Lymes disease Signs, Symptoms, diagnostic methods treatment and prevention.



Epidemiology and introduction to Lyme’s Disease


Lyme disease is a tick born disease caused by bacteria named Borrelia. These bacteria belong to the family of spirochete and the major causative agent for the Lyme’s disease is the Borrelia burgdorferi sensus stricto.
However, the bacteria vary according to the region. The bacteria which cause Lyme’s disease in U.S.A is Borrelia burgdorferi sensus strict, while of Europe is Borrelia burgdorferi sensus strict, Borrelia garinii and Borrelia afzelii. The Asian Lyme’s disease is caused by Borrelia garinii and Borrelia afzelii.

This disease is transmitted through a tick names Ixodes ticks (Ixodes Dammini & Ixodes Scapularis). The major endemic areas affected by Lyme’s disease are Northeastern coastal states, Wisconsin and Minnesota, Coast of Oregon and Northern California.


Mechanism of disease transmission

The Ixodes ticks get these bacteria from the rodents as of rats and the larva of these Ixodes ticks are infected from these bacteria. These larvas transform into Nymph stage where it spreads to human by biting them. This way the nymph of the Ixodes transmits the bacteria to humans.

Signs and Symptoms

In the early stages of Lyme disease, you may experience flu-like symptoms that can include a stiff neck, chills, fever, swollen lymph node, headaches, fatigue, muscle aches, and joint pain. You also may experience a large, expanding skin rash around the area of the tick bite named Erythema migrans.

However, the progression of the disease to the advanced stage can be characterised with the greater symptoms of
Frank Arthritis (most commonly affecting the knee with not more than 3 joints affected and the arthritis vanishes in the last several days of the disease),
Neurological symptoms (Unilateral or bilateral Bell’s (facial) palsy, paresis, Lyme meningitis, peripheral neuritis and mild encephalopathy),
Heart problems (arrhythmias’, transient heart block of first degree and so on).

Diagnostic Methods

Nevertheless, the diagnosis of this disease cannot be provided alone with physical findings but they need to be used in parallel with other advance diagnostic methods as of serological examination.

The serologic data by IFA, ELISA and immmunoblotting techniques shows thepresence of IgM or IgG antibodies in patient’s serum against Borrelia burgdorferi. These tests are insensitive during the first several weeks of infection. Western blot is the more accurate method and is used in 6-12 weeks after the infection to confirm the results.

The other method used in the diagnostic process is the direct isolation method. The biopsy of the skin lesions may yield the organism in 50% or more of cases.

Treatment

The main treatment plan for this Lyme disease is the full on full antibiotic therapy. Doxycycline and amoxicillin are used for two to four weeks in early cases. Cefuroxime or erythromycin can be used for patients who are allergic to penicillin or who cannot take tetracycline. More developed (advanced) cases, may require treatment with intravenous ceftriaxone or penicillin for 4 weeks or more.

Prevention

Wear long pants and sleeves.
Use insect repellents
Do your best to tick-proof your yard.
Check yourself, your children and your pets for ticks.
Do not assume you are immune.
Remove a tick with tweezers.
Vaccination. GlaxoSmithKline developed a recombinant vaccine (LYMErik) against Lyme disease, based on the outer surface protein A (OspA) of B. burgdorferi.