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Lyme Disease in Michigan
(Including other tick-borne illnesses)
Published by the Michigan Lyme Disease Association
35431 Brush St., Wayne, MI 48184 Toll Free 1-888-784-5963 (Lyme)

The Michigan Lyme Disease Association (MLDA). is committed to the education of the public regarding Lyme disease and other tick-borne illnesses.

What is Lyme Disease?
Lyme Disease is a spirochetal bacterial infection that is thought to be transmitted predominantly by the bite of the Ixodes Scapularis tick, commonly referred to as the black-legged tick or deer tick. Other species of ticks such as the dog tick, wood tick, Lone-star tick, rabbit tick, and biting insects such as deer flies, horse flies, and mosquitoes have been shown to carry the Lyme Disease bacteria. Their ability to transmit the disease is not known at this time and studies are continuing to determine what exactly is transmitting the disease to humans. It is important to remember that not all ticks carry the Lyme bacteria.

Is Lyme Disease a new disease?
It was first recognized In 1976 by doctors at Yale University In Conn. There was a cluster of children living in three towns on the coast of Conn. diagnosed with Juvenile Rheumatoid Arthritis. In 1975 two mothers from Lyme, Conn. became very suspicious that something else was brewing and brought it to the attention of the CT State Dept. of Health. The researchers found that most of the patients with arthritis lived in heavily wooded areas with the first symptoms beginning In summer. In addition the disease was not contagious from person to person.

Curiously, several patients remembered having had a bulls-eye rash before the arthritis began. It turned out that the same round red skin rash, named Erythema Migrans (EM) had actually been described by a Swedish physician in 1909.

Doctors knew that these patients had been bitten by a  tick before the rash started. It also became clear that Lyme Arthritis was actually a more complex illness that not only involved the skin, but the nerves system and hearts of both children and adults.

Europeans had also described earlier In the 20th century neurological involvement associated with an expanding skin lesion following a tick bite that they called Bannwarth's Syndrome. Since the skin rash was later found to respond to penicillin, researchers concluded that bacteria could be the root of the illness rather than a virus which would not respond to an antibiotic.

In 1982, Dr. William Burgdorfer was able to find within the tick the spirochete that causes Lyme Disease. Subsequently, the bacteria was named Borrelia burgdorferi (Bb). This discovery was a major step in being able to tie the worldwide picture of Lyme Disease together as well as becoming the springboard for further research regarding the biology, transmission, treatment, and prevention of this disease.

Who gets Lyme Disease?
Anybody can get Lyme Disease. People who frequent the woods and forest edges such as campers, hikers, outdoor workers and hunters are generally more likely to come in contact with ticks. However, Lyme Disease has also become a suburban illness because new home development has encroached on the woodland. Ticks feed on field mice, deer. small rodents and birds. Domestic animals such as dogs, cats, and horses, can also become host to the ticks. Although these animals are possible carriers of Lyme Disease, it is not believed that they can transmit the disease directly to humans. What can occur is that pets can bring ticks into our yards and homes, leaving us susceptible to being bitten. Birds, mice and rodents passing through our yards can also deposit these unwelcome guests near our homes.

What are the symptoms?
Lyme Disease is thought to occur in three stages, however, they overlap and not all patients go through all three. About 63% of the patients may get the rash, (EM). It usually starts at the bite site, but may also appear anywhere on the body. The rash may grow in a circular pattern like a target over several hours to several days.  Not all Lyme rashes are bulls-eye rashes and many people do not recall having had a rash.

In some cases, fatigue, fever, chills, headache, stiff neck, muscle/joint aches or other flu-like symptoms are the first indication of illness. In the weeks, or months following a tick bite, the pain (or weakness) in the joints, muscles, tendons, or bones may become migratory. Temporary heart involvement may cause palpitations or fainting. Severe itching, temperature fluctuations, and vision problems may occur. A multitude of symptoms may come and go causing doctors to treat only the symptoms and not recognize the overall systemic nature of Lyme Disease. 

In some untreated patients, the spirochete will remain inactive and never create any severe health problems. However, in other patients the untreated infection may result in the development of other problems associated with Lyme. Because many individuals do not get the rash, Lyme Disease may go undiagnosed.

Lyme Disease infection that has gone undetected, untreated, or inadequately treated can lead to a chronic state called late-stage Lyme Disease. This stage includes debilitating arthritis, bouts of numbness in the limbs, Bell's Palsy, and neurological disorders. Symptoms may go into temporary remission and then recur or be replaced with new symptoms. The disease can mimic Lupus, Lou Gehrig's Disease, Multiple Sclerosis or Parkinson's. It can present many faces, thus persons diagnosed with these named illnesses should ask their doctor to confirm that Lyme Disease is not the cause of their symptoms.

How is Lyme Disease Diagnosed?
Lyme Disease is a clinical diagnosis. Perhaps the most serious problem facing Lyme victims is diagnosing the disease. Lyme Disease mimics so many other illnesses and the pattern of symptoms varies from patient to patient. At present, there are tests available: the ELISA, Western Blot, Lyme Disease Urine Antigen and the PCR. These tests are to be used in conjunction with symptoms and patient history. Some people test negative but may still have Lyme Disease. Education for you and your physician is a must.

How can Lyme Disease be treated?
People with a known tick bite or known EM rash should be given oral antibiotics early in the disease. They should not wait for symptoms, as they may not show up for some time. Your treatment of oral or IV antibiotics should be discussed with a Lyme literate physician. There are over 300 strains of Bb bacteria world wide and unfortunately there is no test to tell us which antibiotic works for which strain. The Borreliosis bacteria is different from many others because it lives a very long time and has an extremely long generation time. It also may go into periods of latency. There isn't a test to tell us that the Lyme bacteria is completely gone. One of the best ways to help your physician is to keep a daily log so he/she may see which antibiotic may or may not be working. It is very important to be treated as soon as possible to prevent the disease from reproducing and becoming a multi-systemic illness.

How do you protect yourself from getting tick-borne diseases?
There are simple steps to prevention. First be aware of the tick's habitat: bushes, tall grasses, woods, yards, and wood piles. Second, wear appropriate clothing. When temperatures allow, wear long pants and tuck your shirt inside. Pull your socks up over your pantlegs and wear good shoes. Light colored clothing makes it easier to spot a tick. The use of an insect repellent that is EPA approved.  Read the directions on the can very carefully. Sprays containing Permethrin may be used on clothes only, and must be sprayed outdoors and dried before you wear them. Third, monitor yourself, children and pets immediately after coming inside. Inspect clothes, undress and check for ticks. Check all areas by rubbing your hands over the skin. Ticks are very small and you may feel them before you see them. Remove any attached tick. Save the tick in a small bottle with the date and the bite's location. Be alert for early symptoms and watch for any signs of a rash for a month or so. Call your physician and record your tick bite. Use tick-control products in your yard, on yourself, and your pets. Follow all package directions.

How should you remove a tick?
Proper tick removal is essential. Use fine-point tweezers to grasp the tick as close to your skin as possible. Do Not squeeze the tick's body. Grasp it where it's mouthparts enter the skin and tug gently and repeat as necessary until it releases it's hold. Take your time and be patient, it may take a few pulls before the tick releases itself.   Pull it straight out. Do Not squeeze the tick's body. Wipe the bite area thoroughly with an antiseptic. Save the tick in a covered bottle. Record date and place where bitten. This facilitates testing at a later date. Your doctor may find this information and the tick specimen helpful in diagnosis if a rash or other symptoms of Lyme Disease subsequently appear.

Can there be more than one disease from a tick bite?
Yes, ticks carry other diseases such as Anaplasmosis, Babesiosis, Erhlichia, Bartonella, Tick Fever, and RMSF. You may not get any of these from a tick bite, on the other hand, you may be infected with more than one bacteria from one tick bite. It is imperative that your doctor look at all your symptoms and test for other tick-borne illnesses. Research is ongoing regarding all these diseases and it is best to be educated with this information.

Babesiosis: A malaria-like infection caused by a parasite that targets red blood cells.
Symptoms include headache, fever, chills, muscle pain, sweating and anemia.

Ehrlichiosis: A bacterial infection caused by several types of rickettsiae which invade and kill white blood cells. Symptoms include fever, headache, chills, extreme muscle pain, anemia, decrease in white blood cells, lung infection, elevated liver enzymes and a rash could occur.

Rocky Mountain Spotted Fever: An infection caused by Rickettsia rickettsii and has been reported throughout North America. Symptoms include headache, chills, flu-like aches and pains, high fever and a reddish to black rash that looks like measles, starts on the extremities and can spread to the entire body.

Other tick-borne illnesses found in the USA are Colorado Tick Fever, Relapsing Fever, Tick Paralysis and Tularemia. Anyone who needs more information may call our toll free number 1-888-784-5963(LYME).

HOW LYME DISEASE CAN STRIKE
The following symptoms of Lyme Disease vary on severity of the infection and the amount of
time before treatment. You may have some, many, or even different symptoms.

Eyes or Vision:
Inflammation of the membranes lining eyelids
Inflammation of the eye
Loss of normal pupillary reflexes in response to light
Inflammation of the optic nerve
Abnormal sensitivity to light
Double vision
Inflammation of the iris

Heart:
Slowed heart rhythm caused by improper conduction of electrical signals in and to the heart
Inflammation of the heart muscle and/or the membrane surrounding the heart
Irregular heartbeats
Enlarged heart
Fainting, dizziness
Shortness of breath
Chest pain, may feel like a heart attack
Rapid heartbeat or skipped beats
A triple cadence in heart sounds caused by an abnormal third or fourth beat

Arthritic:
Painful joints
Arthritis, inflamed joints
Inflammation of muscles, and/or tendons
Disease located in the muscles
A collection of fluid that has escaped the knee joint or a bursa and formed a new sac in an adjacent area

Neurologic:
Paralysis of a facial nerve
Meningitis
Disease of spinal nerve root
Inflammation of the brain, multiple nerves, spinal cord and/or arteries in the brain
Disease of the peripheral nerves, and/or the nerve networks
Spasmodic movements of limbs and/or facial muscles
Loss of muscle coordination caused by disease in the cerebellum of the brain
Partial paralysis of muscles, and/or Bell's Palsy
Seizures
Headache ranging from mild to severe
Stiff neck
Impairment of normal sensations
Abnormal sensations: itching, prickling, tingling
Sleep disturbance
Hearing loss or hypersensitivity to sounds
Ringing in the ears
Partial paralysis of one side
Paralysis of lower extremities

Neuropsychiatric:
Mood swings, irritability, poor concentration, instability, forgetfulness/memory loss, general deterioration, psychosis, loss of appetite

Other Symptoms:
Fever, fatigue, sore throat, disease of the lymph nodes, enlarged spleen, enlarged liver, testicular swelling, nausea, vomiting, cough, hoarseness, diarrhea, abdominal pain, rashes, menstrual irregulari
ty and speech problems