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Guide to Lyme Disease

Part 1 of 4 - What Is Lyme Disease? What Are the Symptoms of Lyme Disease?

By Carol & Richard Eustice, About.com

Updated: August 1, 2008

About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

How Did Lyme Disease Become Known?

Lyme disease was first recognized in 1975 after researchers investigated why unusually large numbers of children were being diagnosed with juvenile rheumatoid arthritis in Lyme, Connecticut, and two neighboring towns.

  • The researchers discovered that most of the affected children lived and played near wooded areas where ticks live.
  • They also found that the children’s first symptoms typically started in the summer months, the height of the tick season.
  • Several of the patients interviewed reported having a skin rash just before developing their arthritis.
  • Many also recalled being bitten by a tick at the rash site.
  • Further investigations discovered that tiny deer ticks infected with a spiral-shaped bacterium or spirochete (which was later named Borrelia burgdorferi) were responsible for the outbreak of arthritis in Lyme.

    In Europe, a skin rash similar to that of Lyme disease had been described in medical literature dating back to the turn of the 20th century.

    Lyme disease may have spread from Europe to the U.S. in the early 1900s, but health experts only recently recognized it as a distinct illness.

    Ticks Transmit Lyme

    Ticks that most often transmit Lyme disease in the U.S. (these ticks look very similar)

  • Ixodes scapularis (most common in the Northeast/Midwest but also found in the South/Southeast)
  • Ixodes pacificus (found on the west coast)
  • Ticks & Hosts Which Cause Lyme Disease
  • Role of Deer & Rodents

    Small rodents and deer play an important role in a deer tick’s life cycle.

  • deer ticks lay eggs that turn into larvae that feed on mice and other small mammals
  • larvae then develop into immature ticks called nymphs
  • nymphs then feed on small mammals and humans
  • adult deer ticks usually feed on deer during the adult part of their life cycles
  • Both nymphs and adult ticks can transmit Lyme disease causing bacteria.

    On-The-Rise

    The recent increase of the deer population in the Northeast and of housing developments in areas where deer ticks are commonly found probably contributed to its increased spread.

    The number of reported cases of Lyme disease as well as the number of geographic areas in which it is found have increased. Lyme disease has been reported in nearly all states in the United States, although more than 95% of all reported cases are concentrated in:

  • Northeast / Mid-Atlantic states
  • Wisconsin
  • Minnesota
  • No. Calif
  • Lyme disease is also found in large areas of Asia and Europe.

    Symptoms of Lyme Disease

  • Lyme Disease Screening Quiz
  • Lyme Disease: Test Your Knowledge
  • Erythema Migrans

    Usually, the first symptom of Lyme disease is a red rash known as erythema migrans (EM).

  • The telltale rash starts as a small red spot at the site of the tick bite.
  • The spot expands over a period of days or weeks, forming a circular or oval-shaped rash.
  • Sometimes the rash resembles a bull’s eye, appearing as a red ring surrounding a clear area with a red center.
  • The rash, which can range in size from that of a dime to the width of your back, appears within a few weeks of a tick bite and usually at the site of the bite.
  • As infection spreads, rashes can appear at different sites on the body. Erythema migrans is often accompanied by flu-like symptoms such as:

  • fever
  • headache
  • stiff neck
  • body aches
  • fatigue
  • Although these symptoms may resemble those of common viral infections, Lyme disease symptoms tend to persist or may come and go.

    Arthritis

    After several months of B. burgdorferi infection, slightly more than half of people not treated with antibiotics develop recurrent attacks of painful and swollen joints that last a few days to a few months.

  • The arthritis can shift from one joint to another.
  • The knee is most commonly affected.
  • About 10 to 20% of untreated people will go on to develop chronic arthritis.

    Neurologic Symptoms

    Lyme disease also can affect your nervous system, causing symptoms such as:

  • stiff neck and severe headache (meningitis)
  • temporary paralysis of facial muscles (Bell’s palsy)
  • numbness, pain, or weakness in the limbs
  • poor muscle movement
  • More subtle changes also have been associated with Lyme disease such as:

  • memory loss
  • difficulty concentrating
  • change in mood or sleep habits
  • Nervous system problems usually develop weeks, months, or even years following an untreated infection. These symptoms often last for weeks or months and may return.

    Heart Problems

    Fewer than 10% of people with Lyme disease develop heart problems, such as irregular heartbeat, which can start with dizziness or shortness of breath. These symptoms rarely last more than a few days or weeks. Such heart problems generally show up several weeks after infection.

    Other Symptoms

    Less commonly, untreated people may develop other problems weeks, months, or even years after infection. Lyme disease can also result in:

  • eye inflammation
  • hepatitis (liver disease)
  • severe fatigue
  • Although none of these problems is likely to appear without other Lyme disease symptoms being present.

    Go On To Part 2 --- How Lyme Disease Is Diagnosed? --->

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    6. Guide to Lyme Disease - Symptoms of Lyme Disease

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