Latest Recommendations for Managing Lyme Disease

Managing Lyme disease does not only pertain to treatment therapies.

In November 2020, a panel of experts published an evidence-based study for the Infectious Diseases Society of America, detailing the prevention, diagnosis, and treatment of Lyme. This study, led by Paul M Lantos, from the Duke University School of Medicine, is the latest benchmark for managing Lyme disease.

managing Lyme disease includes prevention, diagnosis, and treatment — Managing Lyme disease includes prevention, diagnosis, and treatment

Managing Lyme disease: Prevention

When it comes to management of Lyme, prevention is paramount. The 2020 study advises that anyone at risk of exposure should be proactive in preventing tick bites. There are high-risk areas, like Central Massachusetts, with large deer tick populations. You should be protected from tick bites every time you are outdoors. The study recommends using repellents. On the list of effective repellents, are DEET, picaridin, and permethrin. Oil of lemon eucalyptus is also on the list of recommended tick repellents. If a tick is found, the study recommends removal with clean, fine-tipped tweezers – never using alternate means for removal, such as burning or applying essential oils.

tick control Andover MA — Barrier tick control spray for tick bite protection

Gardner tick treatment measures at home should be employed in high-risk areas, such as Central Mass. While many areas have municipal sprays, they do not reach far enough to offer complete protection. Professional EPA-registered and all-natural tick control sprays are available, and should be considered.

Lyme Management: Diagnosis & Treatment

3 stages of Lyme disease — The black-legged tick is a vector of Lyme disease

The study also recommends submitting a tick for identification after removal, to determine if it is a known vector of Lyme. It suggests that testing the tick for infection does not reliably determine whether a person will contract Lyme disease. Therefore, testing for Lyme bacteria would not be helpful.

Prophylactic antibiotic treatment is recommended only if these three criteria are met:

The tick is identified as a Lyme vector species
The person lives in an endemic area
The tick is attached for more than 36 hours

If these criteria apply, the study recommends a single prophylactic dose of doxycycline up to 72 hours after removal of the tick. The dosage should be 200mg for adults and up to 200mg for children, based on weight. If these criteria are not met, the recommendation is to wait and watch for symptoms.

Lyme disease bullseye rash — Bullseye rash after tick bite

If a rash appears after a tick bite, a clinical diagnosis is recommended, rather than laboratory testing. Patients with the bullseye rash should begin a 10-day course of doxycycline, or a 14-day course of amoxicillin or cefuroxime axetil. If patients cannot tolerate those antibiotics, a 7-day course of azithromycin is recommended for treatment. If a patient has Lyme-related facial paralysis, the study makes no additional treatment recommendations over antibiotics. For patients with Lyme-related arthritis, a 28-day antibiotic regimen is recommended. If the arthritis is severe, and does not respond to this regimen, an additional 2 to 4-week treatment of IV antibiotics is recommended. If severe symptoms of arthritis persist after IV treatment, the patient should be referred to a rheumatology specialist.

Lyme disease can manifest in neurological complications, specifically of the central nervous system. If a patient shows these symptoms, spinal fluid should be tested. A serum test should also be performed. These cases of Lyme disease should be treated with IV ceftriaxone, cefotaxime, penicillin G, or oral doxycycline. Intravenous treatment can be switched to oral treatment, with a recommended treatment duration of 10 to 14 days.

More About This Study

There are extensive recommendations for managing many other facets of Lyme-related illnesses, like carditis, dermatitis, cognitive impairment, and lymphocytoma. Additionally, there are recommendations for co-infection diagnosis and treatment. Read the complete publication here.

Dave Macchia, tick control enthusiast — Dave Macchia, Central Mass tick control enthusiast

Lyme Disease: Men vs. Women

The CDC suggests that more men are diagnosed with Lyme disease than women. Do more men actually contract Lyme disease?

This statement is not a clear-cut answer as to whether more men contract Lyme than women. Studies suggest that gender bias could be a factor in Lyme diagnoses, and because of this bias, more women are reported to have chronic Lyme disease.

gender bias in lyme testing

Lyme testing gender bias is easily explained.

The CDC western blot test requires reaction of five out of 10 bands to be present for a positive Lyme diagnosis. Men generally have six of 10 bands react, while women present with four, leading to a negative Lyme test. Studies suggest that due to this bias in testing, more women end up with chronic Lyme disease simply because of non-diagnosis. These patients are also commonly misdiagnosed with conditions that have similar symptoms to Lyme, such as chronic fatigue or Fibromyalgia.

Lyme disease testing gender bias

Also read: Lyme Symptoms That Might Surprise You

While the CDC Lyme disease surveillance reports more men with Lyme disease than women, another reporting agency, FAIR Health, says that more women file health insurance claims in treating the disease. Between the ages of 23 and 50, twice as many Lyme disease insurance claims were file by women than men. This is a truly odd phenomena – more men test positive, but more women are actually treated for the disease. Should Lyme disease testing for females meet different criteria than males? Early treatment is essential. If women are showing negative Lyme disease tests, but actually do have the disease, it can become a lifelong battle with chronic illness – and a lifelong battle in finding appropriate treatment.

Also read: 83% of enrolled persistent Lyme sufferers at MyLymeData are female.

Additional studies show that women and men react differently to medications. Women are more likely to have adverse effects to medication than men, suggesting that perhaps medication should be formulated differently by gender. Would this be an answer for more effective treatment of Lyme disease in women?

Tick protection is key in preventing Lyme.

No matter if you are male or female, prevention is key, and can be aided with personal tick protection when you are out of doors. In addition to personal protection, at-home tick control can help prevent unfortunate tick encounters in your own yard. With the prevalence of ticks in Central Mass, professional tick control is essential, and is most effectively employed all year long – not just in the spring and summer. In the warm weather seasons, your yard can be treated with a tick barrier spray that will eliminate ticks on contact, and continue killing them for up to three weeks. When the temperature falls below 45°F, tick tubes can be placed in your yard, which will aid in halting the tick life cycle, resulting in less ticks when springtime rolls around.

You didn’t see the tick. You didn’t see the rash. You didn’t see it coming – Lyme Disease

Is it possible that you have Lyme Disease if you didn’t see a tick and didn’t see a rash? Avril Lavigne just learned that the hard way. Here are two truths that make this scenario not only possible but also not all that uncommon.

You won’t hit the bullseye every time

Utter the word Lyme Disease and people shudder. They should. It’s a disease that seems to be way too easy to catch. If ticks are in our grass and our plants and our leaves, how are we supposed to enjoy our lives without giving up on being outdoors? The nice thing is if you do somehow get bitten by a diseased tick, you will know right? Many people look for the bullseye rash to confirm they have Lyme Disease. But, about 20% of the time, Lyme Disease does not present with a bullseye rash. Unfortunately, the lack of such a rash cannot spell relief 100% of the time – only 80% of the time.

Nymph ticks are about the size of a poppy seed. Would you notice a nymph tick if it crawled on you?

Poppy seed sized ticks

If you think you have all the symptoms for Lyme Disease – fever, chills, sweats, muscles aches, fatigue, nausea & possibly joint pain but you never pulled off a tick, you may not be out of the woods.

In fact, nymph ticks are only about the size of a poppy seed which almost completely ensures that you won’t see a nymph tick that crawled on you. It’s so small, you likely won’t know if it bit you either.

Recently Avril Lavigne publicly announced that she has been suffering from Lyme Disease. She doesn’t know how or where she caught it and it took a very long time to come to a Lyme disease diagnosis.

The best protection is protection at home. Your yard is where you spend the majority of your outdoor time. A seasonal tick protection includes regular spraying that both eliminates adult ticks in your yard and continues to eliminate them based on our microencapsulated timed release system.

Tag: Lyme disease diagnosis