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What is Lyme Disease

January 13, 2017 · by Wayne County Lyme Disease Task Force

Lyme Disease is a bacterial infection, caused by the spirochete Borrelia burgdorferi, that is acquired from the bite of an infected tick. It is most common in the Northeastern states, the Upper Midwest and the Pacific Northwest states. However, cases of Lyme Disease have been reported in all 50 states. Typical symptoms are “flu-like” and include fever, headache, general achiness and fatigue. Some people may develop a distinctive “bulls-eye” rash. If left untreated, the infection can spread to the joints, heart, nervous system, brain, muscles and more.

Ticks often harbor other bacterial, protozoal, viral and parasitic organisms that can be transmitted through the same tick bite. The co-infections are often challenging to diagnose, as clinical features often overlap with many of the other tick-borne diseases, including Lyme Disease. Some of the most common tick-borne co-infections are: Babesia, Ehrlichia, Anaplasma, Bartonella, Rocky Mountain Spotted Fever, Tularemia, Powassan Encephalitis and Southern Tick-Associated Rash Illness (STARI).

Lyme Disease is often called “The Great Imitator.” Symptoms often mimic those of many other diseases. Misdiagnoses include: Multiple Sclerosis, Lupus, Rheumatoid Arthritis, Fibromyalgia, Alzheimer’s Disease, ADD/ADHD, depression, anxiety, Parkinson’s Disease, mental illness, Chronic Fatigue Syndrome, Lou Gehrig’s Disease, carpel tunnel syndrome and more. There are over 150 common Lyme Disease Symptoms that are core symptoms of other diseases.

Lyme Disease is a clinical diagnosis – based on your medical history, symptoms and exposure to ticks. A negative blood test result does not mean you don’t have Lyme Disease. However, if the “bulls-eye” rash is present, it is a definitive diagnosis of Lyme Disease and treatment should begin immediately. Antibiotics are used to treat Lyme Disease and treatment options are continually evolving. Lyme literate doctors (LLMDS) will prescribe 6 to 12 weeks of a common antibiotic, like doxycycline or amoxicillin for a case of Lyme Disease that is caught early. This is effective for most people. Treatment may be extended if your symptoms remain. If not treated promptly, Lyme Disease may become persistent and longer courses of antibiotics may be necessary. It is imperative that patients educate themselves and become an advocate for their health rights.

Symptoms

January 12, 2017 · by Wayne County Lyme Disease Task Force

Lyme Disease can begin with mild flu-like symptoms, such as fever, headache, general achiness, swollen glands, extreme fatigue and a possible rash. Some people may only present with a headache, sleep disruption, memory and/or concentration problems. Initial symptoms may occur within a day or up to eight weeks after a bite from an infected tick.

The typical rash associated with Lyme Disease is the “bull’s-eye” rash. However, the rash is seen in fewer than 50% of diagnosed cases. It may also present in other forms, such as a round or oval reddish rash. If the “bull’s-eye” rash is present, it is a definitive diagnosis of Lyme Disease and treatment should begin immediately.

If the initial infection goes undiagnosed and untreated, the infection can progress, traveling throughout the body and affecting any organ. Most patients experience extreme, debilitating fatigue. In the heart, the bacteria may cause palpitations. In the digestive tract, it may cause nausea, acid reflux, irritable bowel or diarrhea. Hypothyroidism and menstrual irregularities occur when the bacteria enters the endocrine system. Learning disabilities, memory impairment, headaches, sleep disturbances and concentration problems may occur when it enters the brain. A patient may also experience joint pain and swelling, muscle soreness, twitching and cramps.

HEAD, FACE AND NECK SYMPTOMS
Headache
Facial paralysis
Tingling of nose, cheek or face
Stiff neck
Sore throat, swollen glands
Heightened allergic sensitivities
Twitching of facial and/or other muscles
Jaw pain and/or stiffness
Change in smell, taste
DIGESTIVE SYMPTOMS
Nausea and/or vomiting
Irritable bladder
Unexplained weight loss or gain
Loss of appetite, anorexia
RESPIRATORY AND CIRCULATORY SYMPTOMS
Difficulty breathing
Night sweats and/or chills
Heart palpitations
Diminished exercise tolerance
Heart block or murmur
Chest pain or rib soreness
PSYCHIATRIC SYMPTOMS
Mood swings, irritability, agitation
Depression and/or anxiety
Personality changes
Malaise
Aggressive behavior
Suicidal thoughts
Crying easily
Disturbed sleep (too much, too little)
Difficulty falling or staying asleep)
Paranoia and/or hallucinations
Obsessive compulsive behavior
Manic behavior
COGNITIVE SYMPTOMS
Dementia
Forgetfulness
Short and/or long term memory loss
Attention deficit problems
Confusion and/or difficulty thinking
Difficulty concentrating
Difficulty with reading and/or spelling
Disorientation
REPRODUCTION AND SEXUALITY SYMPTOMS
Female
Unexplained menstrual pain
Menstrual irregularity
Reproduction problems
Extreme PMS symptoms
Cessation of menstrual cycle
Male
Testicular and/or pelvic pain
Erectile dysfunction

EYES, VISION
Double or blurry vision
Conjunctivitis (pink eye)
Over-sensitivity to light
Eye pain or swelling around eyes
Floaters and/or spots
Red eyes
EARS, HEARING
Decreased hearing
Ringing and/or buzzing in ears
Sound sensitivity
Pain in ears
MUSCULOSKELETAL SYMPTOMS
Joint pain, swelling and stiffness
Shifting joint pain
Muscle pain or cramps
Poor muscle coordination
Muscle weakness
NEUROLOGIC SYMPTOMS
Numbness, tingling or pinpricks in body
Burning and/or stabbing sensations
Burning in feet
Weakness and/or paralysis of limbs
Tremors and/or shaking
Seizures
Poor balance and/or dizziness
Difficulty walking
Motion sickness and/or wooziness
Lightheadedness and/or fainting
Encephalopathy
Encephalitis
Meningitis
Encephalomyelitis
Academic or vocational decline
Auditory processing problems
Word finding problems
SKIN SYMPTOMS
Erythema Migrans (rash)
“Bulls-eye” rash
GENERAL WELL BEING SYMPTOMS
Decreased interest
Extreme fatigue
Unexplained fevers
Flu-like symptoms
OTHER SYMPTOMS
Dysfunction of thyroid
Liver inflammation
Bladder and kidney problems

The Stages of Lyme Disease

January 11, 2017 · by Wayne County Lyme Disease Task Force

Lyme Disease symptoms may appear quickly, or gradually over time. The symptoms are incredibly varied and often mimic the symptoms of other diseases. If diagnosed early, Lyme Disease can usually be easily treated with antibiotics. However, if the diagnosis is delayed, treatment and recovery become more difficult. Lyme Disease can go through several stages, depending on the length of infection and where the infection has spread in the body.

Stage 1 – Early Localized Lyme Disease
Early Localized Lyme Disease usually develops 1 to 4 weeks after infection. Symptoms may include:

Circular, red “bull’s-eye” rash that may expand over time
Flu-like symptoms:
- Fatigue
- Fever
- Chills
- Joint and muscle pain
- Stiff neck and headache
- Swollen lymph nodes
- General feeling of illness

In some cases, symptoms may not always be present, and a Lyme Disease infection may not even be suspected.

Stage 2 – Early Disseminated Lyme Disease

Early Disseminated Lyme Disease may occur weeks to months after initial infection. The symptoms may range from mild to severe and may include:

Flu-like symptoms similar or worse than Stage 1 symptoms
Expanding, circular “bull’s-eye” rash
Rashes on other parts of the body
Fatigue
Sore throat
Swollen lymph nodes
Fever
Chills
Joint and muscle pain
Headache and stiff neck
Pain, weakness or numbness in the arms and/or legs
Paralysis or weakness of facial muscles
Poor memory
Pink-eye
Episodes of pain, redness and swelling in joints, especially knees
Palpitations

Stage 3 – Late Disseminated Lyme Disease

This serious stage of Lyme Disease occurs when the disease has not been treated during the earlier stages. Damage to the joints, brain and nerves may develop months or years after infection. Symptoms may include:

Severe headaches
Arthritis of the large joints (knees, hips, etc), which may cause swelling, redness and fluid build-up
Numbness and tingling of the hands, feet and back
Extreme fatigue
Temporary paralysis of the facial muscles
Heart arrhythmia
Memory loss
Mood disorders
Sleep disturbances
Difficulty concentrating
Mental fogginess
Night sweats

Post-Treatment Lyme Disease Syndrome (PTLDS)

Also called “Chronic Lyme Disease, ” PTLDS has a wide range of symptoms and may go on for months and even years. Unfortunately, many people with Lyme Disease are misdiagnosed for years, allowing the infection to spread throughout the body. Research suggests that several factors, including a low-grade persistent infection or a Lyme-triggered autoimmune response, may account for the persistent symptoms¹. About 1 in 10 people who get Lyme Disease will have lingering symptoms², which may include:

Extreme fatigue which can linger for years
Widespread muscle and joint aches
Arthritis
Stiff neck
Extreme headaches
Memory loss
Shooting pain, tingling and loss of feeling in arms, face, hands and legs
Bell’s Palsy
Hearing and/or vision loss
Irregular heartbeat
Depression, stress and anxiety disorders
Ringing in ears
Dizziness and/or poor balance
Speech difficulty
Sleep disturbances
Sexual dysfunction
Confusion
Organ damage

¹Chronic Lyme Disease. (n.d.). Retrieved from http://canlyme.com/just-diagnosed/treatment/chronic-lyme-disease/
²Chronic Lyme Disease (PTLDS) — Complications. (n.d.). Retrieved from http://www.webmd.com/arthritis/chronic-lyme-disease-complications

Other Tick-Borne Diseases

January 10, 2017 · by Wayne County Lyme Disease Task Force

Lyme Disease is the most common vector-borne illness in the United States. However, ticks also carry many other bacterial, protozoal, viral and parasitic infections that can be transmitted through the same tick bite. These co-infections “can complicate the treatment and management of the primary infection and lead to a longer-lasting, more devastating illness,” according to Dr. Daniel Cameron, President of ILADS. Co-infections may be difficult to diagnose because many of the co-infection symptoms are often attributed to Lyme Disease. Dr. Joseph Burrascano Jr., board member of the International Lyme and Associated Diseases Society (ILADS) stresses that the “diagnoses of tick-born co-infections remains a clinical one,” based on signs and symptoms and a history of exposure to blacklegged ticks.

Babesiosis: caused by a parasite that infects the red blood cells. The organism can be transmitted through a tick bite or contaminated blood transfusion. Symptoms are often flu-like and include high fever, irregular fevers, chills, sweats, lethargy, headaches, nausea, body aches and fatigue. The disease may also cause a specific type of anemia, called hemolytic anemia, since the parasites infect and destroy red blood cells.

Bartonella: caused by a bacteria carried by fleas, body lice and ticks. Early symptoms usually include fever, fatigue, headaches, swollen glands, enlarged lymph nodes and sore throat. Some patients may present with a streak-mark rash, which has the appearance of stretch marks. Other key symptoms may include insomnia, seizures, encephalitis, gastritis, lower abdominal pain, and sore soles of the feet.

Ehrlichiosis: caused by a parasite that infects and kills white blood cells. Many patients experience flu-like symptoms such as fatigue, fevers, headaches and muscle aches. More severe symptoms may include vomiting, confusion, anemia, decreased white blood cells, seizures, encephalopathy, meningitis, elevated liver enzymes and even death.

Anaplasmosis: caused by a bacterial infection and shares the same symptoms as Ehrlichiosis.

STARI (southern tick-associated rash illness): a Lyme-like disease believed to be transmitted by the Lone Star tick. However, the causative agent has not been clearly identified and there is no commercial test available. Symptoms may include a rash (similar to those seen in Lyme Disease), fevers, headaches, stiff neck, joint pain and fatigue.

Powassan Virus: caused by a flavi virus. Common symptoms include fever, headache, nausea, vomiting, stiff neck, sleepiness and weakness. More severe symptoms may include confusion, seizures, memory loss, encephalitis and long-term neurologic problems.

Tularemia: caused by a bacterial infection. Symptoms may include headaches , chills, skin ulcers, swollen lymph nodes, inflamed eyes, sore throat, mouth sores, pneumonia, diarrhea and vomiting.

Other tick-borne co-infections include Colorado Tick Fever, Tick-borne Relapsing Fever, Q Fever, Rocky Mountain Spotted Fever and Tick Paralysis. This list is not all-inclusive as new tick-borne diseases continue to be discovered.

Kids and Lyme Disease

January 9, 2017 · by Wayne County Lyme Disease Task Force

“The number of reported Lyme Disease cases, occurring annually, has more than tripled over the past 10 years, with children most at risk for the disease,” according to the Centers for Disease Control and Prevention (CDC). Children are especially susceptible to becoming infected with Lyme Disease and its co-infections because of the amount of time spent outdoors. “The highest infection rate occurs in children, ages 5 to 9. Overall, the disease is most common among boys, ages 5 to 19,” according to the CDC.

“While treating the medical aspect of the disease is paramount, for children and adolescents with chronic Lyme Disease, medical treatment alone is often not enough. Many of these children have Lyme related psychiatric symptoms or educational impairments. Their serious symptoms, combined with the duration of the illness often leads to gaps in their development. Their isolation can leave them lonely, and inhibit their ability to interact with peers, ” states Sandy Berenbaum, LCSW, BCD in a letter published in Lyme Times Children’s Treatment Issue¹.

Because the symptoms of Lyme Disease can be non-specific, adults may not realize a child is ill. The most common symptoms in children and adolescents include headaches, fatigue unrelieved by rest, gastrointestinal problems, sleep disturbances, joint and muscle pain, poor concentration, inability to focus, mood swings, sudden behavioral changes, tics, light and/or sound sensitivity and new onset of anxiety disorders². Other symptoms may include poor short-term memory, difficulty reading and/or writing, confusion, fevers, chills and dizziness.

The more severe symptoms of Lyme Disease meet the same criteria for one or more other illnesses, allowing the disease to progress untreated. Many children and adolescents have been misdiagnosed with anxiety disorder, depression, anorexia nervosa, AD/HD, Obsessive Compulsive Disorder, Tourettes and psychosis.

Lyme pediatric specialist Charles Ray Jones, MD documented gestational Lyme Disease in some children he thinks were infected in utero who presented with symptoms including frequent fevers, increased incidence of ear and throat infections, increased incidence of pneumonia, irritability, joint and body pain, poor muscle tone, gastroesophageal reflux, small windpipe (tracheomalacia), cataracts and other eye problems, developmental delay, learning disabilities and psychiatric manifestations³.

Lyme Disease may negatively impact a child’s ability to perform academically because the disease can contribute to learning disabilities and behavioral problems. However, children may qualify for special education accomodations or services. Sandy Berenbaum, LCSW, BCD also recommends unlimited time for testing, separate testing locations, reading tests to students and being excused from a percentage of homework to help children with Lyme Disease caused learning disabilities⁴.

¹“Adolescents and Lyme Disease.” Daniel Cameron MD. Web. 19 Feb. 2016
²Berenbaum, S., LCSW, BCD. (n.d.). Tick-Borne Disease In Children And Adolescents A Medical Illness/ A Multidisciplinary “Cure”
³“Children with Lyme Disease.” LymeDisease.org. Web. 19 Feb. 2016. https://www.lymedisease.org/lyme-basics/lyme-disease/children
⁴Berenbaum, S., LCSW, BCD. (n.d.). Kids and Lyme Disease How It Affects Their Learning