Childhood Diseases – On a Mission to Educate: Lyme Disease
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My last article, "Childhood Diseases – On a Mission to Educate: Ringworm" we learned that Ringworm is a fungal infection that develops on the top layer of the skin. It is characterized by a red circular rash with clearer skin in the middle. Ringworm got its name because of this appearance on the skin and it should be stressed that there is no actual worm involved in this condition. Ringworm is very contagious and can easily be passed from person to person. It is common among children but it can also affect people of all ages & animals.
There are four major areas of the body that ringworm can affect: ringworm of the scalp, ringworm of the body, jock itch and athlete’s foot. Treatment can vary depending on the affected area but in most cases a topical medication such as an antifungal cream, ointment, or spray may be recommended by the doctor. Most cases of ringworm get resolved within 2-4 weeks. Today I would like to move onto another childhood illness called Lyme Disease.
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What Is Lyme Disease?
According to Results RNA (https://www.resultsrna.com/cardiovascular-effects-lyme-disease/) Lyme Disease is an infection that is caused by tick bites. Most people are aware of the “complications and debilitating effects of Lyme disease bit few know of the damaging cardiovascular effects of Lyme Disease.” Borrelia Burgdorferi is the bacteria that causes Lyme disease. It is carried by a specific type of tick called the Blacklegged Tick, which is also known as the deer tick.
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Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/lyme-disease/basics/definition/con-20019701) stated that there are actually four main species of Lyme disease bacteria: Borrelia burgdorferi, Borrelia mayonii, Borrelia afzelii and Borrelia garinii. “Borrelia burgdorferi and Borrelia mayonii cause Lyme disease in the United States, while Borrelia afzelii and Borrelia garinii are the leading causes of Lyme disease in Europe and Asia.” It should be noted that people are more likely to get Lyme disease if they live or spend time in grassy and heavily wooded areas where these ticks thrive.
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What Is the History of Lyme Disease?
Ticks and Lyme disease have been around for thousands of years according to Bay Area Lyme Foundation (http://www.bayarealyme.org/about-lyme/history-lyme-disease/). There has been a recent autopsy on a 5,300 year old mummy which has the presence of bacteria that causes Lyme disease. Dr. Alfred Buchwald, a German physician, was the first to describe a chronic skin rash (erythema migrans) which is now recognized as Lyme disease more than 130 years ago. It wasn’t until the 1960s & 1970s that the US recognized Lyme disease.
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Bay Area Lyme Foundation stated that it was in the early 1970s that a group of children and adults in Lyme, Connecticut and the surrounding areas were suffering from puzzling & debilitating health problems. Some of the symptoms these people were suffering from were “swollen knees, paralysis, skin rashes, headaches, & severe chronic fatigue.” It wasn’t until the mid-70s that research began which described the signs and symptoms of this new disease which they called Lyme after Lyme, Connecticut.
“Today Lyme disease is one of the fastest growing vector-borne infections in the United States. The CDC estimates that there are over 329,000 new cases of Lyme disease each year here in the US.”
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What Are the Symptoms of Lyme Disease?
According to the Centers for Disease Control & Prevention (CDSC) (https://www.cdc.gov/lyme/signs_symptoms/index.html) there are two stages of symptoms of Lyme Disease : Early Stage (3-30 days after tick bite) and Later Stage (days to months after tick bite).
Early Stage Signs & Symptoms:
- Fever, chills, headache, fatigue, muscle & joint aches, and swollen lymph nodes
- Erythema migrans (EM) rash: 1) Occurs in approximately 70 to 80 percent of infected persons, 2) Begins at the site of a tick bite after a delay of 3 to 30 days (average is about 7 days), 3) Expands gradually over a period of days reaching up to 12 inches or more (30 cm) across, 4) May feel warm to the touch but is rarely itchy or painful, 5) Sometimes clears as it enlarges, resulting in a target or “bull’s-eye” appearance, 6) May appear on any area of the body
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Later Stage Signs & Symptoms:
- Severe headaches and neck stiffness
- Additional EM rashes on other areas of the body
- Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
- Facial palsy (loss of muscle tone or droop on one or both sides of the face)
- Intermittent pain in tendons, muscles, joints, and bones
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- Heart palpitations or an irregular heart beat (Lyme carditis)
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
- Nerve pain
- Shooting pains, numbness, or tingling in the hands or feet
- Problems with short-term memory
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CDC stated that untreated Lyme Disease can produce a large range of symptoms such as fever, rash, facial paralysis and arthritis. They also stressed that you should seek medical attention as soon as you can if you observe any of these symptoms and have had a tick bite, live in areas that have known cases of Lyme disease or have traveled to areas where there are known Lyme disease occurrences.
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How Is Lyme Disease Diagnosed?
According to Medicine Net (https://www.medicinenet.com/lyme_disease/article.htm) during the early phase of Lyme disease, doctors can sometimes make a diagnosis by finding the classic red rash in patients who have been recently in areas where Lyme disease is common. He/she may do a review of the patient’s history and examine the patient to rule out other possible diseases that may have similar joint, heart and nervous system findings. Blood tests are not necessary in the early stage phase but it can sometimes help to see if there are antibodies present which indicate bacteria in later phases of Lyme disease. This is not a reliable method as antibodies can give a false indication of disease.
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Medicine Net also stated that “Lyme blood testing is helpful in a patient who has symptoms compatible with Lyme disease, who has a history of a tick bite at least a month prior, or who has unexplained disorders of the heart, joints, or nervous system that are characteristic of Lyme disease.”
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There are many tests and exams that can be conducted to diagnose Lyme disease according to New York Times (http://www.nytimes.com/health/guides/disease/lyme-disease/overview.html). As mentioned above, a blood test can be conducted to check for antibodies to bacteria. The most common test used is called ELISA. There are other tests that can be conducted when the infection has spread:
- Electrocardiogram
- Echocardiogram to look at the heart
- MRI of the brain
- Spinal tap (lumbar puncture to examine spinal fluid
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How Is Lyme Disease Treated?
According to the New York Times (http://www.nytimes.com/health/guides/disease/lyme-disease/overview.html) anyone who has been bitten by a tick should be watched closely for at least 30 days. The article stated that “A single dose of doxycycline may be offered to someone soon after being bitten by a tick, if all of these conditions are true:”
- The person has a tick that can carry Lyme disease attached to his or her body. This usually means that a nurse or physician has looked at and identified the tick.
- The tick is thought to have been attached to the person for at least 36 hours.
- The person can begin taking the antibiotics within 72 hours of removing the tick.
- The person is over 8 years old and is not pregnant or breastfeeding.
“A 10 day to 4-week course of antibiotics is used to treat people who are diagnosed with Lyme disease, depending on the choice of drug:"
- The choice of antibiotic depends on the stage of the disease and the symptoms
- Common choices include doxycycline, amoxicillin, azithromycin, cefuroxime, and ceftriaxone
Pain medications such as Ibuprofen are occasionally prescribed to relieve joint stiffness.
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Two Conflicting Treatment Philosophies For Lyme Disease
According to Lyme Disease.org (https://www.lymedisease.org/lyme-basics/lyme-disease/treatment/) there are two standards of care: One is the Infectious Diseases Society of America (IDSA) which thinks that Lyme disease is hard to catch and easy to cure with a short course of antibiotics. In contrast the International Lyme and Associated Diseases Society (ILADS) feels that Lyme disease is difficult to diagnose and treat resulting in a persistent infection in many patients with Lyme disease. ILADS recommends “individualized treatment based on the severity of symptoms, the presence of tick-borne coinfections and patient response to treatment.”
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There are two categories of Lyme according to ILADS: Early Lyme & Late or Chronic Lyme. The following are the treatment approaches according to ILADS:
Early Lyme:
- More aggressive and longer antibiotic treatments, especially for “High Risk” tick bites where the tick came from an endemic area, was attached a long time, and was removed improperly.
- Treat a Lyme rash for a longer period of time to ensure that the disease does not progress.
- Don’t withhold treatment pending laboratory test results.
The earlier treatment intervention is started the better the outcome for the patient.
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Late or Chronic Lyme:
- ILADS believe that ongoing symptoms reflect active infection which should be treated until the symptoms have resolved. ILADS physicians use “treatment approaches employed for persistent infections like tuberculosis, including a combination of drugs and longer treatment durations.”
It should be noted that all medical treatments have a certain amount of risks that are associated with them. For instance, antibiotics can wipe out beneficial intestinal flora which can lead to a greater possibility for additional health problems. So in this case, one should take probiotics while on antibiotics.
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How to Remove a Tick Safely
If you find a tick on you or your child, you should first know how to remove a tick. According to Kids Health (http://kidshealth.org/en/parents/lyme.html#) the risk of developing Lyme disease after being bitten is low. “It also takes at least 24 to 48 hours for the tick to spread the bacteria that cause Lyme disease.” But to be safe, it is recommended that you remove the tick as soon as possible. The following is what you need to do to remove a tick:
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- Use tweezers to grasp the tick firmly at its head or mouth, next to the skin.
- Pull firmly and steadily on the tick until it lets go of the skin. If part of the tick stays in the skin, don't worry. It will eventually come out — although you should call your doctor if you notice any irritation in the area or symptoms of Lyme disease.
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- Swab the bite site with alcohol.
- Put the tick in a sealed container to preserve it. Then, call your doctor, who might want to see the tick to determine if it's the type that can carry Lyme disease.
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How to Prevent Lyme Disease
Kids Health stated that there is no sure way to avoid getting Lyme disease but one can minimize risk by the following tips:
- Be aware of ticks in high-risk areas like shady, moist ground cover or areas with tall grass, brush, shrubs, and low tree branches. Lawns and gardens may harbor ticks, too, especially at the edges of woods and forests and around old stone walls (areas where deer and mice, the primary hosts of the deer tick, thrive).
- Wear enclosed shoes or boots, long-sleeved shirts, and long pants. Tuck pant legs into shoes or boots to prevent ticks from crawling up legs.
- Use an insect repellent containing 10% to 30% DEET (N,N-diethyl-meta-toluamide).
- Wear light-colored clothing to help you see ticks more easily.
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- Wear light-colored clothing to help you see ticks more easily.
- Keep long hair pulled back or tucked in a cap for protection.
- Don't sit on the ground outside.
- Check for ticks regularly — both indoors and outdoors. Wash clothes and hair after leaving tick-infested areas.
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- Take a shower right away once you are home.
- Run your clothes in a hot dryer for 10 minutes before you wash your clothes to kill any ticks.
- Protect your pets. Consult with your veterinarian about tick-protection products/methods.
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Perform Daily Tick Checks
The CDC highly recommends that you do a body check for ticks after being outdoors. Check yourself and/or child in the following areas:
- Under the arms
- In and around the ears
- Inside the belly button
- Back of the knees
- In and around all head and body hair
- Between the legs
- Around the waist
Also check all clothes and pets because they may carry ticks into the house.
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Children and Lyme Disease
A child is more at risk for Lyme disease in certain parts of the U.S. and during the spring and summer months when ticks are more active. According to Hopkins Medicine (https://www.hopkinsmedicine.org/healthlibrary/conditions/pediatrics/lyme_disease_in_children_90,P02833) the following areas have the most cases of Lyme disease:
- Northeastern states, such as Massachusetts and Connecticut
- Mid-Atlantic states, such as New Jersey and Pennsylvania
- Wisconsin and Minnesota
- Northern California
- Many cases have also been reported in Asia and Europe.
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Symptoms of Lyme disease in a child:
Per Hopkins Medicine the most common symptom is a ring-shaped rash that looks like a bull’s-eye. This rash does not always occur but if it does the rash may:
- Appear several days after infection
- Last up to several weeks
- Be very small or very large, up to 12 inches across
- Look like other skin problems such as hives, eczema, sunburn, poison ivy, or flea bites
- Itch or feel hot, or not be felt at all
- Go away and come back several weeks later
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Several days or weeks after a bite from an infected tick, the child may have flu-like symptoms:
- Appear several days after infection
- Last up to several weeks
- Be very small or very large, up to 12 inches across
- Look like other skin problems such as hives, eczema, sunburn, poison ivy, or flea bites
- Itch or feel hot, or not be felt at all
- Go away and come back several weeks later
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Weeks to months after the bite, the following symptoms may develop:
- Nervous system symptoms. Examples are inflammation of the nervous system (meningitis) and weakness and paralysis of the facial muscles (Bell palsy)
- Heart problems, such as inflammation of the heart (myopericarditis) and problems with heart rate
- Eye problems, such as inflammation of the eyes
- Skin disorders
- Severe tiredness
- Weakness
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Months to a few years after a bite:
- Inflammation of the joints (arthritis)
- Nervous system symptoms such as numbness in the arms and legs, tingling and pain, and trouble with speech, memory, and concentration
Symptoms of Lyme disease can be like other medical conditions. It is vital that parents make sure that their child is seen by a doctor and provided a diagnosis. As seen throughout this article, it is extremely important for early medical intervention and remember, Lyme disease can be very difficult to diagnose. Be your child’s advocate!
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Facts About Lyme Disease?
Lyme Light Foundation (https://lymelightfoundation.org/about-lyme/ten-things-you-should-know-about-lyme-disease/) listed Ten Facts About Lyme Disease:
- Lyme disease is a world-wide infectious disease and has been reported in all 50 states, 25% of the reported cases are children. Lyme disease had been found on every continent but Antarctica.
- Typically Lyme disease is transmitted through a bite from an infected deer tick. These ticks, often the size of a poppy seed, can leave an undetectable bite.
- Fewer than 50% of people infected get the bull’s eye rash. Some develop flu-like symptoms a week or so after becoming infected, however, many people are asymptomatic but can develop Lyme symptoms months, years or decades later.
- Common Symptoms include: fatigue, neck stiffness or pain, jaw discomfort, muscle pain, joint aches like arthritis- typically in the knees, swollen glands, memory loss, cognitive confusion, vision problems, digestive issues, headaches and fainting.
- The Lyme spirochete bacteria is hard to detect and hard to kill. Lyme disease is growing at epidemic proportions in the United States.
- It is called the great imitator; looking like many other health problems (Fibromyalgia, Arthritis, Chronic Fatigue Syndrome, Bells Palsy, ADD, MS and Lupus).
- The medical community is divided over the diagnosis and treatment guidelines. Health insurance often doesn’t cover the treatment for Chronic Lyme disease.
- The standard and most commonly prescribed for diagnosing Lyme test is the ELISA test. This test, often not sensitive enough to detect Lyme, can produce a false negative. The more sensitive test is called the IgG and IgM Western Blots test. The preferred testing lab is IGeneX Lab in Palo Alto. www.igenex.com.
- If you suspect you have Lyme, contact a LLMD, (Lyme Literate Medical Doctor). Informative websites on the disease: www.ilads.org, www.lymedisease.org, www.lymediseaseassociation.org, www.igenex.com, www.underourskin.com.
- A recommended book to read: Cure Unknown by Pamela Weintraub and a recommended DVD is Under Our Skin.
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In conclusion Lyme Disease is an infection caused by a bacteria called Borrelia Burgdorferi which is usually spread by tick bites. An infected tick’s bite can transmit the bacteria into a person’s bloodstream causing fatigue, fever, headache and sometimes a rash. The greatest risk to a person with Lyme disease is an untreated condition which can eventually cause major complications to vital organs, blood vessels and the person’s entire immune system. It can also lead to joint degeneration and infection causing arthritic symptoms. Worse yet, untreated Lyme disease can lead to serious heart and blood vessel complications, nerve damage and other major problems in areas like the endocrine system and the central nervous system. So everyone should take Lyme disease very seriously!
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I hope you learned something from this article about Lyme Disease. There are many resources on the internet if you need more specific information. I will continue this series with another childhood disease post. I hope you will continue to join me in this quest to learn about these illnesses that children usually encounter when they are young. Thank-you for reading my article on ”Childhood Diseases – On a Mission to Educate: Lyme Disease”. If you would like to follow me, please check HERE
These are my previous articles. if you are interested in reading it:
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