Q + A: Lyme disease

Monday, May 1, 2017

Planning an outdoor adventure? WVU Medicine primary care provider Mollie Cecil, MD, tells you about her experience with Lyme disease and how to protect yourself.

What is Lyme disease?
Lyme disease, named after the city of Lyme, Connecticut, where it was first identified, is a tick-borne infection that is spread when a person is bit by a deer tick, which is a much smaller species than the more common wood and dog ticks. Deer ticks are traditionally found in the northeast and upper-Midwest regions of the United States, but Lyme disease is on the rise in West Virginia. A tick must be attached for about 24 hours to transmit Lyme disease, so removing a tick promptly is crucial.

What are the symptoms?
Only 20 percent of people who get Lyme disease even notice the tick bite before they get symptoms. I contracted Lyme disease from a tick bite in August 2016 and know firsthand how bad it can make you feel – fatigue, fever, headache, joint pain, and a skin rash. If not caught early, it can also cause severe arthritis and inflammation of the heart.

One of the most prominent features of Lyme disease is a rash shaped like a red bull’s-eye that appears at the site of the tick bite. It can slowly enlarge or develop into multiple rashes. My bull’s-eye rash was about nine inches in diameter and located on my upper thigh. If you develop any strange rashes or other symptoms after a tick bite or being outdoors in tick-infested areas, make an appointment with a primary care provider.

How can I prevent Lyme disease?
I don’t remember ever taking a tick off of me, so the only way I could have prevented Lyme disease is by never getting a tick bite. Preventing a tick from biting you is the best defense against Lyme disease. Important prevention tips are:

  • Wear long pants, boots, and long sleeves when you are going into areas with high tick concentrations, such as the woods and fields.
  • Use insect repellants with DEET, picardin, or other similar chemicals. Alternative and natural tick repellants are available, but there is mixed evidence showing they work.
  • Treat your pets with flea and tick prevention medications. Dogs, especially, can harbor deer ticks and can get Lyme disease.
  • Check yourself, family, friends, and pets for ticks whenever you come inside. Deer ticks often bite in hard-to-see and covered areas, such as the groin, armpit, scalp, and waist. Because I’m allergic to many chemical insect repellants, one of the most important things I now do after coming inside is to carefully check myself for ticks. You also need to check your clothes and outdoor gear for ticks.
  • Take a shower soon after coming indoors to wash away any ticks.
  • Ticks are most commonly found in the warm months, but can be found at any time of year. Follow prevention measures year round.

How is it treated?
Thankfully, Lyme disease can be easily treated with oral antibiotics if caught early. A common regimen that I was on includes taking the antibiotic doxycycline for 21 days. More severe Lyme disease or Lyme disease that is not caught early may require intravenous (through the vein) antibiotics.

It is not uncommon to feel tired and have aches and weakness for weeks or months after treatment. I went from doing long-distance biking, hiking, and swimming to having difficulty doing basic household chores and even taking showers. I was also much more susceptible to colds and other viruses. I did not fully recover from my symptoms until about five months after I first became sick.

Some people feel tired and unwell for more than six months after getting Lyme disease, a condition known as post-treatment Lyme disease syndrome or chronic Lyme disease. Some doctors give these patients prolonged courses of antibiotics; however, there is currently no evidence showing that this approach improves a patient’s symptoms or functioning and is not recommended by the Centers for Disease Control and Prevention.

Talk with your family doctor right away if you are concerned about any tick bites or rashes. If possible, bring in the tick that bit you so that your family doctor can correctly identify it. Ask your family doctor if you have any questions about tick bite and Lyme disease prevention. By working together, your doctor can help you prevent Lyme disease from occurring and speed your recovery if you do contract it