Lyme Disease

Cause

Lyme disease is caused by the bacterium Borrelia burgdorferi. The disease is transferred to humans by ticks that have been infected with this bacterium. Infection usually occurs after the infected tick has been stuck on the human body for twenty-four hours. After a few days, the bacteria enter into the lymph and bloodstream and they can spread throughout the body. It can happen that a tick is infected with more than one bacterium and may also cause other infections. After infection, it takes three to thirty days before the first symptoms occur.
If a person is walking or camping in a forest in summer, then he or she runs the highest risk of being bitten by a tick that is infected. Especially if the skin is uncovered, there is more risk of a tick bite.

Symptoms

Early symptoms include a red ring-shaped rash around the site of the tick bite (erythema migrans, EM) and flu-like symptoms, such as headache, stiff neck, fever, muscle aches and fatigue. However, these symptoms can also be absent.
Later, various signs and symptoms can occur. Lyme disease is a multisystem disease, which can lead to, among other things, neurological (nervous system and brains), dermatologic (skin), rheumatologic (muscles and joints), cardiac (heart), opthalmologic (eyes) and psychiatric symptoms.

Diagnosis

The doctor makes the diagnosis of Lyme disease based on the medical history and the symptoms. When seeing an EM, the diagnosis is immediate clear. Without an EM, the diagnosis is more difficult to make. Tests are often used. These tests are in support of the diagnosis; the diagnosis cannot be made on the basis of the test results alone. For different reasons, the tests can provide both false positive and false negative results.

Treatment

Lyme disease can be successfully treated with antibiotics if this is done early after infection. If a person has been infected for a long time, it gets more difficult to successfully combat the disease. There is disagreement about which treatment is best. The duration, dose and antibiotics to use vary from doctor. The ILADS, an international Lyme organization, advises in case of an EM a high dose over a period of six weeks. When a person has been infected for some time, the ILADS recommends antibiotics even for months or years, until the symptoms stay away.
There’s no vaccine for Lyme disease.

Prognosis

Lyme disease can cause (severe) heart and joint problems and nervous disorders. But usually, this disease heals well. The patient must take antibiotics within three to four months after the bite. Damage to joints and nervous system doesn’t always recover completely. Without treatment, the disease may eventually be fatal.
It is expected that an increased number of ticks leads to an increased number of cases of Lyme disease.

Considerations

• The risk of tick bites can be reduced by wearing the following clothing: a shirt with long sleeves tucked in the pants, long trousers tucked into the socks and sturdy walking shoes which protect the whole foot and ankle.
• Keep walking in the middle of a path and avoid bushes as much as possible.
• Look at yourself and others for the presence of ticks after outdoor activities. Check well, because ticks are almost invisible. Use a magnifying glass, if necessary.
• Remove ticks soon. The longer the tick is in the skin, the greater the chance that it’s transferring pathogens. Don’t use alcohol, iodine, oil or other means to remove the tick. Remove the tick by gripping it by the head, as close as possible to the skin, with a pointed tweezers or a special tick remover and pull it out slowly. If a piece of the head remains, it’s harmless. Disinfect the bite wound afterwards.
• Make a note of when and where on the skin you have been bitten.

Facts

• Lyme disease is named after the village of Old Lyme in the state Connecticut in the United States, where an epidemic of this disease occurred in 1975.
• The causer of Lyme disease, the bacterium Borrelia burgdorferi, is named after the American doctor Wilhelm Burgdorfer, who discovered the bacterium in 1982.
• The prevalence of Lyme disease is 0.2%.