Lyme Disease Diagnosis and Precautions

August 17, 2016

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According to the US Centers for Disease Control (CDC), Lyme disease is the fastest growing vector-borne infectious disease in the US. The number of cases has increased 25-fold since national surveillance began in 1982, now infecting some 300,000 people a year.

The disease is transmitted by the blacklegged tick and the Western blacklegged tick whose range is spreading north. The most recent surveys by CDC biologists show that they are found in more than 45% of US counties, compared to only 30% in 1998.

Once only in Ontario, Canada, Lyme-carrying ticks are now found in almost all the Canadian provinces. The Public Health Agency reported 500 cases of Lyme disease in 2014 and 700 in 2015.

Misdiagnosis

Chronic Lyme disease patients may face a long hard fight to recovery, but first it’s a battle to get the correct diagnosis. Songwriter and actor Kris Kristofferson of Local 257 (Nashville, TN) faced a diagnosis of Alzheimer’s, before he was tested and diagnosed with Lyme disease, according to recent interviews with his wife, Lisa. After many years of suffering with painful fibromyalgia, memory loss, and depression, he began aggressive treatment for Lyme disease and his health improved. Luckily, Lisa was an intuitive advocate who recognized that, cognitively, something did not add up.

The unfortunate reality is that Lyme disease often goes undiagnosed because doctors are not looking for it. Patients and physicians rely on telltale signs: a tick on the skin, the bull’s eye rash (Erythema Migrans (EM) rash), and joint pain. But research shows only 50%-60% of patients recall a tick bite, and the rash is reported in only 35%-60% of patients. Joint swelling typically occurs in only 20%-30%
of patients, and is easily masked by the prevalent use of over-the-counter anti-inflammatory medications.

Adding to the problem, people who have Lyme disease can test negative until their body builds up antibodies. Other patients can test false positive due to autoimmune disorders. The CDC recommends a two-tier testing process.

When Lyme disease is misdiagnosed during the early stages, it progresses to a chronic form that’s even more difficult to diagnose and treat. Symptoms can be debilitating, including severe fatigue, anxiety, headaches, and joint pain that mimic other conditions. Meanwhile, the disease causes complications involving the heart, nervous system, muscles, and joints. Patients may suffer through a complicated maze of specialists in search of appropriate treatment.

Treatment

If you live in an endemic area for Lyme disease and suspect you may have been infected, prophylactic treatment for at least three weeks is advised. Early treatment will prevent the body from mounting an antibody response, and subsequent testing for Lyme will be negative.

Antibiotic choice presents another host of problems. Doxycycline also treats other tick-borne pathogens, including Q Fever, and Rocky Mountain Spotted Fever. However, the parasites may carry bacteria not responsive to doxycycline. One side-effects are sun sensitivity and stomach problems. The typical 100mg twice daily dose may not reach therapeutic levels. Amoxicillin and Cefuroxime are better tolerated, but do not cover as wide a spectrum of infections.

Prevention and Precautions

Avoid tick-infested areas, especially in spring and early summer when nymph ticks feed. Adult ticks are more of a threat in fall. Ticks favor moist, shaded environments, especially leafy wooded areas and overgrown grassy habitats.

• Wear light-colored clothing to spot ticks more easily.

• Walk in the middle of designated trails.

• Wear closed-toed shoes.

• Avoid low-lying brush or long grass.

• Tuck pant legs into your socks to prevent ticks from crawling up your legs.

• Use insect repellents containing  DEET or Icaridin on skin and clothing.

• Check clothing for ticks often, then shower or bathe within two hours of being outdoors to wash away loose ticks.

While tick transmission is most common, new studies indicate that there may be other ways to contract Lyme, including blood transfusions or mosquito bites.

For a symptoms checklist go to:
www.lymedisease.org.

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