• Montgomery County Health Department
    Questions & Answers about Lyme Disease

    1.  What is Lvme disease?

    Lyme disease is a bacterial infection caused by a spiral shaped microorganism called a spirochete. The name of the Lyme disease bacterium is Borrelia burgdorferi; consequently the disease often is called Lyme borreliosis.

    2. How is Lyme disease spread?

    Lyme disease is spread by the bites of certain ticks. The deer tics, Ixodes dammini, are responsible for transmitting the infection in the northeastern and central United States. On the Pacific Coast and in the southeast, Lyme disease is spread by blacklegged ticks that closely resemble the deer tick.

    3. How do ticks carrying Lvme disease differ from other-- ticks'?

    The most important distinction is size. The vector ticks of Lyme disease are much smaller than dog ticks and cattle ticks. The nymphal stages of Ixodes dammini which are chiefly responsible for transmitting infections to humans are black and no bigger than a pinhead- The adult t4-ck, which may transmit infections in the fall, are only slightly large--.

    4. What are the early symptoms of Lyme Disease?

    The earliest signs of Lyme disease are flu-like symptoms (fatigue, fever, headache, muscle and joint pains, and a very characteristic skin like rash called erythema migrans. This rash generally appears as a red, circular patch that expands slowly, often to a very large size. The center of the patch may clear as the rash enlarges. resulting in a ringlike appearance. The rash may be warm but is not painful.

    5. What are the later manifestations of Lyme Disease?

    Some of the symptoms of Lyme disease may not appear until weeks or months after the initial onset of illness. The infection may inflame the heart, leading to disturbances of the heart rhythm. Lyme disease may affect the nervous system causing muscle weakness of the face and limbs or pain and numbness. Meningitis, an inflammation of the covering of the brain may occur resulting in a stiff neck and severe headache. In later stages of the disease, arthritis may develop, and the joints may become red, swollen and painful.

    6. How is Lyme Disease diagnosed?

    Lyme disease is diagnosed from its clinical features and with the aid c@@ serological (blood) tests. Often the serologic test does not become positive until several weeks after the onset of illness.

    7. Can Lyme disease be treated and cured?

    Most Lyme disease patients treated in early states of the disease, when only rash and flu-like symptoms are present, will respond favorably to therapy and remain well. Even among patients not treated until later stages of the disease, the majority respond to therapy. In a small proportion of cases, symptoms may recur and additional courses or antibiotics are necessary. Permanent damage to joints cc--u--s in a small number of patients. 

    8. What antibiotics are used to treat Lyme disease?

    Tetracyclines (tetracycline, doxycycline) and penicillins (penicillin, ampicillin) are usually used in treating early stages of Lyme disease. Intravenous penicillin and ceftriaxone are commonly used to treat patients in later stages of the disease. Other antibiotics and drug combinations are under evaluation.

    9.  Are there special problems if Lvme disease occur?

    Lyme disease acquired in pregnancy may lead to infection of the fetus. Although some cases of fetal infection resulting in malformations and miscarriage have been reported, there have been no reported instances of an adverse outcome when the expectant woman was adequately treated.

    10.  Where does Lvme disease occur?

    Lyme disease occurs in a near worldwide distribution in Europe, northern Asia and North America. In the United States, Lyme disease has been reported from 46 states; only Alaska, Hawaii, New Mexico and Arizona have not reported cases. However, the risk of Lyme disease is greatest in 3 areas: (1) in the mid-Atlantic and New England states, from Maryland to Boston; (2) in the upper mid-West in Wisconsin and Minnesota; and (3) on the Pacific coast, especially northern California. Over 80% of the nations cases occur in these three areas.

    11.  Is Lyme disease spreading?

    Yes, the tick vector of Lvme disease is now present in areas of the country where it had not been recognised previously. The tick can be spread by birds, deer, and by humans transporting pets, including horses.

    12. Where am I likely to be exposed to ticks carrying Lyme disease?

    The tick vectors prefer wooded areas and overgrown fields. However, in many suburban areas where residential lawns and parks are located within or near woods, ticks may be found in the borders between maintained areas and woods, and even among ornamental plantings and on lawns. Local health departments, park or extension services may have information on the local distribution of ticks.


    ·         Whenever possible, avoid areas that are infested with ixodes danmini or other vector ticks of Lyme disease (Ixodes pacificus on the Pacific coast).

    ·         Wear light colored clothing, so that adherent ticks are visible. Inspect Yourself frequently for adherent ticks and remove them.

    ·         Wear long pants and long-sleeved shirts, and tuck pant cuffs into socks. Tape the tops of socks over pant legs. Avoid wearing sandals.

    ·         Use repellents on clothing and/or skin. Repellents; containing DEET may be used on clothing and skin. In some states, permethrin, an insecticide that kills ticks, is available for use on clothing. This product should not be used directly on skin. Follow label directions and avoid excessive use.

    ·         There is some evidence that the longer an infected tick stays attached, the greater the likelihood that it will transmit infection. Inspect yourself frequently for adherent ticks and remove them promptly. These ticks are very small, as tiny as a pinhead, and may be difficult to find.

    ·         In areas where Lvme disease is endemic, ticks may be brought into the home on pets. Inspect animals to remove ticks that are loose in the hair. Consult a veterinarian for appropriate tick repellents for your pets.