Can Lyme Disease Be Prevented
People aren’t able to become immune to Lyme disease. So even if you’ve had Lyme disease, you can get it again. No vaccine is available currently to prevent the disease.
The FDA approved a Lyme vaccine called LYMErix in 1998. The vaccine was not 100% effective, however. The FDA still recommended preventing the disease in other ways. In 2002, the company that made LYMErix said it would no longer offer the vaccine.
To help prevent Lyme disease, follow these guidelines.
Lyme And Ancient History
In 2017, a team at the Yale School of Public Health studied the history of Lyme disease in North America by analyzing the DNA of the Lyme disease bacterium a group of species of spiral-shaped bacteria, or spirochetes, known as Borrelia.
The Yale researchers sequenced the full genomes of Borrelia burgdorferi sensu stricto taken from deer ticks. They read all one million letters of this full Lyme bacterial genome, allowing them to trace its presence back at least 60,000 years. That means the Lyme bacterium has been circulating North America since long before humans even arrived on the continent.
The researchers concluded that the bacterium most likely spread from the northeast U.S. to the south and west to California. This confirms that in the U.S. today, Lyme disease is not limited to New England but is in fact present in all 50 states.
Pre-20th century: Lyme in colonial AmericaIn North America, the history of Lyme disease and humans dates back at least to the colonial period. Colonists and visitors to North America in the 17th and 18th centuries wrote about the prevalence of ticks in forested areas of the Northeast as well as people suffering Lyme-like symptoms.
In fact, these accounts coupled with the Yale research above suggest that Lyme did not emerge through evolutionary processes, but rather changed and spread geographically due to ecological changes starting around that time.
This bacterium was later named Borrelia burgdorferi in Burgdorfers honor.
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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Q: I’m Achy And Tired All The Time Could I Have Lyme Disease
The answer is yes, possibly. When a patient comes into my clinic for the first time, I take down their clinical history. If I suspect tickborne disease, I ask if they’ve been exposed to ticks or tick habitats. Have they observed any rashes? The typical Lyme rash expands and is ringlike, usually not itchy or painful. If it’s under a person’s hairline, between the toes, or on the back of the body, it may not be noticed. At least 21% of Lyme patients, and probably more than 50%, never see a tick or a rash.
Early Lyme patients present with flu-like symptoms. Tick bites and resulting symptoms often occur in the summer, but in my California practice, Lyme season may overlap with the fall/winter flu season, confusing the diagnostic picture.
Next, I do a complete physical exam, with an emphasis on neurological deficits, such as loss of balance, tremors, facial asymmetry , and asymmetric reflexes. Then, I ask about the progression of their symptoms over time. In the first few months of Lyme disease, patients often experience malaise, fatigue, mild to severe headaches, nerve pain or tingling in the hands or feet, all in a relapsing-remitting course. In other words, the symptoms wax and wane.
What Are The Complications Of Lyme Disease
Lyme disease affects people differently. Relapse and incomplete treatment responses happen. Relapse and incomplete treatment responses happen. Complications of untreated early-stage disease include:
Frequent hospitalizations to manage the disease
Some of these complications result in chronic, debilitating conditions.
Some people may develop post-Lyme disease syndrome . A condition also known as chronic Lyme disease includes PLDS, but also other syndromes. Usually, these are characterized by persistent musculoskeletal and peripheral nerve pain, fatigue, and memory impairment.
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Researchers Discover A Unique Bacterial Property Potential Target For Treating And Diagnosing Lyme Disease
- Virginia Tech
- Researchers have discovered that the bacterium that causes Lyme disease has a highly unusual modification in its protective molecular bag — its peptidoglycan, which is common to all bacteria.
You don’t have to go far to find ticks. Just step outside and look for some grass. Look to the top of the shiny, green blade — usually ankle high. A tick might be there, waiting.
If something breathing brushes up against grass, the tick takes something similar to a needle — called its hypostome, which has dozens of fishing hook barbs — and inserts it into the skin. If unnoticed, Lyme disease could be transferred to its host after about 24 hours of feeding.
Virginia Tech researchers discovered that the bacterium that causes Lyme disease has a highly unusual modification in its protective molecular bag — its peptidoglycan, which is common to all bacteria.
The change in this bacterium is unprecedented — it’s an unusual sugar modification that is not known to occur in any organism. One way the bacterium gets this sugar modification is from ticks by absorbing a carbohydrate unique to ticks. The alteration is specific to ticks and allows the bacterium to better move and be more likely to cause disease.
The findings were recently published in Nature Microbiology.
In 2019, Jutras discovered that B. burgdorferi sheds peptidoglycan once it invades the human body. Although all bacteria have peptidoglycan, many do not shed the substance.
A long and winding road
Climate Change Increases The Threat Of Lyme Disease
Lyme disease is the most common vector-borne disease in the U.S. according to the CDC. In fact, the CDC estimates that there are at least 300,000 cases of Lyme disease in the U.S. every year, acknowledging that cases have tripled since 1995.
Experts are increasingly recognizing climate change as a major cause for the increase in cases. Warmer winters allow ticks to survive farther north than usual, expanding the geography of the disease, and lengthier summers extend the peak period of disease.
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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.
What Kinds Of Neurological Problems Are Caused By Lyme Disease
Typically, three main neurological complications develop in people with untreated Lyme disease.
- Cranial neuropathy: If the infection affects nerves of the face, some patients might experience cranial neuropathyor dysfunction of the peripheral nervescausing drooping or swelling. The most common form of cranial neuropathy is Bells palsy, which is muscle drooping on one side of the face.
- Meningitis: If the bacterial infection reaches the meninges, or the tissue lining the brain and spinal column, it may cause inflammation and tissue damage. Patients with meningitis are likely to experience fevers, headache, fatigue, and stiff neck.
- Radiculoneuritis: If the bacterial infection reaches the nerve root, or the part of the nerve cells that attaches to the central nervous system , it can cause severe pain, numbness, and other abnormal sensations.
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Q: Why Don’t Many Lyme Specialists Accept Medical Insurance
Many of the sickest tickborne-disease patients end up in my clinic, and the delays, paperwork, and restrictions on treatment and test options imposed by insurance companies often threaten the well-being of patients. More importantly, there are only medical diagnostic codes for acute/early Lyme, not chronic/late Lyme.
A first-time patient who has a chronic, long-term infection typically requires at least two hours just to take down a medical history and do the physical exam. Getting to the bottom of what is causing the illness requires multiple blood tests, scans, and other studies to confirm or deny different possible causes. Oddly, insurance reimbursement rewards doctors for the volume of patients seen, not for successful diagnoses and treatments that improve patient health.
Time is of the essence in treating my tickborne-disease patients and delaying necessary testing just because it falls outside of insurance company guidelines harms patients. I went into medicine to help my patients regain full health and experience joy I didn’t choose this profession to battle insurance companies.
What You Need To Know About Lyme Disease
Lyme disease is an infection caused by the spiral-shaped bacteria Borrelia burgdorferi, which is most commonly transmitted by a tick bite.
There are over 300,000 estimated new cases of Lyme disease in the United States each year.
The symptoms of Lyme disease depend on the how long the infection has been present in the body. The first sign of Lyme disease is often an expanding round or oval red “bullseye” rash.
If left untreated, people may develop neurological symptoms and heart problems, and have an approximately 60 percent chance of developing Lyme arthritis.
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Ticks Vs Bears Deer And Mice
Considering the bear population growth was dramatic enough that it required intervention, where does that leave the prevalence of ticks? Should we start calling the deer tick, which is commonly associated with the white-tailed deer that it feeds upon, the bear tick?
The continued impact on tick abundance, I think that is a real stretch, Hurst says of black bears. The density of bears is so much lower than the density of other potential tick hosts, mainly white-tailed deer.
The DEC estimates 6,000 to 8,000 black bears currently roam the state in areas open to bear hunting, like the Adirondacks and the Catskills. By contrast, the DEC estimates that statewide, 220,000 white-tailed deer are killed by hunters each year just a portion of the overall deer population, which according to Hurst is estimated to between 1 and 1.2 million.
In addition to there being fewer bears in New York, Dr. Richard S. Ostfeld, disease ecologist and senior scientist for the Cary Institute, says that bears host much fewer ticks per animal than other animals, such as white-tailed deer and mice. Ostfeld cites two studies, one conducted in Pennsylvania, and one conducted in New Jersey, that observed the prevalence of ticks on black bears. The Pennsylvania study is the one cited by some reports that claim bears may be leading to an increase in tick populations.
If you compare bears to a lot of other wildlife, theyre just not hosting very many ticks.
Management Of Deer Populations
Deer do not get infected with the bacterium that causes Lyme disease. However, deer are a main source of the blood adult ticks need to reproduce. Some have proposed that culling deer populations through increased hunting will reduce the incidence of Lyme disease.The impact of deer reduction on tick abundance or Lyme disease has been examined in several studies with mixed results. Studies on islands indicate that culling deer populations reduces the tick population, but this approach is not practical or realistic in the contiguous United States, since deer are constantly migrating. Even if one town in Massachusetts were to increase hunting of deer, it would prevent immigration of deer from adjacent towns, and the impact of this strategy in decreasing human disease remains unproven. For more information on deer management strategies see MassWildlife.
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A New Cause Of Lyme Disease Discovered
Researchers at the Mayo clinic were testing blood of people with suspected Lyme, and came across unexpected findings in six of 9,000 patients tested between 2012-14. The samples of DNA in their blood didnt match that of Borrelia burgdorferi. The researchers named the newly identified species B. mayonii, after the Mayo Clinic founders. So far, the new species has only been found in the Midwestabout 25,000 blood samples from residents of 43 other states were tested, with no positive results. Of more than 100,000 patient specimens, 102 tested positive for B. burgdorferi. Dr. Bobbi Pritt explains that the Mayo lab offers the standard two-tier testing for Lyme recommended by the CDC and the IDSAantibody testing that we know misses a lot of cases, and did in half of these patients. Additionally, their lab offers PCR testing, which can detect very low levels of bacterial DNA. But Lyme is still difficult to diagnose, with less than 50% of patients who even have the classic bulls eye erythema migrans rash having detectable levels of the bacterial spirochetes. Dr. Pritt cautions, Most cases of Lyme disease dont have sufficient levels of bacteremia to make PCR testing of blood a sensitive method for diagnosis.
Magnitude Of The Problem
In 2009 there were 29,959 confirmed and 8,509 probable cases of Lyme disease reported to CDC, for an incidence of 13.4 cases per 100,000 population. During the same year, Massachusetts had 4,019 confirmed and 1,237 probable cases, an incidence of 61.0 per 100,000 population. The annual number of confirmed cases has been rising steadily over the past 15 years.
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New Lyme Disease Bacteria Discovered: Cdc
Infection may trigger nausea, vomiting and a more widespread rash, officials say
TUESDAY, Feb. 9, 2016 — A new Lyme disease-causing bacteria has been identified in the United States, and it may bring even worse symptoms, health officials said.
Borrelia burgdorferi was the only bacteria species believed to cause Lyme disease in North America — until this new discovery, the researchers said. The newly-identified bacteria, called Borrelia mayonii, appears closely related to B. burgdorferi, say a team from the U.S. Centers for Disease Control and Prevention.
“This discovery adds another important piece of information to the complex picture of tick-borne diseases in the United States,” CDC microbiologist Jeannine Petersen said in an agency news release.
The first indication there might be a new species of Lyme disease-causing bacteria was unusual lab test results from six samples from people suspected to have the illness. Further genetic testing at the CDC and the Mayo Clinic in Rochester, Minn. pinpointed the new species of bacteria.
So far, it has only been found in the upper Midwest, the study said.
Preliminary findings suggest that illness caused by the new bacteria is similar. But, there may be some differences. Both cause fever, headache, rash, and neck pain in the first days after infection, and arthritis weeks after infection.
The findings were released Feb. 8 in The Lancet Infectious Diseases Journal.
What Makes Yale Medicine’s Approach To Lyme Disease Unique
The discovery of Lyme disease is actually credited to two Yale physiciansAllan Steere, MD, and Stephen Malawista, MDwho identified the mysterious inflammatory disease after a rash of illnesses cropped up during the summer of 1975. That year, two mothers living in Old Lyme, Conn., refused to accept the diagnosis of rheumatoid arthritis among the children living in their town.
The mothers reached out to the Connecticut State Department of Health and the Yale School of Medicine for help, starting an epidemiological study that would ultimately uncover the bacterial infection transmitted by ticks. Today, doctors in Yale Medicines neurology department provide care for patients who have infections that affect the nervous system.
Thanks to a powerful partnership with research programs at Yale Medicine, patients benefit from the most recent advantages in treatment.
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A Brief History Of Lyme Disease In Connecticut
The history of Lyme disease in Connecticut began in 1975 when a cluster of children and adults residing in the Lyme, Connecticut area experienced uncommon arthritic symptoms . By 1977, the first 51 cases of Lyme arthritis were described, and the Ixodes scapularis tick was linked to the transmission of the disease. During 1982, Borrelia burgdorferi, the bacterium that causes Lyme disease, was discovered and the first brochure addressing Lyme disease was developed by the Arthritis Foundation. Serology testing became widely available in Connecticut during 1984. In 1987, Lyme disease became a reportable disease. All physicians were required to report any and all cases of the disease. By 1988, the news of Lyme disease spread and national media attention began. The first federal funding for Lyme disease surveillance, education, and research became available in 1991. The first Lyme disease vaccine became available in 1997. To help determine the efficacy of the vaccine, Lyme disease was made laboratory reportable in 1998. However, the manufacturer withdrew the vaccine from the market in 2001. In 2002, the vaccine efficacy study ended, and Lyme disease was removed from the list of laboratory reportable findings however, it remained a physician reportable disease.
This page last updated 7/1/2019.
Q: Why Is Lyme Disease So Controversial
The controversy is mostly centered around whether persistent Lyme disease symptoms are caused by an active bacterial infection or an autoimmune condition, where a person’s immune system attacks the body after the microbes have been eradicated by antibiotics. Based on my experience treating hundreds of patients and actively reviewing new evidence on chronic Lyme out of Tulane and Johns Hopkins, I have no doubt that the Lyme disease bacteria is capable of hiding out in the body for months to years, causing destructive long-term inflammation and illness.
The challenge is getting the best diagnostic and treatment evidence out in a timely manner so that our “first responders” in medicineemergency room physicians and primary care doctorsrecognize early Lyme so that none of these patients reach the potential chronic stage, where long-term damage can prevent a full recovery. I’m currently working with a nonprofit, Invisible International, to accelerate this process. The bacterium that causes Lyme disease was discovered in 1981, 40 years ago, and I believe medicine can do better by these patients.
For a checklist of common Lyme disease symptoms or to find an experienced tickborne-disease physician, visit the Lymedisease.org website. To learn more about diagnosing and treating vector-borne diseases, watch Invisible International’s online, evidence-based physician medical education courses.
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