It is caused by some bacteria of the Borrelia genus that live in the belly of some species of ticks. The symptoms can be different, but usually antibiotic therapy is used at an early stage, before the bacterium can spread
Many of us have seen a tick up close: a small, seemingly harmless animal that often hides in the folds of the skin after a walk outdoors. Although rarely, this arthropod can choose humans as a host, and in some cases transmit certain diseases to them, including Lyme disease.
The idea of a tick transmitting a bacterium may be a bit shocking, but in most cases we are talking about a condition that, if addressed with the right information, can be managed without problems and with excellent results. Let’s get to know her better.
What is Lyme syndrome
Lyme syndrome, also called Lyme disease or Lyme borreliosis, is caused by certain bacteria of the Borrelia genus that live in the belly of some species of ticks. It is a multisystem disease, meaning that, in the absence of treatment, it can involve various organs or systems:
- the skin;
- the joints;
- the nervous system;
- the heart (in rare cases).
Lyme disease may seem like a complicated disease but, in practice, especially in children, it often has a simpler evolution than one might imagine. A characteristic sign almost always appears that allows it to be recognized immediately and, with the appropriate therapy, complete recovery is achieved.
How it is transmitted
What is the relationship between ticks and Lyme disease? What is at the basis of this pathology?
Not everyone knows how Lyme disease is transmitted. Some think that a quick bite from a tick is enough, even if promptly removed, but this is not the case: to transmit Borrelia, the tick must remain attached to the skin for at least a day, often more than 24-36 hours. This aspect is fundamental, because it makes Lyme disease largely preventable: checking your skin after a day outdoors is a simple gesture, but one that can be very useful.
Ticks become infected by biting small mammals, especially rodents, which act as a natural reservoir for the bacterium. Lyme disease is common in various parts of Europe, North America, and parts of Asia. In Italy it is more frequent in the northern and part of the central regions, especially in wooded areas and meadows on mountains and hills.
Incubation can vary from a few days to a month. It is also good to know that contracting the disease does not immunize us once and for all: if another infected tick attaches itself long enough, the disease can return.
Symptoms of Lyme disease
Given its multisystem nature, the symptoms of Lyme disease can be different. Usually, due to the consequentiality that characterizes them, they are divided into several stages.
First stage
The first sign, as well as the most typical, is erythema migrans: the skin rash that characterizes Lyme disease is a red patch that, as the days pass, widens from the bite site. It is not a simple local redness, because it tends to grow day after day and often takes on the classic “target” shape, with a lighter center and a darker outer ring. It can appear in barely visible areas and rarely causes itching or pain. Depending on the location of the bite, this manifestation of Lyme disease can affect any site, even the face.
Often, but not always, mild symptoms such as low fever, headache, joint pain and tiredness are associated.
Second stage: when the infection spreads
If left untreated, Borrelia can spread into the blood and cause:
- neurological signs, such as facial nerve paralysis;
- meningitis;
- heart rhythm disorders;
- more severe joint pain.
These manifestations are decidedly less common than erythema migrans, because antibiotic therapy is usually used before the bacterium can spread.
Third stage: late symptoms and chronic Lyme disease
It is the late stage, characterized above all by forms of recurrent arthritis, persistent neurological problems and chronic skin changes. Chronic Lyme disease today is a rare condition, almost always linked to long-term missed diagnoses.
What are the consequences of Lyme disease?
Before the discovery of antibiotics, Lyme disease could have a very impactful and dangerous evolution. Today, with adequate and timely therapy, the risk of complications is reduced to practically zero: the disease heals and leaves no consequences in the vast majority of cases.
Sometimes, after treatment, symptoms such as tiredness, difficulty concentrating or muscle pain may appear for a few weeks: this is the so-called post-treatment syndrome (PTLDS), a transitory phenomenon whose causes are not yet clear, but not linked to the persistence of the bacterium.
What to do if you find a tick
After a day outdoors it is worth doing a quick skin check, paying particular attention to the places favored by ticks: back of the knees, armpits, groin, behind the ears.
To remove a tick, simply use tweezers, grasping it delicately, without crushing it, as close to the skin as possible, rotating it several times to extract it without breaking it. It is important to avoid using your hands and crushing it with your fingers. Alternative methods such as matches, oils, alcohol, gasoline, acetone, ammonia or other irritants do not help and can make the situation worse. After removal simply wash the area. Over the next 30 days, the area should be observed to see if erythema appears.
In some Italian regions where there is a high prevalence of ticks affected by Borrelia, especially in Alpine and pre-Alpine areas, there are protocols that invite you to contact your pediatrician in any case for the removal and/or possible analysis of the tick, alive or dead.
Diagnosis of Lyme disease
There are various ways to make a diagnosis of Lyme disease. When erythema migrans is noticed following a tick bite, the picture is quite characteristic and therapy can be started immediately, without confirmatory tests.
Blood tests, such as ELISA and Western Blot, become useful, in doubtful cases, after a few weeks, when the body has had time to produce antibodies. In particular cases, PCR on biological liquids can be used. Blood tests that are too early therefore risk being negative even in the presence of infection.
Treatment of Lyme disease
As previously mentioned, Lyme disease is treated with antibiotics. The choice of the specific antibiotic depends on age, stage and individual loco-regional protocols; in children, oral antibiotics, such as amoxicillin, are usually used, while doxycycline can be used in older children.
In some more complex cases, ceftriaxone, an antibiotic administered intramuscularly or intravenously, can be used. In any case, the therapy is usually longer (even 2-3 weeks) than more classic antibiotic therapies, such as for tonsillitis or otitis. For Lyme disease, alternative treatments do not work and should not delay starting the correct antibiotic therapy.
How to protect children from Lyme disease
Prevention is based on very concrete habits: when you go on an excursion outdoors, especially in wooded environments or in meadows with tall grass, you need to wear long, light-colored clothes and closed shoes.
If desired, you can use repellents compatible with the age of the child; It is very important to remember to check your skin on your return: ticks are small, they move slowly, without causing any discomfort, so we hardly notice their presence unless we look for them.
All these are simple measures, which do not limit the trip but serve to effectively reduce the risk. Unfortunately, unlike other tick-borne diseases, there is not yet a Lyme disease vaccine for humans.
Does Lyme disease affect dogs too?
Yes! Dogs can develop Lyme disease, experiencing fever, tiredness and lameness. For them, unlike humans, there are vaccines that veterinarians can offer in the most at-risk areas.
Where to find help in Italy
In case of doubts, the pediatrician remains the most immediate point of reference. Many hospitals have dedicated Lyme disease centers within their infectious disease services.
