Answers to Your Questions About Lyme Disease
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joan
12:42
If oral antibiotics / say hip arthritis how long does it take for symptoms to disappear before you would put someone on intravenous antibiotics?
Einstein Healthcare Network
12:43
Joan: we usually try oral antibiotics for a month; if there's no improvement in arthritis at that point, then we would move on to intravenous (or intramuscular) therapy.
Bob
12:43
Shouldn"t every test for Lyme also include a test for Babesia or other infections that could be caused by the tick bite?
Einstein Healthcare Network
12:45
Bob: That's a good question. The 3 treatable infections that come from deer tick bites are Lyme, anaplasmosis, and babesiosis. The first 2 are both treated by doxycycline, so there's no need to test specifically for anaplasma. Babesiosis has so far been rare in Pennsylvania, and the test has some false positives, so we are not currently testing unless we have clinical suspicion.
Maureen
12:46
Would an IgM antibody spike in a previously infected person indicate new infection?
Einstein Healthcare Network
12:47
Maureen: IgM tests are inherently unreliable because of the details of how IgM behaves; IgM titers tend to rise in response to almost any type of acute illness, so they aren't too useful in diagnosing a new infection.
Tara
12:47
Once a tick is engorged, how can one differentiate it from another type of tick? Prior to becoming engorged it is obvious to tell the difference.
Einstein Healthcare Network
12:48
Tara: it's not easy, but if you show it to someone with expertise (like me!), it's possible to tell. You need to get a good look at the scutum (the part at the front that includes the mouth parts.
Val
12:48
bulls eye after tick bite, bld work neg for lymes. Do I have lymes disease?
Einstein Healthcare Network
12:49
Val: If you had a big red rash after a tick bite, you should assume it is Lyme. The test may not become positive until several weeks later.
Mark
12:49
Can they fall out of trees that are overhead or bushes by the sidewalk and get on you? Or do you need to brush up against them?
Einstein Healthcare Network
12:50
Mark: You need to brush against them. They crawl out to the tip of a twig or leaf of grass and then hold on with their 4 hind legs while waving their 4 front legs in the air looking for a passing animal to grab onto. This behavior is called "questing." They don't fly, jump, or hop.
Mike S
12:50
What is your opinion on herbal remedied for lyme disease?
Einstein Healthcare Network
12:51
My opinion is that once there is solid evidence of efficacy, they are no longer referred to as herbal remedies but as standard medical treatment!
F A
12:51
In children under 8 year age with possible exposure(tick found by parent and removed). Is antibiotic prophylaxis indicated? if so, what would be drug of choice. What would be the best time for serology testing? Is it in necessary, if no symptoms are present?
Einstein Healthcare Network
12:52
F A: see the earlier answer about prophylactic doxycycline. If no rash appears at the site of the bite within 3-4 weeks, then there is no need to be concerned about Lyme disease.
joan
12:52
If you test positive - no idea when bit - but only symptom is stiff hips - is that very unusual? Was told throughout school hips were always tight but never hurt until now.
Einstein Healthcare Network
12:53
Joan: it's very unlikely that bilateral stiff hips are caused by Lyme.
Val
12:53
I have heard that ticks now live year round. Is this true?
Einstein Healthcare Network
12:55
Val: it's true. They can live for months in the house, or can wake up and become active during the winter if there's an unusual warm spell. I once removed an adult tick from one of my son's scout mates during a camping trip in January when the temperature rose to 70 fahrenheit.
Tara
12:55
I know a large, red rash is a definite indicator of Lyme, but it is still possible that one has contracted the disease without the presence of any red rash? There seems to be some debate regarding this. Some people think that as long as there is no rash, you are in the clear. Thank you.
Einstein Healthcare Network
12:57
Tara: in retrospective studies of people with Lyme arthritis or Lyme neurological disease, only half the people recall a rash. This is probably because the ticks that succeed in feeding for several days without being spotted are the ones that attach in hard-to-see places (behind the ear, in the groin, etc); when a rash appears in these areas, it is likely to go unseen. In prospective studies of tick bites, essentially every bite that led to Lyme had a rash at the site of the bite.
Greg
12:57
Short of keeping hungry free range chickens in my yard, what else can be done to control ticks "questing" by my house?
Einstein Healthcare Network
12:58
Greg: there were some experiments of trying to eliminate ticks from mice by distributing cardboard toilet paper tubes stuffed with permethrin-impregnated cotton around the yard so that the mice would use the cotton for their nests. The experiments were mildly successful, but for an average sized yard they had to use about a thousand tubes!
Bob
12:59
Most Lyme Doctor specialists will not recognize any insurance, including Medicare. They claim that the government and drug companies do not recognize Lyme disease as a serious disease. Can you tell me what the medical community is doing to erase this myth?
Einstein Healthcare Network
1:00
The issue here is that insurance companies will typically pay for treatment that has been shown to be effective, but not for treatments that are considered experimental or unnecessary or potentially harmful. If new treatments are accompanied by solid scientific evidence of efficacy, then we will be able to obtain coverage for them.
Tara
1:00
Do you know the lifespan of deer ticks and how frequently they need to feed? Thank you.
Einstein Healthcare Network
1:00
They live for 2 years, and feed 3 times.
1:01
Thanks to everybody for your interest and for the great questions. I had fun. I hope it was good for you too.
To learn more about Einstein Healthcare Network’s infectious disease services – including Lyme disease diagnosis and treatment – and to make an appointment, go to https://www.einstein.edu/infectious-disease or call 1-800-Einstein.

The information contained in this chat is not intended or implied to be a substitute for professional medical advice. Einstein has a talented team of primary physicians and specialists who you can contact or make an appointment to see to discuss your specific medical problems; but most importantly, you must always seek the advice of a physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition. Nothing contained in this chat should be used for medical diagnosis or treatment.
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