Lyme Disease 101

Minnesotans across the state are at risk for acquiring tick-borne diseases. The highest risk is in the southeast, east central and north central areas of the state. Grassy fields, brush-filled wooded landscapes and places where residential neighborhoods meet the forest edge are prime tick habitat. This brochure contains information to help you mitigate your risk for Lyme and other tick-borne diseases.

Blacklegged Ticks in 49% of U.S. Counties

US Lyme Disease Prevalence Map

CDC

Preliminary estimates released by the Centers for Disease Control and Prevention indicate that the number of Americans diagnosed with Lyme disease each year is around 300,000. read more

MN Dept. of Health

If a patient has an EM highly suggestive of Lyme disease and recent symptom onset (<2-3 weeks), B. burgdorferi antibody tests are not recommended because of low sensitivity at this stage of infection. Read More

Life Cycle of Blacklegged Tick

FAQ’s & Common Myths

What is Lyme disease?

Lyme disease is an infection caused by the bacterium Borrelia burgdorferi. It can involve any system in the body. The brain and central nervous system, peripheral nervous system and musculoskeletal systems are most commonly involved.

Lyme produces a wide array of symptoms. These symptoms vary from patient to patient and an individual’s symptoms often fluctuate – intense one day and almost nonexistent on another.

How is Lyme disease treated?

The treatment of Lyme disease may require the use of antibiotics.

In addition to antibiotics, many practitioners use naturopathic medicine with both acute and chronic Lyme disease to assist the immune system in detoxing, calming inflammation, supporting the gastrointestinal tract during antimicrobial therapy and alleviating pain. Herbal antimicrobials, probiotics, dietary changes, and immune support can all aid in the healing process with Lyme disease.

Can I still have Lyme after treatment?

Yes; treatment sometimes fails and symptoms and/or signs of the infection may persist or progress. If that should happen, additional treatment may be necessary.

Common symptoms of Lyme disease include: fever, headache and joint aches.

True

What does the rash typically look like?

Roughly 80% of all EMs are solid colored and oval shaped.  The color can range from a faint salmon to dark red. On highly pigmented skin, the rash may appear like a bruise. The “bulls-eye” or target-like rash is the easiest EM to recognize, but it’s not commonly seen.

If you get a rash (erythema migrans) when does it usually appear?

The rash usually appears 2 to 30 days after the bite.  A Lyme rash will often disappear on its own without treatment, but may linger for quite some time. It may reappear later as a single rash or emerge as multiple rashes.

No bull's-eye rash = no Lyme disease.

False, about 30% of people never develop an erythema migrans rash. Of those who do, fewer than 20% will develop the “classic” bull’s-eye rash.

What other diseases can Lyme be mistaken for?

MS, ALS, ADHD, fibromyalgia, chronic fatigue syndrome, Parkinson’s or mental illness.

If a patient previously had Lyme disease and is bitten by another infected tick, are they immune to Lyme disease?

No; they are not immune and can develop a new case of Lyme disease.  Additionally, multiple bites may expose you to other tick-borne diseases.

What blood tests should I have?

Depending on the circumstances, blood tests are not always appropriate. In cases of a known tick bite or when an EM rash is present, testing is not helpful. That’s because the common Lyme disease tests look for human antibodies to the bacteria and it can take several weeks for those antibodies to appear.

If your symptoms have been present for several weeks or longer, ask your doctor to order IgM and IgG Western Blot tests. There are also labs specializing in testing for tick-borne infections. One such lab is IGeneX in California.

If you have a negative test that means you do not have Lyme disease.

False, due to a variety of factors, lab tests for Lyme disease are not always reliable. Some people never test positive for Lyme disease even though they are infected. That’s why Lyme disease is a clinical diagnosis – based on a patient’s history and physical exam.

On the Western Blot test which bands are specific for Lyme disease?

No one can claim that any band is specific for Borrelia burgdorferi (meaning that a positive band is not the result of cross reactivity with other bacteria). Proving this would require performing Western blots on all other bacterial, viral and parasitic infections to verify that none produce the same antibody bands as Bb.

Lyme disease is not the only disease transmitted by blacklegged ticks.

True, you can also acquire different diseases from different tick species. Blacklegged ticks can transmit anaplasmosis, babesiosis, Powassan encephalitis, bartonellosis, and B.miyamotoi in addition to Lyme disease.

Do you feel a tick bite?

Generally no, because deer ticks are tiny, nymphs are the size of a poppy seed, and a tick bite is painless, many people do not realize they’ve been bitten.

Pets, like humans, can contract Lyme disease from ticks.

True. See Kids & Pets.

Other names for the deer tick is the black-legged or bear tick.

Yes

What are the most common hosts for Lyme disease?

Typical hosts include mice, squirrels, rabbits, ground-feeding birds and deer.

Do ticks have life stages?

Ticks have four life stages: egg, larva, nymph and adult.  Ticks may feed on hosts that harbor Lyme disease bacteria three times during their life cycle. You can acquire Lyme disease from the nymph and adult stage when they feed on you.

What are the best ways to protect yourself from contracting Lyme disease?

  1. Use concentrations of 20% Picaridin or 30% DEET on skin.
  2. Use Permethrin on clothing, shoes and camping gear.
  3. When you return home remove clothing before walking through the house.  Place all items in the dryer and tumble at the highest heat setting.  Dry clothes require only 15 minutes, wet clothing requires 1 hour.  Note that washing alone will not kill ticks.
  4. Shower, scrubbing vigorously, to remove any ticks not yet attached.
  5. Check yourself and your loved ones immediately after returning from tick habitat and for several days thereafter.
  6. Remember to check your pets for ticks too.

To avoid ticks, walk in the middle of the trail.

True

Deer ticks can fly or jump off of trees.

No, they sit on a blade of grass or vegetation and wait for a host to pass by.

The best way to remove a tick is by using a pair of tweezers.

True, get as close to the head as possible and gently but firmly pull straight out. Do not squeeze the tick or put Vaseline or irritant on the tick. See Tick Removal.

How many Borrelia burgdorferi species and strains are there in the U.S. and world wide?

The list of identified Borrelia bacteria continues to expand.  The majority of Lyme disease cases are caused by these three species: Borrelia burgdorferi, Borrelia afzelii, and Borrelia garinii.  To date, more than 100 strains of Borrelia have been identified n the U.S.