This Fall Think About Lyme Disease

By W. Gifford-Jones, M.D Created: August 30, 2012 Last Updated: August 31, 2012
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Close up of an adult female and a nymph tick—carriers of Borrelia burgdorferi, the bacterium that causes Lyme disease. (Getty Images)

Close up of an adult female and a nymph tick—carriers of Borrelia burgdorferi, the bacterium that causes Lyme disease. (Getty Images)

Do you believe you must be in an infected area to get Lyme disease? If you do, think again. A 10-year study reports that you can catch this malady in your own backyard.

Since spring and fall are prime times for this disease, being forewarned is forearmed, particularly since a bite of the deer tick can have far-reaching health consequences.

Lyme disease was first suspected in North America in 1975. In Lyme, Conn., an unusual number of children were developing what was initially thought to be juvenile rheumatoid arthritis.

A team of scientists from Yale University was sent to study this cluster of patients. These children all exhibited a bull’s-eye rash. In addition, they also suffered from muscular, heart, and neurological problems. The final diagnosis? Lyme disease.

The first case occurred in Canada in 1977 when a 13-year-old girl in southwestern Ontario was diagnosed with the disease.

Lyme disease is due to a bacterium, Borrelia burgdorferi, which resides in deer, mice, squirrels, and other small animals. The blacklegged tick (deer tick) becomes infected when feeding on these animals, and its bite then transmits the disease to humans.

Ticks are not insects. They are arthropods, closely related to spiders and mites. They usually have a two-year life cycle during which time they feed three times.

Studies show that there may be 2,000 infected ticks per acre of forested land. They stay at the end of tall grass or on other vegetation waiting for unsuspecting people to walk by. They must remain attached to the skin for several hours to transmit Lyme disease.

The 10-year study revealed that the blacklegged tick is present as far north as the 50th parallel. Researchers studied 591 blacklegged ticks collected from dogs, cats, horses, and people who had not traveled out of Ontario or who had not been to a Lyme-disease-infected area. They found that 12 percent of ticks, usually females, were infected with B. burgdorferi.

The widespread distribution is believed due to songbirds dispersing immature blacklegged ticks during their northward spring migration.

The message for doctors and the public is that people and domestic animals are at risk of contracting Lyme disease in their own communities.

Lyme disease has been labeled The Great Imitator. Like syphilis, it can mimic many different diseases and has a multitude of clinical symptoms. The result is that doctors often miss the diagnosis.

The first sign is usually a rash that erupts within a month after the initial bite of an infected tick. The rash is often found at the site of the bite, is red and circular with a clear center that resembles a bull’s-eye. But a report from the U.S. Centers for Disease Control says that only three out of ten people get a bull’s-eye rash.

The rash may be painless or painful, itchy, and hot. Patients normally complain of flu-like symptoms such as fatigue, headache, aching muscles, and low-grade fever. There may be pain in the joints and enlargement of lymph nodes.

If untreated, three to five months later the disease strikes again. About one in ten patients develops cardiac abnormalities, such as irregular heartbeat or heart block. The majority of people recover after a short time.

Neurological complications occur in about 10 percent of patients. Peripheral nerves may be involved, or patients may suffer from encephalitis, meningitis, or Bell’s palsy.

The last stage of Lyme disease occurs five months to five years after the initial infection. Patients complain of pain primarily in large joints such as the knees. A few cases have been reported in which symptoms were similar to multiple sclerosis.

The best treatment for Lyme disease is prevention. Wear long-sleeve shirts and pants tucked into socks while walking in wooded areas. Light-colored clothing is also preferable, as ticks can be more easily spotted.

Use an insect repellent. Check clothes for ticks, and examine your body, including hair and scalp. It’s also prudent to check pets and brush them off outdoors.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is He may be contacted at

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