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What is Lyme disease?

Lyme disease is an infection caused by the bite of an infected deer tick, which is much smaller than the tick commonly found on dogs. Only a small percentage of deer ticks carry the disease, and the tick needs to stay attached for 24 to 36 hours to transmit the disease-causing bacteria. Lyme disease isn't spread from person to person, so you can't get it from someone who has it.


You may not realize that you've been bitten by an infected deer tick because it's so small. But later, you may notice a rash at the bite site that looks like a bull's-eye target. You may also have flulike symptoms, such as fever, tiredness, muscle and joint aches, and chills.


Lyme disease is rarely fatal, but in some people it causes chronic problems, such as forgetfulness, irritability, sleep disturbances, stiff neck, an irregular heartbeat, arthritis, and paralysis on one side of the face. Early detection and prompt treatment with prescription antibiotics can help you recover completely from Lyme disease.


How will my health care provider know I have Lyme disease?

Your health care provider will begin by asking you questions about your symptoms and your recent activity, including outdoor activities where you might have been exposed to ticks or travel to areas where Lyme disease is common. She'll ask if you've recently had any rashes, especially in the shape of a bull's-eye, or other symptoms, such as a fever or aching muscles.


She'll look for a rash by examining your skin, including areas under your arms, behind your knees, and in skin folds.


She may also take a blood sample to test for Lyme disease. If she thinks Lyme disease is likely, she may want you to start antibiotic treatment right away. She may also perform a painless ECG (electrocardiogram) if you have heart symptoms, such as an irregular heartbeat.


If you have symptoms that suggest infection of the central nervous system, such as a severe headache and stiff neck, your health care provider may perform a spinal tap to get a spinal fluid sample, which can also be tested for Lyme disease and other infections. To perform a spinal tap, she'll numb your lower back and insert a needle into your spine to remove a small amount of the fluid that cushions your spinal cord and brain.


How is Lyme disease treated?

Your health care provider will prescribe an oral antibiotic, such as doxycycline or amoxicillin. If your Lyme disease is diagnosed early, you'll take the antibiotic for 2 to 3 weeks. If you have a more advanced case of Lyme disease, you may need to take it for a longer time. Some patients with stubborn or serious infections need intravenous antibiotics.


Take your antibiotic as directed by your health care provider. She may continue or repeat it until your symptoms clear up.


If you have joint pain, your health care provider may prescribe medication to make you more comfortable. She'll encourage you to exercise moderately, drink plenty of fluids, and get plenty of rest.


Don't stop taking your antibiotic without your health care provider's approval, even if you feel fine. Stopping too soon may let the infection come back or get worse. If you have a problem with side effects from the antibiotic, talk with your health care provider so she can adjust your treatment.


Once I've had Lyme disease, am I immune to it?

No. Even if you've been successfully treated for Lyme disease, you could get it again. No vaccine is available, so protect yourself by avoiding tick bites.


How can I protect myself from Lyme disease?

If you spend a lot of time outdoors, especially in wooded or high brush areas in northeastern or mid-Atlantic states, you're at risk for deer tick bites. Spring and summer months are the most dangerous times. Follow these steps to help you stay safe:


* When you go into the woods or areas of high brush, wear light-colored clothing so you have a better chance of seeing a small tick and brushing it off. Wear long sleeves and long pants. Tuck your shirt or undershirt into your pants and tuck your pant legs into your socks or boots. Stay on paths if possible, away from high grass or brush.


* Wear insect repellents especially designed to repel ticks. Most contain the chemical DEET. The Centers for Disease Control and Prevention says DEET is safe and effective, but don't apply it to a child's face or hands.


* When you return home, remove your clothing and wash it immediately.


* Check your skin and scalp for ticks.


* Check your pets, especially dogs; they can bring ticks into your home.


* If you find a tick, use fine-tipped tweezers or your fingers (covered with a tissue) to grasp the tick firmly as close to your skin as possible. Don't squeeze the tick's body. With a steady motion, pull it away from your skin. Clean the area with an antiseptic, such as rubbing alcohol. Watch the area for signs of infection, such as redness, swelling, and pain, and contact your health care provider if you suspect an infection.



For more information on Lyme disease, visit the Lyme Disease Foundation Web site at http://www.lyme.org or the American Lyme Disease Foundation Web site at http://www.aldf.com.


This patient-education guide has been adapted for the 5th-grade level using the Flesch-Kincaid and SMOG formulas. It may be photocopied for clinical use or adapted to meet your facility's requirements. Selected references are available upon request. For more tips on writing education guides, see the first article in this series: "Writing Easy-to-Read Teaching Aids" (March 2002).

Figure. A deer tick ... - Click to enlarge in new windowFigure. A deer tick (above) is less than 1 mm long-much smaller than the common dog tick.
Figure. Below, the b... - Click to enlarge in new windowFigure. Below, the bull's-eye rash at the bite site.
Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

Special thanks to Tracy Kane, MEd, patient-education coordinator, Albert Einstein Health Care Network, Philadelphia, Pa.