- Diseases, Disorders & Conditions
Lyme Disease - Pictures, Symptoms, Treatment, Causes, Contagious
What is Lyme Disease?
Lyme disease is a vector borne and systemic infection transmitted to the body through a bite from deer ticks. This bacterial illness is the most common and evenly distributed bacterial infection in the United States. Lyme disease initially starts in the skin and can later on result to aberration in the heart, central nervous system, joints and eyes after the causative agent has reached the bloodstream and into the circulation.
Lyme disease was first recognized by Dr. Allen Steere in 1975 during the outbreak of what was then thought to be juvenile rheumatoid arthritis in three towns in Lyme, Connecticut. William Burgdofer, through his study, discovered the causative agent of the disease when he isolated a spirochete from the mid gut of a tick called Ixodes. The etiologic agent was discovered by Burgdofer in 1982 and report of the disease from the same vector has dramatically increased.
Prognosis is excellent for early stage of Lyme disease as early phase is curable. Later stage and severe case of the disease however, has a complicated prognosis especially when patient is unresponsive to antibiotic treatment and immune response is suppressed.
Lyme disease is prevalent in North America, Europe and Africa or in temperate regions and with incidence of the disease is dependent on the distribution of the vector. The incidence is most common during the months between May and November with incidence reaching its peak during the months of June and July. Both male and female in all age levels including children can get infected with this bacterial disease.
Manifestation of Lyme disease varies while the disease is progressing. The infection is inoculated in the skin from the bite site with the infection spreading away from the initial bite of the tick.
The signs and symptoms of Lyme disease are medically divided into three phases and each with varying degree of manifestations.
Early localized infection is an isolated erythema localized to site of tick bite with infection that has not yet spread through the entire body and onset of infection is within a month from initial bite.
- Rash initially appears on the site of bite characterized with red expanded ring. Bright red outer ring may also develop forming a “bull’s-eye” appearance. The rash formed is called an erythema migrans and is the main feature of Lyme disease.
- Flu like symptom is also manifested such as chills, fever, fatigue, headache and body ache.
Early disseminated infection involves the heart and nervous system and with onset of few weeks to few months following initial infection. The bacteria during this stage may have reached and spread in the bloodstream.
- Erythema migrans develop across the body insignificant to the initial bite site
- Joint pain that is severe and is usually located in the knee and may radiate to any part of the body.
- Muscle ache and pain
- Heart palpitations
- Facial palsy on either one or both side of the face.
- Swelling of the membranes of the brain characterized by symptoms of neck stiffness and severe headache with sensitivity to light.
Late or Chronic Lyme disease occurs within a few months or few years with recurrence after latency and involves damage o motor and sensory nerves and includes inflammation of the brain and arthritis. Infection during this stage has spread all over the body with manifestations that are disabling and permanent paralysis.
- Onset of Bannwarth syndrome or nerve pain that is emanating from spine
- Hands or feet may develop shooting pains and numbness
- Motor impairment such as leg weakness and gait impairment
- Bladder control impairment
- Fatigue and depression
- Arthritis of joint especially in the knees.
Lyme disease is an infection from a spirochete in genus Borrelia known as Borrelia burgdorferi transmitted by a bite from a tick found commonly on Ixodes dammini.
Borrelia burgdorferi was first isolated from mid-gut of Ixodes and discovered by Willy Burgdorferi in 1982. Borrelia burgdorferi is a spirochete that harbors in the intestinal tract of animals and can also be found in the human oral cavity. This spirochete moves in viscous environment through rotation of their filament. Spirochete has width that is below the resolving power of light microscope and they are much longer rather than wide. They cannot be identified with the use of conventional microscope and can only be seen with the use of dark-field microscopy. Borrelia burgdorferi is commonly found in the United States and making up for most cases of Lyme disease.
Borrelia garinii is another strain from genus Borrelia that can cause Lyme disease and can only be found in Europe. This spirochete accounts for most cases of Bannworth syndrome associated in Lyme disease including white matter encephalitis. Another strain that can only be found and cause Lyme disease in Europe is Borrelia afzelii.
The main vector for spirochete Borrelia burgdorferi is Ixodes scapularis or dammini. Ixodes carries a tick that is hard-bodied and no bigger than the head of a pin that it is impossible for this tick to be seen easily. It is during the nyhmpal stage of the deer tick that carries the spirochete and infects humans and their bites are even harder to see owing to their size of smaller than the pinhead.
Lyme disease is not easily diagnosed as the deer tick can also spread other type of disease with signs and symptoms similar to that of Lyme disease. Doctors initially take note of the medical history of the patient and especially take into consideration the previous whereabouts of the patient prior to the infection especially with the suspicion of Lyme disease.
Diagnosis of Lyme disease on the other hand is clinically based on objective physical exams and findings, blood tests and confirmation of exposure to vectors of deer tick. It is the serological blood test however, that is commonly utilized in identifying and confirming infection from spirochete of genus Borrelia.
ELISA or enzyme-linked immunosorbent assay is the first protocol for identifying Lyme disease in detecting Borrelia burgdorferi and other strains of Borrelia.
Western blot test is the next step in identifying Lyme disease when prior ELISA test is positive of Borrelia burgdorferi. This test is done to further confirm diagnosis of Lyme disease.
Lyme disease is commonly treated with antibiotics and the type of antibiotics given depends on the stage of the disease and the response and condition of the patient towards the treatment. Oral antibiotics are given during the early stage of the disease both in children and adults and given a course of 14 to 21 days treatment with antibiotics. Intravenous antibiotics are given when the disease has already involved the central nervous system and is given for 14 to 28 days although recovery from symptoms may take some time.
Is Lyme disease Contagious?
Lyme disease is not contagious nor can it be transmitted from person to person. The transmission of the disease is from vector to humans. The disease can only be transmitted once the deer tick in nymphal stage carrying the spirochete injects its saliva to human skin once human is bitten. The bacteria will then spread to distant area from original site of bite and eventually invade the bloodstream. Transmission of infection takes place with the deer tick attached to the skin for a period of 36 to 48 hours.