Lyme disease is an infectious illness caused by the bacterium Borrelia burgdorferi. It's transmitted mainly through tick bites. The disease was identified in 1975 in a group of children in and around Lyme, Conn. The children showed signs of what initially appeared to be juvenile rheumatoid arthritis. Investigators were alerted to the unusually large numbers of these cases centering on one geographical area and eventually traced the signs and symptoms to their bacterial origins. The condition was named Lyme disease.

Lyme disease can affect people of all ages. It's most commonly characterized by a distinctive rash, flu-like symptoms and aching joints. To contract Lyme disease, you have to be bitten by an infected deer tick. Not all deer ticks in a high-risk area are infected with the bacterium that causes Lyme disease. And only a small percentage of people who are bitten by a deer tick get Lyme disease. Still, take proper precautions in areas where ticks live. Increased awareness and prevention are key to avoiding Lyme disease.

• Rheumatoid arthritis

Signs and symptoms

The signs and symptoms of Lyme disease tend to progress as the disease progresses. Yet not everyone who contracts Lyme disease exhibits all of the symptoms. Common signs and symptoms include:

• Rash. A small, red bump may appear within a few days, even up to a month, at the site of the tick bite. Over the next few days, the redness expands and may resemble a bull's-eye with a red ring surrounding a clear area and a red center. The rash shows up at the site of the bite — usually in your groin, buttocks, underarm, waist or navel area, or behind your knee — and may be warm to the touch and mildly tender. The rash may affect up to as many as 80 percent of people who have Lyme disease, but may be overlooked or absent in some cases.

• Flu-like symptoms. A fever, chills, fatigue, body aches and a headache may accompany the rash.

• Migratory joint pain. If the infection remains untreated, sharp pains might appear in any joint weeks to months later. Joint pain may appear for a few days then disappear and reappear in another joint.

• Neurological problems. Inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell's palsy), numbness or weakness in your limbs and poor muscle movement may occur weeks, months or even years after an untreated infection. Memory loss, difficulty concentrating, and changes in mood or sleep habits also can be symptoms of later-stage Lyme disease.

• Less common signs and symptoms. A very few people may experience heart problems, such as an irregular heartbeat, several weeks after infection, but this rarely lasts more than a few days or weeks. Other less common manifestations of the disease include eye inflammation, hepatitis and severe fatigue, although these don't usually show up unless other Lyme disease signs and symptoms are present.

• Bell's palsy

• Fatigue

• Headache

• Hepatitis

• Meningitis

Causes

The spiral-shaped bacterium that causes Lyme disease typically is carried by a genus of ticks known as Ixodes. Ixodes, which include the deer tick, live in the low bushes and tall grasses of wooded areas and are more abundant in the spring, summer and fall. Deer ticks are sometimes no bigger than the head of a pin.

To contract Lyme disease, you have to be bitten by an infected deer tick. If you're bitten and the tick stays attached to your skin for approximately 48 hours, a bacterium called Borrelia burgdorferi can travel from the tick's gut to your bloodstream. These bacteria soon migrate to parts of the body where they later produce symptoms of Lyme disease.

Risk factors

Where you live or vacation can affect your chances of getting Lyme disease. So can the type of outdoor activities you enjoy. The most common risk factors for Lyme disease include:

• Spending time in wooded or grassy areas in certain areas. Deer ticks are most prevalent in the coastal Northeast, mid-Atlantic states, Wisconsin, Minnesota and northern California — particularly during summer months, but they're also found in Europe and Asia.

• Leaving skin exposed while in wooded or grassy areas. Ticks can easily attach themselves to uncovered flesh.

• Not removing ticks promptly or properly. Bacteria from a tick can infect your bloodstream if you're bitten and the tick stays attached to your skin for 48 hours or longer. If you remove a tick within 24 to 48 hours of attachment, your risk of acquiring Lyme disease is low.

When to seek medical advice

Only a minority of tick bites lead to Lyme disease. The longer a tick remains attached to your skin, the greater the risk of contracting the disease. If you know you've been bitten and experience signs and symptoms — particularly if you live in an area where Lyme disease is prevalent — see your doctor immediately. Treatment for Lyme disease is most effective if begun early. Tick bites also can be the cause of other illnesses, such as Rocky Mountain spotted fever, Colorado tick fever, ehrlichiosis and tick paralysis. See your doctor if you have any tick bite that concerns you.

Signs and symptoms of Lyme disease may disappear spontaneously, but that doesn't mean the disease is gone. Left untreated, Lyme disease can spread to the rest of your body within 6 months to 2 years, causing arthritis and nervous system problems.

Lyme disease > 1 > 2 > 3 > 4

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