Lyme Overview

What is Lyme Disease?

Nearly 40% of tested deer ticks were positive carriers of the bacteria that causes Lyme disease, according to data from the Illinois Natural History Survey at the Prairie Research Institute. Outdoor jobs, outside activities, and pets increase the likelihood of encountering infected ticks. Preventing exposure to ticks and recognizing the signs and symptoms of tick-borne diseases for early intervention can go a long way in reducing the long-term symptoms experienced by people.  

Tick Attachment Times 

Throughout a tick’s two-to-three-year lifecycle, it’ll feed on multiple warm-blooded hosts as its food source. The longer a tick is attached to its host, the greater the risk it transmits an infection. However, the attachment times for tick-borne diseases vary, and some diseases can be transmitted in a matter of minutes. Therefore, even if a tick is attached for a short time, it’s still possible for a person to become infected by a tick-borne disease. 

Symptoms of Lyme Disease 

The initial symptoms of Lyme disease and other tick-borne diseases may be general, flu-like in nature, and similar to other diseases, which may lead to the tick-borne disease being undiagnosed or misdiagnosed.  

The bullseye rash (erythema migrans or EM rash) commonly associated with Lyme disease occurs in less than half of all Lyme infections. When present, a bullseye rash is the telltale symptom of a Lyme disease infection.  

Other symptoms include:

  • Fatigue

  • Fever

  • Chills

  • Headaches

  • Cognitive impairments

  • Muscle and joint pain

  • Neck pain

  • Facial paralysis (Bell’s palsy)

  • Overall unwell feeling.

Additionally, some people will develop cardiac, neurologic, and psychiatric symptoms. Early testing may not show an infection, as it could take up to six weeks to develop enough antibodies to be detected on a test. 

Diagnosis and Testing of Lyme Disease 

Many physicians, scientists, and government officials are beginning to recognize the need for more accurate Lyme disease testing. The testing is most accurate for those in the acute stages of the illness — the highest rates of accuracy occur four to six weeks after the initial infection.  

Typical Lyme disease tests are a two-step process called standard two-tiered testing (STTT), which includes an ELISA and, if positive, a follow-up with the Western blot. But the STTT is 40 years old and has limitations: though readily available, the test was designed to detect only one strain of one species of borrelia – usually Borrelia burgdorferi. The testing misses infections caused by other species or strains, leading to false negatives and missed or delayed diagnoses. Additionally, current testing measures antibodies the body makes to the infection, which can take up to 6 weeks to develop, so testing multiple times may be necessary.

Two labs ILA recommends to improve the accuracy of those who may have Lyme, are in the later stages of Lyme, or have gone undiagnosed for a significant amount of time include:

  • IGeneX: Known for their extensive network of physicians and significant list of testing options for tick-borne disease, IGeneX tests for more pathogen strains than any other lab. IGenex is also dedicated to physician education and training and works with several nonprofit and advocacy groups throughout the country.

  • MDL: MDL provides a range of vector-borne disease testing options, and their services are typically covered by private insurance carriers, Medicare, and Medicaid. They also offer affordable patient pricing for non-insured individuals.

When evaluating a patient for Lyme disease, factors such as the signs and symptoms of the tick-borne disease, the likelihood of exposure to infected ticks, the potential of other diseases to cause similar symptoms, and laboratory tests should be considered. At the present time, no testing exists to demonstrate that a patient has been “cured” of Lyme disease. 

Coinfections 

Besides Lyme disease, the Illinois Department of Public Health (IDPH) has also identified such tick-borne diseases in the state as tick-borne relapsing fever (TBRF), Rocky Mountain spotted fever (RMSF) and other rickettsial diseases in the spotted fever group, ehrlichiosis, alpha-gal syndrome, anaplasmosis, and babesiosis.  

Coinfections are a mounting danger and more prevalent than previously thought. Babesia, for example, may be present in up to 40% of people with Lyme disease, suggests a review in Trends in Parasitology. 

Pregnancy and Lyme Disease 

“Untreated Lyme disease during pregnancy can lead to infection of the placenta. Spread from mother to fetus is possible but rare,” the CDC states. With early treatment, many potential problems and complications can be prevented. At present, no research has evaluated the development outcomes of children of mothers infected with Lyme disease while pregnant. 

Long-Term Lyme Disease Symptoms 

Research suggests between 10% and 20% of people with acute Lyme disease continue to have persistent or intermittent symptoms following treatment with antibiotic therapy. The CDC refers to the period after treatment as “post-treatment Lyme disease syndrome.” However, this statistic doesn’t take into account those who went undiagnosed or were misdiagnosed for several weeks, months, or years, which can result in significant debilitation and a drastic reduction in quality of life.

Follow-up care is crucial to ensure patients have recovered from Lyme disease or receive appropriate medical care and support for persistent symptoms associated with Lyme and coinfections. With an increase in infected ticks in Illinois, it’s crucial for residents to remain vigilant and knowledgeable about Lyme disease and other tick-borne diseases. Take preventative measures and seek appropriate medical attention if you think you may have been infected. Stay informed, stay proactive, and together, we can combat Lyme disease.

Facts and Takeaways

  • Lyme disease is the fastest-growing, vector-borne infectious disease in the United States. It is 1.5 times more common than breast cancer and 6 times more common than HIV. 

  • The typical bulls-eye rash occurs in less than half of all Lyme infections.

  • Current testing is only 40 to 60% accurate. Newer studies indicate it may be even less.

  • It can take 4 to 6 weeks for your body to build enough antibodies to be detected on a test.

  • Most insurance companies don’t cover treatment beyond a few weeks of antibiotics for an acute case of Lyme. However, Illinois is one of the few that has coverage for state-regulated plans.

  • Mice, migratory birds, and deer are the causes of major spread.

Illinois Lyme Association seeks to educate, support, and advocate for people battling Lyme disease. If you would like a copy of this information, please download our printable factsheet here.

References:

Statewide Tick Surveillance Highlights Widespread Establishment of Ticks & Pathogens. Prairie Research Institute factsheet (2024).