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Beware of the Bite: Why is Lyme Disease So Hard to Diagnose?

May 9, 2018
Published in: General

grove of trees

The thought of a tick burrowing into your skin and sucking your blood is enough to give anyone a case of the creepy crawlies. These pests are more than just a minor nuisance. The blacklegged tick, sometimes called a deer tick, carries bacteria that can infect humans with Lyme disease. Each year, approximately 30,000 Americans are diagnosed with Lyme disease.

Closeup of a tick on clothingNinety-five percent of Lyme disease cases come from:
  • Virginia
  • Vermont
  • Wisconsin
  • Rhode Island
  • Pennsylvania
  • New York
  • New Jersey
  • New Hampshire
  • Minnesota
  • Massachusetts
  • Maryland
  • Maine
  • Delaware
  • Connecticut

Diagnosing Lyme disease can be difficult because symptoms often mimic other diseases or may disappear and reappear over a long period of time. Here's what you need to know about Lyme disease, and why it's so hard to diagnose.

The Lay of the Land

Not all blacklegged ticks (a.k.a. deer ticks) carry Lyme disease. Those that do inject one of four bacteria into the bloodstream causing Lyme disease. Blacklegged ticks look like other common ticks. Young blacklegged ticks are too small for easy detection. Don't use the appearance of a tick to decide whether it's a blacklegged tick versus a non-harmful tick.

Certain factors increase your risk of acquiring Lyme disease. These include:

  • Working or recreational activities in the woods or tall grass. Remember to remove debris from your yard that may be a breeding ground for ticks.
  • Pets that run in the woods or tall grass can carry ticks into your home, increasing your bite risk. Check your pets often and thoroughly for ticks!
  • Failing to wear protective clothing such as long sleeve shirts and long pants. Exposed skin is a target for ticks. Protective bug spray also adds an extra layer of protection.
  • Failing to conduct frequent and thorough body checks for tick bites. Removing a tick within 48 hours of a bite reduces your risk of getting Lyme disease!

I'm Bit…Now What?

Sick woman with cloth on forehead drinking teaIf a tick bites you, it's important to pay close attention to your symptoms and seek medical care. Lyme disease symptoms can occur early on or lay dormant for weeks, months, and even years. Early intervention is the best way to prevent further complications from Lyme disease.

Early Symptoms of Lyme disease (3 to 30 days):

  • A red bull's eye rash that expands over a few days
  • Flu-like symptoms: Fatigue, fever, chills, headaches, body aches

Later Symptoms of Lyme Disease:

These symptoms often accompany a bull's eye rash and flu-like symptoms.

  • Joint Pain: Swollen and painful joints, especially the knees. Joint pain may move around from joint to joint.
  • Nausea and vomiting
  • Wide spread rashes
  • Irregular heartbeat
  • Swollen eyes
  • Liver inflammation
  • Impaired memory
  • Neurological Conditions: brain membrane inflammation, paralysis of the face, numb or weak arms and legs, decreased muscle control

Diagnoses Dilemma

Doctor reading a book and thinking

Diagnosing Lyme disease is difficult because symptoms mimic other diseases or may be dormant for days, weeks, or years. Testing for Lyme disease may produce false negatives if antibodies haven't developed, the immune system is suppressed, or the test doesn't measure the strain that's infected the patient. It's estimated that 20-50% of people with Lyme disease received a false negative test result.

Doctors must use a combination of testing, lab work, and patient history to diagnose Lyme disease. As a patient, you have an important role in this process. If you suspect you're at risk for Lyme disease, the following actions items and information are beneficial for your diagnoses.

Action Items

  • Make a complete list of all your symptoms.
  • List all medications you're taking.
  • Include a list of any major life changes or stressors.
  • Take a friend or family member with you to your appointments to help you remember important information and questions.

Prepare Answers

  • When did your symptoms start?
  • Are your symptoms constant or intermittent?
  • Does anything improve your symptoms?
  • Does anything make your symptoms worse?
  • Do you know if a tick bit you?
  • Have you been in wooded areas?

Trouble to Treatment

Antibiotics are the most common treatment for Lyme disease. Oral antibiotics are usually prescribed for 14 to 21 days. If Lyme disease is impacting your central nervous system, your doctor may administer antibiotics directly into your vein. For some people, Lyme disease symptoms persist even after treatment. More research is needed to understand and effectively treat these symptoms that are antibiotic-resistant.

Lyme disease is a serious illness that can have far reaching impacts on your health. Though there are several tests for diagnosing Lyme disease, they are not fully developed enough for 100% accuracy. Lyme disease symptoms are common in other diseases. The symptoms can also vary in lifespan. These factors make Lyme disease hard to diagnose. Prevention is the best defense against tick bites and Lyme disease. Make sure you're taking the proper steps to keep you and your family safe!