The North American Lyme disease is a zoonotic tick-borne illness resulting from the spirochete bacteria infection called B. burgdorferi sensu stricto (s.s) that belongs to the Borrelia genus. However, American Lyme disease infectious bacteria differs from B. afzellii and B. garinii species that cause the European borreliosis. In fact, this disease has a massive impact on humans and animals since it’s invasive and persistent.
Where is Lyme disease (LD) mostly common?
- US: - Mostly in the north-eastern states from Maine to Virginia
-Minnesota
-Michigan
-Wisconsin
-Northern California
-Oregon - Some Europe parts
- Japan
- China
Lyme disease Symptoms:
- Headache
- Skin rash (erythema migrans)
- Fever
- Fatigue
- Chills
- Lymph nodes swelling
Untreated Lyme disease symptoms:
Above all, if you have LD it’s important to treat it immediately. To clarify, the symptoms may reach a wider spectrum if the infection is ignored, starting with joints, and ending with cardiac and nervous complications. Hence, the symptoms are as follows:
- Arthritis associated with extreme joint pain (especially knees)
- Facial palsy
- Pain in muscles, bones, tendons, joints
- Heart palpitations (Lyme carditis)
- Painful nerves
- Neck stiffness
- Short breath
- Hands or feet tingling numbness
- Severe headaches
- Dizziness
- Rashes appear on different body areas not just at the tick bite site
- Brain and spinal cord inflammation
Mechanism of B. burgdorferi s.s infection:
The deer or black legged tick vector bites the human host, so the saliva containing the bacteria circulates in the blood stream. In addition, the infectious bacteria adapt to the host environment by undergoing remarkable gene expression adjustments. Thus, the bacteria lead to inflammation response in the host after multiplying and pervasion.
Stages of infection:
-Early localized: characterized by erythema migrans.
-Early disseminated: involves flu-like, cardiac and neurologic manifestations.
-Late disseminated: includes arthritis.
How to prevent tick-borne Lyme disease?
- Using pesticides
- Handle with Insect repellent
- Get rid or clean areas that works as a home for ticks
- Immediately remove any tick that comes in contact
Diagnosis:
Without doubt, the diagnosis of Lyme disease is done by checking the patient’s symptoms, previous exposure to ticks and laboratory analysis. Indeed, laboratory testing is basically IgG and IgM testing. As a matter of fact, IgM testing is done as a 2-step protocol, where patient’s showing symptoms are tested by IgM chemiluminescent immunoassay (CLIA) and confirmed if positive with IgM immunoblotting. Moreover, LD arthritis is tested by a rheumatologist.
Treatment of Lyme disease:
Antibiotics prevent complications if taken during early infection stage. In case of joint pain, ceftriaxone and doxycycline are effective. Also, antibiotics helps arthritis in about 90% of patients. However, the other 10% if not treated by a second course, treatment is done by anti-inflammatory drugs or arthroscopic synovectomy.
References:
-Bush LM, Vazquez-Pertejo MT. Tick borne illness-Lyme disease. Dis Mon. 2018;64(5):195-212. doi: 10.1016/j.disamonth.2018.01.007
-Coburn J, Garcia B, Hu LT, et al. Lyme Disease Pathogenesis. Curr Issues Mol Biol. 2021; 42:473-518. doi:10.21775/cimb.042.473
-Przytuła L, Gińdzieńska-Sieśkiewicz E, Sierakowski S. Diagnostyka i leczenie boreliozowego zapalenia stawów [Diagnosis and treatment of Lyme arthritis]. Przegl Epidemiol. 2006;60 Suppl 1:125-130.
