Treatment Of Lyme Disease
Early diagnosis and proper antibiotic treatment of Lyme disease is important and can help prevent late Lyme disease. The following treatment regimens reflect CDCs interpretation of the most current data for four important manifestations of Lyme disease. These regimens are consistent with guidanceexternal icon published by the by the Infectious Disease Society of America, American Academy of Neurology, and American College of Rheumatology.
Some patients report persistent symptoms of pain, fatigue, or difficulty thinking even after treatment for Lyme disease. The state of the science relating to persistent symptoms associated with Lyme disease is limited, emerging, and unsettled.
Additional researchexternal icon is needed to better understand how to treat, manage, and support people with persistent symptoms associated with Lyme disease. In light of these research gaps, recommendations for treatment of persistent symptoms in people previously treated for Lyme disease are not provided here.
If you are interested in information on chronic Lyme diseaseexternal icon, see NIHs website.
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Chronic Lyme Disease Vs Ptlds
The terms chronic Lyme disease and Post-Treatment Lyme Disease Syndrome are sometimes used interchangeably. However, PTLDS is slightly more restrictive, referring to patients who have received treatment for Lyme disease but go on to experience Lyme disease symptoms. It does not include those who received a misdiagnosis or delayed diagnosis and have developed chronic symptoms of Lyme disease before receiving any kind of treatment.
The CDC defines PTLDS as generalized and/or recurring pain, fatigue, and cognitive difficulties that last for more than 6 months after treatment. These mirror symptoms associated with chronic Lyme disease, with or without treatment.
How Is Lyme Disease Diagnosed
A healthcare provider will diagnose Lyme disease based on symptoms, physical findings and whether or not you’ve been in an area populated by infected ticks.
Many people dont remember or know that theyve been bitten by a tick. This is because the tick is tiny, and its bite is usually painless.
Your provider will confirm the diagnosis using a blood test. If your first blood test is negative for Lyme disease, you won’t need another test. If the first test is positive or equivocal, your provider will conduct the test again. You have to have two positive results to be diagnosed with Lyme disease.
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Chronic Lyme Disease Vs Acute And Late Stage Lyme
One reason chronic Lyme disease is harder to detect and treat than Lyme at earlier stages is that chronic Lyme disease symptoms are more wide-ranging and varied. Chronic Lyme disease can cause symptoms of early Lyme disease such as fatigue and muscle aches to recur, but it can also cause new symptoms that affect different parts of the body.
Azlocillin Comes Out On Top
The drug, which is not on the market, was tested in mouse models of Lyme disease at seven-day, 14-day and 21-day intervals and found to eliminate the infection. For the first time, azlocillin was also shown to be effective in killing drug-tolerant forms of B. burgdorferi in lab dishes, indicating that it may work as a therapy for lingering symptoms of Lyme disease.
Pothineni and Rajadas have patented the compound for the treatment of Lyme disease and are working with a company to develop an oral form of the drug. Researchers plan to conduct a clinical trial.
Rajadas is also a professor of bioengineering and therapeutic sciences at the University of California-San Francisco.
Other Stanford co-authors are Hari-Hara S. K. Potula, PhD, senior research scientist postdoctoral scholars Aditya Ambati, PhD, and Venkata Mallajosyula, PhD senior research scientist Mohammed Inayathullah, PhD and intern Mohamed Sohail Ahmed.
A researcher at Loyola College in India also contributed to the work.
The study was funded by the Bay Area Lyme Foundation and Laurel STEM Fund.
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Who’s At Risk Of Lyme Disease
The risk of getting Lyme disease is higher:
- for people who spend time in woodland or moorland areas
- from March to October because more people take part in outdoor activities
It’s thought only a small proportion of ticks carry the bacteria that cause Lyme disease. Being bitten doesn’t mean you’ll definitely be infected. However, it’s important to be aware of the risk and speak to a GP if you start to feel unwell.
Can Lyme Disease Be Prevented
Most people with Lyme disease get the infection during the late spring, summer and early fall when immature ticks are out feeding. In warm climates, few tick bites take place during winter months.
Deer ticks are most often found in wooded areas and nearby grasslands. Theyre especially common where the two areas merge, including neighborhood yards where deer occasionally roam. Ticks dont survive long on sunny lawns. They dry out quickly and die.
Although only about 1% of all deer ticks carry Lyme disease-causing bacteria, there are areas in which over 50% of the ticks carry the bacterium. The diseased ticks are often found in the U.S. Northeast and upper Midwest areas. Ticks also live in coastal areas.
Black-legged ticks can get the infection from animals other than deer. Mice, voles and some squirrels can carry the bacteria.
How can I prevent tick bites?
The following tips can help you avoid tick bites:
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How You Get Lyme Disease
If a tick bites an animal carrying the bacteria that cause Lyme disease, the tick can become infected. The tick can then transfer the bacteria to a human by biting them.
Ticks don’t jump or fly. They climb on to your clothes or skin if you brush against something they’re on. They then bite into the skin and start to feed on your blood.
Generally, you’re more likely to become infected if the tick is attached to your skin for more than 24 hours. Ticks are very small and their bites are not painful, so you may not realise you have one attached to your skin.
Transmission Of Bb Via Ixodes Spp Vectors
The black-legged ticks, Ixodes scapularis and Ixodes pacificus on the West Coast, are the primary vectors of Bb in the USA. In endemic areas, the proportion of Ixodes spp. ticks infected with Bb can be remarkably high. One recent survey of the pathogen burden of 197 Ixodes scapularis ticks collected from New York and Connecticut where LD is endemic, revealed 111 ticks were infected with Bb and 37 were co-infected with more than one human pathogen . The high pathogen burden is consistent with previous tick surveys in the same region . In contrast, the percent of infected ticks in other regions of the USA is much lower. In recently published surveys across California, for example, fewer than 5% of Ixodes spp. ticks were infected . Ixodes ticks sometimes carry multiple strains of Bb that may impact the course of disease in people that are co-infected. One tick survey showed that 39% of Ixodes ticks in North America are infected with multiple genotypes of Bb .
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Where Are Ticks Found
Ticks are found throughout the UK and in other parts of Europe and North America. There are a high number of ticks in the Scottish Highlands.
They can be found in any areas with deep or overgrown plants where they have access to animals to feed on.
They’re common in woodland and moorland areas, but can also be found in gardens or parks.
Treatment For Chronic Lyme Disease
Sometimes, people go through treatment for Lyme disease but their symptoms donât go away. If this lasts over 6 months, itâs known as chronic Lyme disease or âpost-treatment Lyme disease syndromeâ .
Doctors still arenât sure why some people get PTLDS. Some believe that getting Lyme disease may cause damage to your tissues or immune system. Others believe itâs because the bacteria that causes Lyme hasnât completely gone away.
There is little evidence that taking more antibiotics at this stage will help. They may actually be harmful. Instead, your doctor will focus on treating the symptoms youâre still having. This will be different for everyone. Some people could benefit from a medicine that relieves fatigue, while others may need a drug that can help with headaches or very sensitive skin.
Your doctor could also have you try a treatment that helps people with chronic fatigue syndrome or fibromyalgia.
More research is needed to figure out how best to treat PTLDS. Itâs something that can be frustrating. Just remember: Many people who have this condition do start feeling like their old selves after a few months.
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Hunting For Alternative Drug
Frustrated by the lack of treatment options for Lyme disease patients with lingering symptoms, Rajadas and his team began hunting for a better alternative in 2011. In 2016, they published a study in Drug Design, Development and Therapy that listed 20 chemical compounds, from about 4,000, that were most effective at killing the infection in mice. All 20 had been approved by the Food and Drug Administration for various uses. One, for instance, is used to treat alcohol abuse disorder.
Jayakumar Rajadas
In this most recent study, azlocillin, one of the top-20 contenders, was shown to eclipse a total of 7,450 compounds because it is more effective in killing B. burgdorferi and causes fewer side effects. Lyme disease affects more than 300,000 people annually, according to the Centers for Disease Control and Prevention. It can affect various organs, including the brain, skin, heart, joints and nervous system, and cause heart problems and arthritis if untreated. Symptoms include fever, headaches, chills, and muscle and joint pain.
Traditional antibiotics, such as doxycycline, are effective as an early course of treatment for the infection in the majority of patients, but it remains unclear why these drugs fail to treat 10% to 20% of patients, Rajadas said.
What Are The Risk Factors For Post Treatment Lyme Disease
Risk factors for Post Treatment Lyme Disease include:
- Delay in diagnosis
- Increased severity of initial illness
- Presence of neurologic symptoms
Increased severity of initial illness, the presence of neurologic symptoms, and initial misdiagnosis increase the risk of Post Treatment Lyme Disease. PTLD is especially common in people that have had neurologic involvement. The rates of Post Treatment Lyme Disease after neurologic involvement may be as high as 20% or even higher. Other risk factors being investigated are genetic predispositions and immunologic variables.
In addition to Borrelia burgdorferi, the bacteria that causes Lyme disease, there are several other tick-borne co-infections that may also contribute to more prolonged and complicated illness.
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Lyme Disease Treatment: 2 Herbal Compounds May Beat Antibiotics
Lyme disease transmitted via tick bite affects thousands of people in the United States and around the world. Currently, doctors use antibiotics to treat it, but could plant-based remedies be more effective?
Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi .
The disease spreads to humans through the bite of a tick that carries the bacterium, and it affects an estimated each year in the U.S. alone.
Currently, healthcare professionals choose between three antibiotics in the treatment of Lyme disease. These are doxycycline, cefuroxime, and amoxicillin.
Sometimes, however, antibiotics are not effective in eradicating all traces of B. burgdorferi from the system, which means that the disease can persist.
When this happens, bacterial cells that have developed antibiotic resistance can continue to proliferate. These are known as persister cells .
Because of this, researchers have been looking into alternative modes of fighting the bacterium, and their first line of inquiry has focused on natural remedies.
In 2018, an in vitro study suggested that 10 plant-derived essential oils could help fight off B. burgdorferi.
Now, researchers from the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, and from the California Center for Functional Medicine and Focus Health in Berkeley, have conducted a new study that has led them to believe that two specific plants may lead to more effective therapies against Lyme disease.
What Are The Symptoms Of Chronic Lyme Disease
Despite some skepticism in the medical community, chronic Lyme disease is a growing epidemic in the U.S. This stems partly from the shortcomings of many of the officially recommended Lyme disease tests, which leave too many patients with untreated infections that then become persistent and debilitating.
The following article will cover what you should know about chronic Lyme and provide an introductory but non-exhaustive chronic Lyme disease symptoms checklist.
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What Are The Symptoms
The main feature of Lyme arthritis is obvious swelling of one or a few joints. While the knees are affected most often, other large joints such as the shoulder, ankle, elbow, jaw, wrist, and hip can also be involved. The joint may feel warm to the touch or cause pain during movement. Joint swelling can come and go or move between joints, and it may be difficult to detect in the shoulder, hip, or jaw. Lyme arthritis typically develops within one to a few months after infection.
Prolonged Lyme Disease Treatment: Enough Is Enough
- Raphael B.Stricker, MD, ILADS, 450 Sutter Street, Suite 1504, San Francisco, CA 94108rstricker@usmamed.com
- Lorraine Johnson, JD, MBA
Dr. Halperin’s editorial accompanies publication of the long-awaited NIH- sponsored randomized controlled trial by Fallon et al. from Columbia University. The Columbia study concludes that patients with chronic neurologic symptoms of Lyme disease benefit from longer therapy with intravenous antibiotics, despite the fact that these patients had been sick for an average of nine years and had failed prior treatment. Halperin disagrees with the study conclusion.
The Columbia study found improvement after 10 weeks of retreatment, but relapse when treatment was withdrawn. This clinical pattern has been reported for years in Lyme disease patients, consistent with persistent infection with the Lyme spirochete. . The Columbia study confirms that the quality of life in chronic Lyme disease is worse than in congestive heart failure. For these patients the math is simple: without treatment, there can be no improvement in quality of life. In treatment terms, not enough is not enough.
References
3. Johnson L, Stricker RB. Treatment of Lyme disease: A medicolegal assessment. Expert Rev Anti-Infect Ther 2004 2:533-557.
4. Phillips SE, Harris NS, Horowitz R, Johnson L, Stricker RB. Lyme disease: scratching the surface. Lancet 2005 366:1771.
6. Stricker RB, Johnson L. Lyme disease: A turning point. Expert Rev Anti- Infect Ther 2007 5:759-762.
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What Is Lyme Arthritis
Lyme arthritis occurs when Lyme disease bacteria enter joint tissue and cause inflammation. If left untreated, permanent damage to the joint can occur. Lyme arthritis accounts for approximately one out of every four Lyme disease cases reported to CDC. Because of reporting practices, this statistic may overstate the frequency of arthritis among patients seen in routine clinical practice.
Some Chronic Lyme Disease Symptoms
As mentioned, chronic Lyme disease consists of a broad cluster of physical, cognitive, and psychiatric symptoms. Some of these symptoms are much more common, while others almost never occur, but can be deadly. But even the less severe symptoms, such as chronic fatigue and pain, can lead to drastic changes in quality of life for chronic Lyme patients.
Chronic Lyme survivors have reported experiencing the following symptoms for months to years after infection:
- Intermittent fevers, chills, and sweats
- Chronic inflammation
- Numbness and tingling in the limbs
- Dizziness and shortness of breath
- Heart palpitations and irregular heartbeat
- Anxiety and paranoia
- Multiple-chemical sensitivities
Chronic Lyme disease can be linked to deadly symptoms, such as Lyme carditis .
According to Lymedisease.org, studies consistently show that chronic Lyme disease patients have poorer quality of life than those with other chronic diseases. One of their own studies showed that 75% of surveyed patients reported at least one symptom as severe or very severe.
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What Are The Side Effects Of Lyme Disease Treatments
Antibiotics, like all medications, have the potential for side effects. Any antibiotic can cause skin rashes, and if an itchy red rash develops while on antibiotics, a patient should see their physician. Sometimes symptoms worsen for the first few days on an antibiotic. This is called a Herxheimer reaction and occurs when the antibiotics start to kill the bacteria. In the first 24 to 48 hours, dead bacterial products stimulate the immune system to release inflammatory cytokines and chemokines that can cause increased fever and achiness. This should be transient and last no more than a day or two after the initiation of antibiotics.
The most common side effect of the penicillin antibiotics is diarrhea, and occasionally even serious cases caused by the bacteria Clostridium difficile. This bacterial overgrowth condition occurs because antibiotics kill the good bacteria in our gut. It can be helpful to use probiotics to restore the good bacteria and microbiome balance.
What Is The Treatment For Lyme Disease
The first-line standard of care treatment for adults with Lyme disease is doxycycline, a tetracycline antibiotic. Other antibiotics that have activity against borrelia include the penicillin-like antibiotic, amoxicillin, and the second generation cephalosporin, Ceftin. The mainstay of treatment is with oral antibiotics, but intravenous antibiotics are sometimes indicated for more difficult to treat cases of neurologic-Lyme disease, such as meningitis, and cases of late Lyme arthritis.
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Chronic Lyme Disease Symptom Severity
In LDos chronic Lyme disease survey, over 75% of patients reported at least one symptom as severe or very severe and 63% reported two or more such symptoms. Find out more about LDo peer-reviewed published surveys. The chart below shows the severity of ten common chronic Lyme symptoms.
The survey also found that patients with chronic Lyme disease have high disability and unemployment rates. Over 40% of patients with chronic Lyme disease reported that they currently are unable to work because of Lyme disease and 24% report that they have received disability at some point in their illness.