Other Names

Borreliosis

What is Lyme disease?

Lyme disease is an inflammatory disease, caused by bacteria called Boriella burgdorferi. This bacterial infection causes joint inflammation, fever, headache, rashes and other flu-like symptoms.

Causes, Incidence and Risk Factors

Lyme disease is spread by the bite of a tick, belonging to the genus Ixodes (deer tick). Lyme disease owes its name to Lyme, Connecticut, USA where Ixodes ticks are found in abundance. The chances of contracting Lyme disease, after a tick bite, are slim. This is because a tick must be attached to the body for 36-48 hours, before the infectious bacteria are transmitted. However for those affected, the disease can have significant and even catastrophic results. Thankfully, if Lyme disease is diagnosed early, it can be treated effectively with antibiotics.

Nearly 20,000 cases of Lyme disease are reported each year. If left untreated the disease progresses through three stages.

The three stages of Lyme disease are:

• Primary Lyme disease - Infected individuals notice the first signs of infection. Flu-like symptoms are present including rashes, fever, headache, lethargy, muscle and joint aches. In this stage, there may still be evidence of a tick bite, which looks like a red, raised, bulls-eye shaped lesion.
  
  
• Secondary Lyme disease, also known as early disseminated Lyme disease, is a progression of the disease to include neurological (blurred vision) and cardiac difficulties. If left untreated, many people show signs of cardiac irregularities on ECG, some even experience heart failure.
  
  
• Tertiary Lyme disease, also known as chronic persistent Lyme disease, includes additional neurological, skin and joint complications. Joint inflammation with chronic arthritis can be continuous and debilitating. At this stage treatments may fail to resolve the condition.

Signs and Symptoms

Visit your family doctor if you find:

• A reddened, non-itching area at the site of a tick bite, that increases in size over a period of time., and is followed by a central clearing of redness resembling the archer's bull's eye.
• Fever, chills, fatigue
• Muscle pain
• Sensitivity to light, headache and neck-stiffness
• Sleepiness, memory and mood problems
• Joint pain, lasting for months or years at a time not relieved by medication

Screening and Diagnosis

A definitive test for Lyme disease is not available and routine tests with body fluids and tissues are not reliable. Therefore, physicians must rely heavily on physical examination and history. A physician would be interested to know if an individual had spent time in the woods or deep grasses and would look for red, bull's-eye shaped lesions. Additionally, tests such as immunofluorescent assay and ELISA (Enzyme Linked ImmunoSorbant Assay) detect up to fifty percent of the infection in the initial stages.

An X-ray is taken to rule out any other causes of chronic joint pain.

Additional Consideration:

Presence of Lyme disease can give false positive results to tests done for Syphilis, which is a sexually -transmitted disease.

Treatment

Prompt and early treatment can prevent the more serious complications of Lyme disease. Treatment plans are similar to that of rheumatoid arthritis. A patient's response to treatment is variable from complete cure to mild remission.

• The most common treatment regimens include antibiotics like penicillin, cephalosporins, tetracyclines and metronidazole in heavier doses and longer periods than normally given for other diseases.
  
  
• Alternative treatments include Fever Therapy, which is one of the more popular naturopathic treatments. Fever therapy can be described as intentionally raising one's body temperature to approximately 101 degrees Fahrenheit in order to start the body's natural defense system (immune system), which will fight off any infectious disease. Usually, a hot bath is used to do this. It has produced promising results in cases of early infection - before the infection has peaked. Please contact a physician before using this treatment or any other alternative treatments.

Outlook

Most cases of Lyme disease are treated in the primary stage with antibiotics. These patients do not have any long term heath effects from the infection. Untreated Lyme disease can progress to early disseminated Lyme disease (secondary Lyme disease) and then, chronic persistent Lyme disease (tertiary Lyme disease). If left undiagnosed and untreated for a significant amount of time, Lyme disease can have enormous complications.

Complications:

• Joint deformity
• Heart diseases
• Neurological changes
• Skin conditions

Prevention

Lyme disease is transmitted by Ixodes tick bites (deer ticks). So take adequate precautions against tick bites while walking heavily wooded areas, deep grass, or even zoos. Wear protective gear such as a long-sleeved shirt, pants, and head and neck covering when trekking in the woods or walking through tall grasses. Pets that carry ticks can increase the risk of getting Lyme disease, so use caution when handling pet dogs. Seek your doctor's advice if you have any of the above symptoms or suspect you may have contracted Lyme disease.

References

1. Rahn,DW and Malawista, SE 1991. Lyme disease, Ann Intern Med, 114, 472