It’s Time to Recognize Lyme (Part I)

By Riva Preil

Lyme disease is a bacterial infection (belonging to the Borrelia genus) which is transmitted via infected ticks.  The disease is named after the towns Lyme and New Lyme, Connecticut, where many cases were reported in 1975.  It is considered a vector transmitted disease, a disease that is transferred from one agent (such as an insect or animal) to another organism.  Once the infected tick bites an individual, the borrelia infection can enter the human bloodstream and can spread to many different body systems if untreated.  Generally speaking, there is a one to two week incubation period, which means that the symptoms may not appear until several days post infection.

The three stages of Lyme disease are: early localized infection, early disseminated infection, and late disseminated infection.  During the early localized stage, the bacteria remain at the site of the bite and have not yet spread to the bloodstream.  The classic sign of this stage is a red bull’s eye rash pattern which may be warm but is usually not painful.  This rash is called erythema migrans (EM) or erythema chromium migrans.  It is present in approximately 80% of cases and it usually remains for three to thirty days.  Other signs of the early localized phase mimic those of the flu, including headache, fever, and muscle soreness.

If left untreated, the disease progresses to the early disseminated phase.  At this point, the Borrelia bacteria enter the bloodstream and spread throughout the body.  This may occur within days to weeks after being bitten, and transition from localized to disseminate stage differs from person to person.  The EM rash may develop in body parts other than the original bite site, and the individual often develops joint, muscle and tendon pain.  Furthermore, they may experience heart palpitations and dizziness due to heart rate changes.  In addition, 10-15% of people develop neurological signs (called neuroborreliosis) including facial muscle weakness, similar to Bell’s Palsy.  Some may even develop meningitis, which manifests as severe headaches, neck pain and stiffness, and light sensitivity.  The person may also experience radiculoneuritits, which includes shooting pain and altered sensation due to nerve impairment. (to be continued…)

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