When you mention Lyme disease, most people immediately think of the famous bulls-eye rash.

But, according to Dr. Tam Ly, an infectious diseases specialist who has treated many patients in the area, only 60 to 80 percent of Lyme disease sufferers ever experience the rash, and those who do may never even notice it.

Lyme disease is prevalent in the Northeast United States and is common in the Fauquier area. It is caused by the borrelia burgdorferi bacteria, carried by infected deer ticks from one animal to another.

The late spring and summer are peak times for Lyme disease transmission, both because of the deer ticks life cycle and because this is the time when people are spending more time outside gardening, camping, hiking, and playing in the nice weather.

Ly said Lyme disease often presents a constellation of symptoms, meaning there are a range of seemingly unrelated problems and it can be tricky to pinpoint the exact problem, especially if you never saw the tick.

Logan’s experience
This is an experience with which eight-year-old Logan Van de Water is now all-too-familiar. The rising third-grader never saw the tick that bit her in April, nor did she experience a rash.

Logan ran a high fever for a few days. Two or three weeks later, she was getting sicker and sicker, said her father Mark Van de Water.

Logan said she had a terrible headache for a few weeks, and had a hard time getting comfortable. Her parents took her to her pediatrician, Dr. Joshua Jakum, but since no one knew about the tick bite (and it was so early in the season), the possibility of Lyme disease did not leap to mind.

Also, as Dr. Ly explained, there are no tests that are sensitive enough to detect Lyme disease in its early stages. Early on, Ly said, patients may experience fatigue or flu-like symptoms. If patients have the rash, then physicians will usually prescribe antibiotics right away, but without a rash or any evidence of a bite, it can be hard to track down the root cause.

As the disease progresses, symptoms may change into more chronic fatigue, Ly said. After longer exposure, the bacteria may begin to affect other systems, causing problems with the heart and brain, such as fainting or memory loss.

In Logans case, a few weeks after her bite, Logans neck became so stiff that she couldnt touch her chin to her chest. In the end, thats what unlocked the puzzle.

Logan was tagging along with her brother and mother, Read, at a doctors visit, when the physician spotted her sore neck. I was going to wait in the waiting room, she said, but I ended up going to the hospital.

At the hospital, Logan had a spinal tap, which confirmed the presence of meningitis an infection of the tissues around the brain. Some forms of the disease can be highly contagious and very deadly. Logan was admitted to a local hospital and kept in isolation (with her parents) where she began a course of intravenous antibiotics.

After three days of isolation, doctors confirmed that Logan had the non-contagious, Lyme-related variety of meningitis. This meant Logan could have guests, and that none of her classmates or family members was at risk for developing the infection.

Once she could have visitors, classmates, friends and teachers from her school filled the room and added 57 stuffed animals to her collection. She even had a visitor from the Pet Therapy Program, a fluffy white Samoyed named Samantha. After eight days in the hospital, Logan went home with a tube in her arm so that her parents could keep up her antibiotics at home.

After more than a month of fevers, headaches, tests, and too much needles, Logan finally vanquished the disease and was able to return to school.

Today, except for a few small healing wounds in Logans left arm, she is the picture of health. She wears a crisp summer dress with a watermelon headband holding back her straight brown hair. Because she is young, and because of the excellent care she received, she will have no lingering long-term effects from her bout with Lyme. She is all smiles, tan and full of sunshine.

Wiser now from her experience, Logan offered this advice to her peers: If youre playing outside, if you see a moving freckle, if its already sucking your blood, you need to show your parents or your doctor.

Tick removal
As for how to get the clingy bloodsuckers off your skin, Dr. Ly advised removing any ticks as soon as possible with a pair of tweezers. The faster you remove the bug, the better the chances of avoiding any problems.

After plucking the tick, If the mouth parts are still attached, thats okay, Ly said. You will have removed the part of the bug that contains the dangerous bacteria.

When to call
In an area such as Alexandria, where Lyme disease is fairly common, Ly said tick bite sufferers should give their physician a call any time they have concerns about a bite. The doctor will want to know about any symptoms, how long ago the bite happened, how long the tick was attached (if it was fat and engorged, chances are it had been attached for some time), and how long ago the tick was removed.

Seeking a physicians help sooner rather than later can keep you from suffering more-serious effects later on, and the treatment within the first few days is simply a one-week course of antibiotics.