From: Parade Magazine, April 29, 2001

Each year, more than 15,000 Americans are infected with an often-unrecognized condition characterized by fatigue, headaches and overall aches and pains. The good news is that it's preventable and treatable.

How to Beat Lyme Disease
By Dr. Isadore Rosenfeld

If you're tired, achy, have frequent headaches and generally feel out of sorts - all for no apparent reason - and these symptoms persist for days or weeks, it may be Lyme disease. This infection strikes more than 15,000 Americans every year, and one study showed that the average sufferer sees five doctors before being correctly diagnoses!

Lyme disease is caused by a bacterium called Borrelia burgdorferi. It is delivered to you by a tick that has been feeding on the white-footed mouse, the white-tailed deer or other mammals and birds. The culprit tick can be in its nymph stage (in the spring) or adult stage (in the fall). Fewer cases of Lyme disease occur in the fall, because the adult tick is larger and easier to see, so you are more likely to remove it before you're infected. The nymph, no larger than a pinhead, is often missed.

How do you know you have Lyme disease?
More than half of the people with Lyme are unaware of having been bitten by a tick. The first evidence of the disease is the sudden appearance of its signature bull's-eye rash (see image). Often, however, there is no rash, or it may not have the typical appearance. (You may see the rash anytime from three to 30 days after a tick bites you, but usually between seven and 14 days. It can vary in size - up to several inches - and last for several weeks.)

If the diagnosis is missed, the fatigue, joint pains, headaches and low-grade fever may continue. You then enter stage two of the disease. Palpitations may develop, plus heart pain if the bacteria have inflamed the heart muscle; and if the nervous system was attacked, there may be facial paralysis, drooping eyelids or meningitis.

If you remain untreated or if treatment fails, the disease enters its late stage. Your joints swell, you develop arthritis, several areas of your skin may become red and leathery, and you hurt all over. Patients in whom B. burgdorferi has affected the brain may become confused and, if they're older, may be misdiagnosed as having Alzheimer's.

If your doctor suspects Lyme disease, you'll need a blood test to confirm the diagnosis. However, the test is not always conclusive, and you may have to repeat the blood analysis in two to four weeks.

How to avoid Lyme disease
Simply avoid being bitten by a tick. But that's easier said than done, because ticks seem to be everywhere that deer and white-footed mice live or roam. They infect not only humans but also dogs and cats, horses and other animals that happen to be around. (According to the Centers for Disease Control, there is no evidence that humans can contract Lyme disease from wild or domestic animals, only from ticks.) There are several things you can do to prevent being bitten by a tick (see box at right).

If you find a tick on you...
Don't panic. Remember, it must itself be infected before it can give you the disease - and most ticks are not infected. Also, it takes the tick about 36 to 48 hours to transmit the bacteria to you. So, if you are tickless in the morning and spot one in the afternoon, you're not likely to have been infected.

Remove the tick as soon as possible, preferably with tweezers. Pull it steadily outward and away from your skin. (You don't need alcohol,  jelly, a hot match, a lighted cigarette or anything else to remove it.) Then apply alcohol or some other disinfectant t the area. After you've removed it, seal the tick in a jar of alcohol and bring it to your doctor for identification. Every day for a month, check the site where you found the tick, so you can spot the rash if it appears.

How to treat Lyme disease
Wait for the rash or other symptoms to appear before starting any therapy. The three most widely used drugs are doxycycline, amoxicillin and ceftin. They are given orally for three to four weeks. Be assured that if the disease is successfully treated early enough, you'll be cured. However, the antibodies remain in your system, and you may continue to test positive. You can also be infected again.

What about Lyme vaccine?
The FDA approved a vaccine against Lyme disease at the end of 1998. It is given in three shots and costs a little less than $100 per shot. We're not sure how long the vaccine remains protective. So far, it has been shown to be safe only in healthy persons between the ages of 15 and 70, although there have been disturbing reports of severe arthritis after its use. I don't advise it for anyone who is pregnant, has arthritis or suffers from heart disease. But you should consider it if you live in an area where ticks and the animals that harbor them are abundant, or if you've been cured of Lyme disease and remain vulnerable to exposure.

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