Several antibiotics are effective for treating Lyme disease. These are usually given by mouth but may be given intravenously in more severe cases. Patients treated with antibiotics in the early stages of the infection usually recover rapidly and completely. Most patients who are treated in later stages of the disease also respond well to antibiotics. A few patients may have persistent or recurrent symptoms and may require a second 4-week course of antibiotic treatment. Longer courses of antibiotics have not been shown to be beneficial in patients who have been previously treated and have chronic symptoms. Varying degrees of permanent damage to joints or the nervous system can develop in patients with late Lyme disease. Typically these are patients in whom Lyme disease was unrecognized in the early stages or for whom the initial treatment was inadequate. Lyme disease is rarely life-threatening.
Prevention and early diagnosis of Lyme disease are important during pregnancy. Rarely, Lyme disease acquired during pregnancy may lead to infection of the placenta and may possibly lead to stillbirth. Studies of women infected during pregnancy have found that there are no negative effects on the fetus when the mother receives appropriate antibiotic treatment for her Lyme disease.
There are several approaches to Lyme disease prevention, including personal protection, tick control, post-exposure antibiotics, and early diagnosis and treatment.
You can decrease the chances of being bitten by a tick with a few precautions.
Avoid tick-infested areas This is especially important in May, June, and July. Many local health departments and park or extension services have information on the local distribution of ticks. If you are in tick infested areas, walk in the center of trails to avoid contact with overgrown grass, brush, and leaf litter at trail edges.
Use insect repellent Spray insect repellent containing a 20-30% concentration of DEET on clothes and on exposed skin; use 10% DEET for children. You can also treat clothes (especially pants, socks, and shoes) with permethrin, which kills ticks on contact. Permethrin can also be used on tents and some camping gear. Do not use permethrin directly on skin. Always follow the manufacturer’s instructions when applying any repellents.
Wear protective clothing Long pants and long sleeves help keep ticks off your skin. Light-colored clothing will help you spot ticks more easily. You can even tuck pant legs into socks or boots and shirt into pants to keep ticks on the outside of clothing. Tape the area where pants and socks meet so that ticks cannot crawl under clothing.
Ticks can get a ride indoors on your clothes. After being outdoors, wash and dry clothing at a high temperature to kill any ticks that may remain on clothing.
Perform daily tick checks Always check for ticks after being outdoors, even in your own yard. Because ticks must usually be attached for at least a day before they can transmit the bacteria that cause Lyme disease, early removal can reduce the risk of infection. Inspect all body surfaces carefully, and remove attached ticks with tweezers. Avoid crushing the tick’s body. DO NOT use petroleum jelly, a hot match, nail polish, or other products. Grasp the tick firmly and as closely to the skin as possible. With a steady motion, pull the tick’s body away from the skin. Do not be alarmed if the tick’s mouthparts remain in the skin. Cleanse the area with an antiseptic.
Recent studies have examined the value of giving antibiotics to prevent Lyme disease after a known tick bite. While giving antibiotics for tick bites is not routinely practiced, it may be beneficial in some cases, depending on disease presence in the local area and duration of tick attachment. Physicians must determine whether the advantages of using antibiotics outweigh the disadvantages in any particular instance.
The early diagnosis and proper treatment of Lyme disease are important strategies to avoid the costs and complications of infection and late-stage illness. As soon as you notice a characteristic rash or other possible symptoms, consult your health care provider.
For the Guidelines on the diagnosis and treatment of Lyme disease and other tick-borne infections developed by the Infectious Diseases Society of America, see the CDC website.
A vaccine for Lyme disease has been developed but is no longer available. The vaccine manufacturer discontinued production in 2002, citing insufficient consumer demand.