Beware of Lyme Disease, “The great imitator”

BY W. GIFFORD- JONES MD & DIANA GIFFORD-JONES

What a relief to be outside after being isolated by the coronavirus. But beware! Warmer weather means that ticks are in the woods around you. Or even in your own back yard.  A report in the Canadian Medical Association Journal shows, a tick bite can trigger diverse and deadly consequences.

One case involved a 37-year-old man complaining of flu symptoms, fever, sore throat and joint pain. He had been in a tick-infested area several weeks earlier but did not recall a tick bite. His doctor diagnosed a viral infection and the patient improved.

Weeks later heart palpitations, shortness of breath, and chest pains sent him to the emergency room. There was no evidence of the typical tick rash. But an ECG showed complete heart block. The diagnosis? Lyme carditis. Treatment of the disease was started.
Yet the man’s condition deteriorated, and he died.

Another case involved a 4-year-old boy who developed fever, vomiting, general weakness, unsteady gait, and disorientation. Fortunately, doctors made a speedy diagnosis, antibiotics were administered, and the boy recovered.

A third patient, a 57-year-old woman, suffered severe neurological symptoms, showing several organs in the body can be affected. It’s why Lyme Disease has been called, “the great imitator,” and why diagnosis is often delayed.

Families with country homes are well aware of the pleasures of outdoor life. But they know the hazards of tick season which runs from April through October. So how do you protect yourself?

First, know your enemy. The black-legged tick is an insect related to spiders and mites. It has a two­-year life cycle and needs a host to feed.

Next, ticks are plentiful. Studies show that there may be 2,000 infected ticks in an acre of forested land.

If bitten by a tick, you might find it lodged in your skin and needing immediate removal.  But ticks can bite, eat, and move on without you knowing. So you need to be aware of signs you’ve been bitten. A tick bite might produce nothing more than a little bump, but it can also result in a rash that appears even as long as a month after a bite. The classic tick bite rash looks like a bulls eye, as it’s red, circular, with a clear center and red ring around it. But don’t be fooled by not seeing it. The U.S. Centers for Disease Control reports that only three people in ten get this specific rash. Bites may be painless, or painful, itchy and hot. It can be associated with low-grade fever, headache, sore muscles, fatigue and often-joint pain.

The best Rx is prevention, prevention, and prevention. It’s worth every effort, given the risk of cardiovascular and neurological complications. This means wearing clothing that protects arms and legs, and the use of insect repellent.

Follow a strict routine of searching to ticks on all parts of the body after being in tick territory. This involves complete removal of clothing and having a proper tweezer available if a tick is found.

How soon should it be removed? Some studies say that it takes 24 hours before a tick transmits Lyme Disease. But good sense says it’s prudent to remove it as soon as possible to decrease the risk of transmission. And don’t forget to check pets for ticks or give them anti-tick medication.

If untreated, the disease strikes again in about three to five months. About one in ten patients develop an irregular heart rate, or heart block. The majority recover after a short time.

Neurological complications develop in about 10% of cases. For instance, peripheral nerves may be involved, or they may suffer form Bell’s Palsy, meningitis or encephalitis.

A final cycle of Lyme Disease starts from five months to five years following the first infection. Patients tend to complain of pain in large joints such as the knee.

So, take this disease seriously. Never forget prevention is better than cure.