- What is Lyme disease?
- What are the symptoms of Lyme disease?
- Acute Lyme disease
- Erythema Migrans (or bulls-eye rash)
- Chronic Lyme disease
Lyme disease is an infectious illness caused by the bacterium known as Borrelia, which creates a condition more correctly known as Borreliosis or Lyme Borreliosis.
The bacteria, a spirochete, is transmitted when an individual is bitten by a vector usually a tick. Lyme disease can impact many bodily systems and organs and can, in some cases, mimic other illnesses ie lupus.
People with Lyme disease are frequently diagnosed with other co-infections caused by vector-borne bacteria and parasites such as Babesia, Bartonella, Rickettsia, Mycoplasma and Ehrlichia. We thank the Canadian Lyme Disease Foundation for their list of symptoms.
The name 'Lyme disease' was coined in the United States of America when an outbreak of juvenile arthritis occurred in the town of Lyme, Connecticut, and the outbreak was subsequently found to be caused by the Borrelia bacteria.
Video: What is Lyme Disease? Easy to watch for people who have difficulty reading.
Lyme disease manifests as a multi-systemic illness that can result in symptoms affecting random parts of the body including the muscles, joints, organs, brain, gastro-intestinal and neurological systems.
Lyme disease is generally categorised into acute (early) and chronic (late) stages of disease each with varying symptoms. Most diagnosed cases in Australia have progressed to the late stage because there are no early intervention strategies in place to ensure appropriate treatment following tick bites.
Symptoms in early stage Lyme disease (close to the time of the bite) commonly include: flu-like symptoms, headaches, fever, swollen lymph nodes, fatigue, muscle aches and joint pain.
Symptoms in late stage Lyme disease (extending to many months, or even years, following tick bite) often manifests as multi-systemic illness, which may include: gastro-intestinal problems, neurological problems, balance problems, chronic fatigue and random muscle and joint pain. Late stage Lyme disease can be mild, moderate or severe and, if left untreated, an cause severe disability or become fatal.
There are many symptoms associated with acute (early signs of) Lyme disease. These signs are (but not limited to) flu-like symptoms with fevers, fatigue, swollen glands, sore throat, nausea and vomiting, headaches, stiff neck, light sensitivity and may include Bell’s palsy and other neurological symptoms.
The bulls-eye rash (erythema migrans) of Lyme disease is only present in approximately 50% of cases.
Dr Richard Horowitz indicates that Lyme disease can present as an acute or chronic illness. He cautions - rashes do not always present as perfectly bulls-eye. Solid rashes, and solid spreading rashes without a distinct centre, can also indicate a Lyme disease infection. Furthermore, many patients do not develop a rash at all, nor remember a bite.
If you are concerned you may have Lyme disease, start by printing and completing Dr Richard Horowitz's questionnaire. It's a great starting place for clarity and discussion with your Lyme-aware doctor.
The following symptoms can be attributed to Lyme Disease when it has reached the Chronic stage of disease. You can read more on Chronic Lyme disease here.
- Unexplained hair loss
- Headache, mild or severe, Seizures
- Pressure in head, white matter lesions in brain (MRI)
- Facial paralysis (Bell’s Palsy, Homer’s syndrome)
- Tingling of nose, (tip of) tongue, cheek or facial flushing
- Stiff or painful neck
- Twitching of facial or other muscles
- Jaw pain or stiffness
- Dental problems (unexplained)
- Sore throat, clearing throat a lot, phlegm ( flem ), hoarseness, runny nose
- Double or blurry vision
- Increased floating spots
- Pain in eyes, or swelling around eyes
- Oversensitivity to light
- Flashing lights/peripheral waves/phantom images in corner of eyes
- Decreased hearing in one or both ears, plugged ears
- Buzzing in ears
- Pain in ears, oversensitivity to sounds
- Ringing in one or both ears
- Irritable bladder (trouble starting, stopping) or interstitial cystitis
- Upset stomach (nausea or pain) or GERD (gastroesophageal reflux disease)
- Bone pain, joint pain or swelling, carpal tunnel syndrome
- Stiffness of joints, back, neck, tennis elbow
- Muscle pain or cramps (fibromyalgia)
- Shortness of breath, can't get full/satisfying breath, cough
- Chest pain or rib soreness
- Night sweats or unexplained chills
- Heart palpitations or extra beats
- Endocarditis, heart blockage
- Tremors or unexplained shaking
- Burning or stabbing sensations in the body
- Fatigue, chronic fatigue syndrome, weakness, peripheral neuropathy or partial paralysis
- Pressure in the head
- Numbness in body, tingling, pinpricks
- Poor balance, dizziness, difficulty walking
- Increased motion sickness
- Lightheadedness, wooziness
- Seizures - often 'atypical'
- Mood swings, irritability, bi-polar disorder
- Unusual depression
- Disorientation (getting or feeling lost)
- Feeling as if you are losing your mind
- Over-emotional reactions, crying easily
- Too much sleep, or insomnia
- Difficulty falling or staying asleep
- Narcolepsy, sleep apnea
- Panic attacks, anxiety
- Memory loss (short or long term)
- Confusion, difficulty in thinking
- Difficulty with concentration or reading
- Going to the wrong place
- Speech difficulty (slurred or slow)
- Stammering speech
- Forgetting how to perform simple tasks
- Loss of libido
- Sexual dysfunction
- Unexplained menstral pain, irregularity
- Unexplained breast pain, discharge
- Testicular or pelvic pain
- Phantom smells
- Unexplained weight gain, loss
- Extreme fatigue
- Swollen glands/lymph nodes
- Unexplained fevers (high or low grade)
- Continual infections (sinus, kidney, eye, etc)
- Symptoms seem to change, come and go
- Pain migrates (moves) to different body parts
- Early on, experienced a "flu-like" illness, after which you have not since felt well.
- Low body temperature
- Allergies/chemical sensitivities
- Increased effect from alcohol and possible worse hangover
The first Australian-acquired case of Lyme disease was reported in New South Wales in 1982.
Current and accurate figures of Lyme cases in Australia are unknown because Lyme disease is not a notifiable disease in Australia and patients are not formally counted.
Many patients with Lyme disease are not properly tested and are often diagnosed with other conditions in the early stage of their illness.
The LDAA estimates there are well over 2,000 medically confirmed cases in Australia and many more, perhaps in the order of hundreds of thousands, undiagnosed cases.
Positive diagnoses for Lyme disease have been recorded in all age groups and socio-economic groups, with infections reported and acquired in all states and territories of Australia, in both suburban and country areas
This link provides an overview of research which supports the existence of Borrelia in Australia.
Lyme disease and its common co-infections are likely to be transmitted in multiple ways. Most commonly, Lyme disease is spread via a tick bite, however, other suspected modes of transmission include:
- Placental transfer (from mother to unborn baby) and through breast milk;Contact with urine and other bodily fluids from infected animals;
- Blood transfusions (blood banks do not screen donated blood for these pathogens); and
- Sexual transmission.
Further information and an extensive list of research sources on alternate modes of Transmission is available here.
The LDAA contends further research is required to confirm the growing body of anecdotal evidence and preliminary research which suggests alternate modes of transmission are possible.
The Lyme Disease Association of Australia asserts:
- Lyme disease is a clinical diagnosis, based on a patient’s history, symptoms and current presentation. Blood tests can be used to support a Lyme disease diagnosis; however they may not be entirely reliable. Blood tests should not be the defining mechanism used to rule out Lyme disease as a diagnosis.
- If a patient presents with Lyme-like symptoms, Lyme disease and its associated co-infections should be properly investigated and ruled out before reaching a conclusive diagnosis. Further information on diagnosis and testing is available on the LDAA site.
- At this time, Australian testing facilities are not adequately equipped to test for all the Borrelia species that can cause Lyme-like illness. The LDAA suggests that the most reliable testing is currently conducted through the IGeneX lab in the United States of America and Infectolab in Germany.
- The LDAA’s concerns about the inadequacies of Australian testing processes are detailed in the LDAA's formal response to the Department of Health’s Scoping Study commissioned by the Chief Medical Officer (pages 23-31).
- Further information and references for this section.
The diagnosis and treatment of Lyme disease and its associated co-infections can be very complex and few Australian doctors are trained in managing this condition.
The LDAA advises patients who suspect they have Lyme disease to consult with an experienced Lyme-literate doctor who can identify Lyme-related infections, decide if testing is required and guide treatments based on clinical presentation. Most Lyme-literate doctors are willing to mentor less experienced GPs for follow-on treatment.
Patients should be treated according to one, or a combination of, the following Australian Treatment Guidelines:
- Australian Chronic Infectious and Inflammatory Disease Society (a closed members only group).
- International Lyme and Associated Disease Society - Guidelines.
- Diagnostic Hints and Treatment Guidelines for Lyme and other tick borne illnesses by by Dr J Burrascano.
- Guidelines and treatment of the German Borreliosis Society.
- Further information on treatment options and finding a Lyme-literate doctor
For further information and references supporting the above statements you can visit our references section here.