Lyme disease is a world-wide infectious disease caused by microscopic bacteria carried by tiny ticks. There are several species of deer ticks that become infected with the spiral bacterium, Borrelia burgdorferi. Unsuspecting humans and animals walking through woodlands and brushy areas may be bitten by a tick and never know it. The tiny ticks, some the size of poppy seeds, may stay on your body for hours to days. The tick engorges itself with blood. If infected, the spirochete is transmitted to the bloodstream of the person or animal during the bite. A characteristic red bulls-eye rash (EM) at the site of the bite is present in less than 40% of patients. The rash may appear within days to weeks after the bite, but could be hidden in hairline or underarms.
Some patients report flu-like symptoms, fever, aches, fatigue, neck stiffness, jaw discomfort, muscle pain and stiffness, swollen glands, and red eyes. Symptoms may appear, disappear and reappear at various times. Nervous system abnormalities include memory loss and partial facial paralysis (Bell’s palsy). Migratory joint pains, and pains in the tendons, muscles and bones may occur later in the disease. Arthritic symptoms, if present, usually affect the large joints like the knees.
The same tick that carries the bacteria that causes Lyme Disease, can also carry other pathogens. The most common are Babesiosis, Ehrlichiosis, Bartonellosis and Rickettsiosis (Rocky Mountain Spotted fever). It is estimated that up to 25% of the ticks that cause Lyme disease may transmit one or more of these other diseases. Babesiosis is like malaria with the symptoms of acute disease being fever, chills, vomiting and fatigue. It is usually self-limiting except in Lyme patients and those who have undergone splenectomy. There are two forms of Ehrlichiosis: Anaplasma phagocytophila (HGA) and HME (Human Monocytic Ehrlichiosis). HGA is primarily on the East coast, upper Midwest and California. HME is primarily in the Southeast, lower Midwest and Southwest, with cases reported in CA, NJ, NY, and WI. These acute diseases may have symptoms of fever, chills, vomiting and fatigue and require prompt antibiotics. Subclinical forms of these diseases may be present in patients with Lyme disease.
Several tests are available for a diagnosis of Lyme disease. These include direct and indirect tests. Indirect tests look for the patient’s immune response to B. burgdorferi. Direct tests look for the presence of B. burgdorferi antigens or nucleic acids.↑