.  While these activities are great and I enjoy them myself, as well as brook fishing and berry picking, they significantly increase your risk of contracting a tick- borne disease.  the number of tick-borne illnesses has increased over the past few years with experts estimating that over 200,000 cases of just Lyme disease and that’s only one of several different tick-borne diseases fund in the US including Colorado tick fever, Rocky Mountain fever, and tick-borne relapsing fever as well as a few others.  Some are milder than others and most closely resemble more “common” illnesses so they frequently go unreported.  One of the main reasons tick-borne illnesses are so under reported is that people don’t recall being bitten.  These ticks are very small, usually about the size of a pin head, which makes them extremely difficult if not impossible to detect them let alone recall being bitten by one.
The best way to prevent tick-borne illnesses is to prevent tick bites.  Ticks are unable to survive in areas that are hot and dry, however, they can be active in temperatures over 40F including winter so you should take precautions  even in winter.  When you are going to spend any time outside, especially in grassy wooded areas you should wear long pants as well as long sleeve shirts.  Wear shoes and socks, and tuck the bottoms of your pants into your socks.  It’s also a good idea to wear light colored clothing which will make it easier to spot any ticks.  If you have long hair it’s good idea to braid or tie it up and cover it because ticks can also get into your hair,  If you work outside you should spray your clothes.  Most experts recommend products that contain permethrin as it kill ticks.  Clothing and camping gear treated with permethrin keep their protective abilities through several washings.  Boots can also be treated with permethrin.  Permethrin should never be used on the skin.  Repellents with DEET can be used on the skin.  Use of repellants containing 25-30% DEET can repel ticks for several hours.
When you return to your home you should perform a cursory “tick check” of your clothes and remove any tick you see before entering the house.  Remember ticks are very small and difficult to detect so remove your clothes when you enter the house and put them in the dryer.  Set the dryer on high for at least an hour to kill any ticks that you didn’t see.  Shower as soon as possible preferably with in 2 hours as this has been shown to reduce your chances of developing Lyme disease.  Also, showering can help to wash off any unattached ticks.  After showering is a good time to do a full body tick check.  If you don’t have a partner that can check your back and scalp use a mirror.  A hand held mirror works best because you can move it to see all hidden areas.  Especially check under your arms and around as well as  in your ears, in your belly button area as well as around your waist and between your legs.
Should you find a tick on your body whether or not it is attached should be removed promptly.  Remember ticks need to be attached for 24 to 48 hours before transmitting most tick diseases so removing them promptly is crucial.  The best way to remove the tick is with a pair of tweezers and grab the tick as close to the skin as possible and pull it straight out.  Some ticks require significant force to pull them out.  Once you have removed the tick clean the area with antiseptic and apply a small amount of antibiotic ointment.  Record the date and location you found the tick.  Symptoms of most tick-borne diseases don’t manifest for several days to weeks after you’ve been bitten so if you develop symptoms of a tick-borne illness after being bitten contact your doctor and be sure to let him/her know you have been bitten by a tick and when you were bitten.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at