Lyme Disease

Lyme disease is the most common tick-borne disease in North America and Europe, and the fastest-growing infectious disease in the United States. It is named after the town of Lyme, Connecticut where a cluster of cases was identified in 1977, although clinical features of the disease had been described in Europe as early as 1909. Lyme disease has now been reported in 49 of 50 states in the U.S, and on every continent except Antarctica. The cause of Lyme disease is a bacterial infection with a spirochete from the species complex Borrelia burgdorferi sensu lato, which is most often acquired from the bite of an infected Ixodes tick. Borrelia burgdorferi was first identified in 1982 by Willy Burgdorfer, a tick-borne disease expert at the U.S. National Institute of Allergy and Infectious Diseases' Rocky Mountain Laboratories in Hamilton, Montana. While Borrelia burgdorferi sensu stricto is the predominant cause in the U.S., Lyme disease in Europe is more often caused by Borrelia afzelii or Borrelia garinii.

The disease varies widely in its presentation, which may include a rash and flu-like symptoms in its initial stage, followed by musculoskeletal, arthritic, neurologic, psychiatric and/or cardiac manifestations. Early detection and prompt antibiotic treatment most often result in an excellent prognosis. However early detection is difficult when the characteristic rash is not present, and even those who are diagnosed and treated early may remain symptomatic.

Delayed or inadequate treatment may often lead to late stage Lyme that is disabling and difficult to treat. Amid great controversy over diagnosis, testing and treatment, two different standards of care for Lyme disease have emerged.

Lyme disease has many signs and symptoms, but skin signs, arthritis and/or various neurological symptoms are often present. Like syphilis, the symptoms frequently seem to resolve, yet the disease progresses. Conventional therapy is with antibiotics. People who suspect they have been exposed to Lyme disease should consult a doctor with knowledge of the disease immediately.

Persons who remove attached ticks should be monitored closely for signs and symptoms of tick-borne diseases for up to 30 days. Single-dose doxycycline therapy may be considered for deer tick bites when the tick has been on the person for at least 36 hours.

Traditional treatment of acute Lyme disease usually consists of a minimum two-week to one-month course of antibiotics. In later stages, the bacteria disseminate throughout the body and may cross the blood-brain barrier, making the infection more difficult to treat. or late diagnosed Lyme is treated with oral or IV antibiotics, frequently ceftriaxone, for a minimum of four weeks.

With little research conducted specifically on so called chronic Lyme disease, treatment remains controversial. Currently there are two sets of peer-reviewed published guidelines; the International Lyme and Associated Diseases Society advocates extended courses of antibiotics for chronic Lyme patients, while the Infectious Diseases Society of America does not recognize chronic infection and recommends no treatment for persistent symptoms following infection. Double-blind, placebo-controlled trials of long-term antibiotics for chronic Lyme have produced mixed results.

...More at Wikipedia 

Related Links:

• US National Library of Medicine
• Mayo Clinic

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