Feeling sick with fever, even mild, along with chills, fatigue, and joint pain during this pandemic era, all seem to indicate the coronavirus, particularly in summer with the flu season still months away. But there may be another culprit: Lyme disease.
“Lyme disease is as common this year as it was last year or the year before,” Dr. Daniel Cameron, a Lyme disease specialist in a private office in Mount Kisco, New York, told TODAY.
Also, Lyme disease, caused by a bacteria or parasite in a tick, is reputed to mimic other conditions.
“It triggers cytokines, the inflammatory process, and by triggering the entire natural immune system, it will mimic some other infections that affect the immune system,” said Cameron. When the immune system is working hard to clear the infection, it can cause symptoms very similar to COVID-19.
There are a number of symptoms that could indicate COVID-19 or Lyme disease. These symptoms, according to the Centers for Disease Control and Prevention, include:
- Fever
- Cold
- Muscle pains
- Fatigue
Diagnosing correctly
Finding out which of these two diseases someone may have is key, said Dr. Edward Jones-López, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California.
There is treatment for Lyme, but the timing of this medication is crucial.
“The important thing about Lyme is that if you diagnose it and treat it early, you avoid serious complications from the disease,” Jones-López said.
To find out if it’s really Lyme disease, looking at everything is important. For example, knowing the regions of the country where Lyme disease rates are most common may give some clues.
“Lyme-borne ticks are expanding more rapidly across the country, but have historically been restricted to very particular areas of the country,” Jones-López said.
The Northeast States are found by the CDC to have a high incidence, as are Illinois and Minnesota. Lyme also tends to occur in the hot summer months, Jones-López TODAY said.
A unique feature of Lyme is a bull’s-eye rash that forms exactly where the tick bite occurs.
“That initial rash is very characteristic and is a great opportunity to differentiate the two diseases,” said Jones-López. But the rash of the target does not occur in all cases. If the rash is somehow missed, the disease progresses to more general symptoms of discomfort and may be more difficult to pin down.
Since one area of the body that Lyme tends to spare is the lungs, if there is lung involvement, that would quickly distinguish COVID-19 from Lyme, Jones-López said. She added, however, that it is the general general pattern of symptoms that is most important here.
Testing possibilities
Testing is also part of the equation. Tests can be used to confirm or exclude a diagnosis of Lyme or COVID-19. For Lyme, testing involves measuring antibodies, which can take a few days or up to two weeks to develop after a tick bite, Jones-López explained.
Meanwhile, for COVID-19, there is the possibility of using PCR (polymerase chain reaction) to detect the actual genetic material of the virus or to test antibodies to see if someone has been infected with the virus in the past, he continued.
Still, Cameron notes, not all antibody tests are necessarily as reliable as doctors would like.
“We know that there are false negatives in Lyme disease,” said Cameron TODAY. “It’s good to get tested, but there are people who just can’t get a positive result.”
Similarly, there may be similar difficulties for some with COVID-19 in verifying that they have the disease. “There are patients who are convinced that they had COVID; They went through all kinds of problems, but they don’t get a positive test, “said Cameron.
However, based on the overall clinical picture, although the two diseases have similarities at some stages, an experienced doctor will be able to make the call, Jones-López told TODAY.
Treatment options
For treatment, knowing the difference is essential because managing a case of Lyme is completely different from treating with COVID-19. Most often, adults and teens with Lyme disease are treated with the antibiotic doxycycline, while those under the age of eight receive amoxicillin, Cameron said.
Meanwhile, COVID-19 treatments continue to evolve. At this time, the antiviral drug remdesivir has shown promising results in patients with moderate COVID-19, according to a late-stage study. The anti-inflammatory drug dexamethasone has been reported to reduce deaths in critically ill patients.
One last thing to keep in mind this summer is that it is actually possible to have both illnesses at the same time.
“Due to the current situation with COVID, where there is essentially uncontrolled transmission right now, as daily cases show, you could definitely have both if you are adventurous enough, which means you are in contact with nature and with other humans, “Jones-Lopez said.
What this means for the course of any of the diseases is still unknown. Cameron advises people to be very careful.
“I just don’t like beating two diseases,” said Cameron. “I don’t know if it makes it worse; I guess the worst could be. “
