Lyme disease

Early signs and symptoms

A small, red bump, similar to the bump of a mosquito bite, often appears at the site of a tick bite or tick removal and resolves over a few days. This normal occurrence doesn't indicate Lyme disease.
However, these signs and symptoms can occur within a month after you've been infected:

• Rash. From three to 30 days after an infected tick bite, an expanding red area might appear that sometimes clears in the center, forming a bull's-eye pattern. The rash (erythema migrans) expands slowly over days and can spread to 12 inches (30 centimeters) across. It's typically not itchy or painful but might feel warm to the touch.

• Erythema migrans is one of the hallmarks of Lyme disease, although not everyone with Lyme disease develops the rash. Some people develop this rash at more than one place on their bodies.
• Other symptoms. Fever, chills, fatigue, body aches, headache, neck stiffness and swollen lymph nodes can accompany the rash.

Later signs and symptoms

If untreated, new signs and symptoms of Lyme infection might appear in the following weeks to months. These include:
Erythema migrans. The rash may appear on other areas of your body.
Joint pain. Bouts of severe joint pain and swelling are especially likely to affect your knees, but the pain can shift from one joint to another.
Neurological problems. Weeks, months or even years after infection, you might develop inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell's palsy), numbness or weakness in your limbs, and impaired muscle movement.

Less common signs and symptoms

Several weeks after infection, some people develop:

• Heart problems, such as an irregular heartbeat
• Eye inflammation
• Liver inflammation (hepatitis)
• Severe fatigue

Diagnosis

Lyme disease can be a difficult condition to diagnose, particularly in its latter stages, because its symptoms are also shared by other, more common conditions, such as infections, or arthritis. While the characteristic skin rash can provide an important clue, not everyone with Lyme disease will develop the rash.

If you do not develop the rash, you will need to have some tests so that your GP can confirm, or rule out, a diagnosis.

Treating Lyme Disease

Antibiotic tablets (oral antibiotics) are recommended for the treatment of early-stage Lyme disease. Most people will require a 2-3 week course of antibiotics. If you are prescribed antibiotics, it is important that you finish the course even if you are feeling better because this will ensure that all the bacteria are destroyed. These usually include doxycycline for adults and children older than 8, or amoxicillin or cefuroxime for adults, younger children, and pregnant or breast-feeding women.

A 14- to 21-day course of antibiotics is usually recommended, but some studies suggest that courses lasting 10 to 14 days are equally effective.

Mid- and late-stage Lyme disease can also be treated with antibiotics. If your symptoms are particularly severe, antibiotic injections (intravenous antibiotics) may be used. Most people with mid- and late-stage Lyme disease will require a prolonged course of antibiotics.

The antibiotics that are used to treat Lyme disease (both oral and intravenous) can make your skin more sensitive to sunlight. Therefore, you should avoid prolonged exposure to the sun and avoid using tanning equipment until you have finished the course.  

Pregnancy and breastfeeding

If you are pregnant and get Lyme disease, treatment with antibiotics will not pose any additional risk to your unborn baby.

As the bacteria that cause Lyme disease cannot be passed on through breast milk, it is safe to continue breastfeeding if you have Lyme disease.

The best way to prevent getting Lyme disease is to be aware of the risks when you visit areas where ticks are likely to be found, and to take sensible precautions.

Travellers to other European countries, or to North America, where the infection occurs more frequently than in these islands, should also be aware of the risks.  It is important to remember that you can contract Lyme disease in Ireland and the UK.

You can reduce the risk of infection by:

• being aware of ticks and which areas they normally live in,
• wearing appropriate clothing in tick-infested areas (a long-sleeve shirt and trousers tucked into your socks),
• using insect repellents,
• inspecting your skin for ticks, particularly at the end of the day, including your head, neck, and skin folds (armpits, groin, and waistband),
• making sure that your children's head and neck areas, including scalps, are properly checked,
• checking that ticks are not brought home on your clothes, and
• checking that pets do not bring ticks into your home in their fur.

How to remove a tick

If you find a tick on your skin (or your child's skin), you should remove it by gently gripping it as close to the skin as possible, preferably using fine toothed tweezers, and pull steadily away from the skin.

Do not use a lighted cigarette end, a match head, or volatile oils to force the tick out. Some veterinary surgeries and pet supply shops sell inexpensive tick removal devices, which may be useful if you are frequently exposed to ticks.

Whether you’re receiving treatment for Lyme caught in the early stages, or living with Chronic Lyme Disease, these supportive therapies will help you fight the infection and feel better.

• Get lots of rest.
• Avoid caffeine or other stimulants that may affect sleep quality.
• Avoid alcohol or use in moderation.
• No smoking.
• Exercise to your ability when possible being careful not to overdo it.
• Modify your diet to include high quality protein and be high in fibre and low in fat and carbohydrates – reduce simple carbohydrates, use those with low glycemic index.

References:

https://canlyme.com/living-with-lyme/

https://www.mayoclinic.org/diseases-conditions/lyme-disease/diagnosis-treatment/drc-20374655

https://www.hse.ie/eng/health/az/l/lyme-disease/