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not diagnosed in a timely manner, Lyme can be impairing if left untreated. Most experts agree that the “bull’s eye” or “doughnut-like” rash, or erythema migrans, is the most telling clinical sign, usually appearing within one month of the bite. . The rash, according to the “ Centers for Disease Control and « Prevention (CDC), does not % always rear its head, however, appearing on only about 70 per- \ cent of patients. t
While the CDC instructs k doctors that the rash should be at least 5 cm (about 2 inches) in diameter before using it for Lyme surveillance, it can be less than that for diagnosis purposes. Dr. Chris Novak, a Virginia Department of Health epidemi-1 ologist, explained that doctors ^ need to take rash, history of tick * bites, and proximity to ticks all f. into consideration. <
Lyme’s unique rash is an .* excellent way to differentiate*tick bites from other insects, *’ such as spiders, Which usually** remain relatively small. ^ Rappahannock physician Dr. *. Jerry Martin said of diagnosing #’ varying rashes, “sometimes we have to make a judgment call.” *.
Adding to the contusion is * an allergic reaction some have' • to tick saliva. These rashes — ! appearing within hours or days \ following a bite — do not usually c expand, however, and disappear '• soon after.
Aside from the indicative ■ rash, “early Lyme” may also ! include flu-like fatigue, chills and fever, headache, swollen j
See LYME DISEASE, Page AS *
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