Lyme disease is the most common vector-borne disease in the
U.S.
Epidemiology
Gender M:F; 1:1 except for the
presentation of acrodermatitis chronica atrophicans (M<F)
Transmission infected Ixodes
tick
Organism
Borrelia burgdorferi
Member of the Spirochaetales family
which also includes Treponema and Leptospira
Risk Factors
Exposure in regions where deer
population is high during the spring or summer
Northeast or Midwest geographic
location
Clinical Presentation
Centers for Disease Control (CDC)
clinical case epidemiologic surveillance criteria for defining Lyme disease
Erythema migrans (EM) ≥5 cm in
diameter or
Laboratory confirmation of
infection and at least 1 late manifestation
Musculoskeletal manifestation
recurrent, brief attacks of objective joint swelling in 1 or more
joints
Neurological manifestations
Lymphocytic meningitis
Cranial neuritis
Radiculoneuropathy
Encephalomyelitis
requires demonstration of CSF antibody production
Cardiovascular
manifestations acute second or third degree arteriovenous (AV)
heart block
Lyme disease stages
Stage 1 early localized
May begin within hours to
several weeks after infection
Characterized by erythema
migrans (EM) or lymphocytoma (rare in U.S.)
Regional adenopathy and/or
minor constitutional symptoms
Stage 2 early disseminated
Occurs weeks to months
following the tick bite
Characterized by neurologic
and cardiac involvement (manifested in 15% and 8% of patients,
respectively)
Manifestations
Fever
Myalgias
Multiple EM lesions
Meningitis
Bells Palsy
Guillain-Barr้-like
syndrome
Cardiac conduction
abnormalities
Arthritis
Stage 3 late disseminated
Can develop within a few weeks
to 2 years following infection
Symptoms are more severe than
early disseminated
Characterized by arthritis
Occurs in 60% of
individuals not effectively treated early in infection
Tends to be intermittent,
lasting from several days to weeks
Late Lyme disease can affect
central nervous system
Patients may have memory loss,
fatigue and polyneuropathy
Initial symptoms usually appear in
late spring/early summer, when ticks are active
Late manifestations occur anytime
Diagnosis
Laboratory testing
Diagnosis depends on clinical
features, combined with available laboratory tests
C6 peptide antibodies or
Borrelia antibodies by ELISA
Refer to the Lyme Disease Testing
algorithm
Current CDC recommendations for
serologic diagnosis of Lyme disease
Screen with a polyvalent ELISA
test
Confirm equivocal and positive
results with Western Blot
Refer to Lyme Disease Testing
algorithm
Co- and triple-infections by parasites
that cause babesiosis and human granulocytic ehrlichiosis may occur
Serologic testing specific for
these agents is recommended
Co- and triple-infections by
parasites that cause babesiosis and human granulocytic ehrlichiosis may
occur; serological testing specific for these agents is recommended
Treatment
Lyme disease, caught early, is easily
treated
Treatment prevents progression to
chronic stage
Severe, long-term effects occur in
<10% of untreated patients
If known tick bite and erythema
migrans present, proceed with treatment; testing is not necessary
Then
i wised up and got informed and took a more specific, newer test
by IgeneX Labs
in California
I knew, i had this terrible disease....i had 29 symptoms,
and i knew i was real sick.
Can you really see what is happening to everyone here? Allen
Steere (CDC) wants to keep this
disease in the Rheumatology department, as a arthritis of the
knee....when really it's a relapsing fever
and should be in the Neurology department. That is why the
ELISA standard was raised so high at the
Dearborn Conference in 1994 to .99 to be equivocal
or positive, and it misses SO MANY PEOPLE who are really
positive.
It is terrible what is happening. We should not have to
fight for our health!
PLEASE
don't let this happen to you, or someone you love.
If you even think you might have Lyme, seek a
group and