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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Lyme Disease

What is it?

Lyme disease is an infection caused by a bacterial spirochete (a corkscrew-shaped organism) spread by a bite from an infected tick. It is named after the community of Old Lyme, Connecticut, where the disease was first identified. Lyme disease may affect several organ systems, and symptoms vary, some arising months or even years after a bite. Left untreated, the infection may affect the brain, heart, or joints, resulting in a type of chronic arthritis (see Infectious Arthritis for more information). The common deer tick carries the infection and is prevalent in New England, along both U.S. coasts, and in the upper Midwest. Deer ticks are small compared to dog ticks: Adults are the size of a pinhead; nymphs smaller still. Between 20 and 60 percent of ticks carry the bacteria, but infection is rare if the tick is removed within 48 hours of attachment. Lyme disease is preventable; it also responds well to treatment, especially if caught early. In some cases, it subsides spontaneously.

What Causes It?

  • A bacterial infection causes Lyme disease. Ticks acquire the disease from infected mice and deer and may then transfer the bacteria to humans.

Prevention

  • Cover exposed skin when in grassy or wooded areas where ticks may be present. Tuck long pants into socks, wear shoes instead of sandals, and wear long-sleeved shirts. Light-colored clothing makes ticks easier to see.
  • Use an insect repellent containing DEET (diethyltoluamide) during outdoor summer activities.
  • Check skin, clothing, and pets for ticks after an outing. Pets should wear tick-repellent collars.
  • Use fine-tipped, curved tweezers to remove a tick attached to your skin. Grasp the tick as close to your skin as possible and pull steadily to remove it. Avoid squeezing the bloated abdomen, as this may inject bacteria into your skin or bloodstream. Do not touch the tick, because bacteria from a crushed tick may penetrate even unbroken skin. Preserve the tick by dropping it in rubbing alcohol.Wash your hands and apply antiseptic to the bite.
  • Do not use petroleum jelly, kerosene, or a lighted match or cigarette to remove the tick.
  • A new vaccine (Osp A) has been approved for use in adults; it appears to decrease the transmission rate of Lyme by 80 percent following an infected bite.

Diagnosis

  • Patient history and physical examination.
  • Blood tests. Cument antibody tests used to detect Lyme disease may be inconclusive, especially with early infection. As such, Lyme disease remains a clinical diagnosis to be made only by a physician.
  • A preserved tick may be examined to determine if it is the type that carries the infectious bacteria.

How to Treat It

  • Antibiotics are prescribed for as long as three weeks to treat early stages; other antibiotics, given intravenously, may be needed to treat chronic arthritis or neurologic forms of the disease.
  • OTC pain relievers reduce fever and inflammation.

When to Call a Doctor

  • Call a doctor if Lyme disease symptoms develop.