Lyme Disease - General Information
Lyme disease is an illness caused by a spirochete bacteria, Borrelia burgdorferi, which is transmitted to animals and man through the bite of infected ticks.
The disease is reported worldwide and throughout the United States. The states of New York, Pennsylvania, Massachusetts, Connecticut, Rhode Island and New Jersey account for the majority of cases in the United States. However, cases are reported from all geographic regions of the country. Different ticks are carriers in the different regions. Ixodes dammini (the deer tick) in the Northeast and midwest, Ixodes scapularis (the black-legged tick) in the South, Ixodes pacificus (the western black-legged tick) in the West and Amblyomma americanum (the lone star tick) found in several regions are all considered vectors. This is a growing concern that Dermacentor variabilis (the American dog tick) may also be capable of transmitting the disease. Transmission by biting insects (flies, fleas, mosquitoes) is speculated but appears to be quite rare.
Not all ticks are infected. Infection rates in tick populations vary by tick species and geographic region from as few as two percent to 90 percent or more.
The Deer Tick
Ixodes dammini is responsible for most of the cases of Lyme disease in the northeastern United States. These ticks are found in grassy areas (including lawns), and in brushy, shrubby and woodland sites, even on warm winter days. They prefer areas where some moisture is present. The tick has three life stages: larva, nymph and adult. Each stage takes a single blood meal. They feed on a variety of warm blooded animals including man, dogs, cats, horses and cows. The bite is painless so most victims do not know they have been bitten. The nymphal stage appears to be responsible for most Lyme disease cases. Both the larval stage (about the size of a grain of sand) and nymphal stage (about the size of a poppy seed) attach to a variety of small mammals, but prefer the white-footed mouse, the main reservoir of the Lyme disease bacteria. The adult ticks (about the size of a sesame seed) prefer to feed on white-tailed deer. The entire life cycle requires three separate hosts and takes about two years to complete.
Larval and nymphal deer ticks also attach to birds. Indeed, birds may be a primary means by which the ticks (some infected) are spread from one area to another. Some species of birds also function as a reservoir of infection.
Lyme Disease Symptoms in Humans
In about 50% of the cases a characteristic rash or lesion called erythema migrans is seen. It begins a few days to a few weeks after the bite of an infected tick. The rash generally looks like an expanding red ring. It is often described as looking like a bull's-eye with alternating light and dark rings. However, it can vary from a reddish blotchy appearance to red throughout. And can be confused with poison ivy, spider or insect bite, or ringworm. At about the same time that the rash develops, flu-like symptoms may appear with headache, sore throat, stiff neck, fever, muscle aches, fatigue and general malaise. Some people develop the flu-like illness without getting a rash.
Seek prompt medical attention if any of these symptoms appear, especially after being bitten by a tick or visiting an area where Lyme disease is common. If possible document the presence of the rash by taking a picture because it may disappear before a physician can see it. A picture in this case is worth 10,000 words!
If ignored, the early symptoms may disappear, but more serious problems can develop months to years later. The later symptoms of Lyme disease can be quite severe and chronic. Muscle pain and arthritis, usually of the large joints is common. Neurological symptoms include meningitis, numbness, tingling, and burning sensations in the extremities, Bell's palsy (loss of control of one or both sides of the face), severe pain and fatigue (often extreme and incapacitating) and depression. Heart, eye, respiratory and gastrointestinal problems can develop. Symptoms are often intermittent lasting from a few days to several months and sometimes years. Chronic Lyme disease, because of its diverse symptoms, mimics many other diseases and can be difficult to diagnose.
Acrodermatitis chronica atrophicans
This is a condition that often develops in older women. Several years may pass from the tick bite until the development of this phenomenon. The symptoms usually involve changes in the skin around the tick bite, such as swelling bluish or reddish discoloration of the skin.
Neuro borrelia
About 15 per cent of people with borrelia develop so-called neuro borrelia, between one and five weeks after the tick bite. The central nervous system is affected and the symptoms that result are very mixed and not specific. The symptoms often begin with back pain, typically between the shoulder blades and in the neck like a slipped disc. The pain worsens at night.
Distorted feelings around the area of the bite
The nerves become numb, especially in the face. This may occur at any time up to four weeks after the pain began. Sometimes neuro borrelia may present itself as meningitis, with fever, headache and stiffness in the neck. In rare cases, the disease may become chronic, with a slowly developing destruction of the nervous system, numbing, partial hearing impairment and the development of dementia. Neuro borrelia demands immediate treatment, usually with an admission to hospital.
Inflammation of the joints or Lyme arthritis
This condition may present itself in days or, rarely, years after the bite, but it is very rare. The inflammation of the joints causes pain and swelling. Often, only one joint is inflamed and, rarely, more than three. The most commonly affected joint is the knee followed by the shoulder, elbow, foot, and hip. It has symptoms similar to arthritis.
When treated, the swelling will go away in about one to four weeks but it may return in later months or even years.
Effects on the heart
Lyme disease may cause:
- inflammation of the heart tissues, along with arrhythmia
- heart failure may develop in severe cases.
Treatment
Lyme disease is treated with antibiotics. Timely treatment increases chances of recovery and may lessen the severity of any later symptoms in both animals and man. The most effective treatment will be recommended by your physician or in the case of your animals by your veterinarian and will depend on the stage of the disease. Treatment for later stages is more difficult often requiring extended and repeated courses of antibiotic therapy. In animals and man treatment failures and relapses are reported.
How does the doctor make the diagnosis?
A diagnosis of Lyme disease is more likely if the patient remembers a tick bite and presents the doctor with the erythema migrans rash.
To make a firmer diagnosis the doctor may take a blood sample to determine whether the patient has developed an antibody towards Lyme disease in their blood.
Antibodies can typically be found between two and four weeks after contracting the disease, but sometimes the antibodies do not appear for up to eight weeks. This means that the patient may have Lyme disease even though the antibody test is negative.
On the other hand, a positive antibody test does not necessarily mean that borrelia has recently been contracted. The antibodies may be found in the blood several years after an infection is over. Unfortunately, the antibody test is not a very efficient diagnostic tool: false-positive results are common.
If the doctor suspects neuro borrelia then hospital admission is required for tests on fluids from the spinal canal. This is to determine whether Lyme disease has entered the nervous system.
In cases of chronic neuro borrelia the treatment may include a CT scan of the nervous system.
Failure of a Physician to Diagnosis Lyme Disease
A doctor’s failure to conduct the appropriate testing required to detect Lyme disease can result in serious medical and neurological damage to a patient. If this has happened to you or someone you know then you may be entitled to compensation as a result of the physician’s negligence.
The Lewis Law Firm has been successful in recovering millions of dollars for those victimized by such medical negligence. If you, or someone you know, have been a victim of this traumatic procedure, call us so we may help you receive compensation.
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