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As mannequin Bella Hadid opens up about Lyme illness and different well being points, her ordeal brings up many questions. What precisely is Lyme illness, and the way is it contracted and unfold? How is the sickness recognized and handled? What does it imply when somebody has “power Lyme”? Is there a vaccine for Lyme illness?
To assist us with these questions, I spoke with Dr. Leana Wen, an emergency doctor and professor of well being coverage and administration on the George Washington College Milken Institute Faculty of Public Well being. She beforehand served as Baltimore’s well being commissioner.
CNN: Are you able to begin by explaining what Lyme illness is?
Dr. Leana Wen: Lyme illness is a bacterial an infection. The bacterium Borrelia burgdorferi is the most typical trigger. In uncommon instances, Borrelia mayonii could trigger the sickness additionally. In the USA, Lyme is the most typical illness unfold by vectors, that are animals like mosquitos and ticks that unfold infections. Lyme illness is transmitted by the chunk of a specific tick, the black-legged tick (Ixodes scapularis and Ixodes pacificus).
There are three phases of Lyme illness. The primary stage is early localized illness that begins inside a day to 4 weeks after the tick chunk. Folks develop flu-like signs akin to headache, muscle aches and fatigue. Some develop a attribute “bull’s-eye” rash referred to as erythema migrans.
The second stage happens three to 12 weeks after the preliminary an infection. That is the “early disseminated” stage through which individuals have extra widespread signs. These can embody dizziness, chest ache, palpitations, arthritis and facial nerve paralysis.
The third stage is “late disseminated” illness, which may happen months after an infection. Right here, once more, there’s a constellation of signs. They embody ongoing joint ache, fatigue, melancholy, palpitations, and different neurological, rheumatological and cardiac involvement.
CNN: How is Lyme illness handled, and why is it necessary to get immediate remedy?
Wen: Early analysis and immediate remedy can forestall issues and the development to the subsequent phases of illness. The usual remedy is antibiotic remedy. Most individuals are cured after taking oral antibiotics for 10 to 14 days.
Preventive remedy is widespread, too. If somebody has been bitten by a black-legged tick, also referred to as a deer tick, in an space of the nation recognized to have Lyme, they may take one dose of the antibiotic doxycycline to stop Lyme an infection. This ought to be performed inside 72 hours of the tick chunk. It’s necessary to rigorously take away the tick if it’s nonetheless hooked up. Take an image and take it with you to the physician’s appointment, or ship the image to your supplier should you’re having a telemedicine go to.
CNN: Is there a blood check one may take to see whether or not they have Lyme illness?
Wen: Sure, although there are a number of limitations. The most typical exams are antibody exams, which detect antibodies the physique makes in response to an infection. These exams most likely don’t flip constructive till a number of weeks after an infection, so if somebody simply acquired contaminated and took the check, it will likely be adverse even when the particular person has Lyme. As well as, the antibodies may persist within the blood for months and even years, however their presence alone doesn’t signify that Lyme illness is the reason for all of the signs an individual could have. False positives can even happen, with another tickborne illnesses and autoimmune diseases triggering a constructive end result within the absence of Lyme illness.
CNN: Then how is Lyme illness recognized?
Wen: Usually, it’s recognized by a cautious symptom documentation and an publicity historical past. Bodily indicators, such because the attribute rash, enlarged lymph nodes or joint swelling, can assist within the analysis, as nicely. Blood testing might help however has limitations, as I discussed earlier. The supplier usually presumptively treats with antibiotics primarily based on the scientific historical past.
CNN: What does it imply when somebody has “power Lyme”?
Wen: There’s a situation known as post-treatment Lyme illness syndrome, or PTLDS. This refers to individuals who have had Lyme illness however, six months or longer after finishing remedy, nonetheless have persistent signs. These signs can embody fogginess, issue considering, ongoing fatigue, and nerve and joint ache.
It’s not recognized why some individuals develop PTLDS. There are a number of hypotheses, together with a persistent an infection or autoimmune response. The signs of PTLDS may be handled, however there isn’t any confirmed remedy.
The time period “power Lyme illness” contains individuals who have PTLDS. It’s typically additionally used to explain signs in individuals who haven’t been recognized with Lyme illness. Based on the Nationwide Institute of Allergy and Infectious Ailments, “due to the confusion in how the time period (power Lyme illness) is employed, and the shortage of a clearly outlined scientific definition, many specialists on this discipline don’t assist its use.”
In my expertise as a doctor and affected person advocate, I’ve met many individuals who imagine they’ve this situation and are actually struggling. Many are debilitated because of this and unable to operate as they beforehand did. Similar to lengthy Covid and different comparable circumstances, there may be a lot that we don’t perceive about this situation. Much more analysis must be performed in an effort to alleviate the very actual agony and misery that these sufferers are experiencing.
CNN: Is there a vaccine for Lyme illness?
Wen: There are a number of vaccines towards Lyme illness for canine. For people, there are some late-stage scientific trials which are ongoing, together with one by Pfizer that might be submitted for regulatory approval by 2025.
CNN: What are methods to keep away from contracting Lyme?
Wen: With no vaccine, the easiest way to stop Lyme illness is to stop tick bites. If you’ll areas the place ticks recognized to hold Lyme are discovered, put on long-sleeved shirts and pants. Use insect repellent that incorporates DEET. As soon as you come indoors, look at your self — and kids and pets — for ticks. Take away the tick if discovered, and instantly contact your major care supplier to ask about preventive antibody remedy. And keep alert for signs, since early antibiotic remedy is essential to stop longer-term penalties.
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