The Infectious Agent: B Burgdorferi
In 1982, Burgdorfer and colleagues isolated the infectious agent that causes Lyme disease that now bears his name: Borrelia burgdorferi . The genus Borrelia is a member of the family Spirochaetacaea, also known as spirochetes, which are Gram-negative bacterium characterized by a wavelike body and flagella . Burgdorfer and colleagues collected and dissected hundreds of Ixodes ticks from Shelter Island, New York and found that most of them contained spirochetes, specifically in the mid gut region. They further characterized the spirochetes with dark field and electron microscopy. Finally, indirect immunofluorescence revealed that antibodies extracted from serum of Lyme disease-infected patients reacted positively with the spirochete, while serum from control patients did not thereby confirming the link between the tick-derived spirochete and Lyme disease. In the United States, Lyme disease is primarily caused by the spirochete Borrelia Burgdorferi sensu stricto. Other related genospecies of Borrelia such as B. garinii, and B. afzelii have been identified in Europe and Asia.
What Happens At Your Appointment
The GP will ask about your symptoms and consider any rash or recent tick bites you know about.
Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions and there’s not always an obvious rash.
2 types of blood test are available to help confirm or rule out Lyme disease. But these tests are not always accurate in the early stages of the disease.
You may need to be retested if you still have Lyme disease symptoms after a negative result.
How Is Lyme Disease Diagnosed
Lyme disease is difficult to diagnose because symptoms are not consistent and may mimic other conditions. The primary symptom is a rash, but it may not be present in up to 20% of cases.
Diagnosis for Lyme disease must be made by a healthcare provider experienced in recognizing Lyme disease. Diagnosis is usually based on symptoms and a history of a tick bite. Testing is generally done to confirm the diagnosis and rule out other conditions. This may need blood and other lab tests.
Research is underway to develop and improve methods for diagnosing Lyme disease.
The symptoms of Lyme disease may look like other medical conditions or problems. Always talk with your healthcare provider for a diagnosis.
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Ongoing Symptoms Of Lyme Disease
A few people who are diagnosed and treated for Lyme disease continue to have symptoms, like tiredness, aches and loss of energy, that can last for years.
These symptoms are often compared to fibromyalgia and chronic fatigue syndrome.
It’s not clear why this happens to some people and not others. This means there’s also no agreed treatment.
Speak to a doctor if your symptoms come back, or do not improve, after treatment with antibiotics.
The doctor may be able to offer you further support if needed, such as:
- referral for a care needs assessment
- telling your employer, school or higher education institution that you require a gradual return to activities
- communicating with children and families’ social care
Page last reviewed: 05 July 2021 Next review due: 05 July 2024
Can Lyme Disease Completely Be Cured
Taking oral antibiotics typically cures Lyme disease after two to four weeks. You may need to get antibiotics through the vein for four more weeks. However, theres no reason to think that Lyme disease stays in you forever after treatment.
A note from Cleveland Clinic
If youre going to spend time in an area that might have ticks, take measures to avoid being bitten. This includes wearing long-sleeved shirts and pants to make it harder for ticks to bite. If you feel sick after being in an area that probably has ticks, make an appointment with your healthcare provider. If your provider prescribes antibiotics, make sure you take all of them as instructed.
Last reviewed by a Cleveland Clinic medical professional on 08/16/2022.
References
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Signs And Symptoms Of Untreated Lyme Disease
Seek medical attention if you observe any of these symptoms and have had a tick bite, live in an area known for Lyme disease, or have recently traveled to an area where Lyme disease occurs.
Untreated Lyme disease can produce a wide range of symptoms, depending on the stage of infection. These include fever, rash, facial paralysis, and arthritis.
The appearance of the erythema migrans rash can vary widely.
- Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash
- Erythema migrans rash :
- Occurs in approximately 70 to 80 percent of infected persons
- Begins at the site of a tick bite after a delay of 3 to 30 days
- Expands gradually over several days reaching up to 12 inches or more across
- May feel warm to the touch but is rarely itchy or painful
- Sometimes clears as it enlarges, resulting in a target or bulls-eye appearance
- May appear on any area of the body
- Does not always appear as a classic erythema migrans rash
Swollen Knee
- Severe headaches and neck stiffness
- Additional EM rashes on other areas of the body
- Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
- Intermittent pain in tendons, muscles, joints, and bones
- Heart palpitations or an irregular heart beat
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
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The Chance Of Getting Lyme Disease
Not all ticks in England carry the bacteria that causes Lyme disease.
But it’s still important to be aware of ticks and to safely remove them as soon as possible, just in case.
Ticks that may cause Lyme disease are found all over the UK, but high-risk places include grassy and wooded areas in southern and northern England and the Scottish Highlands.
SINCLAIR STAMMERS/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/263611/view
Ticks are tiny spider-like creatures that live in woods, areas with long grass, and sometimes in urban parks and gardens. They’re found all over the UK.
Ticks do not jump or fly. They attach to the skin of animals or humans that brush past them.
Once a tick bites into the skin, it feeds on blood for a few days before dropping off.
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The History Of Lyme Disease
Lyme disease gets its name from the town in Connecticut where symptoms of the disease were documented and studied in the 1970s. However, this is only one small part of the story of Lyme disease in the U.S. and beyond. In this article, learn about the history of Lyme disease, from pre-historic times to todays increase in cases due to climate change and other factors.
How Is Lyme Disease Spread
Lyme disease is spread by the bite of an infected black-legged tick. The tick usually must be attached to a person for at least 24 hours before it can spread the germ. Black-legged ticks in Massachusetts can also carry the germs that cause babesiosis and human granulocytic anaplasmosis). These ticks are capable of spreading more than one type of germ in a single bite.
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Preventing Tick Bites And Lyme Disease
There’s currently no Lyme disease vaccine available for humans. However, there are clinical trials taking place in Europe and the U.S.
The best way to protect yourself from tick-borne diseases is to prevent tick bites. Check your provincial public health authority to find out where infected ticks are most likely to be found.
- Wear light coloured, long-sleeved shirts and pants to spot ticks easily.
- Tuck your shirt into your pants, and your pants into your socks.
- Wear closed-toe shoes.
- Apply insect repellent containing DEET or Icaridin to clothing and exposed skin .
- Wear permethrin-treated clothing .
- Walk on cleared paths or trails.
- Keep children and pets from wandering off paths.
- Avoid using trails created by animals , as ticks are often found on the grass and plants along these trails.
Do a check for ticks on yourself and your:
- Outdoor gear, such as backpacks
- Shower or bathe as soon as possible, as it can help you find unattached ticks. If you don’t shower or bathe, do a full-body tick check on yourself and your children.
- If you find an attached tick, remove it as soon as possible.
- To kill unattached ticks on your clothing, put dry clothes in a dryer on high heat for at least 10 minutes. If your clothes are damp, you may need to dry them for longer.
- If you wash your clothes, use hot water and dry on high heat. Ticks can survive a cold/warm wash cycle.
Lyme Disease Frequently Asked Questions
If you have not done so already, remove the tick with fine-tipped tweezers.
The chances that you might get Lyme disease from a single tick bite depend on the type of tick, where you acquired it, and how long it was attached to you. Many types of ticks bite people in the U.S., but only blacklegged ticks transmit the bacteria that cause Lyme disease. Furthermore, only blacklegged ticks in thehighly endemic areas of the northeastern and north central U.S. are commonly infected. Finally, blacklegged ticks need to be attached for at least 24 hours before they can transmit Lyme disease. This is why its so important to remove them promptly and to check your body daily for ticks if you live in an endemic area.
If you develop illness within a few weeks of a tick bite, see your health care provider right away. Common symptoms of Lyme disease include a rash, fever, body aches, facial paralysis, and arthritis. Ticks can also transmit other diseases, so its important to be alert for any illness that follows a tick bite.
References:
Moody KD, Barthold SW, 1991. Relative infectivity of Borrelia burgdorferi in Lewis rats by various routes of inoculation.Am J Trop Med Hyg 44: 135-9.
There are no reports of Lyme disease being spread to infants through breast milk. If you are diagnosed with Lyme disease and are also breastfeeding, make sure that your doctor knows this so that he or she can prescribe an antibiotic thats safe for use when breastfeeding.
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When Should I Call The Doctor
If a tick bites you, call your doctor. Other conditions can cause similar symptoms, so it’s always a good idea to discuss them with your doctor. That way you can get checked and treated, if needed. Call right away if you get a red-ringed rash, lasting flu-like symptoms, joint pain or a swollen joint, or facial paralysis.
Lyme Disease Continues To Expand
The rate of Lyme disease spread has been slow compared to mosquito-borne West Nile virus, yet the current epidemic of Lyme disease is steadily increasing. It is estimated to be spreading 30 kilometers per year.
There has been little effort to try to limit the geographic spread of infected ticks. Most control efforts have been focused on managing tick populations where they are already established. Efforts have so far have included areainsecticide application, bait stations to treat mice or deer with insecticide and vaccinating mice against the bacterium. All of these methods have had limited success in reducing Lyme disease risk, but none have been employed to limit spread.
From an ecology perspective, the question is not why there are so many ticks, but why arent there more. At least 90% of each tick stage disappears over a single generation and we do not understand what happens to them. How many starve to death before finding a host? How many find hosts, but get removed by grooming before they can feed? How many are eaten by other animals or die from parasites? How does weather affect mortality?
Basic research on tick ecology pales in comparison to that conducted on the bacterium and patients. If we knew what limits tick population growth in nature, we might have better insight on how to manage their spread. For now, Lyme disease will continue to expand unabated.
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Did Lyme Disease Originate In The Eastern Us From Borrelia Burgdorferi
The Plum Island Animal Disease Center , that is now managed by the U.S. Department of Agriculture, is dedicated to research on plant and large animal diseases likely to have a significant economic impact on the livestock and agricultural industries. Because of its isolation from the main land mass and stringent containment facilities, it is ideally suited for such work. In 1952, it was managed by the U.S. Army Chemical Corps as a component of its biological warfare program. However, when that program was abolished by a Presidential directive in 1969, it was transferred to the U.S. Department of Agriculture for its present use.
Although the per capita incidence of Lyme disease in the Northeastern United States is more than twice that in the Midwestern United States, the prevalence of B. burgdorferiin the tick vector is nearly identical in both regions. The disparity in the incidence of disease did not appear to be due to a disparity in human invasiveness since a genetic analysis revealed that B. burgdorferi population in the Northeast and Midwest shard a recent common ancestor. This suggests that substantial evolutionary divergence in human invasiveness has not occurred and that the disparity in the incidence of disease between the two regions may be due to animal ecology or human behavior .
Finally, the prehistoric remains of The Ice Manmore than 5,000 years old provide positive evidence of infection by Borrelia burgdorferi .
ABOUT US
No Forests No Deer No Lyme
Lyme disease has existed in North America and Europe for a long time and must have affected American Indians and early colonists. But only recently has it become epidemic.
One reason Lyme disease may have remained obscure in the United States for so long before beginning to spread in the late 20th century had to do with the extensive deforestation to create farmland that began after colonists arrived in North America. With the loss of forests, deer disappeared from most of the Northeast. The only known populations in the Northeast were in the Adirondacks and on Long Island. Without deer, deer ticks, also known as black-legged ticks, were rare, and the bacterium that causes Lyme disease was contained in isolated tick populations, primarily in northern Wisconsin and on Long Island.
That changed when deer were reintroduced for hunting in the Northeast during the early 1900s and began to repopulate new forests.
The infected deer ticks on Long Island were only about six miles from Lyme, Connecticut, separated by Long Island Sound. Once they reached the mainland deer have been seen swimming in Long Island Sound the infected ticks were able to find an unending supply of reproductive hosts.
Scientists in the early 1980s identified the cause of Lyme disease as a previously unrecognized bacterium, Borrelia burgdorferi, carried by deer ticks and transmitted to humans through their bite.
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Key Points To Remember
- Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
- Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
- Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
- Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
- Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.
What Is Cdc Doing
CDC is currently conducting research to understand what concerns healthcare providers and the public may have about any potential Lyme disease vaccines. Once a Lyme disease vaccine is approved as safe and effective by the Food and Drug Administration , CDC will work with the Advisory Committee on Immunization Practices to develop recommendations about where in the U.S. the public might benefit from a Lyme disease vaccine. CDC will communicate these recommendations to increase awareness of a vaccine among the public and clinicians to prevent Lyme disease in the United States.
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How Do I Remove A Tick
You should know how to remove a tick just in case one lands on you or a friend. To be safe, remove the tick as soon as possible.
If you find a tick:
- Use tweezers to grasp the tick firmly at its head or mouth, next to your skin.
- Pull firmly and steadily on the tick until it lets go of the skin. If part of the tick stays in your skin, don’t worry. It will eventually come out. But call your doctor if you notice any irritation in the area or symptoms of Lyme disease.
- Swab the bite site with alcohol.
Note: Don’t use petroleum jelly or a lit match to kill a tick. They won’t get the tick off your skin quickly enough, and may just cause it to burrow deeper into your skin.
What Is Lyme Disease
Lyme disease is an infection caused by the bacteria Borrelia burgdorferi. This spiral shaped bacterium is most commonly spread by a tick bite. The disease takes its name from Lyme, Connecticut. This is where the illness was first identified in the United States in 1975.
Although Lyme disease is a year-round problem, April through October is considered tick season. Cases of Lyme disease have been reported in nearly all states in the U.S. and in large areas in Europe and Asia, but the most common areas are the Northeast, upper Midwest and northwestern states.
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