Lyme Disease Has Subtle Clinical Clues

DEAR VANESSA,

My father, a Maryland resident, was diagnosed with Lyme disease. He told me that based on his experience, Lyme disease is a complex illness. Can you please share more information about this vector-borne disease? Thank you.

-JILL

DEAR JILL,

Lyme disease is an infection that is transmitted through the bite of a tick infected with a bacterium called Borrelia burgdorferi. According to webmd.com, it has now been found in nearly all states and 18 other countries. Most cases - more than 90% - are reported in three regions of the U.S.: Northeast, North Central States, and West Coast, particularly Northern California.

Lyme disease is considered to be a complex illness because it can be hard to diagnose; it mimics a variety of illnesses and its severity can vary from person to person. In the early stages, its symptoms are vague: flu-like symptoms that can include a stiff neck, chills, fever, swollen lymph nodes, headaches, fatigue, muscle aches, facial parlysis (Bell’s palsy), and joint pain. Less common symptoms include eye inflammation and severe fatigue.

A tick bite is an important clue for diagnosis, but many patients cannot recall having been bitten by a tick (the tick is tiny, and a tick bite is usually painless). A large, expanding skin rash that resembles a bull’s- eye is an indication to seek medical attention. If there is no visible rash (as is the case in about one-fourth of those infected), the doctor might order a blood test: ELISA, which measures the levels of antibodies against the Lyme disease bacteria that are present in the body; and Western blot, which identifies antibodies directed against a panel of proteins found on the Lyme bacteria. Other tests include a spinal tap which can detect brain and spinal cord inflammation and can look for antibodies against the Lyme disease bacterium in the spinal fluid. Lyme disease is not contagious. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics.

If Lyme disease is not treated promptly, it can be difficult to cure. In advanced stages, nerve problems and arthritis, especially in the knees, may occur. Some patients develop heart problems, such as an irregular, slow heartbeat. Steps to prevent Lyme disease include avoiding tick-infected areas, wearing protective clothing, using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat.

-VANESSA