Lyme disease is caused by the bacterium known as Borrelia Burgforferi, it is transmitted to humans through the bite of an infected black-legged tick also known as the deer tick, its known distribution is worldwide, but is the most common tickborne infection in North America and Europe. The bacteria which is known as spirochetes for their corkscrew shape, it is one of the few bacteria that has learned to survive without iron, they rely on a supply of manganese for their survival. Whenever an infected tick begins to feed on the host, the spirochetes replicate in the midgut, then they migrate to the salivary glands of the tick and then released into the bloodstream of the host. Most humans get infected through the bites of immature ticks known as Nymphs; they are tiny less than two mm and they only feed during the spring and summer months. Adult ticks can transmit the disease, they are much larger than the Nymphs that they are likely to be discovered before the disease can be transmitted into your body. The CDC estimates that around 300,000 people are diagnosed with Lyme disease each year, however, it is tough to diagnose a patient with the Lyme disease. Lyme is also known as “The great imitator” because their symptoms mimic many other diseases, it can also affect any organ of the body including the brain and the nervous system. Symptoms of an early stage of Lyme may be presented as a flu-like illness, such as fever, chills, sweats, muscle aches.
Some patients even have a rash or Bell’s palsy which is facial drooping. But symptoms days to months after the tick bite become more severe such as arthritis, heart palpitations, nerve pain and problems with short-term memory. Most patients with Lyme are frequently misdiagnosed with fibromyalgia, multiple sclerosis, and various psychiatric illnesses, which includes depression.
There is two test used for the diagnosis of Lyme disease, the first test is Enzyme-linked immunosorbent assay (ELISA) and the Western blot test. The ELISA is a screening test used when Lyme is first suspected in a patient, this test measures the levels of antibodies against the Lyme bacteria. If the test results come back either positive or unclear, a second test is usually recommended and the test is known as the Western blot test.
The Western blot test is a second stage test to confirm a positive ELISA test. This also tests for the antibodies like the ELISA test does but it reports to the reactivity against a panel of ten different proteins found in the Lyme bacteria. The Center for Disease Control also known as the CDC states that five of the bands must come back positive for an overall positive western blot test result. Lyme specialist and scientist believe that there are five specific bands on the Western blot test that are indicative of the Lyme bacteria.
These bands include: twenty three, thirty one, thirty four, thirty nine and ninety three. If any of those five or even all of them come back positive and the patient is showing symptoms of Lyme, then they will feel that the treatment is warranted. There are three stages of Lyme disease a patient can be diagnosed with, Stage 1: early localized Lyme disease, Stage 2: early disseminated Lyme disease, and Stage 3: Late disseminated Lyme disease.
In Stage 1, The bacteria has yet to be spread through the body, this usually occurs three to thirty two days after you believe you have been bitten by an infected tick. The symptoms of this stage include erythema migrans, and 60 to 80% of patients exhibit this symptom seven to fourteen days after the bite. In many cases at this stage, it can be resolved without the use of antibiotics, but the use of the antibiotic therapy can reduce the chance of having long-term conditions such as permanent heart blockage. In Stage 2, the bacteria have begun to spread throughout the body, this stage occurs days, weeks and even months after the bite has occurred. Symptoms of stage two include erythema migrans, Bell’s palsy, heart complications and even severe muscle pain. Without treatment it can lead to long-term complications, these include, Lyme arthritis, brain and nervous system damage, sleep disorders and heart rhythm irregularities. If you’re suspected of having stage two Lyme, they may perform an electrocardiogram, spinal tap or even an MRI.
The standard treatment is a fourteen to twenty one day antibiotic treatment. The last stage of Lyme is Stage 3: It can cause long-term joint inflammation (lyme arthritis) and heart rhythm problems, and nervous system problem are also possible, The stage is characterized by; arthritis, brain disorders, mental fogginess, numbness in legs, arms, hands and feet. Treatment for this stage includes a twenty eight day oral antibiotic, if arthritis does not improve with the oral antibiotics, then intravenous antibiotic is recommended.Patients who are properly diagnosed with Lyme, will be treated with antibiotics whether it’s oral or intravenous.
The antibiotics commonly used are Doxycycline which is used for adults and children who are older the eight years old, and Amoxicillin or Cefuroxime used for adults, children under the age of eight, and pregnant or breastfeeding women. If a patient has a certain neurological or cardiac form of illness they may require the intravenous treatment, side effects of receiving the antibiotics by in this form include; having a lower blood cell count, sometimes mild to severe diarrhea, or even an infection with other antibiotic-resistant organisms unrelated to Lyme. After a patient has finished the treatment time for the stage they had been diagnosed with, sometimes Post Treatment Lyme Disease Syndrome (PTLDS) may start to occur. There is no exact cause of PTLDS, many doctors believe that the symptoms are a result of damage to the tissues and the immune system that would have happened during the infection in the bloodstream. The symptoms included are fatigue, pain or muscle aches at the end of their treatment. Only a small amount of the symptoms can last for more than six months. Patients with PTLDS almost always get better in time, only downside is that it can take months before they can completely feel well. There are many ways to prevent the chance of getting Lyme disease, avoid areas where deer ticks would live, areas like wooded and bushy areas with long grass.
Simple precautions to take to prevent the chance of Lyme is to cover up, use insect repellent with a 20% or higher concentration of DEET to the skin. If bitten by a tick and you notice it, remove the tick as soon as possible with tweezers. Once the tick has been removed entirely, dispose of it and apply antiseptic to the bitten area.