A strange illness that comes after a jungle trek? Could it be Lyme Disease?

You've probably seen small animals clinging to your body when you've been walking in a forest or in a field with tall grass. Among these, ticks are an animal that you need to be a little careful about. Because, some ticks can cause diseases. One such tick-borne disease that we're going to talk about today is Lyme Disease.

What is Lyme Disease?

Simply put, Lyme disease is an infection caused by a bacterium (a type of bacteria called Borrelia burgdorferi). It is transmitted to us, to be precise, when a specific tick that carries this bacterium – also known as a deer tick or black-legged tick – bites us. Not all ticks we see usually carry the disease. Some wood ticks or dog ticks do not carry the germ.

This disease is sometimes called ``borreliosis.`` Lyme disease was first discovered in 1975 in the town of Lyme, USA. There, many children suddenly developed symptoms similar to ``juvenile rheumatoid arthritis.`` Researchers later discovered that the cause was the bites of infected deer ticks that were present in the area.

What are the different stages of Lyme Disease?

Lyme disease can develop in stages. Sometimes these stages can overlap and overlap. Symptoms can affect the skin, joints, heart, or nervous system. There are three main stages:

• Early localized Lyme disease: This usually lasts about one to four weeks after the tick bite.
• Early disseminated Lyme disease: This can affect people one to four months after infection.
• Late persistent, late disseminated or just late Lyme disease: This can affect up to four months, sometimes even years, after exposure.

How common is Lyme Disease?

In countries like America, it is said that about 30,000 patients are reported with Lyme Disease every year. However, there may be more patients who are not reported and diagnosed with the disease. Although there are no exact statistics on the situation in Sri Lanka, it is very important to be aware of this if you live in an environment where ticks are present. Because, in our country too, there are ticks in places like forest areas, tea plantations, and grasslands.

What are the symptoms of Lyme Disease?

Okay, now let's see what the symptoms of Lyme Disease are. These too can vary depending on the stage mentioned earlier.

Early localized symptoms (1-4 weeks)

During this time, you can usually see things like this:

• Red spot or patch of skin: Doctors call this `erythema migrans` (EM) . This is the most common symptom. It starts as a small red spot at the site of the tick bite, within a week to four. Over the course of a few days or weeks, this spot enlarges and can take on a round, triangular, or oval shape. It often looks like a `bull's eye`. That is, it looks like a red ring around a clear area in the middle. This spot can range from the size of a coin to covering a person's entire back. As the infection spreads, several `(EM)` spots like this can appear on different parts of the body.
• Fever
• Headache
• Neck stiffness
• Body aches and joint pain
• Tiredness
• Swollen lymph nodes

Early disseminated symptoms (1-4 months)

In this second stage, the following symptoms may appear:

• The appearance of spots (rashes) as mentioned earlier in several parts of the body.
• Facial paralysis (Bell's palsy). This means that one side of the face appears to be drooping.
• Heart rhythm irregularities, such as a disruption in the heart's electrical system (heart block).
• Numbness or abnormal sensations in some areas (neuropathy).

Late-stage symptoms (months or years later) that may occur if left untreated

If the disease is not treated properly, the following can happen after months:

• Recurrent joint swelling (arthritis), especially affecting large joints like the knees.
• Difficulty concentrating, feeling like your brain is covered in fog. This is also called `brain fog` . This can be caused by brain damage (encephalopathy).
• Polyneuropathy is a condition that affects nerves throughout the body, affecting the skin, muscles, and internal organs.

How is Lyme Disease diagnosed?

Well, then how exactly is Lyme Disease diagnosed?

A doctor will diagnose this disease based on your symptoms, what they see during a physical exam (like the so-called ``(EM)'' spot), and whether you've been in an area where infected ticks may be present.

Think about it, many people don't even remember or know they've been bitten by a tick. The reason is that these ticks are so small that they usually don't feel any pain when they bite.

The doctor will do a blood test to confirm the diagnosis. If your first blood test is negative for Lyme disease, you won't need to do another test. However, if the first test is positive or equivocal, your doctor will do another test. To be certain that you have Lyme disease , you need two positive results (perhaps one positive and one inconclusive).

How is Lyme Disease treated?

Lyme disease is treated with antibiotics . Usually, either doxycycline or amoxicillin are used. These medications are very effective for Lyme disease.

How long you need to take medication depends on what stage of the disease you are in. It is generally said that the sooner you start treatment, the quicker and more complete your recovery will be.

Pregnant women should also seek treatment if they develop Lyme disease. However, there is no evidence yet that the infection can be transmitted from mother to fetus. There is also no strong evidence that Lyme disease increases the risk of miscarriage. So don't panic, just follow your doctor's advice.

What to do if you get bitten by a tick?

Imagine you've been bitten by a tick. What do you do? Don't panic. Here's how to remove the tick:

• With blunt tweezers, grab the tick's 'head', that is, where it is attached to your skin, and pull it gently but firmly upwards until it comes off your skin.
• Don't try to squeeze the tick's body. Don't even touch it with your bare hands. Doing so could expose you to the bacteria on the tick's body.
• Wash the tick bite area thoroughly with soap and water.
• Do not use kerosene or petroleum jelly (such as Vaseline®) to remove ticks. Do not use heated cigarette butts to remove ticks. These are incorrect methods.
• Do not squeeze the tick's body with your fingers or pliers.

Can Lyme Disease be prevented?

Can Lyme disease really be prevented before it occurs? Yes, it is largely possible.

Most people get Lyme disease in the late spring, summer, and early fall. This is when immature ticks are most likely to come out to feed. In warmer climates, tick bites are less common in the winter.

These so-called ``deer ticks`` are most common in forested areas and in the meadows near them. Especially at the edges of these forests and meadows, these ticks can sometimes be found in gardens where deer roam. However, in sunny grassy areas, ticks do not live long. They quickly dry out and die.

Typically, only about 1% of all deer ticks carry the bacteria that cause Lyme disease. However, in some areas, more than 50% of ticks carry the bacteria. Ticks that carry the disease are most common in the Northeast and North Midwest of the United States, as well as coastal areas.

Black-legged ticks can transmit this infection not only from deer, but also from mice, voles, and some types of squirrels.

What should you do to stay safe from ticks?

To stay safe from ticks, keep these things in mind:

• To repel ticks, you can spray your clothes with an insecticide called `(permethrin) . This is available at garden supply stores. Insect repellents containing `(DEET)` can be applied to clothes or directly to the skin. But read the label carefully. Don't use too much. Too much can be harmful.
• Wear long pants and long-sleeved shirts. Wearing clothing that is tight around the ankles and wrists reduces the chance of ticks reaching the skin, and also reduces exposure to insect repellent.
• Wear a hat, tuck your pants into your socks, and wear shoes that completely cover your feet.
• Wear light-colored clothing so that you can easily identify a tick if it is on your body.
• When walking on forest roads and trails, walk in the middle. That way, you're less likely to be bitten by ticks from the overhanging grass and bushes on either side.
• After spending time outdoors in an area where you think there may be ticks, be sure to check your body for ticks (also called a `tick check`). It is also important to wash and shower thoroughly afterwards, and to rub yourself well with a cloth or something that rubs your body.
• If you have ticks on your clothes, put them in the dryer for about 15 minutes. The ticks will dry out and die.
• Ticks can also come into your home from pets , so talk to your veterinarian about ways to protect your pet from ticks.

What is the future for someone with Lyme Disease?

Most of the time, Lyme disease is treatable if treated quickly. Treatment can cure Lyme disease. However, sometimes there may be some long-term effects. If left untreated, Lyme disease can lead to other serious problems, but it is rarely fatal.

Post-treatment Lyme disease syndrome (PTLDS)

Sometimes, even after treatment, some people (between 5% and 15% of people) may continue to experience fatigue, body aches, and headaches. This is called post-treatment Lyme disease syndrome (PTLDS) .

Having these symptoms does not mean you still have the infection. PTLDS does not respond to more antibiotics. For most people in this group, these symptoms gradually subside after about six months.

Chronic Lyme disease

Some people use the term ``Chronic Lyme disease'' to refer to someone who has developed Lyme disease and has symptoms of ``PTLDS''. Some people think that chronic Lyme disease and ``PTLDS'' are the same thing. However, there are times when some people are diagnosed with ``Chronic Lyme disease'' without a prior diagnosis of Lyme disease. Sometimes, it is said that continuing antibiotics will help.

This term may be why some people think that you can get Lyme disease without being bitten by a tick. There is still not enough evidence to prove that mosquitoes transmit Lyme disease. Many researchers do not like to use the term 'chronic Lyme disease' because it is a bit confusing and controversial.

When should you see a doctor?

So, when should you see a doctor?

• If you feel sick after being in an area where ticks may be present, be sure to see a doctor.
• If you have been diagnosed with Lyme disease and are still not feeling well despite taking all the prescribed antibiotics, you should inform your doctor. This is especially important if you have symptoms such as a stiff neck or confusion.

Can Lyme Disease be completely cured?

Yes! Lyme disease usually clears up after two to four weeks of oral antibiotics. In some severe cases, intravenous antibiotics may be needed for up to four more weeks. However, there is no reason to think that Lyme disease will stay in your body forever after treatment.

Things to remember from this article (Take-Home Message)

Okay, so let's remind you of a few things we talked about today about Lyme Disease that we think are important:

• Wear protective clothing when going to areas where ticks may be present (forests, meadows). Things like long pants, long-sleeved shirts, and shoes.
• Use insect repellent, but be careful.
• After spending time outdoors , check your body carefully for ticks.
• If there is a tick, remove it properly. Don't panic.
• If you develop a fever, body aches, or a strange spot on your skin (especially one that looks like a target), either after being bitten by a tick or after visiting an area where there are ticks, see a doctor immediately.
• Lyme disease can be cured if treated early. Take the antibiotics your doctor prescribes exactly and for the prescribed period.

Keeping these things in mind will go a long way in protecting you from Lyme disease, which is transmitted by ticks. Stay healthy!

` Lyme Disease, ticks, tick bites, Borrelia burgdorferi, erythema migrans, symptoms, treatment, prevention