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Lyme’s Disease

When a family plans their summer vacation camping in the park or near prime fishing and hunting areas, it is not in the front of their minds to be very watchful for nymph (juvenile) ticks, as there is a possibility they may contract Lyme’s Disease. What is Lyme’s Disease you may ask? Well I asked the very same thing in July of 2014 when I was diagnosed with just that. Since than I have read many articles, scientific research findings, ranging from the CDC websites, Mayo Clinics website, and even American Lyme’s Disease Association, trying to fully understand just what this disease is. I would like to take a little time to share with you my findings, from its definition, symptoms, signs, diagnosis, and treatments to its possible long-term effects on an individual.
First its important to know that Lyme’s Disease is transmitted from the deer tick to humans, the tick is the carrier of the bacteria Borrella burgdorferi, which is a bacterium called a spirochete, and the cause of what we now call Lyme’s Disease. It was not truly identified and named until 1975, when an unusual number of children in Lyme Connecticut were diagnosed with juvenile arthritis. However manifestations of Lyme’s disease have been reported in Europe as early as 1883. Untreated the Lyme bacteria travels through the blood stream to various body tissues, causing a number of symptoms, some which are severe. LD manifests itself as a multisystem inflammatory disease that affects the skin early on, and spreads to the joints, nervous system, and in a small number of cases other organs in the later stages of the disease.
After learning what LD is, you have to wonder what symptoms an infected person might complain about or what signs we may look for in a potential case. Most importantly always check your body and your families for any signs of ticks after being outside, if you do find one embedded in the skin, carefully remove it and then you will need to watch the bite area carefully over the next few days. There could be flu like symptoms, fever, headaches, fatigue, soreness in the neck, and the most obvious sigh is the EM (erythema migrans) rash, or “bull’s-eye” rash. In most cases there is a small red area where the tick bit and a larger red circular rash around the bite site, making it look like a bull’s-eye. If you believe you may have any of these symptoms you should be seen by your doctor immediately, the sooner LD is treated the less time it has to cause lasting damage and because the tests for diagnosing LD are not accurate all the time it is better to be safe than sorry.
Currently there are a couple of blood tests however the EM rash and the accompanying symptoms are the best way to diagnose LD. The CDC recommend the Western Blot test and the ELISA blood test for diagnosing those who do not have any obvious symptoms in the early stages of LD. Both tests are known to sometimes give incorrect result, both false negatives and false positives. And if the patient is showing neurological symptoms that the doctor may recommend a PCR test which involves a spinal tap. The route that your doctor chooses is based on the severity of the symptoms, the length of time it may have gone undetected and if there is the lack of the “bull’s-eye” rash. It is not unusual for doctors to begin treatment before all results are in if they are fairly confident that LD is going to be your diagnosis. As of the end of 2013 there have been 150,000 reported cases of LD in the United States.
Treatment of LD consists of oral antibiotics in a high dose from anywhere from 21-30 days for adults and 14-21 days for children. Usually the antibiotic doxycyclene is used in adults and amoxicillin is used in children 12 years and under. Sometimes your doctor may feel intravenous antibiotics are called for in the beginning stages of treatment, but there have been no scientific findings that use of antibiotics for longer than 30 days has any benefits to the patient, may even be harmful due to the lowering of the bodies natural immunity. In some LD cases the symptoms and the long term effects of LD persist even after treatment with the antibiotics, in these cases it is termed Chronic LD, but there is not much known about what causes some patients to suffer from chronic LD while others do not, but it is mostly paralleled to the length of time the disease went untreated in the patient and the severity of the symptoms before diagnosis.
In conclusion the best defense is always a prepared offense, so before enjoying the outdoors keep you family covered in bug spray with deet, try and keep outer extremities covered and stay away from areas with a lot of brush if possible because these are the most likely tick infested areas. Also after being outdoors be sure to look yourself and your family over well for ticks and if one is found be sure to remove it being careful to remove the whole tick, or if evidence is present that you may have been bitten be sure to monitor the site for the next couple of weeks. Even though LD is most prevalent in the Northeast and upper Midwest it is making its way inland. It is also common in the Northern California and Oregon Coasts in the United States. Wherever you are when you find yourself in the presence of these pasty critters, remember what precautions to take and the signs and symptoms to be watchful of.

Bibliography
Centers for Disease Control and Prevention. Lymes Disease. 2015. 2012 <www.cdc.gov/topics/LymeDisease>.

Longo, D.L. "Lymes Disease Controversy." Harrisons Online 18th Ed 18th edition (2012).

National Institute of Allergy and Infectious Disease. Lymes Disease. 2012. 2014 <www.niaid.nih.gov/topics/lymesdisease>.

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