Borrelia burgdorferi, which causes Lyme diseases, cannot be transferred from person to person or from an infected animal to a human (5). Two deer ticks, Ixodes scapularis and Ixodes pacificus,are the most common reservoirs of Lyme disease (7). A mouse is a second reservoir of Lyme disease (1). Infected deer ticks are most often found in forest areas and therefore are more common in the northeast, north central andwest coast regions of the United States (7).
Borrelia burgdorferi is a spiral shaped bacterium or spirochete (7). The microorganism is identified as anaerobic, gram-negative organism. Diagnostic factors include using a blood smear to identify antibodies(1). The ELISA and western blot antibody assays are used to detect antibodies for Lyme disease. The western blot assay is more sensitive because it provides detection before the peak response of the organism(4). The detection of antibodies is uncomplicated because antigens are present early after initial infection (4).
Lyme disease may have originated in Europe but in 1975 in the small town of Lyme, Connecticut children began to develop a form of juvenile rheumatoid arthritis (7). Lyme is a town with tick infested, wooded areas. Those who were infected often reported having a rash before the development of arthritis (7). The disease was eventually named after the small town in which it was identified (7).
In stage one of the disease a skin rash develops (1). Erythema chronicum migrans is the red ring rash that develops with a white center; the rash grows larger in time (1). This unique rash is often referred to as the bull's eye rash (1). The rash can appear three days to one month after the tick bite (5). Stage two of the disease may cause symptoms that include fever, malaise, chills, headache, joint pain, and a sore throat (1). More serious affects such as arthritis, dermatitis, neurologicalchanges, and acute confusion can develop in stage three of infection (1).
Virulence factors include antigenic variations (postulated) and motility (1). Research suggests that Lyme disease spirochetes can specifically target, invade, and kill human lymphocytes(2). Spirochetes may become enveloped in lymphocyte membranes, effectively avoiding immune recognition and destruction(2).
Forms of penicillin and tetracycline are used in the treatment of Lyme disease (1). Amoxicillin and doxycycline are oral antibiotics whose duration depends on the clinical response (6). Intravenous antimicrobials, including ceftriaxone or cefotaxime, can be used if a nervous system disease develops or if no response is occurs after taking the oral antibiotics (6). No reliable test has been developed to determine if the disease has been eliminated from the body (6).
LYMErixTM, the producer of the Lyme disease vaccine, removed the use of the vaccine onFebruary 25 of 2002 (3). The vaccine was given to those who were 15-70 years of age where Lyme disease is prevalent or if someone worked or lived in or close to tick infested woods (5). Three doses would be given. The first dose was ideally given during the time period between January and March. The second dose was given one month after the first dose and the third dose was given twelve months after the first dose (5). DEET, found in insect repellents, can be used as a prevention technique. It can be applied to exposed skin and clothes in order to repel ticks (3). Permithrin can also be applied to clothes and will kill ticks on contact (3).
References
1. "Borrelia burgdorferi." 13 April 1999. 22 April 2002 http://www.medinfo.ufl.edu/year2/mmid/bms5300/bugs/borburg.html
2. Garon, Claude F. "The Rocky Mountain Laboratories Microscopy Branch." 4 April 1999. 5 May 2002. http://www.niaid.nih.gov/dir/labs/rmlmb.htm
3."Lyme Disease." 11 April 2002. 29 April2002 http://www.cdc.gov/ncidod/dvbid/lyme/prevent.htm>.
4."Lyme Disease." 16 April 2002. 29 April 2002 http://www.igenex.com/lymeset7.htm.
5. "Lyme Disease - The Facts, The Challenge." 22 April2002 www.cdc.gov/nip/publications/VIS/vis-lyme.pdf
6. "Lyme Disease inTexas." 10 May 1999. 29 April 2002 http://www.tdh.state.tx.us/phpep/dpn/issues/dpn59n10.pdf
7. "Lyme Disease Vaccine: What You Need to Know." 1 Nov. 1999. 29 April 2002 http://www.cdc.gov/nip/publications/VIS/vis-lyme.pdf