Lyme disease is an illness, which if not diagnosed and treated promptly, can cause serious problems involving the heart, joints, eyes, and nervous system.

Lyme disease was first recognized in the United States in 1975 in children from Old Lyme, Connecticut. A similar disease was reported in a grouse hunter from Taylor County, Wisconsin in 1969. It wasn't until 1983, however, that 2 cases of Lyme disease were reported in Indiana. In fact, the bacterium that causes Lyme disease (a spirochete called Borrelia burgdorferi) was not even identified until 1982.

Since 1982, Lyme disease has been reported, with increasing frequency on the East Coast (from Massachusetts to Delaware, in the Midwest (Wisconsin and Minnesota), and in western states (California, Nevada, Utah and Oregon). Over 1300 cases of Lyme disease were reported from 1980 through 1988 in Wisconsin. Since 1983 46 cases have been reported in Indiana.

Signs and Symptoms of Lyme Disease

Lyme disease typically progresses through three stages, depending upon how soon the disease is diagnosed and treated. Prompt medical attention will minimize complications solving the heart, nervous system and joints.

Stage 1

In the earliest stage, people with Lyme disease may have any combination of the following symptoms:

• headache
• a spreading rash
• chills
• aching joints
• fever
• nausea
• fatigue

Without treatment, these signs and symptoms may disappear altogether, or they may recur intermittently for several months.

The characteristic red rash, called erythema migrans (EM), usually appears within 3 to 32 days (average 10 days) after a person is bitten by an infected tick. The rash is circular in shape and can attain a diameter of 2 to 20 inches, with the center of the rash becoming clear. ECM is not restricted to the bite site and more than one lesion can occur elsewhere on the body. Up to 30% of the people who have Lyme disease do not develop ECM lesions, making the diagnosis more difficult.

If Lyme disease is diagnosed during stage 1 (based on characteristic symptoms and sometimes on a blood test), it is easily treated with antibiotics such as tetracycline, penicillin or erthromycin. Other antibiotics such as ceftriaxone also show promise to treating Lyme disease.

Stage 2

Weeks to months after initial exposure to the bacteria or after the first symptoms appear, some people may develop complications involving the heart and/or nervous system. Specific disorders may include varying degrees of heart block, nervous system abnormalities such as meningitis, encephalitis, facial paralysis (Bell's palsy), and other conditions involving peripheral nerves. Painful joints, tendons, or muscles may also be noted during this stage of the disease.

Stage 3

Arthritis is the most commonly recognized long-term sign of lyme disease. From several months to years after their first symptoms appear, people may experience repeated attacks of arthritis. Research has shown that even if Lyme disease was not diagnosed and treated promptly, people who eventually received appropriate antibiotic therapy had fewer relapses than those who were never treated.

Treatment

If you developed any of the symptoms listed under stage 1 and recall being bitten by a tick, or have been in an area where ticks are abundant, discuss your suspicions of Lyme disease with your physician. Your physician will make a diagnosis based on your symptoms and on information you provide about recent travel, or history of tick or insect bites. Prompt treatment with antibiotics can cure the infection and prevent later complications. Treatment during the latter stages of the disease often requires more intensive antibiotic therapy.

Lyme Disease in Domestic Animals

Domestic animals can also develop Lyme disease. Lyme disease has been diagnosed in over 40 breeds of dogs, but is most often reported in hunting or working dogs that spend a great deal of time outdoors. Most Lyme disease infections in dogs have occurred during the months of May and November, although veterinarians have reported the disease during all months of the year. Signs in dogs may include various combinations of the following:

• fever of 103- 106 F
• severe pain
  sudden onset of lameness
• poor appetite
• intermittent lameness for weeks or months
• signs of illness observed within a few days or up to several months after initial exposure
  

Prompt diagnosis and antibiotic treatment with tetracycline or penicillin can rapidly alleviate the signs and pain of Lyme disease in dogs.

Cattle and horses can also contract Lyme disease. They may exhibit a variety of signs, including fever and lameness.

The Tick

Deer ticks (I. dammini) are by far the most common carrier of Lyme disease in Wisconsin, Minnesota, and the eastern coastal states. Recently, other species of ticks such as the lone star tick (Amblyomma americanum), the dog tick (Dermacentor variabilis), and insects such as horseflies, deer flies, and mosquitoes have been shown to carry the Lyme disease bacteria. It is unproven that these other insects can successfully transmit the disease. Currently they are not felt to be important as vectors of the disease.

The deer tick lives a rather complex life cycle. Like many other insect-like creatures, its life cycle involves developing from an egg to a larva, larva to a nymph, and finally from nymph to an adult. The deer ticks are among the first ticks to become active in the spring, and they remain active in various life stages until the first snows in the fall.

Prevention

By routinely checking for ticks after being outdoors, you can remove the ticks before they embed and have the chance to transmit Lyme disease. The highest risk time for acquiring Lyme disease is when the nymphs are active, usually April through July.

1. Conduct thorough tick checks on yourself, your children and your pets after spending time outdoors. Ticks do not fly or jump on their hosts. They wait atop grasses and other vegetation until an animal brushed by against them. Then they cling to skin, fur or clothing and will crawl for a time on the host before they embed and feed. Ticks must be embedded and engorged (not flat) before they transmit the Lyme disease bacteria. Therefore, it is important to look for and remove any ticks as soon as possible in order to prevent infection.

2. Wear light colored clothing. This may not deter ticks, but it makes them easier to find.

3. Tuck pants into boots or socks; wear long sleeved shirts, buttoned at the cuff.

4. Apply tick/insect repellent to pants, socks, and shoes. Products containing 30% DEFT, or 0.5% permethrin are almost 100% effective in repelling deer ticks. If you use these types of products, be sure to follow the directions of the manufacturer on the label.

5. Walk in the center of mowed trails to avoid brushing against vegetation.

6. Fogging or spraying an area with insecticides is not an effective means of tick control.

Removing Ticks
1. The mouthparts of a tick are shaped like tiny barbs. The best way to remove a tick is to grasp it with tweezers as close to the skin as possible, and gently but firmly pull it straight out. If tweezers aren't available, grasp the tick with a piece of tissue. Do not twist or jerk the tick because the head may remain embedded, which can lead to general infection at the bite site. If the head or mouth parts do break off, consult your doctor about removing  them.

2. Wash the bite area and your hands with soap and water and apply an antiseptic to the bite site.

3. Adult ticks can remain on deer and other mammals through the fall and winter. If you spend a lot of time outdoors during his period, be sure to check yourself, your family and your pets daily for ticks. If you hunt or trap, check areas where you cache your game for ticks than may have fallen off during handling.

In General

If you develop the signs and symptoms of Lyme disease contact your physician. Treatment in the early stages of the disease can usually prevent complications.