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Lyme Disease Information

Use this guide to learn important facts about Lyme disease. Get complete information on the signs of the disease, how to identify and safely remove ticks and how to decrease your chances of exposure to ticks and Lyme Disease. The more you know, the better
you can protect yourself.
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General Introduction and Information

Lyme disease is the most frequently reported tick-borne illness in the United States. People become infected with Lyme disease through the bite of a black-legged tick (ixodes scapularis or pacificus) that is infected with the bacterium Borrelia burgdorferi.

Lyme disease was first recognized in the United States in 1975 after an unusual outbreak of arthritis near Lyme, CT. Since then, reports of Lyme disease have increased dramatically.

See Lyme Disease FAQs for more information.
Geographic Distribution

Lyme disease is distributed over a wide geographic area in northern temperature regions of the world. In the United States, most infections occur in the following areas:
  • Northeast, from Maryland to Maine
  • North-central states, mostly in Wisconsin and Minnesota
  • West Coast, particularly northern California
Lyme Disease Signs and Symptoms

The early stages of Lyme disease are usually marked by one or more of the following signs and symptoms:
  • Characteristic bull’s eye skin rash called erythema migrans, a red circular patch that appears at the site of the tick bite within three days to a month after the bite of an infected tick
  • Fatigue
  • Chills and fever
  • Headache
  • Muscle and joint pain
  • Swollen lymph nodes
Some signs and symptoms of Lyme disease may not appear until weeks, months or even
years after a tick bite, including:
  • Arthritis, most likely to appear as brief bouts of pain and swelling, usually in one or more large joints,
    especially the knees
  • Nervous system symptoms, including numbness, pain, nerve paralysis (often facial muscles, usually on one side) and meningitis (fever, stiff neck and severe headaches)
  • Rarely, irregularities of the heart rhythm
  • Problems with memory or cognition, fatigue, headache and sleep disturbances, even after treatment
Lyme Bacteria

Lyme disease bacterium is Borrelia burgdorferi and is spread through the bite of infected ticks. This bacterium can:
  • Go intracellular and hide, go dormant, or mutate
  • Become sequestered in difficult to penetrate sites (central nervous system, joints, eyes)
  • Use the body’s own cells to shield them
  • Have other than spirochete forms, such as L-form or cystic form
  • Be found in patients after long-term treatment
  • Be associated with a neurotoxin
Diagnosis and Testing

The diagnosis of Lyme disease should take into account the following factors:
  • History of possible exposure to ticks in areas where Lyme disease is known to occur
  • Signs and symptoms of the illness
  • The results of blood tests used to detect whether the patient has antibodies to the Lyme disease bacterium (Borrelia burgdorferi)
Currently a two-stage testing process to measure the body’s production of antibodies to the Lyme disease bacterium is recommended. The tests do not detect an infection until the body begins to produce measurable levels of antibodies to the Lyme disease bacterium. The tests are:
  • An enzyme-linked immunosorbent assay (ELISA) or indirect immunofluorescence assay (IFA) followed by
  • A Western immunoblot of samples that tested positive or equivocal to ELSA or IFA.
Co-infections

Other tick-borne diseases, which can be more severe when coexisting with Lyme, can be contracted at the same time as Lyme, including:
  • Babesiosis, which is a parasitic malaria-like illness caused by a protozoa and is sometimes fatal in elderly or those with no spleen
  • Bartonella, a disease caused by an intracellular bacteria that can be transmitted by a tick bite as well as cat bite or scratch
  • Rocky Mountain Spotted Fever, an illness caused by a parasite that can be transmitted by a tick bite
  • Tularemia, a disease caused by a bacterium that can be transmitted by a tick bite
  • Multiple other viruses, many whose effects are unknown
Treatment

Several antibiotics are effective for treating Lyme disease, and these are usually given by the mouth but may be given intravenously in more severe cases.
Tick Identification Guide

There are a number of different types of ticks, including:
  • Ixodes scapularis (includes the deer tick) is found in the Northeast and Upper Midwest,
    and it transmits Lyme disease
  • Amblyomma americanum (includes the lone star tick) is found throughout the United States,
    and it transmits Lyme disease
  • Dermacentor variabillis (includes the American dog tick and wood tick) is found throughout the United States, but no transmission of Lyme disease has been proven
  • Ixodes pacificus is found in the West, and it transmits Lyme disease
Tick Removal

Care needs to be used when removing ticks. Here are some tips:
  • Do not burn or use any substance on the tick
  • Do not grasp, squeeze or twist the body of the tick
  • Grasp the tick close to the skin with tweezers
  • Pull the tick straight out
  • Use an antiseptic on the skin
  • Disinfect the tweezers
  • Wash hands thoroughly
  • Always see a physician for possible diagnosis, testing and treatment
Prevention

You can decrease the chances of exposure to ticks and Lyme disease with a few precautions, including:
  • Avoid tick-infested areas
  • Use insect repellent with 20 to 30% concentration of DEET on clothes and exposed skin
  • Wear light-colored protective clothing, including long sleeve shirts and long pants, and tuck pants into socks
  • Put clothes in the dryer for 30 minutes to kill ticks
  • Perform frequent and thorough tick checks
Get the Facts
  • You can contract many tick-borne diseases simultaneously from the same tick bite
  • You can test negative and still have Lyme disease
  • If you have an erythema migrans rash, you have Lyme disease
  • Not everyone who contracts Lyme disease gets a rash
  • Lyme disease is clinically diagnosed based on a patient’s symptoms, history and examination
  • Lyme bacteria can cross the placenta into the fetus, and its DNA can be found in breast milk
  • Lyme disease patients often get worse before getting better on treatment
  • Lyme symptoms can develop days or months or years after a tick bite
  • Lyme disease can cause death occasionally

Click here to view FAQs about Lyme Disease.

Sources:
Department of Health and Human Services Center for Disease Control and Prevention
Lyme Disease Association, Inc.
Lyme Disease Action
MedicineNet
American Academy of Family Physicians
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