Lyme disease

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Overview

Lyme disease is the most common vector-borne disease in the United States. Lyme disease is caused by the bacterium Borrelia burgdorferi and rarely, Borrelia mayonii. It is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks.  Laboratory testing is helpful if used correctly and performed with validated methods. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat. The ticks that transmit Lyme disease can occasionally transmit other tickborne diseases as well.

Symptoms

People with Lyme disease may react to it differently. Symptoms can vary in severity.

Although Lyme disease is commonly divided into three stages — early localized, early disseminated, and late disseminated — symptoms can overlap. Some people will also present in a later stage of disease without having symptoms of earlier disease.

These are some of the more common symptoms of Lyme disease:

a flat, circular rash that looks like a red oval or bull’s-eye anywhere on your body

fatigue

joint pain and swelling

muscle aches

headache

fever

swollen lymph nodes

sleep disturbances

difficulty concentrating

Get medical attention immediately if you have any of these symptoms.

Causes

Lyme disease is caused by the bacterium Borrelia burgdorferi and rarely, Borrelia mayonii. It is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans.

Risk factors

According to the CDCTrusted Source, as of 2019, the U.S. states with the highest incidence of Lyme disease include:

Pennsylvania

New York

New Jersey

Maine

Wisconsin

New Hampshire

Minnesota

Maryland

Connecticut

Virginia

People who work outdoors are at an elevated riskTrusted Source of Lyme disease, including those who work in:

construction

landscaping

forestry

farming

park or wildlife management

The majority of tick bites happen in the summer when ticks are the most active and people spend more time outside. However, it’s also possible to get Lyme disease from tick bites in early fall, and even in late winter if the weather is unseasonably warm.


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Complications

Chronic joint inflammation (Lyme arthritis), particularly of the knee.

Neurological symptoms, such as facial palsy and neuropathy.

Cognitive defects, such as impaired memory.

Heart rhythm irregularities.

Prevention

The best way to prevent Lyme disease is to avoid areas where deer ticks live, especially wooded, bushy areas with long grass. You can decrease your risk of getting Lyme disease with some simple precautions:

Cover up. When in wooded or grassy areas, wear shoes, long pants tucked into your socks, a long-sleeved shirt, a hat and gloves. Try to stick to trails and avoid walking through low bushes and long grass. Keep your dog on a leash.

Use insect repellents. Apply insect repellent with a 20% or higher concentration of DEET to your skin. Parents should apply repellant to their children, avoiding their hands, eyes and mouth.

Keep in mind that chemical repellents can be toxic, so follow directions carefully. Apply products with permethrin to clothing or buy pretreated clothing.

Do your best to tick-proof your yard. Clear brush and leaves where ticks live. Mow your lawn regularly. Stack wood neatly in dry, sunny areas to discourage rodents that carry ticks.

Check your clothing, yourself, your children and your pets for ticks. Be especially vigilant after spending time in wooded or grassy areas. Deer ticks are often no bigger than the head of a pin, so you might not discover them unless you search carefully.

It's helpful to shower as soon as you come indoors. Ticks often remain on your skin for hours before attaching themselves. Showering and using a washcloth might remove unattached ticks.

Don't assume you're immune. You can get Lyme disease more than once.

Remove a tick as soon as possible with tweezers. Gently grasp the tick near its head or mouth. Don't squeeze or crush the tick, but pull carefully and steadily. Once you've removed the entire tick, dispose of it by putting it in alcohol or flushing it down the toilet, and apply antiseptic to the bite area.