One of these days, they’ll have a Hollywood hero who’s living off the land pull off a tick as he sits next to his giant bonfire roasting his magically quick-cooking ‘wild’ pig. Someday. If you’ve spent any time in the woods, you’d recognize the tick as the most likely part of that picture. While few people appreciate blood-sucking parasites to start with, ticks come with extra problems: They transmit diseases such as Lyme’s.
Lyme’s disease is the most common parasite-transmitted disease in the U.S., with about 30,000/yr reported lately (1). Many more people get exposed but their immune systems successfully defend them (based on antibodies found in the blood of volunteers in areas where the disease is common). Salty and I talk about how to avoid it, recognize it, and what doctors suggest regarding treatment (we ourselves are not physicians and don’t make medical recommendations) in this article and podcast:
What causes Lyme’s disease
It’s not the ticks…exactly. It’s a bacterium, Borrelia bergdorferi, that the tick unwittingly transmits between mammal hosts. The bacterium is transmitted by the black-legged (deer) ticks of the genus Ixodes. These species of ticks have a life cycle that goes like this: Hatch from an egg as a larva. Crawl toward some delicious mammal that smells of carbon dioxide, latch on, and fill up with blood. Drop off, grow, and molt into a nymph. Find another host and fill back up. Drop off, grow, and molt into an adult. Latch on one more time, fill up, reproduce, die.
These are the three life stages of the black-legged deer ticks that transmit Lyme disease.
Larvae are too small to bite humans. They mostly latch on to white-footed deer mice (extraordinarily cute little rodents common in temperate woodland/forest areas). The mice can be infected with the bacteria from a previous bite without getting sick. The larva picks up bacteria during the feed.
If the nymph gets on a human and bites, somewhere between 24 and 48 hrs after it’s begun to feed, the bacteria in the tick make their way into the human, causing an infection. Or the nymph feeds off another host (such as another mammal) and the adult tick is the one that transfers the bacterium to the person. Then the person’s immune system either kicks the bacterium around or the person gets Lyme disease, depending on immune system strength and dose of bacterium that got in.
How to not get Lyme’s disease
Don’t get bitten by infected ticks. My that was easy to type! There are lots of ways to reduce your chance of getting bitten. You can find some of them in this article.
If you do get bitten but get the tick off inside of the first 24 hrs, it’s highly unlikely you’ll be infected. Tick checking carefully after potential exposures is therefore helpful. Don’t count on this step though; those nymphs are so small and inconspicuous (about the size of a pinhead; we used to call them ‘seed ticks’) that 30-50% of the people who test positive for Lyme never were aware of the tick bite. (2)
Since seed ticks are tough to grab, you might use fine-tipped forceps (which really belong in a first aid kit anyway). That works for me; I’ve heard other people recommend applying a bit of tape to the tick(s) and lifting it (them) off.
Also, Lyme’s disease isn’t a nationwide thing, or a worldwide thing. There are varieties in parts of Europe and Asia, but in the U.S. the cases are concentrated in the Northeast, Great Lakes, and Pacific Northwest. We midwesterners have our own tick-borne problems, but our ticks aren’t of the Lyme-carrying varieties.
The dark dots represent where people were when they got diagnosed with Lyme’s disease. The rare cases are thought to be people who picked the disease up in a hotspot then went home. (1)
How to know if you have Lyme’s disease
In the absence of lab tests, it won’t be a positive thing… but knowing what Lyme’s disease looks like will give you a good shot at figuring out what’s going on.
The first stage of the disease, occurring in the days after the bite, feature diagnostically unhelpful fever, malaise (med-speak for ‘you feel lousy’), and generalized muscle aches. As far as diagnosis goes, about 75% of the time there will be a particular pattern of rash, called a bulls-eye rash, at the bite site. The middle where the tick bit (often where clothing or another body part was compressing the skin and helping the tick pierce) will be red, then a paler ring, then another darker red ring. The whole thing is likely to be at least 5 cm (2 inches) across. (2)
You can have Lyme’w disease without the rash; but if you have this rash after being in tick-land, odds are good you’ve got Lyme’s.
That early stage morphs into the second, ‘early disseminated’ stage. The original rash is likely to go away, but similar kinds of rashes may pop up for a few days at other random spots, then go away. Neurological problems such as pain shooting down the path of the leg nerves and meningitis (causing headaches and stiff necks) are common. One particularly helpful diagnostic sign is facial paralysis as the bacteria mess with the facial nerve. Joints may randomly ache and swell, then get better.
This shows the bulls-eye rash, facial paralysis, and joint swelling that may occur with Lyme’s disease.
If it’s not treated by now, 60% of cases will move onto the ‘late disseminated’ stage. Joints, especially knees, intermittently swell and hurt. There can be more neurologic problems: Insomnia, unexplained strong fatigue, foggy thinking and memory problems, sometimes even personality changes.
What do you do if you have Lyme’s disease?
If possible, you see a real physician. Seriously. Improper use of antibiotics is a really bad idea. That said, this is a prepping website, so suppose the doctor thing can’t happen. The sources were in agreement: Antibiotics, as soon as diagnosis is made, are called for. The summary below came from the CDC. (1)
| Age Category | Drug | Dosage | Maximum | Duration, Days |
| Adults | Doxycycline | 100 mg, twice per day orally | N/A | 10-21* |
| Cefuroxime axetil | 500 mg, twice per day orally | N/A | 14-21 | |
| Amoxicillin | 500 mg, three times per day orally | N/A | 14-21 | |
| Children | Amoxicillin | 50 mg/kg per day orally, divided into 3 doses | 500 mg per dose | 14-21 |
| Doxycycline | 4 mg/kg per day orally, divided into 2 doses | 100 mg per dose | 10-21* | |
| Cefuroxime axetil | 30 mg/kg per day orally, divided into 2 doses | 500 mg per dose | 14-21 |
Advanced cases may need IV therapy for 3-4 week, perhaps with Penicillin G … so it would Really be best in a prepping situation not to let it get that far.
Post-treatment Lyme’s disease syndrome
This is one topic on which the Internet is likely to lead you astray if you don’t mind your source quality.
First, post-treatment Lyme’s disease syndrome is definitely a thing. Everyone agrees that some people, even after a full course of antibiotics, show persistent joint pain, fatigue, impaired cognitive function (mostly foggy thinking or poor memory), and/or unexplained numbness. This syndrome may go away, or may not. It’s not accompanied by any blood test indicators that any bacteria remain.
There are people who will tell you they can make this syndrome go away by very long-term, sometimes IV, doses of multiple antibiotics. They’ll tell you (and I don’t doubt them on this) that they so treated some people who then got better.
But here’s the thing: When careful, placebo-controlled clinical trials are done, the people who get the antibiotics don’t do much better than the people who get the placebos. Some members of both groups get better. One study showed a bit of an edge to the antibiotic group in resolution of fatigue, but not of the other symptoms; and there were serious side effects in the antibiotic group. (3, 4)
In summary:
Here’s my own Lyme’s disease plan:
- Don’t get bit by ticks in the Northeast or Great Lakes regions; and if you might have do daily checks and removals.
- If a bulls-eye rash appears, and maybe if the less specific other symptoms occur, see a doctor if I can and take the antibiotics as listed if no doc is available. I’d take the whole course, always.
- Even if there was a post-treatment syndrome, I wouldn’t be attempting further antibiotic treatment for it. That’s a Giant amount of antibiotics in this kind of scenario, and the side effects look worse than the potential benefits.
1) Lyme disease. (2017) Centers for Disease Control. https://www.cdc.gov/lyme/treatment/index.html
2) Bratton, R. L., Whiteside, J. W., Hovan, M. J., Engle, R. L., & Edwards, F. D. (2008). Diagnosis and treatment of lyme disease. Mayo Clinic Proceedings, 83(5), 566-571. doi:10.1016/S0025-6196(11)60731-3
3) New Engl J Med 345:85-92, 2001
4) Neurology 60:1923-30, 2003
The “bullseye” rash…alone…is not always an indicator of having contracted Lyme disease from a tick. I have been bitten and developed that same rash several times, as have some of my family members. None of us have contracted Lyme disease. Almost all Deer Tick bites result in an extremely itchy “bump” which develops a scab and oozes pus. The itchy welts can last a couple of months…but again, they do not necessarily mean that you have contracted Lyme disease.
NJ is well within the area where Lyme is common. In addition to the risk of getting Lyme, there is a high risk of pets (like the Jersey Boys) getting Lyme.
I was diagnosed with Lyme disease 5 years ago and was taking Antibiotics and Nonsteroidal anti-Inflammatory drug which seemed to help. However, I still suffer from some of the symptoms. My symptoms have always been chronic fatigue, joint pain, and even neurological problems in controlling hand and leg movements. I am a 54 year old female. the Antibiotics wasn’t really working and I could not tolerate them for long due to severe side effects, so this year our family doctor started me on Natural Herbal Gardens Lyme disease Herbal mixture, We ordered their Lyme disease herbal treatment after reading alot of positive reviews, i am happy to report with the help of Natural Herbal Garden natural herbs I have been able to reverse my symptoms using herbs, my symptoms totally declined over a 8 weeks use of the Natural Herbal Gardens Lyme disease herbal mixture. My Lyme disease is totally reversed! Their official web page is naturalherbalgardens . c om this is a herbal store that will be leaving it’s footprint in this world. I’m 54 and have never been this healthier
I was bit 5 years ago. Had the rash, swelling and went to the Dr the same day. He didn’t even give a precautionary dose of antibiotics. Here I am 5 years later battling Lyme disease. I had to ask to be tested and it came back positive. I’m on oral antibiotics and supplements. I will probably be getting a PICC line in a couple of weeks.