Lyme Disease: What To Know & How To Get Accurate Testing

Published August 27, 2019 by Jc Drobac

Each year, May marks the start of the three-month span during which more people will get tick bites than any other time of year in the United States (CDC), which means more risk of Lyme disease, a potentially serious bacterial infection caused by the bite of an infected blacklegged tick, also known as the deer tick or bear tick. The disease affects both humans and animals, and was named in 1975 when a group of children in Connecticut were reported to have juvenile arthritis. 

 

June and July are also prime months to incur a Lyme-ridden tick bite. Most studies will confirm that getting tested by late September is possibly the best time to get the most accurate results if you were not aware of getting bitten but start experiencing unexplained symptoms, and then to start treatment. Getting tested sooner could result in a false negative diagnosis, while waiting too long can mean living with symptoms longer than necessary, and can make it more difficult to diagnose and take longer to heal from.

   

There is no benefit of blood testing for Lyme disease at the time of the tick bite; even people who become infected will not have a positive blood test until approximately two to six weeks after the infection develops, post-bite.

 

Ninety-five percent of all confirmed Lyme disease cases in 2015 stemmed from just 14 states, according to the CDC: Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin. And while reported cases stem largely from the Northeast and upper Midwest, a 2016 study in the Journal of Medical Entomology found ticks that carry Lyme disease present in nearly half of all U.S. counties. The Minnesota Department of Health is monitoring the spread of the disease across the state and working with residents to limit exposure to the ticks causing the disease.

While some 30,000 cases of Lyme disease get reported annually, the CDC suggests the actual number of diagnosed cases may be ten times that — about 300,000. If not treated, Lyme disease can produce severe arthritis or cause neurological or cardiac problems.


If you or a family member is experiencing or starts experiencing these symptoms, consider getting tested for Lyme. Symptoms include a distinctive rash, fever, chills, headache, muscle and joint pain, multiple rashes, facial paralysis on one side of the face, fever, stiff neck, headache, weakness, numbness or pain in arms or legs, irregular heart beat, dizziness, feeling lightheaded or heart palpitations, joint swelling from arthritis in one or more joints (usually the knees), persistent weakness, fatigue, shortness of breath, nerve pain and shooting pains, numbness or tingling in the hands or feet, meningitis (inflammation of the brain and spinal cord, leading to headaches and a stiff neck), and swollen lymph nodes.


By reading this article, you’ll learn in detail about Lyme, including which 10 essential oils have been proven to be as (or more) effective than antibiotics for addressing Lyme bacteria!

Prevalence in Minnesota

Here are a few facts about the prevalence of Lyme disease. Did you know, it affects Minnesota far more heavily than the national average?

  • Lyme disease is the most common tick-borne infectious disease in the United States.
  • The Minnesota Department of Health began collecting information on people diagnosed with Lyme disease in 1982. In 1985, Lyme disease became a reportable disease in the state.
  • Minnesota is one of 14 states that has the majority of Lyme disease cases. In 2017, Minnesota had a rate 3 times the national average.
  • Lyme disease is one of several tick-borne diseases in Minnesota.

Transmission (Getting Lyme)

Lyme is spread by blacklegged ticks (also called the deer or bear tick) that are infected with the disease-causing bacteria, Borrelia burgdoferi. Depending on the area you’re in, a small to large percentage of the blacklegged tick population will be infected. The ticks pick up the bacteria when they bite mice or deer that are carrying it.


Ticks tend to attach to hard-to-see areas of the human body, such as the scalp, armpits, and groin. The adult tick or the young nymph bores a tiny hole in the skin and inserts its mouth-parts into the opening, attaching itself to the host.


Not all blacklegged ticks are infected with the bacteria, so not all blacklegged ticks transmit disease. The tick – which first must be infected with Lyme virus – must be attached for at least 24-48 hours to transmit the bacteria. The risk of getting Lyme disease from a tick, even where ticks are prevalent, is between 1.2 and 1.4 percent. The chance of getting Lyme disease increases the longer a Lyme-infested tick is attached. Most people get rid of the larger adults before they have time to transmit the bacterium, so human infections tend to occur as a result of bites from barely visible nymphs.


If you find a brown dog tick, a Rocky Mountain wood tick, or a lone star tick, you don’t have to worry about Lyme disease. But these other types of ticks can carry different kinds of disease-causing bacteria, so it’s good to know which tick you’re dealing with.


Just 3 to 30 days after a blacklegged (deer) tick bite, look for a distinctive rash, fever, chills, headache, muscle and joint pain, and fatigue.

Signs and Symptoms

The rash will disappear after about 4 weeks, even without treatment, but other symptoms can emerge days to months after being bitten. Signs and symptoms of Lyme disease vary among individuals. A person may not have all of the symptoms; often just feel like they have "the flu."


Days to weeks after onset of illness, one or more of these signs and symptoms may occur: multiple rashes, facial paralysis on one side of the face, fever, stiff neck, headache, weakness, numbness or pain in arms or legs, irregular heart beat, dizziness, feeling lightheaded or heart palpitations, persistent weakness, and fatigue. If a person suspects Lyme disease, he or she should contact a doctor immediately.


Stage 3 (“Late Lyme Disease”) may be the first sign of illness in some people. Symptoms can emerge weeks, months, and even years after initial infection if a patient has not received treatment, or if antibiotic treatment has not been fully effective. It can involve problems with the nervous system and the heart. Around 60 percent of untreated patients will experience recurrent bouts of arthritis with severe joint swelling, especially in the large joints.

It's Difficult to Detect

Detection of Lyme disease can be difficult, especially in later stages. The bacteria that causes Lyme disease is hard to detect with current lab tests, making misdiagnosis of the disease common. Early recognition of signs and symptoms of Lyme disease is very important for prompt diagnosis and treatment; this can reduce the time a person is ill and the severity of the disease.

 

Ideally, treatment should occur as soon as the EM rash appears. If a person has been in an area where Lyme disease is common, and they have symptoms, treatment can start even without a blood test.


Diagnosis includes a physical examination (signs and symptoms, presence of a rash) and history of possible exposure to blacklegged ticks; blood tests may be performed. A thorough physical examination and history of exposure are required for proper diagnosis and treatment. A person bitten by a tick may have an allergic reaction and develop a rash, but not everyone with Lyme experiences this symptom. If the rash appears hours, instead of days, after a tick bite, it is likely to be an allergic reaction to the tick, instead of a symptom of Lyme disease—even if the rash is ring-shaped. Other insect or spider bites can also cause a rash. The rash may also be less evident on darker skin.


The only way to test for Lyme disease is to test for the antibodies (via a blood test) that the body makes to combat this bacterium. Because it takes weeks for the antibodies to appear, the testing isn’t reliable in the first 2-3 weeks after being bitten or feeling ill. The first line of testing is called the ELISA test. It picks up antibodies in disseminated Lyme disease 98% of the time but misses them in 2% of cases. The problem with the ELISA test is that it has a high rate of false positives – the test diagnoses Lyme disease in 4% to 11% of patients who don’t actually have the disease. For this reason, another antibody test, the Immunoblot test is recommended after a positive ELISA result to confirm Lyme disease.

 

Diagnosis of Lyme disease is especially tricky because symptoms may closely resemble those of other illnesses. For instance, some early symptoms of Lyme disease (headache, stiff neck, and fatigue) may be mistaken for viral meningitis. There are several key differences, however. Children with viral meningitis are more likely to have a higher fever. A person with Lyme disease often has other symptoms, such as the characteristic bull's-eye rash.


People often test positive for Lyme disease when they actually have a different bacterial illness. It is possible that a person could test positive because they were infected with Lyme bacteria at some point, but the infection is not currently active and is not causing illness. In some cases, a person may test negative for Lyme disease when they are indeed infected.


Other conditions that may have similar symptoms to Lyme disease include viral infections such as influenza or infectious mononucleosis (both cause fever, muscles aches and fatigue), multiple sclerosis (both cause nervous system symptoms), arthritis (both cause joint pain), fibromyalgia, chronic fatigue syndrome, and other tick-borne illnesses.

Complications

  • Recurrent Lyme disease is due to reinfection, not "relapse." In other words, Lyme disease is cured, not "managed," and therefore doesn't go into remission or resurfaces. We can contract it multiple times.
  • If a person’s Lyme disease is not detected and treated early, the result can be lingering symptoms, even after a person has been treated with appropriate antibiotic treatment. This is called Post-Treatment Lyme Disease Syndrome, or PTLDS.
  • Sales of the Lyme disease vaccine Lymerix (the only Lyme disease vaccine for humans) was discontinued in 2001.

Treatment for Lyme

During the early stages of Lyme disease, treatment with antibiotic medication generally results in a rapid and complete recovery. In the later stages, especially if the person has arthritis and neurological conditions, intravenous antibiotics or antibiotic injections will be necessary. Even after treatment is over, patients may still test positive for anti-B. burgdorferi antibodies, but this does not necessarily mean they still have Lyme disease.

 

The disease is treated with antibiotics (or certain, newly-discovered essential oils – scroll all the way down). Antibiotics and these essential oils are very effective in killing the bacteria. Treatment is most effective early in the course of Lyme disease. Lyme disease detected later is also treatable with antibiotics but can cause symptoms that may take longer to go away, even after the antibiotics have killed the bacteria.


In some circumstances, a short (1-day) antibiotic treatment soon after a tick bite might prevent the development of Lyme disease. Several criteria must be met: (1) The tick must be identified as the blacklegged tick (deer tick). (2) The tick must have been attached for at least 36 hours. If it is engorged – puffed up with blood – then it was probably on this long. (3) The local infection rate in the blacklegged ticks must be at least 20%. This is likely the case for much of Minnesota, but call MDH (651-201-5414) if you have any questions. The treatment must be started within 72 hours (3 days) of finding the attached tick on yourself. The treatment is only for adults and children 8 years of older.


Talk to your doctor about the single dose antibiotic treatment if you meet these criteria. You can also take a "wait and see" approach and watch for signs and symptoms of Lyme disease. Prompt treatment of the disease is very effective and will prevent more severe signs and symptoms.

 

Most people have a complete resolution of their symptoms after treatment. A small percentage of patients (especially those diagnosed in the later stages of the disease) may have persistent complaints after treatment, called post-treatment Lyme disease syndrome (PTLDS).

Post-Treatment Lyme Disease Syndrome (PTLDS)

Even after treatment, a few people may experience post-treatment Lyme disease syndrome, sometimes referred to as chronic Lyme disease. This involves nonspecific symptoms, such as fatigue and joint pain, that can persist for months after treatment. Antibiotics are unlikely to help, so treatment aims to relieve symptoms, for example through rest and anti-inflammatory medications. The symptoms should resolve in time.

If You See a Tick On Your Kid...

If you have not done so already, remove the tick with fine-tipped tweezers. The chances that you might get Lyme disease from a single tick bite depend on the type of tick, where you acquired it, how long it was attached to you, and if it is carrying the Lyme virus. Blacklegged ticks need to be attached for at least 24 hours before they can transmit Lyme disease. This is why it’s so important to remove them promptly and to check your body daily for ticks if you live in an endemic area.

Many types of ticks bite people in the U.S., but only blacklegged ticks transmit the bacteria that cause Lyme disease. Furthermore, only blacklegged ticks in the highly endemic areas of the northeastern and north central U.S. (like Minnesota) are commonly infected.


Ticks can also transmit other diseases, so it’s important to be alert for any illness that follows a tick bite.

Always remember to save the tick you find on you or your child. It's important in figuring out which kind of tick bit you or your loved one by looking at photos on the CDC’s website, or send the tick to an insect identification lab. The USDA identifies ticks for free.

How To Remove A Tick

The proper way to remove a tick is to use a set of fine tweezers and grip the tick as close to the skin as is possible. Do not use a smoldering match or cigarette, nail polish, petroleum jelly (e.g., Vaseline), liquid soap, or kerosene because they may irritate the tick and cause it to behave like a syringe, injecting bodily fluids into the wound.

 

The proper technique for tick removal includes the following:

  • Use fine tweezers to grasp the tick as close to the skin surface as possible.
  • Pull backwards gently but firmly, using an even, steady pressure. Do not jerk or twist.
  • Do not squeeze, crush, or puncture the body of the tick, since its bodily fluids may contain infection-causing organisms.
  • After removing the tick, wash the skin and hands thoroughly with soap and water.
  • If any mouth parts of the tick remain in the skin, these should be left alone; they will be expelled on their own. Attempts to remove these parts may result in significant skin trauma.

Tick Identification

It is helpful if the person can provide information about the size and color of the tick, whether it was actually attached to the skin, if it was engorged (that is, full of blood), and how long it was attached.

Identification:

 

Ticks that are brown and approximately the size of a poppy seed or pencil point are deer ticks; however, the size can change with feeding. These ticks can transmit B. burgdorferi (the bacterium that causes Lyme disease) and a number of other tick-borne infections, including babesiosis and anaplasmosis. B. burgdorferi-infected deer ticks live primarily in the northeast and mid-Atlantic region (Maine to Virginia) and in the Midwest region (Minnesota, Wisconsin, Illinois, Michigan, Ohio) of the United States, and less commonly in the western US (northern California).

 

Ticks that are brown with a white collar and about the size of a pencil eraser are more likely to be dog ticks (Dermacentor species). These ticks do not carry Lyme disease, but can rarely carry another tick-borne infection called Rocky Mountain spotted fever that can be serious or even fatal.

 

A brown to black tick with a white splotch on its back is likely a female Amblyomma americanum (Lone Star tick; named after the white splotch). This species of tick has been reported to spread an illness called southern tick-associated rash illness (STARI). STARI causes a rash that is similar to the erythema migrans rash, but without the other features of Lyme disease. Although this rash is thought to be caused by an infection, a cause for the infection has not yet been identified. This type of tick can also carry and transmit another infection called human monocytic ehrlichiosis.

 

A tick that was not attached, was easy to remove or just walking on the skin, and was still flat and tiny and not full of blood when it was removed could not have transmitted Lyme disease or any other infection since it had not yet taken a blood meal. Even if a tick is attached, it must have taken a blood meal to transmit Lyme disease. At least 36 to 48 hours of feeding is typically required for a tick to have fed and then transmit the bacterium that causes Lyme disease. After this amount of time, the tick will be engorged (full of blood). An engorged tick has a globular shape and is larger than one that is not engorged.

Need for Treatment

The clinician will review the description of the tick along with any physical symptoms to decide upon a course of action. The Infectious Diseases Society of America (IDSA) recommends preventive treatment with antibiotics only in people who meet all of the following criteria:

  • Attached tick identified as an adult deer tick.
  • Tick is estimated to have been attached for ≥36 hours (based upon how engorged the tick appears or the amount of time since outdoor exposure).
  • The antibiotic can be given within 72 hours of tick removal.
  • The local rate of tick infection with B. burgdorferi is ≥20 percent (known to occur in parts of New England, parts of the mid-Atlantic states, and parts of Minnesota and Wisconsin).
  • The person can take doxycycline.

If the person meets all of the above criteria, the recommended dose of doxycycline is a single dose of 200 mg for adults, and 4 mg/kg (up to a maximum dose of 200 mg) in children 8 or older.

 

If the person cannot take doxycycline, the IDSA does not recommend preventive treatment with an alternate antibiotic for several reasons: there are no data to support a short course of another antibiotic, a longer course of antibiotics may have side effects, antibiotic treatment is highly effective if Lyme disease were to develop, and the risk of developing a serious complication of Lyme disease after a recognized bite is extremely low.

Preventing Lyme

The incidence of Lyme disease appears to be on the rise in the U.S. The National Science Foundation suggest this could be due to forest fragmentation, as smaller fragments of forest seem to harbor more ticks. Small patches of woodland are common in cities and suburban and rural areas. The number of Lyme cases might go up as the climate changes and ticks have more warm, woodsy places to live.

First, if kids play outside, check them daily for ticks, making sure to inspect easy-to-miss nooks and crannies like the armpits, groin and scalp. Bathing with a washcloth is a simple and effective way to sweep ticks from the skin before they’ve latched on.

 

Bug repellents like DEET and permethrin can help keep ticks away. For kids, the American Academy of Pediatrics recommends formulations with 10 to 30 percent DEET (although Canada’s public health department thinks kids should stick to formulations with 10 percent DEET or less).

 

If you do find a tick that’s attached, remove it right away. A pair of thin-tipped tweezers and an empty container will do the trick, Sood says. “It’s nothing fancy,” he says. Grasp the tick at the mouth end, and pull straight up. “Gentle, steady pressure, and it will generally pop right out,” Sood says.


The best way to prevent Lyme disease is to avoid tick bites. Some ways to do this are:

  • Be alert for symptoms.
  • Be aware of the risk, especially if living in or visiting New England, the upper Midwest or the mid-Atlantic states.
  • Use repellant on the skin, clothing, and hiking or camping gear.
  • Treat pets with anti-tick treatment.
  • Check your body, gear, clothes, and pets for ticks after spending time outdoors.
  • Shower after coming in from outside.
  • Dry clothes at a high temperature to kill ticks.
  • Ask pest control for advice about protecting your yard.
  • Discourage deer by fencing your yard.
  • Remove ticks quickly and correctly, and take a photo in case you need to show a doctor
  • When checking the body, the CDC suggest looking for ticks in the following places: under the arms and behind the knees; in and around the ears; in the belly button; in head and body hair; between the legs; around the waist.

If a tick is attached to the skin for less than 24 hours, it is unlikely to transmit Lyme disease.

Monitoring for Lyme Disease

Many people have incorrect information about Lyme disease. For example, some people are concerned that Lyme disease is untreatable if antibiotics are not given early. This is untrue; even later features of Lyme disease can be effectively treated with appropriate antibiotics. Many local Lyme disease networks and national organizations disseminate unproven information and should not be the sole source of education about Lyme disease.


Whether or not a clinician is consulted after a tick bite, the person who was bitten (or the parents, if a child was bitten) should observe the area of the bite for expanding redness, which would suggest erythema migrans (EM), the characteristic rash of Lyme disease. Approximately 80 percent of people with Lyme disease develop EM; 10 to 20 percent of people have multiple lesions.


The EM rash is usually a salmon color, although rarely it can be an intense red, sometimes resembling a skin infection. The color may be almost uniform. The lesion typically expands over a few days or weeks and can reach over 20 cm (8 inches) in diameter. As the rash expands, it can become clear (skin-colored) in the center. The center of the rash can then appear a lighter color than its edges or the rash can develop into a series of concentric rings giving it a "bull's eye" appearance. The rash usually causes no symptoms, although burning or itching has been reported.


In people with early localized Lyme disease, EM occurs within one month of the tick bite though typically within a week of the tick bite. Only one-third of people recall the tick bite that gave them Lyme disease. Components of tick saliva can also cause a rash; however, this rash should not be confused with EM. The rash caused by tick saliva typically occurs while the tick is still feeding or just after the tick detaches, and usually does not expand to a size larger than a dime.


If EM or other signs or symptoms suggestive of Lyme disease develop, the person should see a healthcare provider for proper diagnosis and treatment.

Person-To-Person Transmission

Lyme disease spread cannot spread between humans. Dogs and cats can get Lyme disease, but they cannot infect humans. There have been no documented cases of anyone contracting Lyme disease by eating venison. Lyme disease also cannot be passed on through the air, food, or water.

 

However, if you are diagnosed with Lyme disease and are also breastfeeding, make sure that your doctor knows this so that he or she can prescribe an antibiotic that’s safe for use when breastfeeding.

 

It can’t be transmitted during a blood transfusion. However, though no cases of Lyme disease have been linked to blood transfusion, scientists have found that the Lyme disease bacteria can live in blood from a person with an active infection that is stored for donation, therefore individuals being treated for Lyme disease with an antibiotic should not donate blood. Individuals who have completed antibiotic treatment for Lyme disease may be considered as potential blood donors. The Red Cross provides additional information on the most recent criteria for blood donation.

Q & A:

I live in the southwestern U.S. and get a lot of Lone Star tick bites. I've heard that I can get "Southern Lyme Disease," is this true?

The lone star tick is primarily found in the southeastern and eastern United States. Lone star ticks do not transmit Lyme disease. However, you are correct to be concerned about this very aggressive species. The lone star tick (Amblyomma americanum) can spread human ehrlichiosis, tularemia, and Southern Tick-Associated Rash Illness (STARI).


The rash of STARI is a red, expanding “bull’s eye” lesion that develops around the site of a lone star tick bite. The rash usually appears within seven days of tick bite and expands to a diameter of 3 inches or more. The rash should not be confused with much smaller areas of redness and discomfort that can occur commonly at tick bite sites. Unlike Lyme disease, STARI has not been linked to arthritis, neurological problems, or chronic symptoms. Nevertheless, the similarity between the STARI bull’s eye rash and the Lyme disease "bull’s eye" EM rash has created much public confusion. The pathogen responsible for STARI has not been identified.


In contrast, Lyme disease in North America is caused by a specific type of bacteria, Borrelia burgdorferi, which is transmitted by two species of blacklegged ticks, Ixodes scapularis and Ixodes pacificus. While blacklegged ticks exist in the southern U.S., their feeding habits in this region make them much less likely to maintain, sustain, and transmit Lyme disease.

I have heard that the diagnostic tests the CDC recommends are not very accurate. Can I be treated based on my symptoms, or do I need to use a different test?

You may have heard that the blood test for Lyme disease is correctly positive only 65% of the time or less. This is misleading information. As with serologic tests for other infectious diseases, the accuracy of the test depends upon how long you’ve been infected. During the first few weeks of infection, such as when a patient has an erythema migrans (EM) rash, the test is expected to be negative. Several weeks after infection, FDA cleared tests have very good sensitivity.


It is possible for someone who was infected with Lyme disease to test negative because some people who receive antibiotics (e.g. doxycycline) within the first few weeks after tick bite may not have a fully developed antibody response or may only develop an antibody response at levels too low to be detected by the test.


Antibodies against Lyme disease bacteria usually take a few weeks to develop, so tests performed before this time may be negative even if the person is infected. In this case, if the person is retested a few weeks later, they should have a positive test for Lyme disease. It is not until 4 to 6 weeks have passed that the test is likely to be positive. This does not mean that the test is bad, only that it needs to be used correctly.

I am pregnant and just found out I have Lyme disease. What should I do?

If you are pregnant and suspect you have contracted Lyme disease, contact your physician immediately. Untreated Lyme disease during pregnancy may lead to infection of the placenta and possible stillbirth.

Thankfully, no serious effects on the fetus have been found in cases where the mother receives appropriate antibiotic treatment for her Lyme disease. In general, treatment for pregnant women with Lyme disease is similar to that of non-pregnant adults, although certain antibiotics, such as doxycycline, are not used because they can affect fetal development. Additionally, there are no reports of Lyme disease transmission from breast milk.

If I have been diagnosed with Lyme disease, do I need to get tested for other tick-borne diseases (coinfections)?

Maybe. The blacklegged ticks that transmit Lyme disease can sometimes also transmit babesiosis and anaplasmosis. Fortunately, Lyme disease and anaplasmosis are treated with the same antibiotics (Wormser et al. 2006). Babesiosis is a parasitic disease that is treated with different medications. If your Lyme disease symptoms do not seem to be going away after taking antibiotics, see your health care provider.

 

There is a great deal of misinformation regarding tickborne coinfections on the internet. The possibility of having three or more tickborne infections or having pathogens such Bartonella or Mycoplasma (which have not been shown to be tickborne) is extremely unlikely.

 

The chance of having multiple tickborne infections depends on your location. Several studies have looked at the prevalence of these different organisms in ticks, though methods and locations are very different. Studies have shown that the rate of coinfection in blacklegged ticks varies by region from 1 to 28%. The most common coinfection in ticks is Borrelia burgdorferi (Lyme disease) and Anaplasma phagocytophilum (anaplasmosis). The frequency of tickborne coinfections in Lyme disease patients from endemic areas ranges from 4 to 45% (Swanson et al. 2006). From 2 to 12% of patients with early Lyme disease may also have anaplasma infection, and 2 to 40% of patients with early Lyme disease may also have babesia infection, depending on the region (Wormser, 2006).

I have been sick for a few years with joint and muscle pain, fatigue, and difficulty thinking. I was tested for Lyme disease using a Western Blot test. The “IgM” Western Blot test was positive but the “IgG” Western Blot test was negative. Is Lyme disease the cause of my symptoms?

Probably not. First, you should only have an immunoblot (such as an FDA-approved Western Blot or striped blot) test done if your blood has already been tested and found reactive with an EIA or IFA.


Second, the IgM Western Blot test result is only meaningful during the first four weeks of illness. If you have been infected for longer than 4 to 6 weeks and the IgG Western Blot is still negative, it is highly likely that the IgM result is incorrect (e.g. a false positive). This does not mean that you are not ill, but it does suggest that the cause of illness is something other than the Lyme disease.

Where can I get a test to make sure that I am cured?

As with many infectious diseases, there is no test that can “prove” you're cured. Tests for Lyme disease detect antibodies produced by the human immune system to fight off the bacteria (Borrelia burgdorferi) that cause Lyme disease. These antibodies can persist long after the infection is gone. This means that if your blood tests positive, then it will likely continue to test positive for months or even years even though the bacteria are no longer present.

 

A research tool called PCR can detect bacterial DNA in some patients. Unfortunately, this is also not helpful as a test of whether the antibiotics have killed all the bacteria. Studies have shown that DNA fragments from dead bacteria can be detected for many months after treatment. Studies have also shown that the remaining DNA fragments are not infectious. Positive PCR test results are analogous to a crime scene – just because a robbery occurred and the robber left his DNA, it doesn’t mean that the robber is still in the house. Similarly, just because DNA fragments from an infection remain, it doesn’t mean the bacteria are alive or viable.

My serologic (blood) test for Lyme is still positive even though I finished 3 weeks of antibiotics. Does this mean I am still infected?

No. The tests for Lyme disease detect antibodies made by the immune system to fight off the bacteria. Your immune system continues to make the antibodies for months or years after the infection is gone. This means that once your blood tests positive, it will continue to test positive for months to years even though the bacteria are no longer present. Unfortunately, in the case of bacterial infections, these antibodies don’t prevent someone from getting Lyme disease again.

I have heard that if I get Lyme disease that I will always have it. Is that true?

No. Patients treated with antibiotics in the early stages of the infection usually recover rapidly and completely. Most patients who are treated in later stages of the disease also respond well to antibiotics, although some may have suffered long-term damage to the nervous system or joints. It is not uncommon for patients treated for Lyme disease with a recommended 2 - 4 week course of antibiotics to have lingering symptoms of fatigue, pain, or joint and muscle aches at the time they finish treatment. In a small percentage of cases, these symptoms can last for more than 6 months. These symptoms cannot be cured by longer courses of antibiotics, but they generally improve on their own, over time.

Can you recommend a doctor who is familiar with diagnosing and treating Lyme disease?

In areas where Lyme disease is common, most family practice physicians, general practitioners, and pediatricians are familiar with diagnosing and treating Lyme disease. If you have symptoms that suggest Lyme disease, or any other tick-borne infection, tell your doctor all these facts. Many doctors may not consider tick-borne diseases in diagnosing your illness unless you report being bitten by a tick, or live in, or have recently visited, a tick-infested area.

 

In areas where Lyme disease is not common or for more complicated cases of Lyme disease, infectious disease specialists are often the best type of doctor to see. The National Institutes of Health provides information about how to choose a doctor. Additionally, your state medical board can help you find out if your health care provider is in good standing.

What is CDC doing about Lyme disease?

CDC has a program of service, research, and education focusing on the prevention and control of Lyme disease. Activities of this program include:

  • Maintaining and analyzing national surveillance data for Lyme disease
  • Conducting epidemiologic investigations.
  • Offering diagnostic and reference laboratory services.
  • Developing and testing strategies for the control and prevention of this disease in humans.
  • Supporting education of the public and health care providers.
  • In addition, the TickNET program supports research that contributes to the understanding of tickborne diseases.

About 4 to 5 percent of people who get treated have symptoms such as fatigue, muscle aches, and trouble sleeping that linger for more than six months. The condition, named post-treatment Lyme disease syndrome, or PTLDS, is commonly known as “chronic Lyme disease,” and on the Internet, it’s a notoriously thorny subject.

 

“There’s a lot of misinformation out there,” Mead says. No one really knows what causes the symptoms. People could be having a delayed immune response, or they may have an undiagnosed illness that’s to blame. But scientists do know that lengthy courses of antibiotics don’t seem to help.

 

“People should be skeptical if providers are telling them that they need to be on months and years of antibiotics,” Mead says. Very few ­— if any — people actually die from Lyme disease. One 2012 study found that from 1999 to 2003, only 23 death certificates listed Lyme disease as the underlying cause (and perhaps only one of those people actually had the disease). During the same time period, the CDC recorded more than 96,000 cases of the disease.

 

But not every case gets reported, Mead says. The CDC estimates that the number of Americans diagnosed with Lyme disease each year is actually around 300,000.

These 10 essential oils can kill persistent Lyme disease:

(From Medical News Today)

Research recently published in the journal Antibiotics demonstrates that a range of essential oils can effectively kill persistent forms of Lyme disease. Some essential oils have strong antibacterial properties.


Antibiotics, such as doxycycline, can usually clear Lyme disease in a few weeks, but in some cases, the infection persists. According to the authors of a new study, approximately 10–20 percent of those who contract Lyme disease continue to report symptoms for months, and in some cases, years.


Medical professionals do not yet know what causes these cases of so-called persistent Lyme infection or "post-treatment Lyme disease syndrome." However, they do know that B. burgdorferi can enter a dormant, or "stationary" stage in which its cells either multiply very slowly or do not divide at all. These so-called persister cells are more resilient to antibiotics. But this new research may have found an unexpected ally in the fight against these Lyme disease dormant bacteria: essential oils!


Dr. Ying Zhang, Ph.D., a professor in the Department of Molecular Microbiology and Immunology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, led the new study.


Garlic, Myrrh, and Thyme kill B. burgdorferi, the bacteria causing Lyme disease. Dr. Zhang and his team had previously found some "highly active essential oils" that were effective against "biofilm and stationary phase B. burgdorferi."

 

In this new study, the researchers screened another 35 essential oils for their antibacterial properties. Using pressed essential oils from plants or their fruits, the researchers tested the activity of the plants' fragrant "essence."

 

Lab-dish tests revealed that ten of these 35 plants have "strong activity" against the latent, "persister" forms of Lyme disease. These essential oils derived from garlic cloves, myrrh trees, thyme leaves, cinnamon bark, allspice berries, cumin seeds, and eucalyptus, among others. We found that these essential oils were even better at killing the 'persister' forms of Lyme bacteria than standard Lyme antibiotics," says Dr. Ying Zhang.


Also, five of these oils were effective against dormant forms of Lyme bacteria in a concentration of only 1 part per 1,000. Specifically, essential oils from garlic bulbs, allspice berries, myrrh trees, spiked ginger lily, and may chang trees "completely eradicated" all Lyme disease bacteria in 7 days, and no regrowth occurred in 21 days. Thyme leaves, cumin seeds, Amyris wood, and cinnamon bark oil were also highly effective against stationary phase B. burgdorferi.

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