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Lyme Light: Understanding the Tick-Borne Bacteria

Deer Tick in Glass Vial

Borrelia is the genus name for the bacterial spirochete that causes Lyme disease. The disease is caused by the bacterium Borrelia burgdorferi in the United States; the European relatives of the bacteria are Borrelia afzelii and Borrelia garinii. The origin of Lyme disease dates back about 40 years when in the mid-70s children living in Lyme, CT were diagnosed with rheumatoid arthritis (RA), which is a disease most commonly seen in older adults, although there is a juvenile rheumatoid arthritis (JRA) form. However, it’s highly unlikely that a group of children living in the same city would develop cases of JRA. Once the children’s parents brought their story to the attention of researchers, further studies led to the 1982 discovery of the cause of the inflammatory condition in these children—bacteria found in the stomach of a deer tick (Ixodes scapularis). These ticks serve as vectors and carry Borrelia burgdorferi in their stomachs until they bite someone and transfer the bacterium to a person. The fifty states have all reported cases of Lyme disease; however, the northeastern part of the U.S. tends to have the most cases.

Interestingly, Oregon State University researchers found ticks fossilized in 15- to 20-million-year-old amber that was located in the Dominican Republic; the ticks were infected with spirochete bacteria that closely resemble Borrelia, which is commonly found in present-day ticks. With this new evidence, it’s clear that ticks have been around well before they were first identified in ‘82. During warmer months, people enjoy spending more time outdoors, which is a good thing as it relates to the health benefits of getting vitamin D from the sun (but don’t spend all day without putting on your SPF), such as improving bone strength, boosting immune function, and even preventing cancer. Unfortunately, spending time outdoors exposes you to a host of other dangers too like tick bites.

It Starts With a Bite
Once you’ve been bitten by a deer tick the bacteria moves into your skin.  Within a few days Lyme disease’s classic bull’s-eye rash develops, which is an expanding pattern of rings forming around the bite mark. However, the rash called erythema migrans doesn’t always develop in everyone and in people with darker skin tones it may be hard to identify the rash. Nonspecific symptoms are also present (e.g., headache, fatigue, muscle and joint stiffness). A rash can be missed, symptoms can be nonspecific, and patients may not even recall getting bit by a tick. After all a tick bite is tiny and difficult to spot. Within days or weeks, the rash will resolve itself and at that time the bacteria continue to spread undetected to cause disease in the heart (arrhythmias, heart failure), nervous system (confusion, Bell’s palsy), and joints (pain, swelling, stiffness, particularly in the knees).

Diagnosing Lyme disease
The classic bull’s-eye rash is helpful in diagnosing Lyme disease. However, when this sign is missing, doctors often rely on history (e.g., the patient was in an area in which Lyme disease is common). If the patient is showing signs of joint pain or heart disease, then running a series of test is required to exclude diseases that may present with similar findings. In the later stages of Lyme disease, the bacteria trigger the production of antibodies to fight off the infection. A lab test is used to confirm Lyme disease; however, it’s reliable within four weeks of a tick bite. Lab testing in patients suspected of Lyme disease is most helpful when (1) there is a 4-week history of a tick bite or (2) there are inexplicable disorders affecting the heart, joint, or nervous system.

Treating Lyme Disease
Antibiotics are used to treat Lyme disease. The type of treatment a patient receives is determined by the stage of the disease: earlier stages are usually treated with oral antibiotics, later stages with intravenous drugs. For swelling and joint pain, an anti-inflammatory drug such as Motrin can be used.

Because Lyme bacteria can lead to disorders of the heart, joint, and nervous system, it’s important that you recognize the symptoms of Lyme disease, especially if you’ve been camping, hiking, or walking in woody, grassy areas. Borrelia burgdorferi, it appears with the latest research, has been around for many more years than what was previously thought. Recognize the symptoms of this tenacious microbe so you can bring concerns of Lyme infection to your physician sooner rather than later.