Published April 2013, (c)Prevention

Prevention News

Is Your Spider Bite Lyme Disease?

The symptoms doctors are missing

By Leah Zerbe

Lyme disease is a tricky business. It's tough to detect, diagnose, and often treat—and symptoms are even frequently missed by doctors, according to a small new study from the University of Medicine and Dentistry of New Jersey. 

Deer ticks are the sneaky culprits harboring Lyme disease, but most people infected don't even recall ever seeing a tick latched onto them. The classic tell-tale sign that you're infected with Lyme is a bull's eye skin rash, but the new research shows that doctors are missing other Lyme disease cases that feature different types of skin rashes, often ones that mimic insect or spider bites, dermatitis, or lupus rashes.

In fact, using a cutting-edge DNA testing method currently only available in research settings, researchers found that 10 of the 14 patients who tested strongly for Lyme disease also had non-classical skin rashes that mimic skin conditions.

"The value of the study is it provides an alert for clinicians to be very wary of a patient who travels or lives in an endemic area, that a rash that they're looking at might actually be Lyme disease," says study author Steven E. Schutzer, MD, professor of medicine at UMDNJ. Here's what to look out for: 

If you suspect Lyme…
Don't rely on a rash. While a bull's eye rash definitely signals Lyme, less than half of infected people actually show that early sign. If you're showing flu-like symptoms, go to the doctor. You're most likely to contract Lyme in New England, the Mid-Atlantic states, or the Great Lakes region, so let your doctor know if you've recently traveled to those areas. 

Don't count 100% on tests. Many standard Lyme tests at the doctor's office (Western Blot, Elisa) miss an alarming amount of Lyme cases; they're often only 45 to 65% accurate. For instance, Dr. Schutzer says you may test negative right after a bite, but positive several weeks later. If your symptoms linger, work with your doctor to rule out other diseases; find a Lyme-literate doctor if you still suspect Lyme. (Some doctors "don't believe in" chronic Lyme disease, so seek out a doctor affiliated with the International Lyme and Associated Diseases Society, or ask for a referral from a local support group.) 

If you find a tick on you…
Remove it right. Don't cover it with clear nail polish or try any other old wives' tales. Get sharp tweezers and remove it like this.

Get it tested. Places like New Jersey Laboratories will test a removed tick for Lyme or other diseases for a fee. Just be sure to follow the labs' instructions for preserving and shipping the tick—often, putting it in alcohol will ruin test results. 

Protect yourself…
Know the enemy. Different ticks carry different diseases. Know which ones are prevalent in your area, what they look like in different stages, and potential diseases they carry by checking out this Tick Identification Chart.

Dress like a geek. Ticks don't fall from trees—they crawl up. Pulling longer socks up over your pants legs makes it harder for ticks to crawl onto your leg.

Cause death by dryer. It's like laundry in reverse. University of Rhode Island researchers found that tossing the clothes you wore outside into the dryer on high for 5 minutes will wipe out any lingering ticks, keeping them out of your home, says Thomas Mather, PhD, director of University of Rhode Island's Center for Vector-Borne Disease and its TickEncounter Resource Center. Mather also urges people to make daily tick checks mandatory in every home.

Seek showers. Research out of Yale found getting a shower within 2 hours of being outside significantly cut down on a person's risk of contracting Lyme disease. 

More from Prevention: What You Need to Know About Lyme Disease