"Ticks are the epitome of the accidental hitchhiker."
I recently came across this quote and thought it was a brilliant analogy. You're enjoying an outdoor hike or family outing, and without your knowledge, you've become the host to an unwanted guest. Smaller than the size of an eraser, this pest, better known as a deer tick, not only attaches to your skin and feeds on your blood, but is also the carrier of Lyme disease, a bacterial infection.
Lyme disease is caused by the bite of a deer tick, and most recipients will have no idea they were bitten. And contrary to its name, a deer tick can also be carried by dogs who can infect their canine owners without contracting this bacterial disease themselves.
Typically, the incidence of this disease peaks in the summer months when the deer tick thrives and multiplies. Long known as a disease endemic to the northeast, Lyme disease has now been found across America. According to a recent report by the Center for Disease Control and Prevention, "The number of people getting diseases transmitted by mosquito, tick and flea bites has more than tripled in the United States in recent years."
Though the telltale symptom of the bull's-eye rash is well known, there are some sneaky and potentially difficult to diagnose symptoms that can mimic other diseases.
Case in point: I recently had a patient who came to the emergency room complaining of shortness of breath and palpitations. Initially, the on-call team thought it was an acute heart problem. But congestive heart failure or a heart attack were eventually ruled out. The patient was found to have a large collection of fluid compressing the heart muscle and was subsequently admitted and diagnosed with pancarditis, or inflammation of the heart muscle and the pericardium, the sac that encases the heart.
We had pinpointed the symptoms but needed a cause. Once CHF and heart attack were ruled out, I had to wonder whether these symptoms were a result of an autoimmune disease, where the body attacks itself. Or could this be a sign of an infection that had been brewing for years?
After running an exhaustive battery of tests, I found the patient had a rip-roaring Lyme infection that had remained indolent for decades.
This medical case highlights the first sneaky symptom. But other heart problems can arise due to a chronic infection. Sneaky symptom No. 2 is a constellation of heart rhythm disturbances, which can be a sign of Lyme disease. Symptoms include palpitations, light headedness, dizziness and fainting, all caused by disruption of the normal electrical system, which normally tells the heart it's time to beat.
Experiencing chills, sweats and fever? You may be coming down with the flu. However, if you don't have a runny nose or hacking cough, your flu-like symptoms may be a third sneaky sign of Lyme disease.
Sneaky symptom No. 4 is joint pain and swelling, often mimicking symptoms of arthritis. Sixty percent of patients with Lyme disease present with joint pain, generally in the larger joints such as the knees, hips and wrists.
Another sneaky symptom of this disease is depression, memory loss and anxiety. Normally if you were experiencing those symptoms, you wouldn't immediately test for Lyme – but once more relevant diagnoses have been ruled out, a test for Lyme disease should be performed. The disease may trigger fatigue, and some people even confuse it with the extreme exhaustion that can occur with depression. If you suddenly have trouble keeping your eyes open, bring up the possibility of Lyme with your doctor.
Surprisingly, sneaky symptom No. 6 is meningitis, a bacterial infection of the meninges, the membranes which surround the brain. Meningitis can present as a sign of the presence of Lyme disease, with symptoms ranging from headache to back and neck pain, often accompanied by photophobia – a sensitivity to light.
In addition to these sneaky symptoms, there are other facts about Lyme disease that may not be well known.
Lyme disease isn't contagious; you can't catch the disease unless you are bitten. If you happen to notice a tick bite, you can remove it yourself if you've been properly trained, though I highly suggest you have it removed by someone adept at tick removal.
Having a tick bite doesn't necessarily mean you'll get Lyme disease. However, if it's available, you should have the tick itself tested for Lyme. Once removed, the tick can be sent to a lab to know if you've been exposed. If the results are positive, a three-week or longer course of antibiotics is generally prescribed, based on the severity of your symptoms.
Here's another interesting fact: Often, Lyme disease is transmitted with other infections, like Babesia, another Lyme-like infection. I've had both, but the infection – contracted in my youth – didn't become symptomatic until recently.
The best defense against Lyme disease is a strategic offense. During the summer months, when hiking or camping, apply bug repellent and wear clothing that covers your body completely. In the evening, have a friend or family member perform a body check. Unlike mosquitoes, ticks bite and then remain attached to your skin for a full blood banquet, which can last several days. Ticks are not easily removed during a shower unless you try to scrub them off, a process I don't recommend since you could inadvertently leave behind unwanted tick body parts.
The use of bug repellent and clothing send a clear message: Hitchhikers are not welcome.
