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| characteristic skin rash called erythema migrans |
The pathognomonic erythematous rash in the pattern of a “bull’s-eye”, which manifested at the site of a tick bite on this Maryland woman’s posterior right upper arm, who’d subsequently contracted Lyme disease.
Lyme disease patients who are diagnosed early, and receive proper antibiotic treatment, usually recover rapidly and completely. A key component of early diagnosis is recognition of the characteristic Lyme disease rash called erythema migrans. This rash often manifests itself in a “bull's-eye” appearance, and is observed in about 80% of Lyme disease patients.
Lyme disease is caused by the bacterium Borrelia burgdorferi, and is transmitted to humans by the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and as illustrated here, the characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system.
Lyme disease is an infection that is transmitted through the bite of a tick infected with a bacterium called Borrelia burgdorferi. Ticks typically get the bacterium by biting infected animals, like deer and mice. Most people who get tick bites do not get Lyme disease. Not all ticks are infected, and the risk for contracting the disease increases the longer the tick is attached to the body.
Symptoms: Early Stage
Within 1-4 weeks of being bitten by an infected tick, most people will experience some symptoms of Lyme disease. A circular, expanding rash (called erythema migrans) at the site of the bite develops in about 70%-80% of cases. Some people report flu-like symptoms at this stage, including fever, chills, headaches, fatigue, swollen lymph nodes, joint pain, and muscle aches.
Symptoms: As the Infection Spreads
If the disease is not detected and treated in its early stages, it can extend to more areas of the body, affecting the joints, heart, and nervous system (about 1-4 months after the initial bite). Additional rashes may occur, and there may be intermittent periods of pain and weakness in the arms or legs. Facial-muscle paralysis (Bell's palsy), headaches, and poor memory are other symptoms at this stage, along with a rapid heartbeat and some loss of control of
Symptoms: Late-Stage Disease
This is the most serious stage of the disease, when treatment was either not successful or never started (usually occurring many months after the initial bite). Joint inflammation (arthritis), typically in the knees, becomes apparent, and may become chronic. The nervous system can develop abnormal sensation because of disease of peripheral nerves (peripheral neuropathy), and confusion. Heart problems are less common, but can include inflammation of the heart muscle.
Do All Ticks Transmit Lyme Disease?
No. In the northeastern and north-central U.S., the black-legged tick (or deer tick) transmits Lyme disease. In the Pacific coastal U.S., the disease is spread by the western black-legged tick. Other major tick species found in the U.S., including the lone star tick and the dog tick, have NOT been shown to transmit the Lyme disease bacterium. But beware: Lyme disease has been reported in all 50 states, as well as in Canada, Europe, Asia, Australia, and South America.
Diagnosing Lyme Disease
Doctors can diagnose the disease through physical findings such as a "bull's-eye" rash along with a history of symptoms. But not everyone has the rash, and not everyone can recall being bitten. Blood tests (ELISA and Western blot) can be taken 3-4 weeks after suspected contact. Other tests, such as a spinal tap or skin biopsy, may be used to confirm a diagnosis or rule out other conditions.
Treating Lyme Disease
Most Lyme disease is curable with antibiotics, particularly when the infection is diagnosed and treated early. Doxycycline, amoxicillin, and cefuroxime are the drugs of choice most of the time for early illness. Later stages might require longer-term, intravenous antibiotics, such as ceftriaxone.
Is There a Lyme Disease Vaccine?
Currently, there is no human vaccine for Lyme disease. The one that did exist -- LYMErix -- is no longer available. Originally approved by the FDA in 1998 to help prevent the disease, the vaccine was pulled from the market by the manufacturer in 2002 due to poor sales. There was concern that the vaccine could trigger arthritis problems, although the FDA never found evidence that the vaccine was dangerous.
How to Remove a Tick
If you have a tick, it is important to remove it properly. Using fine-tipped tweezers, grasp the part of the tick that's closest to your skin -- you want to grab the head, not the belly. Slowly pull the tick straight out, without twisting it. Wash the bite site with soap and warm water. Throw the dead tick into the trash. Do not use a lit match, nail polish, petroleum jelly, or other topical agents in an attempt to remove a tick.
