It's tick season. How is Lyme disease transmitted? Here's what you need to know.

With summer fast approaching, many of us are looking forward to getting out into nature to enjoy the fresh air and beautiful scenery. 

Turns out, some insects have the same idea. 

The Venn diagram between human outdoor activity and nymphal (baby) tick activity has significant overlap. This creates a perfect storm for a surge in Lyme disease, which is curable for most people.  

An article published in The American Journal of Tropical Medicine and Hygiene, says that Lyme disease peaks during the summer months, when humans are the most active outdoors and when nymphal ticks start to emerge. 

Here’s what you need to know about the mysterious illness. 

What is Lyme disease? 

Someone may contract Lyme disease if they are bitten by a tick. The symptoms can be wide-ranging. “Lyme disease is a tick-borne illness caused by the bacteria Borrelia burgdorferi. Typical symptoms include a skin rash, fever, headache, and fatigue. Most patients recover after the infection, but some patients (about 10-20%) develop long-term symptoms which include fatigue, body aches, and difficulty thinking that are often debilitating and life-altering,” says Dr. Brit Adler, a rheumatologist and researcher at Johns Hopkins Medicine in Baltimore, Maryland, and the author of a recently published review paper on the chronic symptoms and complications associated with Lyme disease. 

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Is Lyme disease contagious?

Lyme disease is not contagious. It does not spread from person to person. To become infected with the bacteria, a person must have been bitten by a tick that is infected with the bacteria. According to the CDC, in most cases, a tick must be attached for 36 to 48 hours or more before the Lyme disease bacterium can be transmitted. 

Does Lyme disease go away? 

For most people, a course of antibiotics (around 2-4 weeks worth) will wipe out the infection with no long-term damage. 

However, for some people, Lyme disease may damage the heart, joints or nervous system. 

When left untreated, Lyme disease can lead to a condition called “Lyme Carditis,” which is when the bacterium infects any part of the heart, which can lead to serious complications. 

When Lyme bacteria enter joint tissue, it can lead to joint swelling and inflammation known as “Lyme Arthritis.” 

Some acute neurological complications of a Lyme infection include aseptic meningitis, (inflammation of the meninges, or the lining that protects your brain and spinal cord) and other symptoms like numbness, pain, weakness, facial palsy/droop (paralysis of the facial muscles), or visual disturbances. 

Even after Lyme disease has been treated, lasting symptoms may occur. Adler says, “Some patients with long-term symptoms have a dysregulated autonomic nervous system, which is the part of the nervous system that controls heart rate and blood pressure, digestion, sweating, temperature and pupil size. Most people don't consciously think about these vital functions, but when this part of the nervous system does not work properly it results in multiple symptoms including dizziness when standing, weakness, brain fog, and gastrointestinal symptoms among many others.” 

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Why do doctors not treat Lyme disease?

This is a complicated question. Lyme disease, in its chronic form, has become controversial in recent years – not because Lyme disease doesn’t exist (it does), or that it can’t cause long-term issues, (it can) but because some well-intentioned alternative medicine clinics may promote unproven diagnostic testing or treatments. 

Adler argues that these clinics thrive because traditional medical practices can leave patients behind. “Alternative medicine clinics are filling a huge unmet need for patient care that our medical establishment has failed to address,” she explains.

Adler adds that one reason for this is the inexact diagnostic tools for Lyme, “Lab testing for Lyme disease is imperfect and physicians have little training in how to interpret the results. Diagnosing Erythema Migrans (the 'Bulls-Eye Rash') can also be challenging for a community physician. Because of this, a lot of patients are misdiagnosed, which further adds to physician's discomfort.”

Adler says this is the most confounding issue around a "chronic" Lyme or dysautonomia diagnosis. “A huge problem is that the patient exam and labs are often normal, so the diagnosis is usually made based on symptoms… and it is much easier to attribute a long list of symptoms to anxiety or a psychological disorder than to a disease that we have no exposure to.”

It’s important to note that just because you’ve been bitten by a tick doesn’t mean you’ll get Lyme. Most ticks are not infected with the disease-causing bacterium, (although this can be region-dependent) and as mentioned above, they have to latch onto your skin for several days.

You can protect yourself from ticks and other insects by wearing long sleeves and pants, using bug repellent, checking your skin regularly and showering after being outside. By taking these precautions, you can keep the bugs away.