Health

Lyme disease is an infectious disease caused by a bacterium of the Borrelia genus. It can manifest itself through a wide variety of symptoms and is therefore difficult to diagnose.

IS THE DISEASE COMMON AND HOW IS IT TRANSMITTED?

Lyme borreliosis is relatively common. It is estimated that there are between 12,000 and 15,000 new cases per year in France. The disease is mainly transmitted by ticks that are themselves infected. They inoculate the bacteria into humans by biting them to feed on their blood. As these ticks usually live in wooded areas, you can contract Lyme borreliosis, particularly by walking in the forest. The disease is present throughout mainland France, particularly in the east and center of the country.

WHAT ARE THE SYMPTOMS OF THE DISEASE?

This is a general condition that can affect several organs, mainly the skin, joints and nervous system. The progression of the disease is generally described in three stages:

First stage: Erythema migrans, an inflammation of the skin that slowly spreads from the tick bite site, is the characteristic manifestation of the first phase. The diameter of this red ring is most often between three and several tens of centimeters. It is sometimes associated with flu-like symptoms (fatigue, chills, fever, headache, muscle or joint pain, lymph nodes), and generally occurs three days to one month after the bite. However, this erythema migrans only appears in 50 to 70% of cases or may go unnoticed.
Second stage: The secondary phase is not systematic and only occurs in the absence of treatment during the primary phase. The manifestations can be neurological (headaches, neuralgia, facial paralysis, insomnia, memory disorders, meningitis, etc.), rheumatological (particularly joint pain), cardiac, cutaneous or ocular. These symptoms appear very quickly or several weeks after the primary phase.
Third stage: The tertiary or late phase includes permanent neurological (encephalopathies, psychiatric or neurological disorders), articular (arthritis) or cutaneous (purplish and swollen lesions) manifestations. Such a chronic development is observed, in the absence of treatment, after a few months or a few years. Fortunately very rare, it can induce a very significant disability.

HOW CAN MY DOCTOR DIAGNOSE MY DISEASE?

In order to establish his diagnosis, your doctor can be guided by the recommendations established during the so-called consensus conference which took place in 2006 and aimed to define a common position for experts on this disease.

The red ring indicates the presence of the bacteria. In its absence, it is the combination of several symptoms that guides the diagnosis. The search for antibodies directed against the bacteria (in particular by a technique called ELISA) or DNA molecules of the bacteria, to be done in a specialized laboratory, can help to make this diagnosis.

HOW WILL THE DISEASE BE TREATED?

The treatment is based on taking antibiotics, different depending on whether it is a primary, secondary or tertiary phase, and may require hospital care. It is all the more effective when it is early and must always be accompanied by monitoring, sometimes extended over several weeks. Your doctor can refer you, depending on your symptoms, to specialists, infectiologists, neurologists, rheumatologists, dermatologists, etc., to manage your condition.

WHEN SHOULD I CONSULT?

It is important to consult a doctor quickly if you have a red ring on your skin or if you experience neurological, joint or cardiac problems without any apparent cause. Do this even if you do not remember being bitten by a tick.

Consult your doctor if you are pregnant at the time of the bite, if the bite concerns a child under 8 years old or if the tick has been implanted for more than 36 hours.

Consult your doctor again if your symptoms persist after 2 or 3 weeks of treatment. However, no preventive antibiotic treatment is systematically necessary after a tick bite. Indeed, not all ticks are infected (only 5 to 35% of ticks are infected depending on the region) and not all people bitten by a contagious tick develop the disease.

CAN I RECEIVE PSYCHOLOGICAL SUPPORT?

The neurological, joint and cardiac effects of chronic disease (third stage) are sometimes very painful, disabling and can have an impact on social life. This form requires appropriate medical care and possibly psychological support. You can also contact patient associations.

HOW CAN I PREVENT THIS DISEASE?

Primary prevention aims to avoid contact with ticks.

When walking in the forest, be careful not to expose bare areas of skin. Wear long sleeves, trousers, socks, a hat or cap.
Walk on paths and avoid undergrowth.
Use repellents on your clothing. Ask your pharmacist for advice on this.
Ticks also live in gardens. Clear your garden of dead leaves and tall grass.
Your pets can be reservoirs of the disease. Treat them against ticks.
Secondary prevention lies in detecting and removing ticks.

Given the potential danger of a tick bite, cover yourself up when you go for walks, examine your body from every angle when you return from your walk, and use a tick remover purchased from a pharmacy, following its instructions.

Tick bites are generally painless and often go unnoticed. When you return from your outdoor activities, carefully inspect your body (behind the ears, armpits, creases of the knees, crease of the groin, navel, etc.) and your hair to detect the possible presence of ticks. Ticks are small mites but visible to the naked eye. They grow and are particularly obvious after feeding on blood.
Also inspect your pets.
If a tick is attached to your skin, you must remove it as quickly as possible with fine tweezers or a tick remover (special tweezers available in pharmacies). The longer the tick is attached, the greater the risk of transmitting the disease. Do not try to kill the tick beforehand with a heat source or a chemical substance (ether, alcohol, etc.) and remove it as gently as possible, without pressing or crushing it. Then apply an antiseptic to the bite area. Lyme disease is on the rise in some regions. Learn to identify the first symptoms of the disease in order to treat it as quickly as possible and, above all, learn how to prevent this disease.