“What’s tricky with older adults is fatigue is already common, and they may not get the fever,” says Henry Feder, M.D., a professor of family medicine at the University of Connecticut School of Medicine in Farmington, and an infectious disease expert at the university’s health center. Patients with fatigue as the initial symptom will usually develop the rash within days. Persistent fatigue as the only manifestation of Lyme disease would be very, very unlikely, Feder says.
There are blood tests to detect infection, such as the ELISA test that checks for antibodies to the Borrelia burgdorferi, and the Western blot test, which is often done to confirm a positive result. Additionally, “the tests could signal infection from years ago,” says Michael Zimring, M.D., director of The Center for Wilderness and Travel Medicine at Mercy Medical Center, Baltimore, Md.
Early treatment essential
Most physicians will recommend three to four weeks of oral antibiotic therapy, usually
doxycycline. On rare occasions, a second course of treatment may be necessary. If the disease has progressed, intravenous antibiotics may be prescribed, and recovery can take longer. “If you catch Lyme disease in the rash stage, 10–20 days of antibiotics may be adequate. The rash usually goes away within two days of starting the antibiotics,” Feder says.
If you suspect you’ve been exposed to Lyme disease, but none of the typical symptoms have appeared, see your health care provider. He or she may prescribe antibiotics as a precautionary measure, or suggest watchful waiting.
“Older adults may not tolerate some medications well. They generally experience more problems with side effects, such as diarrhea, fatigue, and headache,” Brandwin says.
The best way to avoid Lyme disease is through prevention. The CDC advises taking the following steps:
■■Avoid the wooded, bushy areas with high grass.
■■Walk in the center of a trail and try to avoid contact with overgrown grass and leaf litter.
■■Use insect repellent with DEET on exposed skin and clothing. Permethrin is another longer-lasting repellent that kills ticks on contact, and can be found at outdoor equipment stores.
■■Wear long pants, long sleeves, and long socks to keep ticks off of your skin, or wear light-colored clothes in order to spot a tick more easily.
■■Perform a tick check before going indoors—even if you were only in your yard.
■■If a tick is removed from your skin within 24 hours, your chances of developing Lyme disease are extremely small.
“Once inside take a good shower to check for ticks,” Zimring says.