Tick-Borne Meat Allergy May Have Affected Virginia Kids
Wednesday, April 10, 2013
WEDNESDAY, April 10 (HealthDay News) -- A red meat allergy linked to certain tick bites has affected some Virginia children, researchers strongly suspect.
From September 2011 to May 2012, 45 children aged 4 to 17 developed itching and had trouble breathing after eating red meat, the study found. All had been bitten by a tick in the past year. Of these, more than 45 percent sought care in the emergency room for their symptoms, and 8 percent were admitted to the hospital.
Previously documented in adults, this phenomenon has been linked to the Lone Star tick, which commonly is found in the eastern and southern United States. Cases also are being reported in central states such as Oklahoma, Nebraska and Missouri, said study co-author Dr. Scott Commins, an assistant professor of medicine and pediatrics at the University of Virginia.
The tick injects spit into the body when it bites, and the body develops antibodies to a carbohydrate in the tick's spit that is known as alpha-gal. This carbohydrate is also present in red meat, so when an infected person eats meat, an allergic reaction is triggered.
Unlike other allergic reactions that occur immediately, this reaction tends to occur within three to six hours after eating red meat.
"The reactions can be ... life-threatening, where an [epinephrine] pen is needed," Commins said.
The new findings appear in the May print issue of the journal Pediatrics.
Because participants entered the study well after their allergic episodes and the researchers did not see their reactions firsthand, it was not proven that tick bites leading to meat allergy was the cause. Blood samples from the children, however, showed they developed antibodies to alpha-gal.
"Parents should look out for tick bites that remain persistently reddened and itchy, as well as for allergic symptoms that occur three to six hours after eating a meal with mammalian meat," Commins said. "Symptoms can [include] hives, swelling, diarrhea and abdominal pain."
The researchers think the problem is becoming more common, although there were study participants who said they have had the allergy for more than 30 years, Commins said.
And the study results "show clearly that physicians should keep this diagnosis in mind even in the pediatric population, especially if the history is consistent with the disease syndrome, including delayed symptoms after ingestion of beef, pork, lamb or even milk," the researchers wrote.
No current remedy exists, Commins said, "but the allergy does seem to fade over time so it is unlikely to be lifelong."
Another expert discussed the study's implications.
"This is an important phenomenon to be aware of when evaluating children who present with delayed allergic reactions as opposed to more classic reactions that occur within five to 30 minutes after exposure to an allergen," said Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City. "Symptoms can include hives, a change in voice or difficulty swallowing associated with throat swelling after eating a hamburger or a hot dog."
The message for parents is clear: "If your child get hives or a rash without any explanation, try to determine what they ate within the past three to six hours, and if it was beef, lamb or pork, you should consult an allergist, especially if your family spends a lot of time outside in areas often inhabited by ticks," Glatter said. "In children living in areas where the Lone Star tick is common, the alpha-gal syndrome should be considered a prime suspect."
Dr. Artemio Jongco, an allergist at Cohen Children's Medical Center in New Hyde Park, N.Y., emphasized that a reaction might require emergency care.
People who develop this allergy may need shots of epinephrine as well as observation in the emergency room, including treatment with antihistamines and steroids to control their symptoms, Jongco said.
"At a minimum, patients who present ... with this history and constellation of symptoms should be prescribed and instructed on the use of an epinephrine autoinjector, and warrant a referral for further evaluation by an allergist," Jongco said. "Moreover, patients with suspected [allergic reaction] and a history of tick bites should be evaluated by an allergist for potential alpha-gal sensitivity."
SOURCES: Scott Commins, M.D., Ph.D, assistant professor, medicine and pediatrics, Asthma and Allergic Diseases Center, University of Virginia; Robert Glatter, M.D., emergency medicine physician, Lenox Hill Hospital, New York City; Artemio Jongco, M.D., M.P.H., Ph.D., allergist, Cohen Children's Medical Center, New Hyde Park, N.Y.; May 2013 Pediatrics
Lyme disease antibody tests are used to help diagnose Lyme disease.
A blood sample is needed. For information on how this is done, see: Venipuncture.
A laboratory specialist will look for Lyme disease antibodies in the blood sample using the ELISA test. If the ELISA test is positive, it must be confirmed with the Western blot test.How to Prepare for the Test
There is no special preparation for the test.How the Test Will Feel
When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.Why the Test is Performed
The test is performed to help confirm the diagnosis of Lyme disease.Normal Results
A negative test result is normal. This means none or few antibodies to Lyme disease were seen in your blood sample. If the ELISA test is negative, usually no other testing is needed.
Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.
The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.What Abnormal Results Mean
A positive ELISA result is abnormal. This means antibodies were seen in your blood sample. However, this does not confirm a diagnosis of Lyme disease. A positive ELISA result must be followed up with a Western blot test. Only a positive Western blot test can confirm the diagnosis of Lyme disease.
For many people, the ELISA test remains positive even after they have been treated for Lyme disease and no longer have symptoms.
A positive ELISA may also occur with certain diseases, such as rheumatoid arthritis.Risks
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight, but may include:
- Excessive bleeding
- Fainting or feeling light-headed
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Lyme disease serology; ELISA for Lyme disease; Western blot for Lyme diseaseReferences
Steere AC. Borrelia burgdorferi (lyme disease, lyme borreliosis). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 242.Update Date: 3/15/2012
Updated by: Mark Levin, MD, Division of Infectious Disease, MacNeal Hospital, Berwyn, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
America is a pharmaceutical mecca. The business philosophy is that natural solutions are folklore, while lab-constructed methods are the real deal. Advertisers spin their information to encourage people to overlook the side effects of these products, of which many list death as a byproduct of use.
The misconception that chemical use is "safe" around people transposes onto the attitude towards animal care, even though severe reactions and death are common occurrences from such exposure. Some of the more concerning products involve flea and tick control methods. An outbreak in shelters, farms, or homes with multiple pets can get quickly out of control and turn into a dangerous infestation. Many believe that the risk of chemical exposure is to the benefit of the population, as a whole. However, there is a natural means for controlling pest issues without exposing people and furry animals to unnecessary health risks.
To safely control and exterminate fleas and ticks use food grade Diatomaceous Earth (DE). This option allows people who work or live with animals to provide responsible care, in a natural way, for half the cost of chemical treatments. This powerful pest controller is compliments of the planet Earth. DE is the natural byproduct of fossilized hard-shelled algae and it is detrimental to insects with an exoskeleton, such as fleas, ticks, and even lice. In the simplest terms, DE is a hyperactive dehydrator that kills off pests just as readily as a chemical treatment without the worry of toxic exposure.
To eradicate pests safely, purchase Food/Natural Grade DE and avoid Pool Grade DE. The reason to pay attention to this distinction is that Pool Grade DE is chemically altered to treat pool water, and therefore has toxic components. To find Food/Natural Grade DE, either locate a local feed store that sells bulk bags, or ask a local garden center if they carry food grade DE.
Animal Application Method:
Thoroughly apply the powder to the animal's coat. Pay attention to crease and fold areas of their skin and ears, as pests prefer these regions. Leave the powder on for 24 hours, then rinse and repeat as necessary. Depending on the level of the outbreak, it can take from 24 hours up to a week for a heavy infestation. The average range is between 24 to 48 hours.
DE is also a responsible preventative measure towards pest infestations, as it eradicates eggs and larvae. Therefore, there does not need to be an outbreak for it to be effective. Lightly sprinkle onto the animal's fur and gently rub. It can be applied to either wet or dry fur. It is best to avoid eye contact, as it may cause mild irritation. A damp towel over the eyes while powdering prevents this issue. However, if some manages to get into the eyes gently rinse with water or eye solution.
Flea Infestation in a Dwelling:
Fleas on animals typically results in a dwelling infestation. Fleas gravitate towards such items as pillows, stuffed animals, beds, linens, carpet, furniture, dog beds, and cat condos. Essentially, anything that breathes. To rid the dwelling of the infestation, rub DE powder into items and do not wash or vacuum until the animals are free of pests. Items, such as stuffed animals, should be placed into a tied trash bag after they are powdered. This is essentially an organic version of bug bombing a dwelling without the associated hazards of chemical bug bombs to people or animals.
Lice Treatment Method:
Thoroughly apply DE powder to scalp area and let it sit overnight. Place a wet towel over the eyes to avoid irritation. If DE does get into the eye, simply rinse away with water or eye solution. Every person exposed to lice, whether they have an itchy scalp or not, should apply DE to their heads. To prevent a lice outbreak in a dwelling, approach treatment in the exact same manner as handling a flea infestation.
Manage Pest Infestation in Yard:
DE is safe for use around plants. Dampen the target area for better adhesion and sprinkle it around. This effectively controls any aggressive insect population with an exoskeleton, like ants, termites, and roaches. To prevent re-occurrence, reapply after a heavy rain or windstorm.
If this year is anything like last year – it is going to be an extremely bad flea and tick season. I've already heard about some cases of fleas in both the cooler Northern States and in the South. It only takes a couple warm days for the fleas to come out of their dormancy.
And it won't be long. Soon the weather will be warm and fleas and ticks will emerge from their dormant life cycles starting up a cycle that leads to full flea infestation in no time at all.
One mistake many dog lovers make is that they wait too long to get on flea prevention. They just don't realize how quickly the fleas go from dormant to full blow infestation cycles that start feeding on your pet.
An adult flea can lay 15 to 20 eggs per day and over 500 in her lifetime. At this rate one flea in your home can become a full flea infestation - imagine fleas on your pet, in your carpets, sofas, clothing and even your bed. Also, don't forget that these armies of bloodsucking fleas need your pet and their blood to repeat the entire cycle.
The only way to protect your pet is to treat them with a flea and tick preventative medication.
Let me ask you a question....
Is your pet in flea medication yet? If not, please do not let your precious pet go another day without protection! A single flea can bite your pet more than 400 times - please act today and give him/her the protection he/she needs!
The simple fact is if you're not protecting your dog from fleas and ticks, your pet is at risk.
Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks; laboratory testing is helpful if used correctly and performed with validated methods. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat. The ticks that transmit Lyme disease can occasionally transmit other tickborne diseases as well.
How ticks spread Lyme disease...
Signs and symptoms of illness...
What to expect from your physician...
When symptoms persist after treatment...
Clinicians, public health officials, and veterinarians...
- If you tuck long pants into socks and shirts into pants, be aware that ticks that contact your clothes will climb upward in search of exposed skin. This means they may climb to hidden areas of the head and neck if not intercepted first; spot-check clothes frequently.
- Clothes can be sprayed with either DEET or Permethrin. Only DEET can be used on exposed skin, but never in high concentrations; follow the manufacturer's directions.
- Upon returning home, clothes can be spun in the dryer for 20 minutes to kill any unseen ticks
- A shower and shampoo may help to remove crawling ticks, but will not remove attached ticks. Inspect yourself and your children carefully after a shower. Keep in mind that nymphal deer ticks are the size of poppy seeds; adult deer ticks are the size of apple seeds.
Any contact with vegetation, even playing in the yard, can result in exposure to ticks, so careful daily self-inspection is necessary whenever you engage in outdoor activities and the temperature exceeds 45° F (the temperature above which deer ticks are active). Frequent tick checks should be followed by a systematic, whole-body examination each night before going to bed. Performed consistently, this ritual is perhaps the single most effective current method for prevention of Lyme disease.
If you DO find a tick attached to your skin, there is no need to panic. Not all ticks are infected, and studies of infected deer ticks have shown that they begin transmitting Lyme disease an average of 36 to 48 hours after attachment.Therefore, your chances of contracting LD are greatly reduced if you remove a tick within the first 48 hours. Remember, too, that nearly all of early diagnosed Lyme disease cases are easily treated and cured.
To remove a tick, follow these steps:
- Using a pair of pointed precision* tweezers, grasp the tick by the head or mouthparts right where they enter the skin. DO NOT grasp the tick by the body.
- Without jerking, pull firmly and steadily directly outward. DO NOT twist the tick out or apply petroleum jelly, a hot match, alcohol or any other irritant to the tick in an attempt to get it to back out.
- Place the tick in a vial or jar of alcohol to kill it.
- Clean the bite wound with disinfectant.
*Keep in mind that certain types of fine-pointed tweezers, especially those that are etched, or rasped, at the tips, may not be effective in removing nymphal deer ticks. Choose unrasped fine-pointed tweezers whose tips align tightly when pressed firmly together.
Then, monitor the site of the bite for the appearance of a rash beginning 3 to 30 days after the bite. At the same time, learn about the other early symptoms of Lyme disease and watch to see if they appear in about the same timeframe. If a rash or other early symptoms develop, see a physician immediately.
Finally, prevention is not limited to personal precautions. Those who enjoy spending time in their yards can reduce the tick population around the home by:
- keeping lawns mowed and edges trimmed
- clearing brush, leaf litter and tall grass around houses and at the edges of gardens and open stone walls
- stacking woodpiles neatly in a dry location and preferably off the ground
- clearing all leaf litter (including the remains of perennials) out of the garden in the fall
- having a licensed professional spray the residential environment (only the areas frequented by humans) with an insecticide in late May (to control nymphs) and optionally in September (to control adults).
Doxycycline, amoxicillin and ceftin are the three oral antibiotics most highly recommended for treatment of all but a few symptoms of LD. A recent study of Lyme arthritis in the New England Journal of Medicine indicates that a four-week course of oral doxycycline is just as effective in treating late LD, and much less expensive, than a similar course of intravenous Ceftriaxone (Rocephin) unless neurological or severe cardiac abnormalities are present. If these symptoms are present, the study recommends immediate intravenous (IV) treatment.
Treatment of late-Lyme patients can be more complicated. Usually LD in its later stages can be treated effectively, but individual variation in the rate of disease progression and response to treatment may, in some cases, render standard antibiotic treatment regimens ineffective. In a small percentage of late-Lyme patients, the disease may persist for many months or even years. These patients will experience slow improvement and resolution of their persisting symptoms following oral or IV treatment that eliminated the infection.
Although treatment approaches for patients with late-stage LD have become a matter of considerable debate, many physicians and the Infectious Disease Society of America recognize that, in some cases, several courses of either oral or IV (depending on the symptoms presented) antibiotic treatment may be indicated. However, long-term IV treatment courses (longer than the recommended 4-6 weeks) are not usually advised due to adverse side effects. While there is some speculation that long-term courses may be more effective than the recommended 4-6 weeks, there is currently no scientific evidence to support this assertion. Click here for an article from the New England Journal of Medicine which presents clinical recommendations in the treatment and prevention of early Lyme disease.
Prevention & Control
Larval and nymphal deer ticks often hide in shady, moist ground litter, but adults can often be found above the ground clinging to tall grass, brush, and shrubs. They also inhabit lawns and gardens, especially at the edges of woodlands and around old stone walls where deer and white-footed mice, the ticks' preferred hosts, thrive. Within the endemic range of B. burgdorferi (the spirochete that infects the deer tick and causes LD), no natural, vegetated area can be considered completely free of infected ticks.
Deer ticks cannot jump or fly, and do not drop from above onto a passing animal. Potential hosts (which include all wild birds and mammals, domestic animals, and humans) acquire ticks only by direct contact with them. Once a tick latches onto human skin it generally climbs upward until it reaches a protected or creased area, often the back of the knee, groin, navel, armpit, ears, or nape of the neck. It then begins the process of inserting its mouthparts into the skin until it reaches the blood supply.
In tick-infested areas, the best precaution against LD is to avoid contact with soil, leaf litter and vegetation as much as possible. However, if you garden, hike, camp, hunt, work outdoors or otherwise spend time in woods, brush or overgrown fields, you should use a combination of precautions to dramatically reduce your chances of getting Lyme disease:
First, using color and size as indicators, learn how to distinguish between:
Deer tick larva (top),
nymph (right) and adult (left).
- deer tick* nymphs and adults
- deer ticks and two other common tick species - dog ticks and Lone Star ticks (neither of which is known to transmit Lyme disease)
*Deer ticks are found east of the Rockies; their look-alike close relatives, the western black-legged ticks, are found and can transmit Lyme disease west of the Rockies.
Lone star tick.
Then, when spending time outdoors, make these easy precautions part of your routine:
- Wear enclosed shoes and light-colored clothing with a tight weave to spot ticks easily
- Scan clothes and any exposed skin frequently for ticks while outdoors
- Stay on cleared, well-traveled trails
- Use insect repellant containing DEET (Diethyl-meta-toluamide) on skin or clothes if you intend to go off-trail or into overgrown areas
- Avoid sitting directly on the ground or on stone walls (havens for ticks and their hosts)
- Keep long hair tied back, especially when gardening
- Do a final, full-body tick-check at the end of the day (also check children and pets)
Manifestations of what we now call Lyme disease were first reported in medical literature in Europe in 1883. Over the years, various clinical signs of this illness have been noted as separate medical conditions: acrodermatitis, chronica atrophicans (ACA), lymphadenosis benigna cutis (LABC), erythema migrans (EM), and lymphocytic meningradiculitis (Bannwarth's syndrome). However, these diverse manifestations were not recognized as indicators of a single infectious illness until 1975, when LD was described following an outbreak of apparent juvenile arthritis, preceded by a rash, among residents of Lyme, Connecticut.
Where is Lyme Disease Prevalent?
LD is spreading slowly along and inland from the upper east coast, as well as in the upper midwest. The mode of spread is not entirely clear and is probably due to a number of factors such as bird migration, mobility of deer and other large mammals, and infected ticks dropping off of pets as people travel around the country. It is also prevalent in northern California and Oregon coast, but there is little evidence of spread.
In order to assess LD risk you should know whether infected deer ticks are active in your area or in places you may visit. The population density and percentage of infected ticks that may transmit LD vary markedly from one region of the country to another. There is even great variation from county to county within a state and from area to area within a county. For example, less than 5% of adult ticks south of Maryland are infected with B. burgdorferi, while up to 50% are infected in hyperendemic areas (areas with a high tick infection rate) of the northeast. The tick infection rate in Pacific coastal states is between 2% and 4%.
U.S. Range Maps and Statistics
To view U.S. Range Maps and Statistics for Lyme disease, click here.
The spirochetal agent of Lyme disease, Borrelia burgdoferi, is transmitted to humans through a bite of a nymphal stage deer tick Ixodes scapularis (or Ixodes pacificus on the West Coast). The duration of tick attachment and feeding is a key factor in transmission. Proper identification of tick species and feeding duration aids in determining the probability of infection and the risk of developing Lyme disease.
The early symptoms of LD can be mild and easily overlooked. People who are aware of the risk of LD in their communities and who do not ignore the sometimes subtle early symptoms are most likely to seek medical attention and treatment early enough to be assured of a full recovery.
The first symptom is usually an expanding rash (called erythema migrans, or EM, in medical terms) which is thought to occur in 80% to 90% of all LD cases. An EM rash generally has the following characteristics:
- Usually (but not always) radiates from the site of the tickbite
- Appears either as a solid red expanding rash or blotch, OR a central spot surrounded by clear skin that is in turn ringed by an expanding red rash (looks like a bull's-eye)
- Appears an average of 1 to 2 weeks (range = 3 to 30 days) after disease transmission
- Has an average diameter of 5 to 6 inches
(range = 2 inches to 2 feet)
- Persists for about 3 to 5 weeks
- May or may not be warm to the touch
- Is usually not painful or itchy
EM rashes appearing on brown-skinned or sun-tanned patients may be more difficult to identify because of decreased contrast between light-skinned tones and the red rash. A dark, bruise-like appearance is more common on dark-skinned patients.
Ticks will attach anywhere on the body, but prefer body creases such as the armpit, groin, back of the knee, and nape of the neck; rashes will therefore often appear in (but are not restricted to) these areas. Please note that multiple rashes may, in some cases, appear elsewhere on the body some time after the initial rash, or, in a few cases, in the absence of an initial rash.
Around the time the rash appears, other symptoms such as joint pains, chills, fever, and fatigue are common, but they may not seem serious enough to require medical attention. These symptoms may be brief, only to recur as a broader spectrum of symptoms as the disease progresses.
What is Lyme Disease?
Where is Lyme Disease Prevalent?
U.S. Range Maps and Statistics
Table of Recommended Antibiotics and dosages
How to Prevent Lyme Disease
How to Remove a Tick
Deer Tick Ecology
Tick species that transmit Lyme Disease: Black-legged tick (Deer tick), western black-legged tick
What is Lyme Disease?
Lyme disease (LD) is an infection caused by Borrelia burgdorferi, a type of bacterium called a spirochete (pronounced spy-ro-keet) that is carried by deer ticks. An infected tick can transmit the spirochete to the humans and animals it bites. Untreated, the bacterium travels through the bloodstream, establishes itself in various body tissues, and can cause a number of symptoms, some of which are severe.
LD manifests itself as a multisystem inflammatory disease that affects the skin in its early, localized stage, and spreads to the joints, nervous system and, to a lesser extent, other organ systems in its later,
disseminated stages. If diagnosed and treated early with antibiotics, LD is almost always readily cured. Generally, LD in its later stages can also be treated effectively, but because the rate of disease progression and individual response to treatment varies from one patient to the next, some patients may have symptoms that linger for months or even years following treatment. In rare instances, LD causes permanent damage.
Although LD is now the most common arthropod-borne illness in the U.S. (more than 150,000 cases have been reported to the Centers for Disease Control and Prevention [CDC] since 1982), its diagnosis and treatment can be challenging for clinicians due to its diverse manifestations and the limitations of currently available serological (blood) tests.
The prevalence of LD in the northeast and upper mid-west is due to the presence of large numbers of the deer tick's preferred hosts - white-footed mice and deer - and their proximity to humans. White-footed mice serve as the principal "reservoirs of infection" on which many larval and nymphal (juvenile) ticks feed and become infected with the LD spirochete. An infected tick can then transmit infection the next time it feeds on another host (e.g., an unsuspecting human).
The LD spirochete, Borrelia burgdorferi, infects other species of ticks but is known to be transmitted to humans and other animals only by the deer tick (also known as the black-legged tick) and the related Western black-legged tick. Studies have shown that an infected tick normally cannot begin transmitting the spirochete until it has been attached to its host about 36-48 hours; the best line of defense against LD, therefore, is to examine yourself at least once daily and remove any ticks before they become engorged (swollen) with blood.
Generally, if you discover a deer tick attached to your skin that has not yet become engorged, it has not been there long enough to transmit the LD spirochete. Nevertheless, it is advisable to be alert in case any symptoms do appear; a red rash (especially surrounding the tick bite), flu-like symptoms, or joint pains in the first month following any deer tick bite could signal the onset of LD.
Erythema migrans rash. This rash can be uniformly red (A) or have a bull’s-eye appearance with central clearing (B). The rash usually is painless but may be associated with slight tenderness, tingling, or itch. It may be accompanied by constitutional symptoms such as fever, headache, arthralgia, or myalgia. Photographs are courtesy of Vijay K. Sikand, MD, East Lyme, CT.
Lyme disease is the result of infection with the bacteria Borrelia burgdorferi. The disease is transmitted by infected ticks that also feed on mice and deer. The tick can be found attached to the skin in many cases. Most cases of Lyme disease occur in the spring and summer months.
Lyme disease, in most cases, can be eliminated with antibiotics, especially if treatment is started when symptoms are first noted.
Lyme disease is divided into 3 phases:
Symptoms start a few days to a month after a tick bite. The classic "bull's eye" lesion does not need to develop for a diagnosis of Lyme disease. If left untreated, the disease can spread to the lymph nodes.
Multiple skin lesions are seen, along with flu-like symptoms and head, neck, and joint pain. There may also be heart or nerve symptoms as well as arthritis, which can develop over a few months to up to 2 years after the initial infection.
The heart, joints, and nervous system can be affected. Symptom can develop over a few months to years after the initial infection and may be difficult to treat.
Erythema migrans, the classic unraised red "bull's-eye" lesion on the skin, will appear days to weeks after the bite. However, about 25% of those affected never get this lesion. Some may complain of flu-like symptoms, including fever; head, neck, and joint pain; and generalized muscle pain. The lesion will resolve without treatment in about a month.
Weeks to months later the bacterium can affect the joints, heart, and nervous system.
The late phase of Lyme disease can also affect the joints, heart, and nervous system. In the heart, there can be an abnormal heart rhythm. The face can become paralyzed (facial muscle paralysis), and you can have confusion and abnormal sensations of the skin such as numbness, tingling, a prickling sensation, or pain. There can be inflammation in the joints, or arthritis, beginning with swelling, stiffness, and pain, commonly affecting the knees.
Ticks begin transmitting Lyme disease about 24–48 hours after attaching to the host. You can reduce your child's chances of getting Lyme disease by removing the tick within 48 hours.
To remove the tick, you will need tweezers and isopropyl alcohol. Your child may be scared, but you should explain that this will not hurt them.
- Sterilize the tweezers with alcohol and make sure to wash your hands. You should not clean or disturb the skin with the tick.
- Grasp the part of the tick that is embedded in the skin with the tweezers, not the body where you may see tiny legs. If necessary, have someone else hold the area with the tick so that the child doesn't jerk away.
- The tick will likely be firmly embedded. Pull it outward in one motion. Do not twist or jerk the tweezers. Do not apply anything to the tick that you think may help it come out smoothly as this may result in a part of the tick being left in the skin.
- Clean the bite wound with alcohol. Children have very sensitive skin, so you may notice an immediate swelling where the once was. If you are not sure that the entire tick has been removed, see your child's doctor.
Lyme disease can be treated and cured with one of several oral antibiotics for 3–4 weeks. The skin rash will go away within a few days of beginning treatment, but other symptoms may persist for up to a few weeks. In severe cases of Lyme disease where the nervous system is involved, the antibiotic may need to be given intravenously. In late stage Lyme disease, symptoms may not go away completely but should improve.
Lyme disease may simply be displayed as a subtle area o
Anyone who has been bitten by a tick should be watched closely for at least 30 days.
A single dose of antibiotics may be offered to someone soon after being bitten by a tick, if all of the following are true:
- The person has a tick that can carry Lyme disease attached to their body. This usually means that a nurse or physician has looked at and identified the tick.
- The tick is thought to have been attached to the person for at least 36 hours.
- The person can begin taking the antibiotics within 72 hours of removing the tick.
- The person is over 8 years old and is not pregnant or breastfeeding.
A 2 - 4-week course of antibiotics is used to treat people who are diagnosed with Lyme disease. The specific antibiotic used depends on the stage of the disease and the symptoms.
Pain medications, such as ibuprofen, are sometimes prescribed to relieve joint stiffness.Outlook (Prognosis)
If diagnosed in the early stages, Lyme disease can be cured with antibiotics. Without treatment, complications involving the joints, heart, and nervous system can occur. However, these symptoms are still treatable.
Rarely, a person will continue having symptoms that can interfere with daily life even after they have been treated with antibiotics. Some people call this post-Lyme disease syndrome. The cause is unknown.Possible Complications
Stage 3, or late disseminated, Lyme disease can cause long-term joint inflammation (Lyme arthritis) and heart rhythm problems. Brain and nervous system problems are also possible, and may include:
- Decreased concentration
- Memory disorders
- Nerve damage
- Paralysis of the face muscles
- Sleep disorders
- Vision problems
Call your health care provider if you have:
- A large, red, expanding rash that may look like a bull's eye
- Had a tick bite and develop weakness, numbness, or tingling, or heart problems
- Symptoms of Lyme disease, especially if you may have been exposed to ticks
Take precautions to avoid direct contact with ticks. Be extra careful during warmer months. Whenever possible:
- Avoid wooded or bushy areas, or areas with high grasses and leaf litter.
- Walk in the center of trails.
- Check yourself and your pets frequently during and after your walk or hike.
When walking or hiking in wooded or grassy areas, spray all exposed skin and your clothing with insect repellant.
See also: Bug repellent safety
You may also treat clothing, such as boots, pants, and socks, with a product that contains permethrin. It remains protective for several washings.
Ticks that carry Lyme disease are so small that they are very hard to see. After returning home, remove your clothes and thoroughly inspect all skin surface areas, including your scalp. Shower soon after coming indoors to wash off any unseen ticks.
Lyme disease is a bacterial infection spread through the bite of the blacklegged tick.
See also: Lyme disease - what to ask your doctor
Lyme disease is caused by bacteria called Borrelia burgdorferi (B. burgdorferi). Blacklegged ticks carry these bacteria. The ticks pick up the bacteria when they bite mice or deer that are infected with Lyme disease. You can get the disease if you are bitten by an infected tick.
Lyme disease was first reported in the United States in the town of Old Lyme, Connecticut, in 1975. In the United States, most Lyme disease infections occur in the following areas:
- Northeastern states, from Virginia to Maine
- North-central states, mostly in Wisconsin and Minnesota
- West Coast, particularly northern California
There are 3 stages of Lyme disease. (See below for symptoms.)
- Stage 1 is called early localized Lyme disease. The infection is not yet widespread throughout the body.
- Stage 2 is called early disseminated Lyme disease. The bacteria have begun to spread throughout the body.
- Stage 3 is called late disseminated Lyme disease. The bacteria have spread throughout the body.
Risk factors for Lyme disease include:
- Doing outside activities that increase tick exposure (for example, gardening, hunting, or hiking) in an area where Lyme disease is known to occur
- Having a pet that may carry ticks home
- Walking in high grasses
Important facts about tick bites and Lyme disease:
- In most cases, a tick must be attached to your body for 24 - 36 hours to spread the bacteria to your blood.
- Blacklegged ticks can be so small that they are almost impossible to see. Many people with Lyme disease never even saw a tick on their body.
- Most people who are bitten by a tick do not get Lyme disease.
Symptoms of early localized Lyme disease (Stage 1) begin days or weeks after infection. They are similar to the flu and may include:
- Body-wide itching
- General ill-feeling
- Light-headedness or fainting
- Muscle pain
- Stiff neck
There may be a "bull's eye" rash, a flat or slightly raised red spot at the site of the tick bite. Often there is a clear area in the center. It can be quite large and expanding in size.
Symptoms may come and go. Untreated, Lyme disease can spread to the brain, heart, and joints.
Symptoms of early disseminated Lyme disease (Stage 2) may occur weeks to months after the initial tick bite. They may include:
- Paralysis or weakness in the muscles of the face
- Muscle pain and pain or swelling in the knees and other large joints
- Heart problems, such as skipped heartbeats (palpitations)
Symptoms of late disseminated Lyme disease (Stage 3) can occur months or years after the initial infection. The most common symptoms are muscle and joint pain. Other symptoms may include:
- Abnormal muscle movement
- Muscle weakness
- Numbness and tingling
- Speech problems
A blood test can be done to check for antibodies to the bacteria that cause Lyme disease. The most commonly used is the ELISA for Lyme disease test. A western blot test is done to confirm ELISA results.
In areas where Lyme disease is more common, your health care provider may be able to diagnose early disseminated Lyme disease (Stage 1) without doing any lab tests.
Other tests that may be done, when the infection has become more widespread, include:
- Echocardiogram to look at the heart
- Spinal tap (lumbar puncture to examine spinal fluid
- MRI of
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Ticks are small, insect-like creatures that can attach to you as you brush past bushes, plants, and grass. Once on you, ticks often move to a warm, moist location, like the armpits, groin, and hair. At that point they typically attach firmly to your skin and begin to draw blood.
Ticks can be fairly large -- about the size of a pencil eraser -- or so small that they are almost impossible to see. Ticks can cause a variety of health conditions ranging from harmless to serious.
This article describes the effects of a tick bite.
This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.
See also: Tick removal
Hard- and soft-bodied female ticks are believed to make a poison that can cause tick paralysis in children.
While most ticks do not carry diseases, some ticks can carry bacteria that can cause:
Ticks live in wooded or grassy fields.Symptoms
Watch for the symptoms of tick-borne diseases in the weeks following a tick bite -- muscle or joint aches, stiff neck, headache, weakness, fever, swollen lymph nodes, and other flu-like symptoms. Watch for a red spot or rash starting at the location of the bite.
The symptoms below refer more to the problems resulting from the bite itself, not the diseases that a bite may cause. Some of the symptoms are specific to one variety of tick or another but not necessarily common to all ticks.
- Apnea (breathing stopped)
- Difficulty breathing
- Severe pain at bite site (some varieties), lasting for several weeks
- Swelling at bite site (some varieties)
- Uncoordinated movement
Remove the tick (see tick removal). Be careful not to leave the tick's head stuck in the skin.Before Calling Emergency
Determine the following information:
- Patient's age, weight, and condition
- Time the tick bite occurred
- Part of the body affected
The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
The symptoms will be treated as appropriate. Long-term treatment may be needed if complications develop. Preventive antibiotics are often given to people who live in areas where Lyme disease is common.Outlook (Prognosis)
Most tick bites are harmless. The outcome will depend on what type of infection the tick may have been carrying and how soon appropriate treatment was begun.
Lyme disease, or borreliosis, is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of an infected blacklegged deer tick. It is the most common tickborne infectious disease in the United States. State health departments reported 22,572 confirmed cases and 7,597probable cases of Lyme disease to the Centers for Disease Control and Prevention in 2010.
NIAID has a long-standing commitment to conduct Lyme disease research with the major goals of developing better means of diagnosing, treating, and preventing the disease. To accomplish these objectives, the NIAID Lyme disease research portfolio includes a broad range of activities designed to increase our understanding of this disease. Learn more about NIAID's Lyme disease research.
- Ehrlichiosis and Anaplasmosis
- Lyme Disease
- Relapsing Fever
- Rocky Mountain Spotted Fever
Tickborne diseases are becoming a serious problem in this country as people increasingly build homes in formerly uninhabited wilderness areas where ticks and their animal hosts live. Tickborne diseases can be caused by viruses, bacteria, or parasites. Most people become infected through tick bites during the spring and summer months.
Rocky Mountain spotted fever, a bacterial disease transmitted by the dog tick, was first identified in 1896. It still exists, although now it can be easily treated. Since then, researchers have identified many new tickborne diseases.
Tickborne diseases can be found throughout the United States. For example, Lyme disease, first discovered in Connecticut in the early 1970s, has since spread to every state except Hawaii.
One of the newest tickborne diseases to be identified in the United States is called Southern tick-associated rash illness (STARI). This disease has a bull’s-eye rash similar to that found in Lyme disease, which is caused by bacteria transmitted by the deer tick. Although researchers know that the lone star tick transmits the infectious agent that causes STARI, they do not yet know what microbe (germ) causes it.
Ticks transmit ehrlichiosis and anaplasmosis, both bacterial diseases. Babesiosis is caused by parasites carried by deer ticks. These diseases are found in several states.
Tularemia, a less common tickborne bacterial disease, can be transmitted by ticks as well as other vectors (carriers) such as the deerfly. Public health experts are concerned that the bacterium that causes tularemia (Francisella tularensis) could be used as a weapon of bioterrorism.
Tickborne disease can usually be prevented by avoiding places where ticks often live, such as dense woods and brushy areas. Using insect repellents containing DEET (for the skin) or permethrin (for clothes), wearing long pants and socks, performing tick checks, and promptly removing ticks also will help prevent infection from tickborne microbes.
Scientists are searching for better ways to diagnose, treat, and prevent tickborne diseases. They are also looking for ways to control the tick populations that transmit microbes.
If you spend time outdoors or have pets that go outdoors, you need to beware of ticks. Ticks are small bloodsucking parasites. Many species transmit diseases to animals and people. Some of the diseases you can get from a tick bite are Lyme disease, ehrlichiosis, Rocky Mountain spotted fever and tularemia.
Some ticks are so small that they can be difficult to see. Ticks may get on you if you walk through areas where they live, such as tall grass, leaf litter or shrubs.
Tick-borne diseases occur worldwide, including in your own backyard. To help protect yourself and your family, you should
- Use a chemical repellent with DEET, permethrin or picaridin
- Wear light-colored protective clothing
- Tuck pant legs into socks
- Avoid tick-infested areas
- Check yourself, your children and your pets daily for ticks and carefully remove any ticks you find