Disease Detection Overview
Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Feb 14, 2019
Last Modified Date: Feb 14, 2019
Published Date: Dec 10, 2018
Is it Lyme Disease or Something Else?
Lyme disease is caused by the transmission of a bacterium called Borrelia burgdorferi to humans from infected ticks, which occurs as these ticks feed on the blood of their unsuspecting human hosts. The bacteria travels through the bloodstream to various body tissues, causing Lyme disease, a multisystem inflammatory disease that affects the skin in its early stages, then spreads to the joints and nervous system, and in some cases, other organs and systems within the body. Western black-legged ticks are the most common carriers. These insects feed on the blood of humans and animals. When you are bitten by an infected tick, the bacteria is transmitted to your blood. People at highest risk for contracting Lyme disease are those who live in rural or suburban areas that are grassy or heavily wooded, or spend time in these areas, since ticks generally thrive in these environments.
Symptoms of Lyme Disease
While most people who contract Lyme disease do experience symptoms of infection, these symptoms are very similar to those of a number of other health issues. This can make Lyme disease difficult to diagnose.
According to the CDC, the first symptom of Lyme disease is typically erythema migrans (EM), a red, expanding rash, which occurs in approximately 70 to 80 percent of infected individuals, usually within 3 to 30 days. This characteristic “bullseye” rash, which typically begins as a small red spot at the site of the tick bite, then expands. Often, as the rash spreads, redness fades from the center, leaving the appearance of a red ring around the original site.
For many people, flu-like symptoms may appear at about the same time as the rash, such as fatigue, fever, chills, headache, swollen lymph nodes, muscle aches or joint pain. In those people who do not get the rash, these symptoms may be the only early indication that they have contracted Lyme disease.
If Lyme disease is not detected and treated during that initial stage when the infection is a localized one, the bacterial infection can spread from that original site to other parts of the body. Lyme disease can cause severe headaches and neck stiffness, joint swelling and pain, overwhelming fatigue, cardiac irregularities, nervous system and cognitive problems. In some cases, a condition called Bell's palsy can develop, which causes paralysis or drooping in one or both sides of the face.
Testing for Lyme Disease: The Lyme Disease Controversy
Today, most people are aware of Lyme disease, a bacterial infection that is spread via the bite of an infected tick. However, many people aren't aware of the controversy within the medical community about this disease, prompted by disagreement on the proper means of diagnosing and treating Lyme disease. If you suspect Lyme disease may be an issue for you, understanding the differing opinions and practices on each side of this debate is essential to making well-informed decisions about your care.
Lyme disease is treated with oral or intravenous antibiotics, depending upon the severity of infection, and with early diagnosis and treatment, is cleared in most patients without lasting effects. However, in about 10 to 20 percent of cases, symptoms can persist for months or years after treatment. It is these lingering symptoms that are the primary source of the ongoing controversy.
The CDC, Infectious Diseases Society of America (IDSA) and other mainstream medical sources call these symptoms Post-Treatment Lyme Disease Syndrome (PTLDS), a condition of that they theorize may stem from damage to tissues or altered immune system function caused by Lyme disease. Standard treatment guidelines for this condition include conservative management of symptoms, with the CDC stating that PTLDS almost always get better with time, although it may take months for patients to feel completely well.
However, the International Lyme and Associated Diseases Society (ILADS), along with many doctors, patients, and Lyme disease advocates disagree, believing that ongoing symptoms are caused by persistent Borrelia burgdorferi infection, a condition they refer to as chronic Lyme disease. For chronic Lyme disease, they recommend tick infection treatment that typically includes long-term antibiotic therapy.
While patients with persistent Lyme disease symptoms often test negative for the bacteria that causes Lyme disease, doctors who diagnose chronic Lyme disease state that such test results often amount to false negatives. They believe that standard diagnostic tests are often not sensitive enough to detect evidence of persistent infection. Many use diagnostic tests from private laboratories that they feel are more sensitive in chronic Lyme disease testing, a practice that proponents of standard Lyme disease protocols state is producing false positive results, justifying ongoing treatment that they feel is unnecessary and, in some cases, risky.
At this point, the jury is still out on the question of chronic Lyme disease. While each side of the debate can claim some scientific backing, existing research has not, as of yet, been conclusive enough to provide definitive proof that either side is correct in their opinions.
So What To Do If You Suspect Lyme Disease?
If you have symptoms that may indicate Lyme disease or know that you have been bitten by a tick, placing you at risk, you may be asking yourself, “Where can I get a Lyme disease Test?” While there are many outstanding questions about Lyme disease, there are some basic facts that all sides agree on.
One of these is that clinical diagnosis is the standard of care – which means an evaluation of your symptoms and risk factors. If your doctor feels, after that evaluation, that Lyme disease is likely, current protocols call for blood tests that detect Lyme disease antibodies and a test called a western blot test to confirm that diagnosis – tests that your doctor will typically order. However, it is important to be aware that false negatives are not uncommon in the early stages of the disease, so retesting after a negative result may be wise. Other tests may be ordered, such as the Polymerase chain reaction (PCR) test, which detects the DNA of the Lyme disease bacterium.
Another point of agreement is that patients who suspect they may have Lyme disease should seek evaluation and testing immediately, since early diagnosis and treatment of Lyme disease greatly reduces your risk of those persistent symptoms that are the main source of all the controversy over this common tick-borne disease.
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