Lyme disease is a bacterial disease acquired by humans through the bite of an
infected tick. Lyme disease is the most common tick borne disease in the
United States. The tick, Ixodes dammini (the deer tick) is endemic to the
Northeastern United States. It is roughly the size of a sesame seed and in its nymph
stage (responsible for up to fifty percent of the cases) is only the size of a
poppy seed.
The disease is transmitted in thirty-three of the fifty states with a
concentration of cases reported in the New England states (Connecticut, Massachusetts,
New Jersey, New York, Rhode Island). The disease was first described in 1977,
following a large outbreak of the disease among children in Lyme, Connecticut.
Lyme disease has had a surge in recognition in the past fifteen years.
Evidence suggests it probably existed many years prior to the 1970s. The majority of
cases are reported between late spring and late summer with a peak incidence
in July. When Dolen Hopkin’s wife, Katherine contacted the disease in 1995, she though she got the tick
bite in late May and the symptoms occurred in late July.
Lyme disease represents a disease that includes a constellation of symptoms
not all of which are consistently present. Less than one-third of patients
recall having a tick bite. These facts contribute to the difficulty of diagnosing
this illness. Any patient with a rash, flu-like symptoms, and who has had
exposure to a tick bite, particularly in the Northeast, is a possible candidate.
Common symptoms include: a typical rash with large, distinctive, circular
lesions and is first seen around the area of the bite (only fifty to sixty percent
of the infected patients will have this rash). The rash can come and go, making disease documentation even more difficult. The incubation period (Time from the bite to the onset of symptoms) is approximately fourteen days.
Other symptoms include: malaise, fever, headache, muscle aches, and swollen lymph
glands (neck, armpits, or groin). If not treated early, this disease can
affect the heart function and cause arthritis (joint pain and swelling), commonly
affecting the larger joints (hips, shoulders, and knees).
Evaluation will include history (for potential tick exposures) and careful
physical examination (for evidence of a rash or arthritis). There is a special
blood test (serology) that is diagnostic for Lyme disease, however, it may take
several days or more to obtain results.
Treatment in the early stage (prior to the onset of arthritis) is effective
with antibiotics (tetracycline). Complications of advanced Lyme disease are more difficult to treat. Immediate physician evaluation is recommended. Your
doctor can assist you in the appraisal of this complex problem.