Lyme Disease: Causes and Effects
Lyme disease is an infection caused by the Borrelia burgdorferi bacterium. It was first acknowledged in1975 by Dr. Allen Steere of Connecticut. It was discovered after a curious outbreak of what was considered to be juvenile rheumatoid arthritis in the suburban village of Lyme, Connecticut. Because of the rural location and the fact that it was summertime, it was generally believed that the condition was caused by an arthropod vector.
In early 1982, the American scientist Willy Burgdorfer was able to isolate a heretofore undiscovered spirochete, or a spiral-shaped bacterium, and cultured it from the mid-abdomen of the Ixodes tick (better known as the common deer tick). The bacterium was eventually found to be the very same spirochete that was found in patients diagnosed with Lyme disease. In lieu of Willy Burgdorfer’s discovery, the new found spirochete was given the scientific moniker Borrelia burgdorferi in his honor.
Borrelia burgdorferi are a species of bacteria of the spirochete class of the genus Borrelia, meaning carried by tick or louse. Borrelia burgdorferi are unique among other pathogenic bacteria in that they can survive without iron. This is possible because they are able to replace all of their iron-sulfur cluster enzymes with enzymes using manganese. Borrelia burgdorferi also react with antiserum from patients diagnosed with Lyme. It is considered a zoonotic vector-borne illness because it is transmitted to humans only via non-humans.
Signs and Symptoms
The first signs of Lyme vary greatly. Usually the first visible symptom is the erythema migrans, or the token “bulls eye” rash. Though this is the stereotypical first sign, less than fifty percent of patients actually receive any skin rash. Even so, the vast majority of patients do not even recall being bitten by the tick. This is because it is the deer tick nymphs that carry the disease. Typically, more tick bite victims recall being stuck by the full grown adult tick. The great majority of full-grown ticks are considered harmless compared to their diminutive counterparts, most of which are the size of a pinhead.
The rash, if there is one present, should disappear from view within a month – whether or not it was treated. However, there other yet more bothersome first stage symptoms. These can include, but are not limited to fever, malaise, fatigue, intense headache, sensitivity to light (photophobia), myalgia (muscle ache) and arthralgia (joint pain).
Treatment and Diagnosis
If the disease is accurately diagnosed and treated, it usually can be completely cured within a few weeks to a couple of months with antibiotics. (One of the most common and effective medications is Doxycycline.) Most doctors prescribe twenty-one to thirty days of doses and repeat the treatment as needed until all the bacteria are killed.
Because Lyme is very hard to diagnose, however, many patients fall between the proverbial cracks. Some would-be cured are diagnosed with multiple sclerosis, muscular dystrophy, cerebral palsy, or even migraines. If they are treated for these ailments when they actually are afflicted with Lyme, the two to three month treatment window may be bypassed, there may be serious consequences.
Once Lyme gets to the lymph nodes and the blood, it is considered to be in its second stage. This stage occurs three months or more after the tick bite, and brings with it a host of serious symptoms. These include complete lethargy, stiff neck, meningitis (possibly), nervous system abnormalities including numbness and pain, possible facial paralysis (Bell’s palsy) and heart palpitations. If one were to progress to the third stage, they may experience mental confusion, forgetfulness, mood lability, chronic arthritis and joint damage.
However, it should be noted that these symptoms may occur, and some patients have only some and not others. Some may have completely different symptoms, and some may have no symptoms at all. Lyme is the chameleon of the world of diseases, always copying another illness that it is not, and ever-changing its appearance from person to person. This is also is what makes diagnosis so frustrating.
The best and most effective way to diagnose Lyme disease is a simple blood test. However, it has been discovered that some blood tests are not all that reliable. Some people have tested negative though all other symptoms are present. Some experts say that this is because a blood test may not pick up on the disease for four to six weeks after the initial tick bite. There has been a vast amount of subjects that were given antibiotics in these cases and have responded to this therapy, thus proving the test inaccurate. There have also been false positive results triggered by other diseases in the blood stream. For these reasons, standard tests are considered moot. Instead, labs now depend on the Western Blot test, among others, to detect the antibodies that a healthy human would produce to fight Lyme, as opposed to attempting to detect the bacteria itself.
Since little is known about the long term effects of Borrelia burgdorferi, there have been controversies within the medical community about the disease. Some doctors believe that it is simply treated with antibiotics and it will forever disappear unless one was to be bitten again. Others believe that it can recur even after treatment, and still others believe that some cases, though treated, wind up becoming chronic, nonetheless. This has been especially difficult for doctors treating what they truly believe to be chronic Lyme, while published medical texts state that such a condition cannot exist. Because of this, insurance companies refused to pay for treatment and doctors were penalized for “wasting” money treating what they were told was a fallacy. Some states had recently passed legislation (Connecticut, where it all started, being one of them) that protect the legal rights of doctors that choose to treat and medicate patients that they believe are truly cursed with the chronic brand of this devastating illness.
Lyme has been found to be the most prevalent tick-borne illness in the United States, and in some areas of the country, it is an extreme public health problem, bordering on an epidemic. It is most prevalent in the Northeastern temperate regions, especially within the corridor between Massachusetts and Maryland, but can also congregate in the North Central areas such as Minnesota and Wisconsin.
There are ten states that recorded a higher number of cases than the national average. Those states are Connecticut, Delaware, Maryland, Massachusetts, Minnesota, New Jersey, Pennsylvania, New York, Rhode Island, and Wisconsin. Of the cases reported to the Centers for Disease Control between 2003 and 2006, ninety-three percent came from those states listed.
It should be noted that because Lyme is only indigenous to specific areas, visitors from other states that are bitten by an infected tick often go either undiagnosed or misdiagnosed, mostly because doctors in other states are not adequately trained about Lyme disease and its cause and symptoms.
Lyme is a larger threat than many in the health community realize, and hopefully, before long, more doctors and health professionals will realize that though it is a local problem, it still is a serious issue to those that have dealt with it, and continue to face it daily.
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