Lyme disease is a bacterial infection transmitted to humans through the bites of ticks infected with the bacterium Borrelia burgdorferi. This disease is considered one of the most prominent tick-borne diseases worldwide. Failure to deal with it properly and early can lead to serious health effects. In this article, the causes and symptoms of the disease, in addition to methods of prevention and treatment.

What is Lyme disease?

 

Lyme disease is a bacterial infection that is considered a vector-borne disease, as it is caused by the bacterium Borrelia burgdorferi that infects ticks, and then transmitted to humans through the bite of these infected insects. Lyme disease is one of the most common vector-borne diseases in the United States of America, and it was first recognized in 1975 when a group of children were diagnosed with rheumatoid arthritis in the towns of Lyme, Connecticut. Researchers at the time indicated that the cause of the spread of the disease was the bites of infected deer ticks.

Where is Lyme disease spread?

 

The mosquito species that carries these bacteria is commonly found in the United States and North Atlantic countries, as well as Europe and Canada. According to the latest statistics, the prevalence of the disease in the United States is about ten infections per 100,000 people, with similar prevalence rates in the North Atlantic countries, with no significant differences in prevalence rates between males and females.

**Tick Sizes**

Ticks come in three sizes that vary depending on their life stage, as they can be the size of a grain of sand, the size of a poppy seed, or the size of an apple seed.

**Lyme Disease and Pregnancy**

If Lyme disease is contracted during pregnancy, the infection can be transmitted to the placenta, which can lead to the possibility of transmission from mother to fetus, but this possibility is rare.

**What are the symptoms of chronic Lyme disease?**

 

Symptoms can include a constant feeling of fatigue, joint pain, difficulty concentrating, and sleep disturbances, and these symptoms often appear after the initial Lyme disease infection.

**What causes chronic Lyme disease?**

 

Chronic Lyme disease is thought to result from untreated Lyme disease, where symptoms persist and may be related to immune system reactions or ongoing infections.

**How ​​is chronic Lyme disease diagnosed?**

 

Diagnosis typically involves a clinical evaluation, review of the patient’s medical history, and serological testing to detect antibodies to Borrelia species, although there is controversy about how to diagnose chronic Lyme disease.

**What are the treatment options for chronic Lyme disease?**

 

Treatment options may include long-term antibiotics and symptom management to relieve persistent symptoms.

**What are the complications of chronic Lyme disease?**

 

Complications may include arthritis, neurological problems, and other systemic effects that require ongoing management and monitoring.

**The characteristic Lyme disease rash:**

In 80% of cases of Lyme disease, the rash appears as an oval rash with a reddish border and is the most prominent sign of the disease. The above images show a “bull’s-eye” pattern, where concentric circles form around a central point. The rash is usually round and evenly red, with the oval ring at least 2 inches (5 cm) wide. Sometimes, the rash may appear as a reddish circle without an outer ring. The rash can gradually expand over the days of infection, reaching about 15-20 cm (6-8 inches), according to the CDC. These rings usually feel warm to the touch, can sometimes itch, and are rarely painful.

**Can Lyme disease be cured?**

 

Yes, Lyme disease can be cured if diagnosed correctly and in a timely manner. Diagnosis involves monitoring symptoms and assessing the person’s exposure to ticks in their area, as well as performing blood tests that may show positive or suspicious results. Treatment usually begins with antibiotics, such as amoxicillin, for periods determined by the doctor based on the condition.

**Is Lyme disease contagious?**

 

Lyme disease is not transmitted from person to person through saliva, so there is no need to worry if you kiss an infected person or drink from the same cup. As for the transmission of the disease through blood, there have been no recorded cases of transmission from person to person during blood donations, but it is preferable for infected people to avoid donating until the end of the antibiotic treatment period. Regarding the possibility of Lyme disease being transmitted through sexual relations, research has not yet proven this, but the possibility of its presence in genital secretions between sexually active partners cannot be ruled out.

Is Lyme disease considered a chronic disease?

 

The earlier Lyme disease treatment is started, the faster the chances of a complete recovery. However, some cases may suffer from pain, fatigue, cognitive problems, and difficulty thinking for long periods of up to 6 months or more, in a condition known as post-treatment Lyme syndrome. Therefore, it can be said that Lyme disease may become chronic in cases where symptoms continue to appear during and after the treatment period. Studies show that about 10 to 20 percent of people who receive antibiotic treatment continue to have symptoms even after treatment ends, without knowing the cause. These symptoms can interfere with a person’s daily activities and affect their emotional state, but they usually improve in most people after 6 months, and in some cases it may take up to a year. Unfortunately, people with chronic Lyme disease are at risk of being reinfected by ticks. Symptoms can last for weeks, months, or even years, making it even more difficult to adjust to a normal life. Lyme disease is caused by the blacklegged tick, also known as the deer tick, which carries the bacterium Borrelia burgdorferi. This tick transmits the bacteria to humans, leading to infection andM with Lyme disease. The blacklegged tick is characterized by its ability to attach to any part of the human body, which makes it easy to spread the infection. Unfortunately, these ticks are found in areas of the body that are difficult to see, such as the scalp, groin, and armpits, where they can remain attached for 36 to 48 hours, which increases the possibility of transmitting bacteria. The blacklegged tick that causes Lyme disease is usually found in the following areas of the United States:

- Northeast.

- Mid-Atlantic.

- Upper Midwest.

- Northern California on the Pacific Coast.

Is Lyme disease serious?

 

Yes, Lyme disease can become serious if not treated in a timely manner. The infection can spread to the joints, heart, and nervous system, which can worsen and increase the severity of symptoms, which may include:

- Severe headache, stiffness, and pain in the neck.

- A larger rash in multiple areas of the body.

- Facial paralysis or weakness of the facial muscles, causing one or both sides of the face to droop.

- Inflammation, swelling and pain in the joints, especially in the knees.

- Frequent pain in the bones, nerves and tendons.

- Palpitations and irregular heartbeat.

- Pain and tingling in the hands and feet.

- Inflammation of the spinal cord and brain.

How can you tell if you have been bitten by a tick?

 

Ticks are small, so you need to pay close attention to see them. If you notice a small red bump on your skin that looks like a mosquito bite, you may have been bitten by a tick. If this bump goes away within a few days, there is no need to worry. You should remember that a tick bite does not necessarily mean you have Lyme disease. If you see a rash that looks like a targeted ring, you may have been bitten by a tick. It is best to consult your doctor about treatment, and if you have an allergic reaction to a tick, you will feel the bite immediately.

**Diagnosis of Lyme disease and its tests**

According to the Centers for Disease Control and Prevention (CDC), Lyme disease is diagnosed by assessing the patient's symptoms and the likelihood of previous exposure to ticks. Blood tests can also be used to detect the presence of antibodies resulting from the infection. Antibody tests are the most common in diagnosing Lyme disease, and can be done using a sample of blood, spinal fluid, or joints. It is worth noting that antibodies usually remain in a person's body for several years even after receiving effective treatment. Tests used to diagnose Lyme disease include:

**Physical examination** A physical examination of the patient can be straightforward and helpful, especially in patients who have clear evidence of previous exposure to ticks, where a distinctive type of rash known as erythema migrans appears. This rash begins as a red spot that expands over days and weeks, and may reach a diameter of about 5 cm or more. Although the rash can be associated with many other medical conditions, what makes erythema migrans associated with Lyme disease unique is that it expands more rapidly and more widely than other diseases. This rapid expansion may be enough to diagnose Lyme disease even in the absence of laboratory tests.

**Lyme antibody test** This test is a common blood test used to detect Lyme disease. It aims to detect the presence of antibodies that the body produces in response to the bacteria that cause the disease. When these bacteria enter the bloodstream, the body begins to produce special proteins known as antibodies, which play a role in fighting these bacteria. Therefore, this test checks for the presence of these antibodies. However, this test is not relied upon as the only means of diagnosing Lyme disease, due to the possibility of inaccurate results.

**Western blot test** The Western blot test is used to confirm positive results from previous tests. In this test, a blood sample is separated into different patterns, and the resulting pattern is compared to a standard pattern that represents known cases of Lyme disease. If a person’s sample contains five or more patterns similar to those of Lyme disease, the result is considered positive. It is important to note that results can vary between laboratories, as some laboratories may use different methods and criteria to interpret the results, meaning that you may get a positive result from one laboratory and a negative result from another.

**Additional Tests** There are three other tests that can be used to diagnose Lyme disease, but they are less common, and they are as follows:

1. **PCR Test**: This test is used to detect the genetic material of the Lyme disease bacteria. However, it is not widely used because it is difficult to perform and expensive, in addition to the possibility of inaccurate results in some cases.

2. **Antigen Detection**: This test focuses on searching for specific proteins related to Lyme disease, which are found in various body fluids such as blood, urine, and joint fluid.

3. **Blood culture**: This test is the most effective in identifying the type of bacteria that causes Lyme disease. This is done by taking a sample of blood or other fluid, then growing it in a special medium that encourages the growth of bacteria.

Are Lyme disease tests accurate?

 

Diagnostic tests for Lyme disease can sometimes be insensitive, leading to false positives. If the result is negative, it does not necessarily mean that the person is free of Lyme disease. This is because the body does not have enough time to produce antibodies when the test is done. It can take up to two months after infection before antibodies show up in a blood test, or a person may have a strain that the test cannot diagnose. Therefore, a new report published in the Journal of Clinical Infectious Diseases acknowledges the need to develop more advanced tests.

What are the symptoms and signs of Lyme disease?

 

Lyme disease progresses over time without treatment, and it may resolve on its own in the early stages. However,Advanced cases, especially in the late stages of the disease, may show severe neurological, cardiac, and muscular symptoms that threaten life. Symptoms are divided into several stages, where the first stage is characterized by the appearance of symptoms near the site of the insect bite, while the symptoms in the second and third stages are more widespread in multiple areas and systems of the body. We can distinguish the following symptoms in each stage:

-** The first stage ** Symptoms appear between the third and thirtieth day after the insect bite, and the rash is the main noticeable symptom, which is very common at this stage, but not all patients notice it. The rash appears as redness at the site of the bite, then expands to increase the area of ​​redness around the area, and then the redness disappears in the middle to take the shape of a target mark. The site of the redness is usually painless. Other symptoms that may appear include the following:

1- Fever.

2- Headache.

3- Joint pain.

4- Severe fatigue.

5- Muscle pain.

**Stage 2** This stage occurs in patients with Lyme disease who have not received appropriate treatment within 3 to 10 weeks after the mosquito bite. At this stage, symptoms spread to several body systems, and this stage is often known as the early disseminated stage. Symptoms at this stage include the symptoms mentioned above, in addition to the symptoms of the first stage.

1- A widespread rash appears in multiple areas of the body.

2- Muscle weakness that may be symmetrical or asymmetrical in the face area.

3- A feeling of pain and stiffness in the neck area.

4- Muscle pain extending from the back and flank to the legs.

5- Numbness and pain in the extremities.

6- An abnormal immune response to cardiac fibers, which may lead to heart rhythm disturbances.

At this stage, we notice the beginning of the appearance of neurological and cardiac symptoms, which indicate the spread of the Borrelia bacteria to the central nervous system, and its symptoms may mimic meningitis or, in rare cases, intracranial inflammation.

**Stage III** At this stage, the symptoms of the previous stages appear, in addition to chronic atrophic seborrheic dermatitis. This condition indicates that Lyme disease infection occurred as a result of a mosquito bite after a long period (several months), as swelling and discoloration of the skin appear on the skin, especially on the back of the hands and feet. The worsening of this condition may lead to damage to the joints and tissues surrounding the affected skin.

Who should undergo Lyme disease tests?

 

Lyme disease tests should be performed when exposed to a tick bite in areas where it is prevalent, and signs and symptoms indicate Lyme infection appear. Some early signs and symptoms of Lyme disease may include the following:

A distinctive rash spreading from the site of the bite.

Fever.

Chills.

Headache.

General fatigue and exhaustion.

Muscle and joint pain

**Lyme disease prevention:**

Fortunately, the ticks that transmit the bacteria that cause Lyme disease cannot fly. Rather, they live in damp or cool environments, such as shrubs and grassy areas, and are transmitted to humans through bites, which leads to the beginning of the spread of the disease. Therefore, it is necessary to follow some guidelines to avoid tick bites:

- Wear long pants and socks when in forests or areas with dense trees, where there is shade and coolness. Also, exposed parts of the body should be covered when dealing with wild plants and trees or while cleaning up fallen leaves.

- You can use some pharmaceutical preparations, such as sprays containing DEET, on your body and clothes to repel ticks. Lemon or eucalyptus oil can also be used for the same purpose.

- Use permethrin on clothing and camping equipment.

- After your hike or camping trip, be sure to shower thoroughly and wash your hair thoroughly.

- Wash your clothes thoroughly to protect yourself from infection later.

- Put the gear you used during your hike in a hot dryer to get rid of any lingering lesions

**Lyme disease treatment**

When you have a Lyme infection, your doctor will prescribe treatment that includes antibiotics. The doses depend on your symptoms. You may need to take these antibiotics for up to 28 days, even if you feel better.

**Antibiotic treatment** In the early stages of Lyme disease, short courses of oral antibiotics are usually prescribed. In more complicated and advanced cases, antibiotic treatment usually lasts for three to four weeks. Patients who have persistent symptoms long after treatment are referred to a specialist for further blood tests, and may be given intravenous antibiotics.