MYTH #1: Lyme disease only occurs on the East Coast of the United States.
FACT: Lyme disease been reported in all states of the United States, throughout Canada, and on every continent in the world. It is the fastest growing epidemic in the United States.
MYTH #2: Everyone with Lyme disease gets a bull’s-eye rash.
FACT: Only 50% of Lyme patients develop the characteristic bull’s-eye rash. Many individuals never develop a skin rash. Symptoms vary with every infection.
MYTH #3: If your Elisa screening test is negative, you don’t have Lyme disease.
FACT: The common Elisa test most doctors use to screen for Lyme misses 35% of culture-proven Lyme disease. Some studies indicate up to 50% of the patients tested for Lyme disease receive false negative results. This is because the tests only look for antibodies, not the Lyme bacterium itself.
MYTH #4: Lyme disease can be effectively treated with a short course of antibiotics.
FACT: According to the International Lyme and Associated Diseases Society, there has never been a study demonstrating that 30 days of antibiotic treatment cures chronic Lyme disease. On the other hand, there is substantial documentation demonstrating that short courses of antibiotic treatment fail to eradicate the Lyme spirochete.
MYTH #5: If you have had Lyme disease, you can’t be infected again.
FACT: Lyme disease is a bacterial infection, which means there is no limit to the number of times you may contract the illness. You may be bitten by a Lyme bacteria-carrying tick, be cured, get bitten, and then get sick all over again.
MYTH #6: Lyme disease is not fatal.
FACT: Although Lyme disease is rarely fatal, clinicians are concerned about potential morbidity. On December 13, 2013, Dr. Joseph D. Forrester, a CDC scientist, published a paper in the Morbidity and Mortality Weekly Report documenting three cases of fatal heart attacks in people with recent Lyme disease. None of the victims had a history of heart disease, nor had they been diagnosed with Lyme disease. (Infection with B. burgdorferi was found at autopsy.) Lyme disease in the brain may also cause fatal encephalomyelitis.
In the case of Lyme disease, mortality can be difficult to determine because deer ticks may carry other pathogens in addition to Borrelia burgdorferi. Some of these such as the Powassan virus, can lead to a potentially fatal encephalitis (inflammation of the brain). A person bitten by a deer tick carrying borrelia may be infected with several potentially lethal pathogens, any one of which, or all combined, may be lethal.Baby ticks and juvenile ticks are smaller than a poppy seed or pin head and exposure is very easy to miss. Ticks in any stage secrete a chemical agent that numbs the skin and makes the bite unnoticeable.
MYTH #7: Lyme-infected ticks only live in rural areas.
FACT: Although Lyme infection is more common in rural areas, residents of urban areas are also at risk for infection. Migratory birds, such as sparrows, have been shown to carry borrelia.
MYTH #8: You can’t contract Lyme disease in the winter.
FACT: An average deer tick lives for two years and can survive in very cold climates. Although infection rates drop in the winter because people spend more time indoors, it is still possible to contract Lyme through contact with dogs and other animals that spend time outdoors.
MYTH #9: Chronic Lyme disease eventually goes away on its own.
FACT: There is no evidence to suggest that Lyme disease, acute or chronic, resolves on its own. Bacterial infections require treatment.
MYTH #10: If a person doesn’t look sick, he or she can’t have Lyme disease.
FACT: Lyme disease is an “invisible illness.” Low energy levels, neurological dysfunction, and pain don’t necessarily change a person’s appearance. Family, friends and physicians sometimes don’t realize that simply not looking sick is not an indication of good health.
MYTH #11: A tick needs to be attached at least 24 hours before it can infect a host.
FACT: There have been a number of studies regarding rates of engorgement in ticks after attachment. In these studies, 24 hours is usually given as the time it takes for the tick to become engorged. Physicians have taken this to mean that only once the tick is fully engorged can the spirochetes travel through the salivary glands and into the host.
In a 1995 study performed on Ixodes ticks infected with two Borrelia species, researchers found that engorgement was not necessary for transmission of the bacteria. The determining factor was how much Borrelia was in the salivary gland of the infected tick, not whether it had fed. The researchers concluded that “Borrelia migration from the tick gut into the salivary glands during early bloodsucking is not a prerequisite for or even important for pathogen transmission with saliva.”
The fact that engorgement is not necessary for transmission may account for why Patma and Remorca found that disseminated Lyme could be found after only six hours. Based on their finding, the authors cautioned that “The current recommendation against treatment of short-duration tick bites may need reconsideration, particularly in hyperendemic areas.”
Finally, in an extensive review of all of the literature pertaining to rates of transmission, Michael Cook found that “The claims that removal of ticks within 24 hours or 48 hours of attachment will effectively prevent LB are not supported by the published data, and the minimum tick attachment time for transmission of LB in humans has never been established.”
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Marcus LC, Steere AC, Duray PH, Anderson AE, Mahoney EB. Fatal pancarditis in a patient with coexistent Lyme disease and babesiosis. Demonstration of spirochetes in the myocardium. Ann Intern Med. 1985 Sep;103(3):374-6.
Moskvitina GG, Korenberg EI, Gorban’ LIa. [The presence of Borrelia in the intestines and salivary glands of spontaneously infected adult Ixodes persulcatus Schulze ticks during bloodsucking]. Med Parazitol (Mosk). 1995 Jul-Sep;(3):16-20. [Article in Russian]
Oksi J, Kalimo H, Marttila RJ, Marjamäki M, Sonninen P, Nikoskelainen J, Viljanen MK. Inflammatory brain changes in Lyme borreliosis. A report on three patients and review of literature. Brain. 1996 Dec;119 (Pt 6):2143-54.
Patmas MA, Remorca C. Disseminated Lyme disease after short-duration tick bite. JSTD 1994; 1:77-78.
Waniek C, Prohovnik I, Kaufman MA, Dwork AJ. Rapidly progressive frontal-type dementia associated with Lyme disease. J Neuropsychiatry Clin Neurosci. 1995 Summer;7(3):345-7.
Sonck CE, Viljanen M, Hirsimäki P, Söderström KO, Ekfors TO. Borrelial lymphocytoma–a historical case. APMIS. 1998 Oct;106(10):947-52.
Esther C. Yoon, Eric Vail, George Kleinman, Patrick A. Lento, Simon Li, Guiqing Wang, Ronald Limberger, John T. Fallon. Lyme disease: a case report of a 17-year-old male with fatal Lyme carditis. Cardiovascular Pathology. Available online 20 March 2015. doi:10.1016/j.carpath.2015.03.003.
Last Updated: 4/22/15