Lyme Disease – Facts over Fear
There is a lot of fear surrounding tick bites and for understandable reasons! Lyme disease can be a confusing, debilitating, and sometimes chronic illness that is borne from ticks and caused by a bacteria called Borreliella.
Lyme disease develops in three phases.
● Early illness presents with a rash, called erythema migrans, which typically develops within 7-14 days of the bite.
● More diffuse disease can occur within days to weeks of infection, including multiple areas of rash and possible neurologic and cardiac findings.
● Late Lyme disease may develop months to years later and classically involves joint inflammation.
Common misconceptions about ticks and tick bites:
1) All ticks can carry Lyme disease.
False. In Michigan, we have 5 types of ticks, and only one of these carry the bacteria associated with Lyme; this is the blacklegged (deer) tick. Furthermore, it is only in highly endemic areas that this variety of tick carries Lyme.
2) All tick bites should be treated.
False. We know that an infected tick takes time to transmit illness from itself to the host. If a tick was removed prior to 48 hours and is not swollen with the host’s blood, there was likely not enough time for the Lyme bacteria to be shared through the tick saliva. However, other non-Lyme illnesses can be transmitted by a tick in under 48 hours, so it is important to always monitor for symptoms of illness such as fever, rash, joint pains, fatigue, and swollen lymph nodes appearing within 30 days of a tick bite. Other tick-borne illnesses include Rocky Mountain Spotted fever, babesiosis, and tularemia.
If your tick bite is of concern, preventative antibiotics must be taken within 72 hours of tick removal. To reiterate, a concerning tick bite would be from a blacklegged tick, a tick that was on the skin for over 48 hours, or a tick that was blood-engorged.
3) Skin redness means infection.
False. It is common to have redness from a tick bite due to a localized reaction from the saliva. This more benign sort of redness appears immediately after the bite. If you have an expanding area of redness, please seek evaluation.
4) Once a person has Lyme disease, they will always have it.
False. Patients treated with antibiotics in the early stages of the infection usually recover rapidly and completely. Most patients who are treated in the later stages of the disease also respond well to antibiotics, although some may have suffered long-term damage to the nervous system or joints. It is not uncommon for patients treated for Lyme disease with a recommended 2-to-4-week course of antibiotics to have lingering symptoms of fatigue, pain, or joint and muscle aches at the time they finish treatment. In a small percentage of cases, these symptoms can last more than 6 months. This is similar to the phenomenon of long–COVID syndrome. These symptoms cannot be cured by longer courses of antibiotics, but they generally improve on their own over time.
Remember: You are not expected to be a tick-identifying expert! Tick ID is available free of charge in Michigan through the Department of Health and Human Services. Take a photo of the tick and email the picture to MDHHS-Bugs@michigan.gov or get a free tick submission kit from the local health department to mail the tick to the MDHHS.
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