What is Lyme disease?

-Lyme disease is a bacterial infection, caused by the  bacterium Borrelia Burgdorferi

-It is transmitted to humans through the bite of an infected blacklegged tick 

  • Borrelia Burgdorferi (B. Burgdorferi) is a spiral-shaped bacterium or what’s called a spirochete
  • Lyme disease was first discovered in Connecticut in 1975, when a cluster of children and adults, living in the Lyme, CT area began experiencing uncommon arthritic symptoms; thus how Lyme disease got is name
  • It wasn’t until 1981 when the bacterium B. burgdorferi was identified by  Willy Burgdorfer

*B. Burgdorferi is one of the few bacteria that can survive without iron

– Lyme Disease Bacterium Switches Out Iron For Manganese To Evade Immune System

*Lyme disease is the most common vector-borne disease in America

  • Vector- any agent (person, animal or microorganism) that carries and transmits an infectious pathogen (in this case being Lyme disease) into another living organism (ex. Tick transmits the disease to humans or other animals, such as field mice)
*Lyme disease and tick-borne illnesses remain controversial issues in the United States and throughout the world*

–  In 2008 there were 35,198 reported cases, almost double the number from just two years ago.

– The Centers for Disease Control and Prevention (CDC) estimates that the actual numbers may be 6-12 times higher than the reported numbers, or up to 420,000 new cases per year—more than ten times higher than the number of cases of AIDS and West Nile virus combined.

– In August 2013, the CDC finally announced that the number of Lyme disease cases each year are up to 12 times more than originally thought; there are over 300,000 new cases per year

*Lyme disease is only one of many tick-borne diseases!
Other tick-borne diseases/illnesses include:
  • Anaplasmosis
  • Babesiosis
  • Bartonella (Note: The CDC states, “Ticks may carry some species of Bartonella bacteria, but there is currently no convincing evidence that ticks can transmit Bartonella infection to humans.”
  • Ehrlichiosis
  • Powassan (POW) Virus Disease 
  • Rickettsia parkeri Rickettsiosis
  • Rocky Mountain Spotted Fever (RMSF)
  • Southern Tick-Associated Rash Illness (STARI)
  • Tick-borne relapsing fever (TBRF)
  • Tularemia
  • 364D Rickettsiosis

Tick-borne Diseases Abroad

Types of Ticks in the U.S.

Types of Ticks in the U.S. (Images from the CDC)

* Some doctors and researchers believe that Lyme can be transmitted other ways, but there have not been any (human) studies performed to prove this.

* It is possible for an infected pregnant woman to pass the disease to their unborn child.

*It has been reported that Babesiosis has been transmitted to humans through blood transfusions.

 

Signs & Symptoms /The 3 Stages of Lyme

Signs and Symptoms of Lyme Disease

  • There are many, many signs and symptoms of Lyme disease
  • Symptoms can occur during any stage of the disease
  • They often vary between person to person
  • Lyme disease is often overlooked and/or misdiagnosed
  • Lyme disease mimics many other illnesses
  • Some symptoms may overlap and occur in different combinations

Early Localized Stage

(3-30 days post-tick bite)

– During this stage, some individuals do not experience any symptoms or overlook symptoms

– Many people may think they have a virus, most commonly, the flu

Symptoms may include:

  • Fever
  • Chills
  • Headache
  • Muscle and joint aches/pains
  • Swollen lymph nodes
  • Small bump or redness at site of tick bite (Not to be confused with insect bites such as a mosquito or spider bite)
  • Erythema Migrans (EM) or “bulls-eye rash”
The "bulls-eye" rash

The “bulls-eye” rash (Info/Image from the CDC)

  • Contrary to popular belief, only 35-59% Lyme patients present with a bulls-eye rash, the flat or slightly raised red circular rash at the site of the tick bite.
  • If you do not have a “bulls-eye rash” you still may have Lyme disease and/or other tick-borne diseases!

Early disseminated stage 

(Days to weeks post-tick bite)

– Infection speads to other parts of the body (From the tick bite site- if left untreated)

– Symptoms may occur sporadically and may come & go

Some of these symptoms are experience (but are not limited to):

  • Additional EM lesions (bulls-eye rashes) in other areas of the body
  • Bell’s palsy (loss of muscle tone on one or both sides of the face)
  • Severe headaches
  • Neck stiffness
  • Meningitis (inflammation of the tissue around brain/spinal cord)
  • Pain and swelling of muscles and joints
  • Shooting pain (often experienced in arms and legs)
  • Trouble sleeping
  • Fatigue
  • Dizziness
  • Heart palpitations

Late Disseminated Stage 

(Weeks, Months or Years Post-Tick Bite)

– There are over one hundred symptoms patients can experience during late disseminated stage (often referred to as “Late Stage Lyme”

– Lyme is often called the “great imitator” like its cousin, syphilis- this is why it is commonly overlooked or misdiagnosed

 – It can be mistaken for illnesses such as, Multiple Sclerosis (MS), ALS, influenza, arthritis and many others

 – Lyme disease is also believed that Lyme can cause illnesses (such as these) over time if left untreated

Signs and Symptoms can include (but are not limited to):

  • Arthritis (intermittent periods of pain & swelling in one or more larger joints; commonly it affects the knees)
  • Joint and muscle aches & stiffness
  • Headaches
  • Migraines
  • Irregular heart rhythm and/or other cardiac issues
  • Memory loss
  • Cognitive impairment
  • Trouble concentrating
  • Fatigue
  • Sleep disturbances (Excessive Daytime Sleepiness (EDS), insomnia, etc.)
  • Bell’s palsy
  • Fibromyalgia
  • Meningitis
  • Hearing loss
  • Vision loss and other vision impairments
  • Depression
  • Anxiety
  • Irritability
  • Other mental health illnesses/symptoms
  • Distal paresthesia
  • Sensory loss
  • Spinal or radicular pain
  • Tingling, burning and/or shooting pains
  • Light and/or sound sensativity
  • Abdominal pain
  • Nausea/vomiting
  • Diarrhea
  • Chest pain, palpitations
  • Shortness of breath
  • Nervous System complications
  • Other neurological symptoms

– Currently the CDC states that “Chronic Lyme Disease” does not exist- they do acknowledge the existence of Post- Treatment Lyme Disease Syndrome (PTLDS)

– However, other countries, such as Germany, acknowledge the existence of Chronic Lyme Disease and have guidelines as to how it should be treated (Diagnosis and Treatment of Lyme Borreliosis: Guidelines)

– Personally, I think it’s only a matter of time before the U.S. recognizes Chronic Lyme disease

 

Testing for Lyme disease and other tick-borne illnesses

  • Enzyme-linked immunosorbent assay (ELISA) test. The test used most often to detect Lyme disease, ELISA detects antibodies to B. burgdorferi. But because it can sometimes provide false-positive results, it’s not used as the sole basis for diagnosis. This test may not be positive during the early stage of Lyme disease, but the rash is distinctive enough to make the diagnosis without further testing in people who live in areas infested with ticks that transmit Lyme disease.
  • Western blot test. If the ELISA test is positive, another test — the Western blot — is usually done to confirm the diagnosis. In this two-step approach, the Western blot detects antibodies to several proteins of B. burgdorferi.
  • Polymerase chain reaction (PCR). This test helps detect bacterial DNA in fluid drawn from an infected joint. It’s not as effective at detecting infection of blood or urine. It’s used for people who may have chronic Lyme arthritis. It may also be used to detect persistent infection in the cerebrospinal fluid of people who have nervous system symptoms.

 

– Most doctors (and usually what insurance companies will cover) will order blood to be drawn- specifically the Western Blot & ELISA- but there are others

– There is still ongoing debates on whether or not these tests are accurate

– People will often spend the money out of pocket for more accurate testing to be done by a lab in California (IgeneX); they not only test for Lyme but other co-infections (but they do not test for RMSF); testing can cost up to/over $1,000!

– This lab can also store your blood for a couple of years, so if you think you are re-infected, they can run your old blood at the same time as your new blood work (it is said to be the most accurate way of telling if you have Lyme)

“Understanding the Western Blot”

“Western Blots- What do all those darn bands mean???”

 

Prevention:

Top Ten Things Everyone Should Know About Ticks These Days

  1. Ticks crawl up
  2. All ticks (including deer ticks) come in small, medium and large sizes
  3. Ticks can be active even in the winter
  4. Ticks carry disease-causing microbes
  5. Only deer ticks transmit Lyme disease bacteria
  6. For most tick-borne diseases, you have at least 24 hours to find and remove a feeding tick before it transmits an infection (this, in my opinion, is one of many things not everyone agrees on)
  7. Deer tick nymphs look like a poppy seed on your skin
  8. The easiest and safest way to remove a tick is with a pointy tweezer
  9. Clothing with built-in tick repellent is best for preventing tick bites
  10. Tick bites and tick-borne diseases are completely preventable

Top Ten Tips To Prevent Chronic Lyme Disease

  1. Know that Lyme disease is a nationwide problem
  2. Check your tick facts
  3. Show your doctor every rash
  4. Don’t assume that you can’t have Lyme disease if you don’t have a rash
  5. Do not rely on test results
  6. Be aware of similar conditions
  7. Avoid taking a “Wait and See” approach to treatment
  8. Don’t be afraid to get a second opinion (or third or fourth!)
  9. Know your treatment options
  10. Expect success

Sources:

TickEncounter Resource Center

International Lyme And Associated Diseases Society (ILADS)

Under Our SkinDir.  Andy Abrahams Wilson. Open Eye Pictures, Inc., 2008. Documentary.

Connecticut Department of Public Health

Centers for Disease Control and Prevention

Mayo Clinic

German Borreliosis Society

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