As the monsoon season sets in, we must take various measures to get rid of mosquitos and insects. Allergic reactions and even insect borne diseases are prevalent during this time, one of which is a fatal tick-borne disease called Lyme disease.

Lyme disease has been widely reported in the USA, Central Europe, South East Asia, and Latin America. In Nepal, its effects were not noticed and diagnosed until recently. In fact, the first ever laboratory confirmed case of Lyme disease in Nepal was in 2017 at Sukraraj Tropical & Infectious Disease Hospital, Teku.

What is Lyme disease?

Lyme disease is caused by a bacterium called Borrelia burgdorferi, and is transmitted to humans through the bite of infected black-legged ticks, called deer ticks. Lyme disease is caused by four main species of bacteria.

In the US, the major host of Lyme disease is Borrelia burgdorferi and Borrelia mayoni. In Europe and Asia, the disease is transmitted by Borrelia afzeli and Borrelia garini.

How do you get Lyme disease?

If you are living in or visiting heavily wooded areas on vacation or for hiking, there are high chances of getting an infectious bite from a tick. Sometimes, even your profession or your choice of outdoor activities might get you infected.

Spending a lot of time outdoors or having an outdoor occupation can lead to increased risk of Lyme disease since ticks can easily attach themselves to your bare flesh.

The bacteria from tick bites takes 36 to 48 hours to enter our bloodstream. This means you have 2 days to safely remove a tick and minimize the chances of getting Lyme disease.

Symptoms of Lyme disease

Early symptoms

From 3 to 30 days after the tick bite, a rash with an expanded red area and clear centers appear in the area. This rash is called erythema migrans, which is the hallmark of Lyme disease. This can slowly expand over days and might be warm to the touch, however, it is not itchy or painful.

Other symptoms such as flu-like symptoms such as fever, chills, fatigue, body and muscle aches, neck stiffness, and swollen lymph nodes are also observed in patients.

Later signs and symptoms

In the later stages the rash will expand in size and also appear in multiple areas of the body. Patients can also suffer from severe joint pain and swelling in the knees can occur. This pain can shift from one joint to another and thus affects motor movement.

Neurological problems can start from one week, month or even years after the infection. These problems include inflammation of the membranes surrounding the brain (Meningitis), temporary paralysis of one side of your face (Bell’s palsy), numb and weak limbs, and impaired muscle movement.

Stages of Lyme disease in a human body

Lyme disease has three stages in the human body, which are:

– Early localized disease with skin inflammation and rashes.

– Early disseminated disease with heart and nervous system involvement including palsies and meningitis.

– Late disease featuring motor and sensory nerve damage and brain inflammation as well as Arthritis.

Diagnosis of Lyme disease

Lyme disease is diagnosed based on symptoms, physical findings and the possibility of exposure to infected ticks. Laboratory blood tests are helpful if used correctly and performed with validated methods. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics.

Prevention of Lyme disease

The best way to prevent Lyme disease is by avoiding areas where deer ticks live. These include wooded, bushy areas with long grass.

When visiting these areas you can follow these preventive steps:

Cover yourself properly

While you are hiking or camping, wear full-sleeved shirts, hats, gloves, and tuck your pants into your socks. Try to avoid trails that have low bushes and long grass.

Use insect repellents

Use insect repellent with a 20% or higher concentration of Diethyltoluamide (DEET). Chemical insect repellents can be toxic, so extra precautions are needed while applying it to children

Tick-proof your lawn

Clear large bushes and dried leaves where ticks live. If you have a lawn or a garden, keep the grass cut low and stack wood neatly in dry, sunny areas to discourage rodents that carry ticks.

Check your clothing and your pets for ticks

After spending time outdoors in wooded or grassy areas, search thoroughly for any hints of tick bites on yourself, your children, and even your pets. Deer ticks are no bigger than the size of a pin-head, so pay extra care while looking for them. Taking a shower can also be helpful after you are home.

Removing a tick

If you find a tick attached to your skin, carefully grasp the tick near its head with tweezers and pull steadily. Do not try to squeeze or crush the tick. Once it has been removed, dispose of it by putting it in alcohol and apply an antiseptic cream to the area.

Treatment of Lyme disease

People who are diagnosed at an early can recover rapidly and completely with the use of prescribed antibiotics. Antibiotics commonly used for treatment include Doxycycline, Amoxicillin, or Cefuroxime Axetil.

Patients with certain neurological or cardiac forms of the disease may require intravenous treatment with antibiotics such as Ceftriaxone or Penicillin. There are also certain guidelines that need to be followed in regard to age, medical history, underlying health conditions, pregnancy, and allergies.

Are you planning on hiking soon?

Swacon International Hospital provides personalized, quick and responsive health care to those in need of trustworthy travel safety advice and preventive measures.

Patients treated at Swacon International Hospital benefit from the combined expertise of the hospital’s highly skilled medical staff who specialize in Travel Medicine.

To book an appointment, call us at +977-1-4478105 or email us at

Health for All