6 Random Questions About Lyme Disease, Answered

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Written By: Melissa Fiorenza

The onset of summer used to spur talk of popsicles, pool parties, and all things rainbows and sunshine. But doesn’t it seem like over the past few years, conversations always turn to ticks as soon as the temperatures start heating up? News headlines shout that tick season will be “worse than ever,” or that there’s a new tick in town you have to watch out for. Honestly, it’s scary!

So we asked a medical professional, Dr. Mollie Jewett, head of the Immunity and Pathogenesis Division at the University of Central Florida College of Medicine, to answer our most burning, random questions about Lyme disease and ticks for our benefit and yours. Take a look.


1. Does every Lyme diagnosis start with that bullseye mark, or does not everyone get the mark?

The erythema migrans rash (bullseye rash) is seen in about 70-80% of patients. That means that 20-30% of patients do not get the rash.


2. Is it possible to have Lyme and not even know you were ever bitten by a tick? (You never even saw one or a mark?)

Yes. Some patients do not get the rash and it is quite possible to not notice that you have been bitten by a tick. The nymph stage (“teenager”) of the black legged tick is extremely small. It is smaller than a sesame seed. Although these ticks are slow feeders, meaning that they stay attached and feed for approximately 3-5 days, they are so small that they can go unnoticed. This is particularly true if the person is not thinking about checking their body for ticks after being outdoors in places where they might encounter ticks.


3. Is it curable? How is it treated—in children and adults?

Lyme disease is treatable with antibiotics. The following is the recommended treatment according to the Centers for Disease Control and Prevention.

 

Treatment for Adults:

Drug: Cefuroxime axetil

Dosage: 500 mg, 2x per day orally

Maximum: N/A

Duration/Days: 14-21

Drug: Doxycycline

Dosage: 100 mg, 2x per day orally

Maximum: N/A

Duration/Days: 10-21*

Drug: Amoxicillin

Dosage: 500 mg, 3x per day orally

Maximum: N/A

Duration/Day: 14-21

 

Treatment for Children:

Drug: Amoxicillin

Dosage: 50 mg/kg per day orally, divided into 3 doses

Maximum: 500 mg per dose

Duration/Days: 14-21

Drug: Doxycycline

Dosage: 4 mg/kg per day orally, divided into 2 doses

Maximum: 100 mg per dose

Duration/Days: 10-21*

Drug: Cefuroxime axetil

Dosage: 30 mg/kg per day orally, divided into 2 doses

Maximum: 500 mg per dose

Duration/Days: 14-21

 

Lyme disease is a multistage inflammatory disease, meaning it typically gets worse the longer it goes untreated. Patients who are diagnosed early typically fully recover with little side effects of the disease. However, the longer patients go undiagnosed and without treatment the more likely they are to have the possibility of prolonged side effects of the disease following treatment. This is termed “Post-treatment Lyme Disease Syndrome” (PTLDS).

According to the CDC: The National Institutes of Health (NIH) has funded several studies on the treatment of Lyme disease that show most people recover when treated within a few weeks of antibiotics taken by mouth. In a small percentage of cases, symptoms such as fatigue (being tired) and muscle aches can last for more than 6 months. This condition is known as “Post-treatment Lyme Disease Syndrome” (PTLDS), although it is often called “chronic Lyme disease.” For details on research into “chronic Lyme disease” and long-term treatment trials sponsored by NIH, visit the National Institutes of Health Lyme Disease website.


4. What's the best way to remove a tick from a child? And after you remove it, should you immediately take him/her to a doctor?

The CDC provides clear directions about how best to remove a tick. After removing the tick the parent should note the date of the tick bite on the calendar (this helps to provide a time context for monitoring if and when following tick bite the child shows any symptoms) and take the child to the doctor.

If you find a tick attached to your skin, there’s no need to panic—the key is to remove the tick as soon as possible. There are several tick removal devices on the market, but a plain set of fine-tipped tweezers works very well.


5. Are ticks with Lyme only found in the deep woods? Or could they somehow make their way into our houses, our bedrooms upstairs?

Black legged ticks are not limited to the deep woods. These ticks can be in more urban areas such as backyards, gardens, and on vegetation along bike paths. It is possible that ticks could be carried inside the house on the outside of clothing or on pets. Exposure to ticks can occur year round but ticks are most active during April-September. If a person has been in an area where he/she might come into contact with ticks he/she should wear clothing treated with 0.5% permethrin and use insect repellents.


6. Is it possible to contract Lyme, as a child or an adult, then live a completely normal, long, healthy life?

Yes, patients that are diagnosed early and are treated appropriately with antibiotics typically recover quickly and completely.