By Laurel Erath, ND
Have you ever had a flu-like syndrome in the middle of the summer? Did you have any new symptoms or worsening joint pain following the flu-like syndrome? In a Lyme-endemic region like Connecticut, tick borne illness could be the culprit for those symptoms. Flu-like symptoms, headache, neck stiffness, and facial paralysis are symptoms of early Lyme disease, which is often diagnosed from spring through fall, when ticks are most active. Ticks are a type of arachnid often found in wooded or grassy areas populated by deer, squirrels, mice, lizards, rabbits, and birds.
Lyme disease is a complex illness caused by a spirochete, a spiral-shaped bacteria called Borrelia, transmitted by a deer tick (black legged tick) or lone star tick bite. There are at least 18 pathogenic strains of Borrelia, the most common being Borrelia burgdorferi. Northeastern states, including Pennsylvania, New York, New Hampshire, Maine, Connecticut, and Vermont, are considered some of the highest incidence areas for Lyme disease. This infection is commonly known by its characteristic bulls-eye rash (aka. Erythema migrans). However, an erythema migrans rash does not occur with every tick bite and although it is known to present with a target-like appearance, some erythema migrans presentations are atypical. It is possible to acquire Lyme disease or another tick-borne illness without an associated erythema migrans rash.
Ticks can transmit more than species of Borrelia. Anaplasma, Ehlrichia, Babesia, Rickettsia, and Bartonella are common co-infections associated with Lyme.
Transmission rates of Borrelia and associated co-infections vary by organism. Viruses, like Powassan virus, can also be transmitted by a tick bite. It is common for a patient diagnosed with Lyme disease to be struggling with more than one infection.
The previous paragraph mentioned symptoms of early Lyme disease. Untreated Lyme disease can spread and become disseminated Lyme disease, manifesting with symptoms in the musculoskeletal, cardiac, and neurological systems. Symptoms include (but are not limited to) fever, night sweats, brain fog, migratory joint pain, joint swelling, lightheadedness, palpitations, mood changes, numbness/tingling, gastrointestinal symptoms, and shortness of breath. Diagnosis of disseminated Lyme disease can be difficult since these symptoms are characteristic of other medical diagnoses such as chronic fatigue syndrome, fibromyalgia, multiple sclerosis, rheumatoid arthritis, and other autoimmune conditions.
Lyme disease is considered a clinical diagnosis, based on a patient’s history and physical exam. Lab results can be supportive of the Lyme diagnosis, but the standard two tiered tests do not have to be positive to make the diagnosis. Various factors contribute to a high prevalence of false negatives in Lyme disease testing. The Lyme ELISA test and Lyme Western blot are specific to Borrelia burgdorferi. The two-tiered testing system does not detect other Lyme-causing Borrelia species. Antibodies do not appear in the blood until several weeks after the tick bite. In some chronically ill individuals, the immune system is not healthy enough to produce a sufficient antibody response. Testing accuracy changes with duration and complexity of infection since the test results are reflective of the individual’s immune response. The more sensitive C6
ELISA test is not currently included in testing standards of care. Comprehensive tick- borne illness testing may not be covered by health insurance.
Treatment of early Lyme disease often includes the use of antibiotics or herbal extracts for one to several months. Disseminated Lyme disease treatment on the other hand is typically more complex and can take months to years. A combination of antibiotics, herbal extracts, supplements, diet and lifestyle changes may be used to improve the overall health of the body while addressing the infection.
During the summer, preventing illness includes protecting yourself from Lyme disease and associated tick-borne illnesses. Methods of prevention include: dressing in light colored clothing, tick checks after every outdoor activity, and wearing insect repellent. When checking for ticks make sure to inspect warm and moist areas like armpits, backs of knees, groin, in and around the ears. It can be a helpful habit to throw your clothes in the wash and shower right after coming in from a wooded or grassy area. If you do find a tick, look at the scutum of the tick to identify it. Ticks can be sent to TickReport or Ticknology for identification and pathogen testing. If you are concerned that a new rash may be erythema migrans, take a picture and contact your physician. If you think you may be suffering from a tick-borne illness, take the MSIDS questionnaire online. This questionnaire was developed by Richard Horowitz, MD to improve the assessment of Lyme disease and the associated bacterial, viral, parasitic, and fungal infections. This questionnaire is available as a pdf on the lymeactionnetwork.org website. For more detailed information on preventing tick-borne illness, refer to a book such as Dr. Alexis Chesney’s, Preventing Lyme & Other Tick- borne Diseases.
Dr. Laurel Erath is a naturopathic doctor at Fernwood Holistic Health.