Lyme disease, Rocky Mountain Spotted Fever, and other tick-borne infections are prevalent across the US. There are regional differences in types of ticks and what proportions carry various diseases. Bites of Lone Star ticks may cause a so-called new infection called STARI (Southern Tick Associated Rash Illness). Until more is known about it, it should be considered a form of Lyme and treated accordingly. Ticks do not know geographical boundaries; people travel, and ticks travel on people, animals, and birds. 40% or more of people with tick diseases do not recall a bite.
Many people who have contracted Lyme-like disease from the Lone Star tick or Lyme disease from the black-legged tick do not develop a rash or the rash may be in a place that is not noticed. The rash may be solid red, usually circular or oval, rather than a “bull’s eye.” Some local reaction to a tick bite with redness and itching is normal and does not in and of inself indicate an infection. RMSF may cause a rash all over the body including the palms and soles of the feet, but some people may not develop a rash. If you develop a rash, take a one or more photos of the rash and record the measurements. It may fade before you get medical care.
The diagnosis of Lyme disease, RMSF, and other tick-borne infections must be clinical, based on history and physical signs and symptoms (which vary according to the disease): exposure to ticks, fever, chills, headache, rash, swollen lymph nodes, fatigue, muscle aches, joint pains, abdominal pain, facial nerve paralysis, signs of brain inflammation, and others. Waiting for lab tests before treatment may cause death or severe impairment.
If Lyme disease is not diagnosed and treated adequately early on, more serious late onset symtoms may occur including numbness, stabbing pains, other severe pain including in the head, joint swelling, profound fatigue, muscle weakness, difficulty with thinking, heart and eye problems, and others. Total disability may occur and occasionally death.
There are no blood tests that can be used for diagnosis during the acute phase of an infection. Currently available tests for Lyme disease are unreliable. For Lyme or Lyme-like disease treatment to be successful, co-infections such as babesiosis or bartonellas must also be diagnosed and treated since they can change the clinical presentation and treatment strategy.
If RMSF is not diagnosed and treated promptly, up to 20% of victims may die. Even with prompt and adequate treatment, mortality may still occur in about 5% of cases. Ehrlichiosis may also cause death if not diagnosed and treated promptly.
Treatment Issues for Lyme or Lyme-like Disease
Prompt treatment with antibiotics during early Lyme disease can cure the infection.
Some clinicians believe 4 to 6 weeks ensures a better cure rate than the commonly described 2 to 3 weeks.
Co-infections should be identified and treated as well.
If treatment is delayed or inadequate, recovery may be long and difficult and may require complex treatment regimens.