Understanding Lyme disease: prevention, recognition & expert treatment

At Breakspear Medical, we’ve been diagnosing and treating Lyme disease for many years, developing expertise in managing this complex bacterial infection. Our experience has taught us that early recognition and proper treatment are crucial for the best outcomes, which is why we want to share our knowledge to help you protect yourself and your loved ones.

The origin story: from Connecticut to global recognition

Lyme disease earned its name from an outbreak in Old Lyme, Connecticut, in the early 1970s. Families in Old Lyme and neighbouring towns began experiencing unusual arthritis symptoms, leading to an investigation that would change our understanding of tick-borne diseases. Researchers discovered that the sheep tick (Ixodes dammini) was carrying a spiral-shaped bacteria called Borrelia burgdorferi, which became known as the causative agent of Lyme disease.

Interestingly, similar symptoms had been documented in Europe years earlier, where patients developed expanding red rashes after bites from sheep ticks (Ixodes ricinus). This connection helped establish Lyme disease as a global health concern, not just an American phenomenon.

Understanding the Lyme disease bacteria

Lyme disease is caused by Borrelia organisms, coiled spirochetes that are remarkably adaptable. These bacteria can exist in various forms within the human body, making them particularly challenging to detect and treat. What makes Borrelia particularly cunning is its ability to survive in ticks at temperatures around 20°C and then adapt to live in warm-blooded animals, including humans, at 35°C.

The bacteria doesn’t harm its tick hosts or secondary hosts, such as rodents and deer, however, it can cause significant problems in humans, dogs, and cats. This adaptability and the bacteria’s ability to change surface markers during different stages of infection contribute to why no two Lyme disease patients present exactly the same symptoms.

Recognising the signs: the three stages of Lyme disease

Early stage: the tell-tale rash

The most recognisable early sign is erythema migrans, commonly known as the “bull’s-eye rash.” This distinctive rash typically appears 8-9 days after a tick bite, starting as a red, circular lesion that expands outward. The skin may appear red to purple, and while it usually occurs near the tick bite site, it can appear elsewhere on the body.

However, it’s crucial to know that this rash only appears in about half of Lyme patients, so absence of the rash doesn’t rule out Lyme disease. Early symptoms may also include muscle aches, fatigue, and fever, which can occur alongside the rash or 2-3 weeks later.

Second stage: systemic symptoms

Approximately 2-4 weeks after the initial infection, patients may experience a general feeling of being unwell, fevers, and various non-specific symptoms. This stage can involve:

• cardiac symptoms: mild heart block is the most commonly reported cardiac issue
• neurological symptoms: Bell’s palsy (facial nerve paralysis), radicular pain, headaches, meningeal symptoms, and occasional eye problems

Late stage: chronic complications

Without proper treatment, Lyme disease can progress to more serious complications:

• skin changes: red and purple patches called acrodermatitis chronica atrophicans
• prolonged neurological problems: ongoing cognitive and neurological issues
• arthritis: typically involving swelling of large joints, particularly the knees

The full spectrum of symptoms

Our experience at Breakspear Medical has shown us that Lyme disease can affect multiple body systems:

• musculoskeletal: joint and muscle pains, muscle twitching
• neurological: headaches, Bell’s palsy, generalised limb pains, hot and cold sweats
• cognitive: memory loss, confusion, “brain fog,” reduced mental capabilities
• digestive: diarrhea, constipation, and other dietary problems
• respiratory: shortness of breath
• general: flu-like illness, overall lack of well-being

Your prevention strategy: staying tick-free

1. Know where ticks live

Ticks thrive in woodland areas and countryside where animals graze. Understanding the tick lifecycle helps with prevention. Ticks progress from egg to larva to nymph to adult tick over a 2-year cycle, taking blood meals at each stage. While larvae and nymphs typically feed on small animals, such as mice, adult ticks prefer larger animals such as deer and sheep.

2. Dress for protection

When venturing into tick-prone areas:

• Wear light-coloured clothing that covers your body (makes ticks easier to spot).
• Tuck trousers into socks to create a barrier.
• Consider treating clothing with repellents.
• Use insect repellents on exposed skin.

3. Conduct regular tick checks

• Perform thorough body checks after outdoor activities.
• Pay special attention to warm, moist areas, such as underarms, behind ears, in hair, behind knees, and the groin area.
• Check children and pets thoroughly.
• Remove any attached ticks promptly and correctly using a tick removal kit. Be sure to remove the entire tick.

4. Proper tick removal

• Grasp the tick as close to your skin as possible.
• Pull upward with steady, even pressure in order to remove the head with the body.
• Clean the bite area and your hands with rubbing alcohol.
• Monitor the bite site for developing rashes over the following weeks.

Why expert diagnosis matters

Testing for Lyme disease presents unique challenges. Unlike many bacterial infections where the organism can be isolated and grown in a laboratory, Borrelia is extremely difficult to culture. This means we must rely on antibody testing, which can be negative in early stages and may remain negative throughout the disease course depending on the patient’s immune response.

At Breakspear Medical, we use American and European laboratories with extensive Lyme disease expertise, particularly for detecting Borrelia strains commonly found in Europe. Our comprehensive approach also includes testing for co-infections such as Babesia, Bartonella, and Ehrlichia, which can occur alongside Lyme disease and complicate treatment.

Our treatment approach

Our years of experience have taught us that successful Lyme disease treatment requires more than just antibiotics. Each patient needs individualised care because no two cases are identical. Our treatment protocol typically includes:

• Targeted antibiotic therapy: often requiring long and repetitive courses for late-stage Lyme
• Immune system support: helping your body fight the infection more effectively
• Prophylactic probiotics: preventing gastric side effects during antibiotic treatment
• Co-infection management: addressing any additional infections

The growing concern

Lyme disease is an increasing problem that appears to be spreading geographically. Climate change and expanding deer populations may be contributing to this trend. While late-stage Lyme disease requires more intensive treatment, our experience shows that proper, comprehensive treatment can significantly improve patients’ lives, even after prolonged illness.

Take action early

The key message from our years of treating Lyme disease is this: early recognition and treatment offer the best chance for a complete cure. If you’ve been in tick-prone areas and develop any suspicious symptoms – whether or not you remember a tick bite or saw a rash – don’t wait. Seek evaluation from healthcare providers experienced in tick-borne diseases.

At Breakspear Medical, we’re committed to staying at the forefront of Lyme disease diagnosis and treatment. Our expertise, combined with advanced testing capabilities and comprehensive treatment protocols, gives our patients the best possible chance for recovery and return to full health.

Remember: prevention is always better than cure, however, when prevention fails, expert treatment makes all the difference.

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Edited and updated excerpt from Breakspear Medical Bulletin Issue 18.