Lyme disease

 

Lyme disease is an infectious disease which is caused by four main species of bacteria of the Borrelia type. The species are Borrelia burgdorferi, Borrelia mayonii,Borrelia garinii and Borrelia afzelii bacteria. In Europe and Asia, the main cause of lyme disease is Borrelia afzelii and Borrelia garinii. In the United States the leading cause of Lyme disease is Borrelia burgdorferi and Borrelia mayonii.

Lyme disease gets transmitted to humans through the bite of infected blacklegged ticks (Ixodes scapularis). This ticks are also known as deer ticks.  These ticks are typically found in wooded and grassy areas. According to the Centers for Disease Control and Prevention , “ about 300,000 people are diagnosed with Lyme disease in the United States every year.”  Diagnosis of Lyme disease is difficult and for that reason many people having actually Lyme disease may be misdiagnosed with other conditions.

 

Sign and symptoms:

If you have had a tick bite , or you have recently traveled to an area where Lyme disease commonly occurs , or you live in an area which is known for Lyme disease please seek medical attention if you observe any of these following symptoms-

Early signs and symptoms:

Rash:  it begins at the site from 3 to 30 days after a tick bite (average is about 7 days). The rash is known as Erythema migrans (EM) rash.  Usually the rash is not itchy or painful and it can spread to about 12 inches (30 cm) across. The rash resembles the pattern of a bull’s eye.

Flu like symptoms: Fever, headache, chills, fatigue, muscle and joint aches, and swollen lymph nodes may accompany the rash.

Later signs and symptoms:

.  Severe headache along with neck stiffness

.  Arthritis with severe joint pain and swelling, commonly involving the knees and other large joints.

. Additional Erythema Migrans rashes on other areas of the body

.  Facial palsy (loss of muscle tone and droop on one or both sides of the face)

.  Intermittent pain occurring in tendons, muscles, joints, and bones

. Episodes of dizziness

. Shortness of breath

. Lyme carditis, which is characterized by Heart palpitations or an irregular heartbeat.

. Inflammation of the membranes surrounding the brain (meningitis) and spinal cord

.  Shooting pains, numbness, or tingling in the hands or feet

. Nerve pain and severe fatigue

.  Short-term memory

 

Diagnosis of Lyme disease:

 

Lyme disease is diagnosed based on those following processes :

. Signs and symptoms

. Clinical diagnosis

. Laboratory diagnosis

In a Lyme disease test antibodies to the bacterium Borrelia burgdorferi  is detected in blood. As the symptoms of Lyme disease are similar to many other diseases, diagnosis of Lyme disease can be hard. The doctor should take a careful medical history and perform general and physical examination. To identify the disease antibody tests can be used.

Antibody tests:

This is the most common test used to help identify Lyme disease. It can take up around 2 months after becoming infected before antibodies can be detected in blood test.  Two types of antibody tests are used to detect Lyme disease :

1 . Enzyme-linked immunosorbent assay (ELISA): This is the most sensitive screening test for Lyme disease. This a rapid test to identify Lyme disease antibodies.

2 . Western blot test: This test confirms the result of an ELISA test. This test is usually done to detect a chronic Lyme disease infection.

Antibody testing is done in a two step process, at first ELISA followed by the Western blot test.

Sometimes along with ELISA and Western blot test , Polymerase chain reaction (PCR) is also done to diagnose Lyme disease.

 

Treatment of Lyme disease:

Antibiotics are used for treating Lyme disease. The sooner treatment begins the quicker and complete recovery would be possible.  Oral and intravenous antibiotics are used for this purpose.

. Oral antibiotics:  These are the standard treatment of early stage Lyme disease. This treatment plan includes –

.  Doxycycline for adults and children aging more than 8 years.

. Amoxicillin / cefuroxime are used for adults, younger children, pregnant and breast feeding women.

The usual course of antibiotics is 14 to 21 days.

Intravenous antibiotics:

Sometimes Lyme disease involves the central nervous system, in this condition doctors may recommend intravenous antibiotics for 14 to 28 days. Although it takes time to recover the patient from symptoms, this is very effective in eliminating infection. Intravenous antibiotics have some side effects. These side effects include : a white blood cell count lower than normal, sometimes mild to severe diarrhea, colonization or infection with other antibiotic resistant organisms which are unrelated to Lyme disease.

After complete treatment, a small number of people may still have some sign and symptoms such as fatigue and muscle aches. These symptoms are known as post post-treatment Lyme disease syndrome. The cause of this syndrome is unknown. Treating with more antibiotic doesn’t help to recover from this syndrome.

 

Preventive measures for Lyme disease:

Prevention is better than cure and the best way to prevent Lyme disease is avoiding areas where deer ticks lives. Always avoid wooded and bushy areas with long grass. By taking some simple precautions you can easily decrease the risk of getting Lyme disease.  The precautions include:

.  Cover up your body: In wooded and grassy areas you should wear shoes with long pants tucked into your socks. Use a hat, gloves and a long-sleeved shirt. Try to avoid walking through long grass and low bushes.

.  Using insect repellents:  Insect repellents along with 20 percent or higher concentration of DEET should be applied to skin. Apply repellents to your children.

.  Tick-proof yard: Make your yard clean by clearing bush and leaves, you should keep woodpiles in areas where enough sunlight can reach

. After spending time in grassy or wooden areas, check yourself, your children and pets for ticks. It is very helpful to take a shower as soon as coming indoor.

. If you can identify any ticks in the body or clothes, remove the tick as soon as possible with tweezers.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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