Lyme Disease Update

By Douglas MacQueen, MD

Lyme disease is a bacterial infection that can be transmitted to people by the bite of an infected deer tick. Ticks obtain the bacteria after feeding on the blood of a small mammal or bird that is infected. An infected deer tick must be attached to you long enough to be full of blood to transmit Lyme disease.

What are the symptoms of Lyme disease?

Typically about two weeks after a tick bite, a circular red rash develops around the bite site. It may be accompanied by fever, chills, headache, and fatigue. If you are not diagnosed and treated at this stage, the symptoms may resolve on their own. A few weeks later, you may develop several round red rashes, fever, or Lyme meningitis, which is infection of the spinal fluid by the Lyme bacteria. Infection of the knee or hip may occur months later. When treated at any of these stages, the infection is completely curable.

What should I do if I discover an attached tick?

Use tweezers to carefully grasp the tick as close to the skin as possible. Gently pull it out with a slow, steady motion because you want to extract the entire tick, including its head. The bite site may be red and itchy while the tick is attached due to an allergic reaction to the tick’s saliva. Keep an eye on the site of the tick bite over the next two to three weeks to see if you develop a rash. If you do develop a rash, see your doctor.

Shouldn’t I see my doctor right away if I suffer a tick bite?

You do not need to routinely see your doctor for every tick bite. Less than half of the local deer tick population carries Lyme disease and ticks are inefficient at transmitting it, which makes your chances of being infected pretty low. If the bite site becomes red, painful, or swollen see your doctor to determine if it has become infected with other bacteria.

Isn’t it routine to take a preventive antibiotic if I’m bitten?

It is not recommended that people take prophylactic antibiotics for every tick bite. Taking too many unnecessary antibiotics is not good for us. Instead, I recommend that you watch for the development of symptoms of Lyme disease and then seek treatment if they develop.

There was a study in The New England Journal of Medicine a few years ago that examined the use of preventative antibiotics in people who found engorged deer ticks on themselves. It showed that only three percent of the people who had engorged ticks removed, and got no prophylactic antibiotics, went on to develop Lyme disease. Of those people who did take prophylactic antibiotics, one percent still developed Lyme disease. It also showed that about one hundred people would need to take preventative antibiotics for a tick bite to prevent one case of Lyme. Thus, any one tick bite has a low chance of transmitting Lyme. Taking preventive antibiotics will not decrease your chances of developing Lyme to zero.

Should I get a blood test for Lyme disease?

Early in the course of Lyme infection your body has not made enough antibodies for the blood test to be positive. Getting tested when you have fever and a Lyme rash is not helpful and could give you and your doctor a false sense that you don’t have Lyme. If you develop a Lyme rash, skip the test and get treated with antibiotics. The test is helpful if someone has meningitis or arthritis from Lyme.

How can I prevent Lyme disease?

Deer ticks are delicate. They want shade and moisture so are likely to be found in the woods where there is underbrush. When you are outside in these areas, wear long pants and long sleeves. Bug spray with DEET is also an effective tick deterrent. After you have been outdoors, it is important to check for the presence of ticks, especially in the groin, armpits, and hairline where it is easy to hide. Be sure to check your young children because they may not notice a tick.

Can I be cured if I get Lyme disease?

One of the prevailing myths right now is that Lyme disease can’t be eradicated if it isn’t treated right away. In fact, Lyme disease is completely curable at any stage with antibiotics.

Dr. MacQueen is an infectious disease specialist who is board certified in internal medicine. He is on the medical staff of Cayuga Medical Center and can be reached at the Cayuga Center for Infectious Diseases at (607) 241-1118.

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