Full comprehension and applied recall of the signs and symptoms of Lyme disease requires knowledge of what the disease is and how it affects the body. That understanding could be of critical importance if you are someone you know is at risk of it. A system-based perspective is the key to health literacy on this topic.
Lyme disease is a multi-system disease caused by the bite of a tick infected with a spirochete – a rod-like bacterium in the shape of a spiraled coil –that transmits the disease. Its identification was in Lyme Connecticut in the year of 1977. Therefore its appropriate name is Lyme disease – not Lyme’s disease, Lime disease, or Lime’s disease as some suppose.
The official name of the bacterium that causes the disease in the United States is Borrelia Burgdorferi. The strains that cause the disease in Europe and Asia are B afzelii and B garinii respectively.
The incidence of the disease has been rising since it first became reportable in 1982. The reason is heightened awareness on the part of physicians and patients alike. Of the 30,000 confirmed cases in the United States as of 2012, most cases have been in the Northeast and Midwest states.
Signs and Symptoms of Lyme disease
Multi-system means it affects several of the systems of the body. Mainly, they are the skin, cardiovascular system, musculoskeletal system and nervous system. The signs and symptoms of Lyme disease depend upon the system(s) it affects and the stage of the disease.
Signs and symptoms of Lyme disease, as is the case with many infectious diseases, are not just due to the direct effects of the germs in the body. Many of the signs and symptoms are the result of the response of the immune system to the spirochetes. Inflammation is the chief response in this respect.
There are 3 stages of the disease. They are:
- early localized infection (primary or stage 1)
- early disseminated disease (secondary or stage 2)
- late disease (tertiary or stage 3)
Stage 1 or localized infection usually occurs within one month following a bite by an infected tick. The cardinal sign is a red flat rash which expands and forms a clear central area resembling a bull’s eye target. The medical name for this skin lesion is erythema migrans. It is usually painless but might be itchy or burning. Usually within days of it forming, smaller flat red spots appear around and adjacent to it. They are termed satellite lesions and indicate spreading of the infection.
Flu-like and other vague symptoms occur in roughly half of infected individuals at this stage of the disease. They can include headache, chills, fever, muscle aches, joint pain, stiff neck, and malaise. They can persist into stage 2 of the disease when it is untreated.
Signs and Symptoms of Lyme disease During Stage 2
Continued spread of the infection to other parts of the body over the ensuing weeks to several months is the early disseminated stage of the disease. During this stage signs and symptoms of involvement of the musculoskeletal, cardiovascular, and/or nervous system(s) appear.
Migratory joint pain is the main symptom of stage 2 disease involving the musculoskeletal system. That means as pain improves or subsides in a joint(s) it spreads to other joints and/or recurs in improved joints. It usually settles in a single joint over 1 or 2 days.
Stage 2 disease of the cardiovascular system can involve the heart muscle, the electrical conduction pathway of the heart, and/or the membrane sac which surrounds the heart. Hence, the signs and symptoms of Lyme disease affecting the heart can be those of myocarditis, heart block, or pericarditis.
Symptoms of myocarditis are usually not present at this stage of the disease but those referable to heart block are. The most common form of heart block which occurs with Lyme disease is first-degree AV block, but more serious second-degree and complete heart block can also occur. As such, associated signs and symptoms might include the following:
- bradycardia (a slow heart rate)
- palpitations (the unpleasant sensation of rapid, irregular, or forceful heartbeats)
- skipped heartbeats detected by feeling the pulse or a doctor listening to the heart with a stethoscope
- syncope (fainting)
- dyspnea (shortness of breath)
The most common symptom of pericarditis is sharp pain in the middle of the chest. There might also be a low-grade fever and an increased heart rate.
Headache is usually the first Lyme disease symptom of involvement of the nervous system. If the disease is untreated though approximately 10 people out of 100 will develop more severe problems including Bell’s palsy, peripheral neuritis and meningitis.
Chronic Lyme disease Symptoms and Signs
Chronic Lyme disease symptoms and signs relate to what victims experience and what others observe in them during the late stage (stage 3) of the disease. Late disease usually develops months to years after the tick bite. The most common signs and symptoms associated with it involve the musculoskeletal system and the nervous system.
Symptoms of late stage involvement of the nervous system are usually those of peripheral neuropathy and encephalopathy. Sufferers may also experience sleep disturbance, mood swings and chronic fatigue.
On occasions the myocarditis of untreated Lyme disease can progress to dilated cardiomyopathy. The signs and symptoms of it are shortness of breath and easy tiring.
Symptoms of Lyme disease and Response to Treatment
Is Lyme disease curable? This is a practical question in addressing the topic of the response of symptoms to treatment. The answer is yes for the most part, if treatment is appropriate and timely.
Stage 1 symptoms usually subside quickly following correct treatment. That treatment is removal of the tick, proper cleaning of the wound and use of the appropriate antibiotic by a trained health care professional. Such an antibiotic is one that kills the spirochetes that cause the disease.
First degree AV node heart block and its symptoms usually subside promptly and completely when the antibiotic is taken by mouth. But more severe (second-degree and third-degree) AV block require hospitalization for intravenous (given through a vein) antibiotics for cure and cessation of symptoms. These more advanced forms of heart block might also require a temporary pacemaker.
There are other reasons for treatment of Lyme disease in a hospital with intravenous antibiotics. They are severe symptoms of shortness of breath, chest pain, fainting and meningitis.
Symptoms of Lyme disease typical of stage 2 disease and the musculoskeletal symptoms of stage 3 for the most part wane following treatment. But other stage 3 symptoms of Lyme disease usually persist in spite of treatment because those aspects of the disease are not curable at that point.
Early diagnosis and timely treatment are the keys to a cure and the elimination of signs and symptoms of Lyme disease.