Lyme disease is disease transmitted by the deer tick also known as the black legged tick. It is caused by an infection called Borrelia Burgdorferi which is a type of bacterium called a spirochete. The deer tick can transmit the spirochetes to humans and other animals causing them to become infected with Lyme disease. Lyme disease first begins as a multi system inflammatory disease which first attacks the skin in the localized stage, then spreads to the joints the nervous system and other organ systems. If the Lyme disease is diagnosed early it can be treated with antibiotics, but it does depend on the progression of the diseases among the patient. Often the tick must be attached to your body for 24 – 36 hours to spread the bacteria to your blood. The spirochete is injected from the victim’s skin into the bloodstream establishing itself in various body tissues.
After an incubation period of 3 to 32 days, the organism migrates outward in the skin, is spread through the lymphatic system or is disseminated by the blood to different body organs or other skin sites. Lyme disease was first described in 1909 in European medical journals. The first outbreak in the United States occurred in the early 1970’s in Old Lyme, Connecticut. An unusually high incidence of juvenile arthritis in the area led scientists to investigate and identify the disorder. In 1981, Dr. Willy Burgdorfer identified the bacterial spirochete organism (Borrelia Burgdorferi) which causes this disorder.
Lyme disease is known to be the number one arthropod disease is the United States occurring in 48 of the 50 states and up to 12,000 cases of Lyme disease diagnosed annually. Lyme disease is has three stages which are early localized disease with skin inflammation, early disseminated disease with heart and nervous system involvement, including palsies and meningitis, and the last stage of the disease called later disseminated which causes motor and sensory nerve damage and brain inflammation as well arthritis.
The first stage is called Localized Lyme disease and in this early phase of the illness, within days to weeks of the tick bite, the skin around the bite develops an expanding ring of unraised redness. There may be an outer ring of brighter redness and a central area of clearing, leading to a “bull’s-eye” appearance, the rash also has a warm to touch feeling .The first rash seen on the patient is called erythema migrans. The redness of the skin is often accompanied by flu-like symptoms which may include fever, chills, fatigue, muscle and joint pain, swollen lymph nodes and headache. Sometimes these more serious symptoms develop without the person ever having had a rash. The redness resolves, without treatment, in about a month. Weeks to months after the initial redness of the skin, the bacteria spread throughout the body and can begin affecting the joints, heart, and nervous system. The later phases of Lyme disease can affect the heart, and cause inflammation of the heart muscle.
This can result in abnormal heart rhythms and heart failure. The nervous system can develop facial muscle paralysis also known as Bell’s palsy, abnormal sensation due to disease of peripheral nerves which is also known as peripheral neuropathy, meningitis, and confusion. Arthritis, or inflammation in the joints, begins with swelling, stiffness, and pain. Usually, only one or a few joints become affected, most commonly the knees. The arthritis of Lyme disease can look like many other types of inflammatory arthritis and can become chronic. Lyme disease occurs in wooded areas with populations of mice and deer which carry ticks, and can be contracted during any season of the year.
The medication used for adults with Lyme disease the antibiotic tetracycline is the drug of choice. Penicillin V and erythromycin have also been used in children. Penicillin V is now recommended for neurological abnormalities. It is not yet clear whether antibiotic treatment is helpful later in the illness when arthritis is the most predominant symptom. Treatment should be started as soon as the rash appears. A clear diagnosis of Lyme disease can be tricky, and often relies on information the patient and through process of elimination the Doctor will be able to out rule other conditions.
Lyme disease and its symptoms often mimic many other diseases which target multi body systems such as Chronic Fatigue Syndrome and Multiple Sclerosis. Doctors will perform a specific blood test called Enzyme Linked Immunoabsorbent Assay (ELISA) which can detect antibodies present of Lyme disease. Results of this test may be inaccurate if patients have had antibiotics soon after contracting Lyme disease, or in those who have weakened immune systems.
1.American Lyme disease foundation. (2006, April). Retrieved from http://www.aldf.com/lyme.shtml 2.American College of Physicians. (2012). Lyme disease- A patients guide. Retrieved from