Lyme Disease - The Basics

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What is Lyme disease?

Lyme disease is caused by infection with Borrelia burgdorferi, a type of bacteria called a spirochete. In the eastern U.S., the infection is transmitted by the bite of a black-legged tick, Ixodes scapularis, commonly known as the deer tick. Lyme disease, which can affect the skin, heart, nerves, or joints, can be effectively treated with antibiotic therapy.

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Do we have Lyme disease in Vermont?

We do have Lyme disease in Vermont. For many years, only a few cases of Lyme disease were reported to the Vermont Department of Health each year. However, starting in 2005, that number started to increase steadily. The increase in reported cases has more or less continued each year. In recent years there have been several hundred reports of people with Lyme disease who were likely exposed in Vermont. Most of the reported cases have occurred in people who live in the southern half of our state, but illness has been reported from all areas of Vermont.

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What are the symptoms of Lyme disease?

The symptoms of Lyme disease can vary because different parts of the body may be affected. The skin, joints, nerves or heart may be involved.

Early symptoms of Lyme disease typically appear within 3 to 30 days after a tick bite and include one or more of the following:

Infections that are not recognized and treated in the early phase may spread to other parts of the body, a condition called disseminated Lyme disease. Symptoms of disseminated disease can occur days to months after the initial infection. Some of the symptoms associated with disseminated disease include:

Up to 60% of people who do not receive treatment develop intermittent bouts of arthritis several months after infection. The arthritis is characterized by severe joint pain and swelling usually of large joints, most commonly the knee. In addition, a small percentage of untreated people develop chronic nervous system problems months to years after infection. Such problems include shooting pains, numbness or tingling in the hands and feet, and problems with concentration and short term memory.

Some people will have lingering symptoms even after being appropriately treated. It is not clear why this happens but it does not appear to be due to ongoing infections. Find more information from CDC on the Post-treatment Lyme disease syndrome page.

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How is Lyme disease spread?

The spirochetes enter the body when an infected tick attaches to the skin to take a blood meal. In most cases, an infected tick must be attached for at least 36 hours in order to transmit Lyme disease. Prompt removal of ticks can prevent infection.

Not all types of ticks carry Lyme disease. In the eastern United States, the black-legged tick, commonly known as the deer tick, is mainly responsible for transmitting the disease. Deer ticks are common in Vermont, but not all of them are infected with the bacteria. Most cases of Lyme disease occur in a few highly affected areas of Vermont.

A history of a known tick bite will help the doctor to know if Lyme disease is the cause of an illness. However, many people with Lyme disease do not remember being bitten by a tick. Deer ticks are tiny and often go unnoticed. For example, nymphal deer ticks, the most common transmitters of Lyme disease, are quite small, usually about 2mm in size (see photo).

tick

From left to right: adult female, adult male, nymph, larvae.
Not to scale. (scale: cm)

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Who is at risk of getting Lyme disease?

Deer ticks live in wooded, brushy and grassy places, including gardens. Individuals at greatest risk are those who spend time outside in areas that have a lot of ticks that are infected with the spirochete. In the Northeast, most illness occurs during the spring when the nymphal ticks are most active and people spend a lot of time outside, often with large amounts of skin exposed.

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What is the treatment for Lyme disease?

Appropriate treatment of Lyme disease with antibiotics almost always results in a full cure. While early treatment is best, most people diagnosed later in the course of illness can also be successfully treated.

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How do you prevent Lyme disease?

The best way to prevent Lyme disease is to prevent tick bites.

 While outdoors

After you come inside

What to do if you have a tick bite

Remove the tick.
Try to remove the tick as soon as you discover it, as it takes at least 24-36 hours for a tick to transmit the bacteria to you.

Safely remove ticks

Early tick removal may reduce the risk of infection of some tick-borne diseases. Follow the steps below to safely remove ticks from animals and humans.

1. Use fine-tipped tweezers and protect bare hands with a tissue or gloves to avoid contact with tick fluids.

image of tick removal with tweezers


2. Grab the tick close to the skin. Do not twist or jerk the tick, as this may cause the mouthparts to break off and remain in the skin.


image of tick removal

 

3. Gently pull straight up until all parts of the tick are removed.

 

DO NOT attempt to remove the tick by touching it with a burnt match or swabbing it with alcohol or petroleum jelly.  This will only aggravate the tick and cause it to release more bacteria into the blood stream.

Thoroughly wash your hands and the bite area

After removing the tick, wash your hands with soap and water or waterless alcohol-based hand rub. Clean the tick bite with an antiseptic such as iodine scrub, rubbing alcohol, or soap and water

More Information

Learn more about preventing tick bites and protecting yourself, your family, & pets against Lyme disease.

Consult your veterinarian for information about tick repellents for your pets.

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