Health Answers

When should you suspect you might have Lyme disease?

By Courtney Humphries
June 13, 2011

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Q. When should you suspect you might have Lyme disease?

A. Lyme disease is an inflammatory disease caused by a bacterial infection from a tick bite. Massachusetts is among the states with the highest rates of Lyme disease, and infection usually occurs in the summer months. Most people who get infected recover fully if treated, but in some cases it can lead to long-term health problems.

The disease can be tricky to recognize because symptoms vary and can be mistaken for milder illnesses. Jonathan Edlow, vice-chair of emergency medicine at Beth Israel Deaconess Medical Center, says that most people have initial symptoms within a week or 10 days of getting a tick bite. They feel generally ill and may have a fever, headache, muscle pain, and stiffness. Most patients also develop a rash on their skin. The hallmark rash of Lyme disease is a bull’s-eye shape: redness with a clear area around the small red center of the bite. But Edlow emphasizes that many rashes look different, often a large oval or round splotch of redness. The rash is usually closer to the center of the body than to hands and feet; typical locations include the upper legs, torso, armpits, and the hairline of children. Unlike most rashes from bites, this one tends not to be painful and itchy.

“Taken together, all those different symptoms are clues, but nothing is 100 percent true all the time,’’ Edlow says. If you have symptoms you suspect may be Lyme disease, it’s important to get treated early. The infection can be treated successfully with antibiotics, but treatment is faster and more likely to be effective the sooner it happens.

Even without treatment, many people will fight the infection off with their immune systems. But if not, a second stage of symptoms can appear weeks to months later. They include Bell’s palsy, a paralysis on one side of the face, nerve pain and irritation, or a mild form of meningitis. In some cases, Edlow says, the heartbeat slows. Months to years later, the disease can lead to arthritis of the joints and cognitive impairments like memory loss.

Edlow says the best prevention is to avoid walking in grass and brush where ticks hide and always check for ticks after being outdoors. If you find one engorged on your skin, a doctor may prescribe a single dose of antibiotics as a precaution.

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