Debating chronic Lyme Disease

Video: Navigating the debate

Tick-bite prevention strategies

  • If your yard borders woods, spread mulch made of cedar chips, a natural insect repellent, along the perimeter. Gravel and other mulches help, too. Planting deer-resistant plants and installing high fences can help keep deer away.
  • Do daily full-body tick checks, remembering that the most dangerous deer tick is in its nymphal state, black-legged — and no bigger than a poppyseed. Ticks must be embedded 24 hours before they can transmit infection.
  • To prevent tick bites, use sprays that are at least 35 percent DEET, reapplying every four hours.
  • Spray your clothes with a natural insect repellent called Permethrin (available at outdoor sports stores).
  • Use year-round anti-tick and anti-flea products on your pets and check them daily for ticks.
  • Wear hats, long sleeves and pants. Stuff pants into socks when hiking; wearing light-colored clothing makes ticks easier to spot.
  • Stay on trails, and walk in the center of them to avoid overhanging grass and brush. Ticks tend to hang on low-lying leaves or grasses waiting for a person upon whom they can hitchhike. Conduct hourly tick checks while hiking.
  • Avoid tick-infested areas, especially during May, June and July.
  • If you do find a tick, remove it gently with tweezers, applying them as close to the skin as possible and trying not to crush the tick’s body. Cleanse the area with soap and water.
  • If a fever and headache and/or bull’s-eye rash develop, seek medical attention as soon as possible. If left untreated, infection can spread to joints, the heart and the nervous system.
  • If you want to find out if the tick is an Ixodes, send it to a local Extension agent who will forward it to the insect identification lab at Virginia Tech. Store the tick in a small, airtight jar with a few drops of rubbing alcohol.

Sources: Dr. Kevin Griffith, Centers for Disease Control and Prevention; Dr. Thomas Kerkering, infectious disease section chief, Carilion Clinic; Eric Day, Virginia Tech entomologist

How Lyme disease is diagnosed

The official word on how to diagnose Lyme disease from the Centers for Disease Control and Prevention:

  • Doctor-diagnosed bull’s-eye rash greater than 5 centimeters; this usually increases in size three to 30 days after infection. (Not all patients will develop the rash or recall a tick bite.) Some patients develop additional lesions elsewhere on the body.
  • Fatigue, chills, fever, headache, muscle and joint aches and swollen lymph nodes. (In some cases, these may be the only symptoms of infection.)
  • All criteria, with exception of rash, must be supported by a positive lab finding to be counted under CDC surveillance guidelines.
  • A two-tiered blood test can be helpful in diagnosing the disease, but only after two to four weeks, after the antibodies develop. Early Lyme disease is diagnosed based on symptoms and the possibility of exposure to infected ticks.

Lyme symptoms

Untreated, the infection may spread to other parts of the body within a few days to weeks, producing an array of symptoms including:

  • Loss of muscle tone on one or both sides of the face (called Bell’s palsy);
  • Severe headaches and neck stiffness due to meningitis;
  • Shooting pains that may interfere with sleep;
  • Heart palpitations and dizziness due to changes in heartbeat;
  • Pain that moves from joint to joint.

The CDC does not acknowledge the existence of chronic Lyme disease, which advocates use to refer to what they believe to be a disabling post-Lyme illness that can cause arthritis, neurological and/or heart problems. But the CDC does concede the following:

After several months, about 60 percent of patients with untreated infection will begin to have intermittent bouts of arthritis, with severe joint pain and swelling; large joints are most often affected, especially knees.

In addition, up to 5 percent of untreated patients may develop chronic neurological complaints months to years after infection, including shooting pains, numbness or tingling in hands or feet, and memory problems.

“Most cases of Lyme disease can be cured with antibiotics, especially if treatment is begun early in the course of illness. However, a small percentage of patients with Lyme disease have symptoms that last months to years after treatment with antibiotics.

“These symptoms can include muscle and joint pains, arthritis, cognitive defects, sleep disturbance or fatigue. The cause of these symptoms is not known. There is some evidence that they result from an autoimmune response, in which a person’s immune system continues to respond even after the infection has been cleared.”

SOURCE: Centers for Disease Control and Prevention

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