Lyme Disease

What is Lyme Disease?

Is a systemic infection due to a bacteria called Borrelia burgdorferi which transmitted by black legged tick bite (deer tick, Ixodes scapularis).[1] Ticks are not insects but Arachnids, a class of Arthropods [4], which is common in North America and Europe.


The materlization of lyme disease would assumably by the banishing of deer and tick population because of the effect reforestation. Ticks attach usually found in hard to see area of the body like armpits, groin and scalp it takes about 36-48 hours skin attachment before the bacteria transmit to the body.

People living in thickly wooded and grassy area are the most likely to catch the disease. Most people infected by a small tick called nymphs, which is hard to discover because of tininess(less than 2mm). In 1883 the original rash manifestation was described as ACA (Acrodermatitis Chronica Atrophicans) by a German doctor Alfred Buchwald.

In 1912, Arvid August Afzelius a Swedish doctor described it as ECM (Erythema Chronicum Migrans.

In 1975, Connecticut town, old Lyme where the panic case of rheumatoid arthritis where wrongly diagnosed and in 1977 when the Connecticut doctors change the diagnosis to as Lyme disease, where they named it after the town of old Lyme.In 1981 the bacteria was specifically identified by Willy Burgdorfer and named it after him(Borrelia burgdorferi sensu). [4]

Deer tick or Ixodes scapularis classifications
image source : originsofhealth.com

Lyme Disease Signs and Symptoms

Early localized stage

  • 3-30 days after-tick bite
  • Redoval-shaped, augmenting rash (erythema migrans, EM )
  • Tiredness , coldness, fever, headache, muscle and joint pains, and inflamed lymph nodes

Erythema Migrans (Bull’s Eye rash)

  • At About 70-80% infected persons rash occurs [1]
  • Begin at the bite site area after 3-30 days
  • Can reach up to 12 inches side to side
  • Bull’s eye likemanifestation
  • Warm to touch but is seldom itchy or painful
  • Lesion may appear in the body [1]

Lyme disease rash ( erythema migrans/ bull’s eye rash)
Image source : Webmd.com

Erythema migrans lesion
Image source : cdc.gov

Early Disseminated Stage (days to weeks after-tick bite)

  • New EM lesions will occur in other parts of the body
  • Loss of muscle elasticity on one or both sides of the face (Facial or Bell’s palsy)
  • Extreme headaches and neck muscle stiffness due to swelling of the spinal cord (meningitis)
  • Pain and swelling in the large joints (knees)
  • Acute pains that may hinder with sleep
  • Throbbing Heart rate and dizziness [1]

Loss of facial elasticity (Facial or Bell’s palsy)
Image source : cdc.gov

Late Disseminated Stage (months-to-years after-tick bite)

At about 60% of infected persons with untreated infection may begin to have irregular course of arthritis, with severe joint pain and swelling.[1]

Chronic symptoms after treatment (after-treatment Lyme disease syndrome)

At about 10-20% infected persons have symptoms lasts months to years post treatment have joint pains,cognitive defects,sleep disturbance or fatigue.[1]

Diagnosis and Testing

The sign and symptoms of Lyme disease changes and indefinite, oftentimes they are also manifested on other conditions. Diagnosis might be crucial. Patient’s history also play a major part on diagnosing the disease, like if they spent summer outdoors,ticks are more active in summer.

Tests for Lyme Disease

Note: These examinations are most accurate at about 1-2 weeks after the body establishes antibodies.[3]

Enzyme-linked immunosorbent assay (ELISA) test

  • Commonly used test to confirm Lyme disease
  • Determines antibodies to Borrelia burgdorferi.
  • Not used as sole basis for diagnosing.

Western blot test

  • Used as the second basis if (+) ELISA
  • Two paced test approach (ELISA, Western blot test)
  • Determine antibody to a few proteins of Borrelia burgdorferi

Polymerase chain reaction (PCR)

  • Determine bacterial DNA fluid
  • Used to people have symptoms ofchronic Lyme arthritis and nervous system symptoms.

Treatment and Drugs

Ticks cannot fly or jump they are often find in grassy and brushy areas or areas that does reach by the sunlight particularly wet areas. However they can detect body odors and exhaled carbon dioxide so we are very high host potential.Usually, infected person treated with four weeks antibiotic course treatment.

Commonly used treatment drugs

Oral antibiotics

  • Doxycycline
  • Amoxicillin
  • Cefuroxime axetil

Intravenous antibiotics

  • Given to patients whose disease has occurred up to the central nervous systemor having cardiac forms
  • Given to adult older than 8 years old
  • 14-28 days treatment [4]

Lyme Disease Prevention

They always say prevention is better than cure. The best way to avoid them is to avoid where they live like bushy places, grassy places and woody places. Here are some simple and helpful precautions:

  • Wear long sleeved clothes, long pants, socks and shoes in walking or staying at grassy, woody places. If gardeningwear gloves and hat.
  • Insect repellant with DEET (Diethyltoluamide)up to 20%[3], used of alternatives repellant, many people are now are using organic products like lemon grass sprays and rosemary sprays because the DEET cause DEET associated seizure according to United States Environmental Protection Agency (EPA )
  • As much as possible check tick attachments on skin or any garments and also on pets, if possible do a quick shower may also help in removing unattached ticks.
  • Quickly remove ticks if attached to skin using tweezers with a steady pull motion after removing clean the bite area with alcohol, soap and water or iodine scrubs.

Vaccines

  • Active Immunization
  • Sadly vaccines for lyme disease had stop the production in 2002, because of decrease on demand and does not last long as protection.[4]

Brands and other names

  • Lyflex
  • LYMErix
  • Recombinant OspA[5]

Dosing

  • 30 mcg IM (deltoid) at 0,1,12 months[4]
  • Not used < 15 years old

Pregnancy category C

Has adverse effect on fetus in animal reproduction and does not have enough and well controlled studies in human. [5]

vaccine for lyme disease (human)
Image source : lymediseaseguide.org

References

  • http://www.cdc.gov/lyme/
  • http://www.mayoclinic.com/health/lyme-disease/DS00116/DSECTION=tests-and-diagnosis
  • http://www.aldf.com/deerTickEcology.shtml
  • http://lymediseaseguide.org/what-is-lyme-disease
  • http://www.medscape.com/resource/lyme-disease

Published on by under Diseases and Conditions.
Article was last reviewed on September 4th, 2016.



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