What Are the Three Stages of Lyme Disease?

3 stages of Lyme disease are early localized Lyme, early disseminated Lyme, and late disseminated Lyme.

Lyme disease is an infectious disease transmitted to humans via ticks. The ticks transfer, during their bite, spiral-shaped bacteria known as spirochetes. Spirochetes may enter the blood after remaining localized in the skin. Lyme disease has the potential to affect multiple organs. Spirochetes can attack the skin, heart, brain, spinal cord, joints, and eyes.

People spending time outdoors are at the highest risk of contracting this disease, especially in woody, bushy and grassy areas of the northeastern and mid-northern US.

Different species of spirochetes cause Lyme disease in humans:

• Borrelia burgdorferi in North America and, less commonly, Borrelia mayoni in the upper midwestern US
• Borrelia afzelii and Borrelia garinii found mainly in Europe and Asia

The stages of Lyme disease can overlap with each other, and patients may not go through all three stages. The symptoms vary depending on the duration and location of the infection.

Early localized Lyme: This stage occurs within one to 30 days of the tick bite and is characterized by a bullseye rash at the site of a tick bite. This rash is the classic first sign of an infection.. During this stage, the infection has not spread throughout the body and is curable.

Prominent additional signs and symptoms at this stage are:

• Expanding rashes which appear as bull’s eye, with or without an itching or burning sensation
• Fatigue
• Muscle pain
• Joint pain
• Headache
• Chills
• Fever
• Neck stiffness
• Swollen lymph nodes
• Sore throat

Early disseminated Lyme: This stage occurs several weeks or months after a tick bite. Bacteria has started to spread throughout the body. Flu-like symptoms are accompanied by:

• Joint pain
• Pain, weakness and numbness in hands and feet
• Inflammation of brain membranes (Meningitis) characterized by a headache, neck pain and eye discomfort due to light
• Mild confusional state, disturbances in memory, mood, sleep and concentration are typical characteristics of a brain disease known as encephalopathy
• Discoloration or swelling may be seen in some parts of the skin
• Fever
• Heart block
• Pink eye (conjunctivitis)
• Facial paralysis
• Multiple rashes

Late disseminated Lyme: If Lyme disease is not treated effectively or left untreated in the first two stages, then it may progress to a chronic stage known as the late disseminated stage. This stage may occur months to years after a tick bite. Bacteria have spread throughout the body and patients develop chronic arthritis of one or a few joints and/or heart or nervous system symptoms. Some of the prominent signs and symptoms include:

• The skin of the hands, feet, elbows, and knees appears like cigarette paper (acrodermatitis chronica atrophicans)
• Knee joint pain is the most observed symptom
• Inflammation of the brain and spinal cord may lead to impaired coordination, partial paralysis, muscle weakness, complete paralysis, seizures, intellectual disability, hearing loss and dysfunction of the urinary bladder
• Skin disorders are characterized by inflammation, discoloration and shrinkage
• Irregular heart rhythm

Antibiotics are used to treat Lyme disease. Patients recover faster if treated in the early stages.

The medications used in the treatment of Lyme disease include:

• Doxycycline
• Amoxicillin
• Cefuroxime axetil

In patients with mild residual joint swelling, treatment with oral antibiotics is continued. For more serious disease of the heart, joints, and brain, intravenous antibiotics are given.

• Lyme disease is rarely fatal if treated early and is curable.
• Awareness about Lyme disease is the best way to prevent this disease.
• Using repellants, inspecting ticks and avoiding ticks are some of the effective ways to prevent disease occurrence.
• While going to woody areas, wear fully covered and light-colored clothes to avoid ticks.
• Pets can easily contract this disease, so it is necessary to make them wear a tick collar.
• For more protection, spray the chemical permethrin on clothes and camping sites.
• Some people have complained about lingering symptoms, even after undergoing recommended treatment for Lyme disease, known as post-treatment Lyme disease syndrome (PTLDS). The common complaints, which persist for six months or more are:
  • Hearing loss
  • Vertigo
  • Mood disturbances
  • Difficulty sleeping
  • Tingling sensation