Lyme disease

Encyclopedia of Alternative Medicine, Apr 06, 2001 by Belinda Rowland

For most patients, oral antibiotics (doxycycline or amoxicillin) are prescribed for 21 days. The doctor may have to adjust the treatment regimen or change medications based on the patient's response. Antibiotics can kill Bb only while it is active, rather than while it is dormant. When symptoms indicate nervous system involvement or a severe episode of Lyme disease, intravenous antibiotic (ceftriaxone) may be given for 14-30 days. Some physicians consider intravenous ceftriaxone the best therapy for any late manifestation of disease, but this is currently controversial.

If aggressive antibiotic therapy is given early, and the patient cooperates fully and sticks to the medication schedule, recovery should be complete. Only a small percentage of Lyme disease patients fail to respond or relapse (have recurring episodes). Most long-term effects of the disease result when diagnosis and treatment is delayed or missed. Co-infection with other infectious organisms spread by ticks in the same areas as Bb (babesiosis and ehrlichiosis, for instance) may be responsible for treatment failures or more severe symptoms. In certain cases, Lyme disease has been responsible for deaths, but that is rare.

A Lyme disease vaccine (LYMErix) is available for persons aged 15 to 70 years. As of early 2000, another vaccine (ImuLyme) awaits U.S. Food and Drug Administration (FDA) approval. Vaccination requires three injections, the first two given a month apart; a third injection given a year later. The vaccine is 49% effective in preventing Lyme disease after the second injection, and 76% effective after the third injection. Vaccination is recommended for persons who live, work, or recreate in areas with a moderate or high risk of exposure to ticks. Even persons who have had a mild case of Lyme disease should get vaccinated. There is also research being conducted concerning vaccination against the tick vector to prevent the tick from feeding long enough to transmit the infection. Even with vaccination, the best prevention strategy is through minimizing risk of exposure to ticks and using personal protection precautions.

Precautions to avoid contact with ticks include moving leaves and brush away from living quarters. In highly tick-populated areas, each individual should be inspected at the end of the day to look for ticks. Most important are personal protection techniques when outdoors, such as:

• Avoid walking through woods, shrubbery, or tall grasses.
• Use repellents containing DEET.
• Wear light-colored clothing to maximize ability to see ticks.
• Tuck pant legs into socks or boot top.
• Check children frequently for ticks.

The two most important factors are removing the tick quickly and carefully, and seeking a doctor's evaluation at the first sign of symptoms of Lyme disease. When in an area that may be tick-populated:

Although ticks are quite small, check for them, particularly in the area of the groin, underarm, behind ears, and on the scalp. Stay calm and grasp the tick as near to the skin as possible, using tweezers. To minimize the risk of squeezing more bacteria into the site of the bite, pull straight back steadily and slowly. Do not try to make the tick back out by using Vaseline, alcohol, or a lit match. Place the tick in a closed container (for species identification later, should symptoms develop) or dispose of it by flushing it in a toilet. See a physician for any sort of rash or patchy discoloration that appears 3-30 days after a tick bite.