What You Should Know About Lyme Disease

Photo Credit: Sydney Hass.
The birds are chirping again and it’s no longer pitch-dark at 4 p.m. At long last, summer is approaching (albeit slowly). And while summer is arguably the best time of the year, it’s certainly not without its drawbacks. You already know that warmer weather makes you a little more conscious of the amount of deodorant and sunscreen you need every morning, but what you might not know is that it’s also the season in which Lyme disease becomes more of a threat.

Lyme, an infectious disease spread by ticks, affects at least 30,000 people per year in the U.S., though some studies suggest that number may be as high as 300,000, according to the U.S. Centers for Disease Control and Prevention (CDC). Cases peak during the spring and summer months, with a majority of cases occurring during June and July.

While Lyme disease is treatable, it can be serious if you don’t know the warning signs and seek prompt medical attention. It can lead to flu-like symptoms that escalate to much more serious things, like joint pain and severe headaches in some cases. The good news: It’s also preventable.

Ahead, we answer the need-to-know questions about staying safe from this warm-weather threat.
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What Is Lyme Disease?

Lyme disease is a tick-borne illness, which means it spreads to humans via a bite from a tick infected with the Borrelia burgdorferi bacteria. The species of tick that can spread Lyme — known as the blacklegged or deer tick — is found in many parts of the country: the Northeast, mid-Atlantic, and north-central states (like Wisconsin and Minnesota). Meanwhile, on the Pacific Coast, the aptly named western blacklegged tick can also spread the disease. This happens predominantly in Northern California, though cases have also been reported in Arizona and Nevada.

However, most of the CDC’s reported cases occur in the Northeast and north-central states. In fact, 96% of cases in 2014 were reported from Connecticut, New Jersey, Delaware, New York, Maine, Pennsylvania, Maryland, Rhode Island, Massachusetts, Vermont, Minnesota, Virginia, New Hampshire, and Wisconsin.
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How Do You Get It?

Lyme disease is transmitted when a tick attaches itself to your body to feed. This often happens in heavily wooded areas, where ticks are more likely to run rampant (so, be extra wary if you’re taking a hike in the woods), but it can also happen just hanging out in your very own backyard if you live happen to live in an an area where there are ticks.

The good news is that in most cases, the tick has to be attached to you for at least 36 hours to transmit the bacteria.
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How To Check Your Body For Ticks

“Tick checks are very important in terms of first-line prevention against Lyme disease,” says Lenore Brancato, MD, a clinical assistant professor at New York University Langone Medical Center. A tick check should be done immediately after being outdoors in tick-infested areas like the woods.

In addition to giving the obvious parts of your body (such as your ankles and legs) a once-over, Dr. Brancato recommends closely looking over the areas of your body where the skin folds (the armpits, groin) as well as the scalp.

If you find a tick, follow the CDC’s advice for getting it out fast:

Use tweezers to grasp the tick’s body as close to your skin as possible, and pull upward. Important: Don’t twist or jerk the tick, or you’ll risk causing its mouth to break off (insert scream-face emoji here), making it harder to get out.

Once you remove it, clean the area with rubbing alcohol and wash your hands with soap and water.

Make sure to get rid of the tick by submerging it in alcohol, before putting it into a sealed container (so you can bring it with you to the doctor, should you develop symptoms).
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How To Prevent Tick Bites

In addition to finding and removing any ticks, you can also take steps to prevent the bites in the first place.

For example, going camping this summer? Be sure to pack plenty of insect repellant, especially bug spray that contains DEET, which works to ward off mosquitoes as well as ticks, Dr. Brancato says. Another good thing is permethrin, which you can spray onto your clothes for extra protection before heading out for a hike.

Dr. Brancato also advises wearing light-colored clothing when venturing out into wooded areas; it’ll give you a better chance of spotting ticks that try to attach to you.
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How Do You Know If You Have It?

First things first: If you find a tick on your body, don’t freak out — again, if you quickly remove it, your risk of actually contracting Lyme disease is much lower. Plus, not every tick carries the bacteria that can make you sick.

According to the TickEncounter Resource Center at the University of Rhode Island, only 20% of blacklegged tick nymphs (young ticks) and roughly half of adult females are infected with the bacteria (adult male blacklegged ticks don't bite, so they don't spread Lyme). This means that as scary as it is, a tick bite doesn't necessarily mean you'll get sick.

Instead, you’ve got to look out for symptoms.

The telltale sign of Lyme is a red rash that develops at the site of infection and forms a bullseye shape. It might feel warm to the touch, but these kinds of rashes are rarely itchy or painful. However, the rash occurs in about 70 to 80% of Lyme cases, so be on the lookout for other signs. Other early symptoms include: fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes.
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What Should You Do If You Think You Have Lyme Disease?

Get to the doctor, ASAP. If caught early, Lyme disease can be nipped in the bud with a two to three week course of antibiotics. When it’s diagnosed and treated in its early stages, most people recover “rapidly and completely,” per the CDC.
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What Will Getting Tested For Lyme Be Like?

If you have symptoms of Lyme, your doctor will want to confirm the diagnosis with a two-step blood test.

The first step is a screening test called an “EIA” (enzyme immunoassay) test. During this process, technicians test your blood sample for an immune response to the bacteria that causes Lyme.

If that blood test comes back positive, the lab will then use the same blood sample for the second step of the process, called the Western blot test. Because the EIA test is sensitive and could pick up a positive result for other diseases, the Western blot is meant to confirm a Lyme diagnosis. It’s good to know that you need both of these tests (having one without the other increases the risk for false positive results, the CDC says), but the second one will mostly be handled by your doctor and your local lab.

What you need to keep in mind: “If you see a rash, take a photo [and] try and get to your doctor straightaway,” Dr. Brancato says. The sooner you know whether it’s Lyme, the sooner you can start treatment.
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What Is Chronic Lyme / Post-Treatment Lyme Disease?

You may have heard of something called chronic Lyme disease, thanks to Real Housewife Yolanda Foster's struggle with the illness. But what is chronic Lyme?

The term "chronic Lyme" is actually controversial (more on that in a second). But it is true that a minority of people (an estimated one or two out of 10 patients) may go on to develop what the CDC defines as Post-Treatment Lyme Disease Syndrome (PTLDS). This is a condition in which symptoms of Lyme — fatigue, pain, or joint and muscle aches — linger for more than six months after a person undergoes antibiotic treatment for the disease.

Although PTLDS is sometimes referred to as "chronic Lyme," experts are divided as to the exact definition of the term. Depending on who you ask, chronic Lyme can include the expected symptoms of PTLDS as well as other non-specific symptoms. The (frustrating) bottom line on chronic Lyme is that there are still many unanswered questions. What little evidence exists on the topic is contradictory and confusing, and many experts remain critical about the concept of a chronic diagnosis.

Dr. Brancato says that because the symptoms of PTLDS can be similar to a variety of infections, lasting symptoms of Lyme are something “that you have to look at with a discerning eye, and make sure that’s indeed what you’re dealing with.”

As far as treatment, research shows that treating PTLDS with long-term antibiotics is ineffective. However, there are treatments available that can help with symptoms like pain and fatigue.
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How Do Ticks Get Lyme?

Well, ticks don’t actually have Lyme disease themselves, Dr. Brancato says. It’s not like they’re experiencing symptoms or anything. Instead, they are just carriers for that B. Bergdorferi bacteria — which, when transmitted to humans, can result in Lyme disease.

Ticks pick up the bacteria when feeding on other animals, namely deer and mice, she says: “The tick itself is just a vector in the carriage of Lyme disease, and it transmits the bacteria in the blood [of humans].”
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Why Is It Called Lyme Disease?

It turns out that Lyme disease is named after the place where it was first reported.

The first report of Lyme was recorded in the town of Old Lyme, CT, in 1977. Today, the disease still occurs predominantly in that northeast region of the United States.
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What's With That Lyme Conspiracy Theory?

Perhaps because Lyme disease can be hard to pin down, there are a lot of myths about it swirling around out there.

One popular myth came about because many conspiracy theorists believe that Lyme disease is the result of a government experiment gone wrong at the U.S. Army-operated Plum Island Animal Disease Center. While Plum Island is located off the coast of Long Island, just across the bay from Lyme, Connecticut (where Lyme disease was first observed) the U.S. Department of Homeland Security maintains that this is impossible.
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What Are Some Other Tick-Borne Diseases?

Lyme disease is the most common tick-borne illness, but there are many others that are far less common, including babesiosis, Rocky Mountain spotted fever, and ehrlichiosis.

Rocky Mountain spotted fever, despite the name, is not limited to the Rocky Mountains. The disease has been reported all throughout the U.S., though five states (North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri) account for over 60% of reported cases. RMSF can be transmitted by American dog ticks, Rocky Mountain dog ticks, and brown dog ticks. About 90% of people who develop RMSF will get a spotted rash within a few days of infection, along with flu-like symptoms. RMSF can be serious if not treated with antibiotics within the first few days.

Babesiosis is most common in northeastern and upper midwestern America. Like Lyme disease, it also peaks during warmer months, but instead of being spread by the deer tick or western black-legged tick, it is caused by parasites that can infect and destroy red blood cells. Most people who get babesiosis don't have symptoms at all and therefore don't even need treatment, but for those who do, the disease is treatable with anti-parasitic drugs.

On the other hand, ehrlichiosis, which can cause fever and other flu-like symptoms as well as nausea, vomiting, and joint pain, is most common in southeastern and south-central regions of the United States. Spread by the Lone Star tick, ehrlichiosis can be serious in people with weakened immune systems, but for some, the symptoms are so mild, they don't require treatment at all.

Like Lyme disease, these and other tick-borne illnesses are preventable. Be sure to use your bug spray and do tick checks after you've been outdoors. If you suspect you might have caught an infection, consult your doctor right away.