Diseases

Lyme Disease

Lyme disease is a rare infection that can be spread to humans through a bite from a tick, a small insect that feeds on blood. It can cause a range of symptoms, from skin rash to heart problems or arthritis.

Lyme disease is caused by spirochetes, a type of spiral bacteria from the genus Borrelia.

Understanding Lyme Disease

Symptoms

A rash, sometimes in a bulls-eye pattern, is often the first symptom of early Lyme disease. However, only 8 out of 10 people will develop any rash. This can make early diagnosis difficult.

Other symptoms of early Lyme disease resemble a viral infection like the flu. You might experience loss of appetite, tiredness, headaches, sore muscles and joints and enlarged lymph nodes. A small number of people might have a fever.

If you have upper respiratory symptoms such as a bad cough, or stomach problems such as diarrhea, the good news is that it is likely not Lyme disease.

If the disease progresses for several months without treatment, the spirochete can infect the blood. Lyme disease becomes more serious at this stage and symptoms can vary from one person to another.

Lyme Disease and Arthritis

The most common joint affected by Lyme disease is the knee. However, it can affect other joints including the shoulders, elbows, ankles, jaw, and wrists. Sometimes only one joint is affected but other times more than one joint is affected.

The arthritis starts very abruptly and can last for weeks to months. In some people the arthritis can flare up and then settle back down. In others it can become chronic and damage the cartilage.

For those with joint pain occurring earlier in the disease, the prognosis is better and it usually improves over time.

Other Features of Lyme Disease

Some people experience neurological symptoms such as meningitis, which affects the brain and Bell’s palsy, which affects the cranial (facial) nerves. If the peripheral nerves are attacked, this can lead to a loss of motor function, pain or loss of sensation. In extreme cases, all of these symptoms can occur together.

The heart can also be a target for Lyme disease. It may result in a blockage of the normal electrical conduction pathways that control the electrical impulses of the heart. Symptoms can include dizziness, light-headedness, shortness of breath, chest pain, and palpitations. Inflammation of the heart muscle can also occur, which causes chest pain and shortness of breath.

Post-Lyme Fibromyalgia

Post-Lyme disease syndrome can manifest as fibromyalgia. Fibromyalgia can be hard to diagnose and treat due to the chronic nature of the disease. Even if tests are positive for Lyme disease, treatment with antibiotics may not improve fibromyalgia symptoms.

Diagnosis

The first clue for diagnosis of Lyme disease is the discovery of a tick bite.

In the early stages of Lyme disease, symptoms are localized to where the tick bite occurred. A rash may form at the site of the bite. The rash often resembles a red bulls-eye with a white centre.

If the tick bite goes unnoticed and the disease progresses, it can be more difficult to diagnose.

If you have been bitten by a tick, it is important to get tested for Lyme disease. A blood test that looks for antibodies to the bacterium will determine if you’ve been exposed. But the test won’t tell you if you have active Lyme disease. A special type of test called a Western blot test will help confirm exposure.

Lyme disease may not be the only infection at play. Other infections can co-exist with Lyme disease. Anaplasmosis is a tick-borne disease caused by the Anaplasma phagocytophilum bacteria. Babesiosis is another disease that can be transmitted by ticks. While these are rare, it is important that your doctor checks for other infections when you are being tested for Lyme disease.

Causes

Lyme disease is caused by infection with a type of bacteria called a spirochete. The most common spirochete bacteria in North America is called Borrelia burgdorferi.

Ticks can get infected by this spirochete by feeding on small animals or birds that host the spirochete. Then, infected ticks can sometimes spread it to humans through a bite.

An infected tick must be attached to a person’s skin for 24-36 hours to transmit the spirochete. Just because you’ve been bitten by a tick, it does not mean you’ll get Lyme disease. Less than 1% of people who get tick bites will become infected.

Did you know that Lyme disease gets its name from a town in Connecticut, U.S.? That’s where it was first discovered in the late 1970s. After several children in Lyme became ill, doctors first thought they had juvenile rheumatoid arthritis. They later discovered it was a tick-borne disease.

Treatments

Once you have been diagnosed with Lyme disease, it is important to begin treatment right away. Your treatment will depend on the stage of your disease when it’s diagnosed.

Medications for Lyme disease

For patients with early localized Lyme disease that consists of a rash and/or flu symptoms, oral antibiotics are the usual treatment. The most common antibiotics prescribed are doxycycline, amoxicillin or cefotaxime. Typically, you will need to take antibiotics for 10-21 days.

Non-prescription analgesic medications such as acetaminophen (Tylenol) and Non-Steroidal Anti-Inflammatory Drugs or NSAIDs can help with flu-like symptoms such as achiness, fever and joint pain.

In more advanced cases of Lyme disease, with neurologic or cardiac symptoms, most patients will need to be admitted to the hospital. Here, the same antibiotics for early Lyme disease are given by intravenous infusion for 10 days up to 1 month. The usual duration is around 2 weeks. If cardiac disease is severe, in rare cases some patients may need to have a pacemaker implanted.

Antibiotics can also be helpful for Lyme arthritis. Usually, they are taken orally for about 1 month. If improvement is slow, the antibiotics may be switched to intravenous administration given in the hospital. NSAIDs can be taken to help with the pain and inflammation of arthritis. If joint pain is severe, a steroid such as oral prednisone might be considered.

In patients suffering from post-Lyme disease syndrome and fibromyalgia, antibiotics are generally not effective.