Lyme disease is a tick-borne infection that can cause serious illness. Named after the Connecticut town where a cluster of cases were diagnosed in the mid 1970s, the disorder has now been reported throughout much of the United States, with the highest levels of infection on the East Coast, from Maine to Maryland, in the Upper Midwest, and in California. The cause is a type of screw shaped bacteria, known as a spirochete, that is transmitted by several species of tiny ticks. Although these ticks are most often found on deer, rodents, and other wild animals, they also bite humans. The first sign of Lyme disease usually is a painless, donut-shaped red rash that develops at the site of the tick bite within a few weeks, although in some cases it shows up sooner. It is often Many people do not know that they have been infected with Lyme disease because they are unaware of having been bitten by a tick. (Up to half of those who are bitten fail to develop the warning rash.) Without treatment, weeks or even months after the bite, arthritic, cardiac, and/or neurological complications may occur. The most common manifestations are joint swelling, pain, and stiffness. Less common complications include cardiac arrhythmias, meningitis, neurological disorders including paralysis, and depression and other psychological problems. Infection in pregnant women may lead to fetal death and miscarriage.
Diagnostic Studies And Procedures
There are blood tests for Lyme disease, but they have limitations. For example, it may take months for an infection to produce a positive result using anti body tests. This situation is expected to change if experimental tests fulfill their initial promise. In the meantime, a diagnosis can often be made on the basis of symptoms and the likelihood of exposure to a tick bite.
Lyme disease usually can be cured with antibiotics, especially if treated in its earliest stages, before complications occur. In the past, penicillin or tetracy cline were the drugs of choice, but current therapy favors doxycycline, a more readily absorbed tetracycline, or amoxicillin, a penicillin derivative that has increased potency. Doxycycline is most commonly used because it has to be taken only twice a day and causes fewer gastrointestinal side effects than amoxicillin, which must be taken three times a day. More serious infections, especially those involving the central nervous system, may be treated with ceftriaxone (Rocephin); this is a new antibiotic that is given by injection or intravenously. Approaches for later and more severe manifestations of Lyme disease remain controversial. Generally, treatment at this stage is longer and more intensive. It may be necessary to undergo two to four weeks of intravenous therapy with ceftriaxone or penicillin G, especially for central nervous system complications such as meningitis. Intravenous therapy may be given in the hospital, an outpatient clinic, or at home by a visiting nurse or IV therapist. If symptoms persist despite a course of IV antibiotics, some doctors recommend long-term intravenous therapy. Others feel this approach is futile. Other medical treatments depend upon symptoms. For example, Lyme arthritis generally responds to aspirin, ibuprofen, and other nonsteroidal antiinflammatory drugs. People with certain types of cardiac arrhythmias may be treated with antiarrhythmia drugs; others may benefit from implantation of a pacemaker. Eye inflammation can be treated with antibiotic eye drops. Medication may also be prescribed to treat depression. Vaccines against Lyme disease are being tested in areas of Connecticut where the disease is widespread. If these prove effective, Lyme disease will become a preventable disorder.
Physical Therapy. A physical therapist can suggest exercises that will help inflamed joints retain function and maintain mobility, but at the same time will not damage them. An occupational therapist can teach new ways to perform daily tasks with minimal pain.
The gentle movements of this ancient exercise routine can help maintain flexibility and may also promote healing and a sense of well being.
The ideal self treatment is to prevent Lyme disease by avoiding tick bites. When walking in tick infested areas, wear light colored clothes on which ticks will be more visible, and spray them with peregrine. Apply an insect repellant that contains DEET preferably in a concentration of less than 35 percent-to exposed skin. (Check with your doctor before using DEET on a young child; it may cause seizures.) Also, try to avoid brush and leaf litter. Shower as soon as possible after any outing into an area known to be populated by ticks, and then examine yourself carefully. If you find a tick attached to your body, remove it promptly by grasping it with a pair of tweezers as close to the skin as possible and tugging gently. The sooner it is removed, the lower the risk that it will transmit infection. Place the tick in a closed container so that it can be examined if you develop any symptoms. Make sure that all cats and dogs wear tick collars, and comb pets regularly to remove any ticks.
Other Causes of Lyme Symptoms
Arthritis symptoms similar to those of Lynne disease may be caused by rheumatoid arthritis, lupus, and Remitter's syndrome, a type of infectious arthritis. Neurological symptoms may be due to encephalitis and other central nervous system infections. Depression and chronic fatigue syndrome may also be mistaken for Lynne disease.