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Lyme Disease

Lyme disease results from infection with spirochetes belonging to the Borrelia burgdorferi sensu lato complex. In Europe and Asia, B. burgdorferi sensu stricto, B. afzelii, or B. garinii causes most cases of Lyme disease; however, in the United States, all cases are caused by B. burgdorferi sensu stricto. The spirochetes are transmitted to humans through the bite of infected ticks of the Ixodes ricinus complex.

Occurrence: Lyme disease occurs in temperate forested regions of Europe and Asia and in the North-Eastern, North Central, and Pacific coastal regions of North America. It is not transmitted in the tropics.

Manifestations: A characteristic expanding rash called erythema chronicum migrans at the site of tick attachment will be seen and a fever with arthritis neurologic manifestations, including facial palsy.

Diagnosis and treatment: Diagnosis is based on taking a blood test or test of cerebro-spinal fluid. Lyme disease can usually be cured by an appropriate course of antibiotic treatment.

Vaccine: From February 2002 Lyme disease vaccine will no longer be commercially available for prevention in endemic areas of the United States. However, because of the genospecies diversity of the agents that cause Lyme disease in Europe and Asia, the vaccine is not likely to be highly efficacious outside North America.

Avoid Lymes disease by: Avoid tick habitats if possible. Application of repellents to skin Acaricides to clothing regular daily checks for any attached ticks can reduce the risk of infection. Because transmission of B. burgdorferi is unlikely to occur in the first 36 hours of tick attachment Prompt removal of any attached ticks will help prevent infection.