IAMAT |International Association of Medical Assistance to Travellers| IAMAT |International Association of Medical Assistance to Travellers|

Country Health Advice Netherlands

For Specific Travellers: Lyme Disease

An increase in the number of cases of Lyme Disease has been observed over the last several years. The greatest increase has been reported in the northeast, south, and the western coast.

Description

Lyme Disease is caused by bacteria belonging to the genus Borrelia transmitted through the bite of infected ticks belonging to the Ixodes genus. Borrelia burgdorferi is the predominant cause of the illness in North America, and Borrelia afzelii and Borrelia garinii in Europe and Asia. Ticks get infected when they feed on deer, birds, and rodents who are reservoirs for the bacteria and spread it to humans typically by nymphs (immature ticks).Due to climate change, tick populations are moving further north in latitude.

Risk

Lyme Disease is present in North America, Europe, and Asia. Travellers involved in outdoor activities in forested areas are at risk, including campers, hikers, and hunters. Brushing against vegetation or walking in city parks known to have infected ticks can also put a person at risk.

Symptoms

Lyme Disease usually progresses in three stages. One of the first symptoms (for approximately 70-80% of persons) is a small bump and skin rash at the site of the bite which usually goes away after 1 or 2 days. After 3 to 30 days, the rash expands to an encircled red patch (known as Erythema migrans or Bull's Eye rash) which is warm to the touch but not painful or itchy. The rash may produce lesions. Other symptoms include fever, headache, muscle and joint pain, chills, fatigue, and swollen lymph nodes. Contact your healthcare practitioner immediately if you develop symptoms.

If untreated, the illness progresses to the second stage within days or weeks after exposure. Symptoms include severe headaches, meningitis, swollen joints, skin lesions, heart palpitations, dizziness, persistent fatigue, sleep disturbance, as well as loss of muscle tone in the face (Bell's palsy). Some of these symptoms usually disappear within weeks or months. However, if untreated, the illness will progress to a third stage which includes arthritis and chronic pain, numbness, tingling of hands and feet, and short-term memory loss.

Lyme Disease usually takes 2 to 4 weeks to treat if started promptly and includes taking antibiotics.

Prevention

Travellers who hike, camp, or undertake outdoor activities in wooded regions or who frequent city parks of endemic areas should take measures to prevent tick bites.

  • Use a repellent containing 20%-30% DEET or 20% Picaridin. Re-apply according to manufacturer's directions.
  • Wear neutral-coloured (beige, light grey) and breathable garments, including long-sleeved shirts and pants. Tuck pants into socks.
  • If available, apply a permethrin spray or solution to clothing and gear.
  • When hiking in wooded areas, stay in the middle of the trail and avoid tall grasses and shrubs.
  • Use a tarp when sitting on the ground.
  • Carefully examine your body, clothing, gear, and pets for ticks before entering a dwelling.
  • Apply sunscreen first followed by the repellent (preferably 20 minutes later).
  • More details on insect bite prevention.

There is no preventive vaccine or medication against Lyme Disease.

Borrelia bacteria images, life cycle, and distribution maps
Infection Landscapes

Health risk description last reviewed: September 7, 2016
Country information last updated: November 29, 2016


Sources

  • Barbour A. Relapsing Fevers and other Borrelia Diseases. In: Guerrant, R; Walker D; Weller P, eds. Tropical Infectious Diseases. 3rd ed. New York: Saunders Elsevier; 2011: 295-302.
  • Sandford C. Lyme Disease. In: Jong, E; Stevens, D, eds. Netter’s Infectious Diseases. New York: Saunders Elsevier; 2012: 430-434.
  • Wertheim, Heiman; Horby, Peter; Woodall, John, eds. Atlas of Human Infectious Diseases. Oxford: Wiley-Blackwell; 2012. 273 p.
  • Centers for Disease Control and Prevention: Lyme Disease
  • Public Health Agency of Canada: Lyme Disease


Travel Health Journal

ALL BLOG POSTS