Every healthy relationship is built on trust, right? So can I really be blamed for trusting my husband, the wildlife biologist, when he told me that Lyme Disease got its name from the citrus-y flavor it gave to the meat of infected deer??
… Ok yes, I guess that was one of my blonder moments….
Much like I was unfamiliar with the infamous brown marmorated stink bug before moving out here to the East Coast, so too was I blissfully unaware of the troubles of ticks before I moved out of Colorado. But that blissful bubble was popped when we moved to New York and continued to live our active, outdoor lifestyle here. Tick checks became a part of the routine after a weekend spent camping in the Catskills or an afternoon hiking in the Gunks.
Previously, the idea of “checking for ticks” was just the inspiration for a cringe-worthy country song. (Sorry, Brad Paisley fans!)
Now, the threat of Lyme Disease and other tick-transmitted pathologies are always in the back of our minds when my husband and I are spending time in the great outdoors. And after four years in the North East, it finally happened- not to my dog who spends every morning tearing through the underbrush in Mendon Ponds Park or to my husband who spends every day out in the wilderness studying native and invasive species. Nope, it happened to me- I got Lyme Disease. You always hear about the tell-tale bulls-eye rash, but I have to say, I did not expect it to be so… obvious. Have a look:
After a weekend spent camping in the Adirondacks, I thought I just had a particularly nasty mosquito bite over my knee. A few days later, though, as I was absentmindedly scratching the itch, I looked down and this rash was staring my right in the (bulls) eye. I hadn’t even noticed a tick on me, which was surprising because A) that’s a pretty hard-to-miss location and B) I thought that a tick had to be attached for 36 hours before transmitting the disease. I decided to do some digging…
While the CDC does state that in most cases, a tick must be attached for 36-48 hours before the bacteria that causes Lyme Disease may be transmitted, other sources say that this time frame could give people a false sense of security. Only around 30% of patients infected with Lyme Disease even recall a tick bite. This was certainly the case for me, as I wouldn’t have even considered Lyme Disease when I experienced the characteristic fatigue and headaches of the disease. I was way more likely to blame the grad school life for those symptoms than Lyme Disease!
Once a tick get situated on its host, it bites into the skin, inserting a feeding tube and a cement-like substance to help it stay in place during its feast. Many ticks have an anesthetic in their saliva that allows them to chomp down without the host feeling it. Transmission of the Lyme Disease causing bacteria, Borrelia burgdorferi, isn’t instantaneous, which is why it is commonly thought that a tick must be attached for a while before the host can be infected.
Only about half of Lyme Disease patients ever present with the stereotypical bulls-eye rash, so I am grateful that my symptoms were so obvious. Left untreated, Lyme Disease can spread to the joints, heart, and nervous system, creating serious long term effects. How can only half of the people who are infected have the rash? What causes the rash to have such a unique, characteristic shape? I had no idea that the answer was so in-depth and fascinating…
I’m including the link to this article because there’s no way that I can do it justice by trying to summarize it quickly here in this blog post. If you’re at all interested in microbiology, read this:
THE BULLS-EYE RASH OF LYME DISEASE: INVESTIGATING THE CUTANEOUS HOST-PATHOGEN DYNAMICS OF ERYTHEMA MIGRANS.
Written by the American Society for Microbiology’s Ashley Hagen Griffin
Published by Microbial Sciences on April 30, 2018
Basically, B. burgdorferi is a spirochete that, once transmitted to the host, replicates locally and spreads away from the bite site at a rate of about half an inch/ hour max. The bulls-eye rash is caused by two inflammatory responses: First, the foreign salivary proteins are targeted by the immune system, creating a red swelling around the bitten area. Then, as the spirochetes replicate and spread outward, the redness and rash expand with them, creating the bulls-eye rash. The appearance of the rash will vary in individuals on a case-by-case basis, depending on the host’s personal immune response. When macrophages are cleared from the infection site more slowly, the rash will appear to be more homogenous. When macrophages are cleared more quickly, the homogenous erythema takes on the more typical bulls-eye appearance. So… kudos to my immune system for wasting no time in clearing those macrophages, I guess!
Below, I’ve included some scary visuals from the CDC. Lyme Disease is spreading like… spirochetes away from the point of infection. So I suppose we don’t all have to like Brad Paisley’s song “Ticks”, but we would do well to heed his suggestions and spend a little more time performing tick checks on our loved-ones.