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Answers to Your Questions About Lyme Disease
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Einstein Healthcare Network
12:17
Doris: No, hair loss is not a feature of Lyme disease.
Gale Kessler
12:17
I worked for SmithKline Beecham and during that time employees could receive a vaccine for Lyme disease. There were three injections. SB discontinued the vaccine. Would you have any idea if I am protected at all from Lyme disease?
Einstein Healthcare Network
12:18
Gale: Unfortunately, the duration of protection from the Lyme vaccine is probably only a year or two.
Tara
12:19
I have read that a tick must be attached to you for at least 24 hours before the possibility of transmitting Lyme. If that is true, can you tell me how long a tick feeds before it starts becoming engorged? I would think knowing this could eliminate unnecessary testing and fears of contracting a disease. (i.e. If it takes longer than 24 hours to become engorged and you remove a tick that is not engorged, you should be safe) Also, I have read that a tick only feeds at three stages of life: larva, nymph and adult. If that is true then contracting a disease should only be possible if you are host to a nymph or an adult, correct? Since the larva has not yet fed on anything, it could not have picked up any pathogens? Thank you.
Einstein Healthcare Network
12:20
Tara: you should be giving this chat! It takes 48-72 hours after attachment for Lyme to be transmitted. And you are correct that the larvae are not infected. Most human cases come from nymphs, and a few from adults - partly because the adults are much larger and tend to be seen and removed before they can do harm.
Michael Kutch
12:21
About 8 years ago I was bit by a deer tick, immediately saw the bulls eye and sought treatment. I received antibiotics and then a follow-up lab test that was negative to prove it was gone. I have not had any symptoms since. Am I at any risk in the future? Do I actually "have" Lyme disease?
Einstein Healthcare Network
12:22
Michael: you don't "have" Lyme disease; you "had" Lyme disease. There's no need for followup testing in people who no longer have symptoms; the antibodies detected by the test can persist for years after successful treatment.
Greg
12:22
Why is this year particularly bad for ticks?
Einstein Healthcare Network
12:23
I suspect it's going to be a bad tick season because the mild winter did not kill either enough ticks or enough mice.
Claudia
12:23
Is testing for infection becoming any more reliable?
Einstein Healthcare Network
12:24
Unfotunately, the testing hasn't made much progress. There's a real need for a test that is has fewer false positives, and which discriminates between people with active disease versus those who have recovered.
Bob Meeker
12:24
Once Lyme disease is in your body, is it always in there, waiting to come back out, even though you have recovered from the initial illness?
Einstein Healthcare Network
12:24
Bob: In the overwhelming majority of cases, once Lyme has been treated it is gone for good.
Kathy
12:25
After being bitten, how long does it take for symptoms to appear and what are the usual symptoms?
Einstein Healthcare Network
12:26
Kathy: it takes about a week for early symptoms to appear: rash, headache, muscle aches, fatigue, joint aches. Later symptoms can occur after several weeks or months: nerve paralysis or pain, arthritis, irregular heart rhythms are the more common ones.
steve
12:26
Are you more likely to get Lyme disease if you had it before?
Einstein Healthcare Network
12:27
Steve: reinfection can occur, but it is not more likely if you had it before.
TomC
12:27
After removing an imbedded tick, how long can it take to develop signs or symptoms of Lyme. Also, as a preventative, I was given a one time 200mg dose of doxycycline. Is this common?
Einstein Healthcare Network
12:28
TomC: the incubation period is usually 1-2 weeks, and if a tick bite results in Lyme, it will almost always be associated with a red rash at the site of the tick bite. Doxycycline for prevention is recomended only if the tick is shown to be a deer tick, and is shown to be engorged with blood, and comes from an area where Lyme is common, and there is no contraindication to doxycycline therapy.
Ruth
12:28
So there is a Lyme vaccine? I thought you said only for dogs?
Einstein Healthcare Network
12:29
Ruth: there WAS a vaccine; it's been off the market for about 15 years.
Mair
12:29
We have so many ticks being found on the dogs in my area, how do we distinguish deer from dog tick? If it is only nymphs that are the problem how does one distinguish a nymph from an adult?
Einstein Healthcare Network
12:30
Mair: you can go to Google images to see pictures of different tick species. The nymphs are 2-3 mm in size, the adults are 6-8 mm in size. You may need a hand lens to identify nymphs.
12:31
Everyone: there's a really excellent book on Lyme disease by Alan Barbour: Lyme Disease, Why it is spreading.... It's available in the Philadelphia and Montgomery County libraries, and on Amazon.
Jen
12:32
How effective are antibiotics in the Lyme arthritis stage?
Einstein Healthcare Network
12:32
Jen: antibiotics are quite effective for Lyme arthritis - although many people experience nonspecfic post-treatment symptoms like fatigue and aching that tend to resolve over the span of weeks to mnths.
sheila
12:33
Once infected with Lyme's and treated with oral antibiotics, is it possible to need further IV antibiotic treatment?
Einstein Healthcare Network
12:33
Sheila: Lyme involving the joints or the central nervous system will usually respond to oral antibiotics, but if not then intravenous antibiotics may be more effective.
RE SHEKER
12:34
Liver enzymes have been elevated since lyme diagnosis & treatment in 2011. All causes eliminated and considered cryptogenic. Is there such thing as lyme hepatitis, either from the bacterium or the treatment? If so, any cure?
Einstein Healthcare Network
12:35
Re Sheker: Hepatitis is not part of the known spectrum of Lyme disease or it's treatment, but medicine is an evolving science and one can never be completely certain that the natural history of a disease is fully known.
12:37
Maria: If patients are concerned about tick bites and plan to see the doctor, I recommend to save the tick in a small jar or Ziplock bag so that it can be identified as to species, and whether or not it is engorged with blood.
Maria: I don't know of any special issues for persons with JRA or taking methotrexate.
Maria
12:37
Do u know of any effective natural tick repellants that are safe
Einstein Healthcare Network
12:38
Maria: there are a number of natural repellents approved by the FDA, but the data on efficacy is spotty.
Mary
12:38
I've had lyme twice in 3 years and taken doxycycline for two rounds each time (42 days ). Is it a re-occur ance or new bite?
Einstein Healthcare Network
12:38
Mary: it's probably a new infection.
Peggy
12:39
what percentage of ticks carry lyme?
how long does a tick have to be attached before it's likely to have
passed on the disease?
other than the fever, do most people escape further damage even if
they don't get an antibiotic?

Does a bout of lyme dealt with only by your immune system yield
antibodies that protect you from future bites?
Einstein Healthcare Network
12:40
Peggy: the percentage of ticks that carry Lyme varies. In our area, about 20% of the nymphs and 60% of the adults are probably infected. Spontaneous cure is not rare - testing in highly endemic areas shows many people with evidence of previous Lyme disease who have no symptoms - but we don't know if that protects you from future infections.
Mike S
12:41
What percentage of tick bites carry the lyme co-infections i.e. bartonella, babesia, etc.?
Einstein Healthcare Network
12:42
Mike S: That's a good question. Ticks don't arry Bartonella - but they do carry babesia and anaplasma. There are a fair number of case reports of people having 2 out of 3 of these infections, but I don't know the exact percentage of ticks which are coinfected. The reason for doxycycline being preferred to amoxicillin for treating Lyme is because it also treates anaplasmosis.
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