Swelling and pain in large weight-bearing joints, especially in the knee.
Years after infection, if left untreated :
Late neurological syndrome
Post-Lyme disease syndrome
Persistent disease after antibiotic treatment
Some infected individuals show asymptomatic infection
Some only manifest nonspecific symptoms
Serologic data by IFA, ELISA and immmunoblotting techniques.
Detect presence of IgM or IgG antibodies in patient’s serum against Borrelia burgdorferi
Tests are insensitive the first several weeks of infection
Western blot is more accurate and is used 6-12 weeks after infection to confirm results
Biopsies of the skin lesions may yield the organism in 50% or more of cases
Doxycycline and amoxicillin are used for two to four weeks in early cases
Doxycycline is also effective against human granulocytic ehrlichiosis
Cefuroxime axetil or erythromycin can be used for patients who are allergic to penicillin or who cannot take tetracyclines.
More developed cases, may require treatment with intravenous ceftriaxone or penicillin for 4 weeks or more
Avoid tick habitats
Wear appropriate barrier clothing that follow personal protection procedures
Apply insect repellent containing DEET to skin
Apply permethrin to clothes
Perform regular body checks for ticks
Remove ticks promptly with tweezers and clean area with antiseptic
Education of the general public
Lyme disease vaccine: LYMErix
Recommended to 15-70 year olds living in endemic areas
Recommended to those who are at risk due to occupation
Only suggested to those who have a seasonal problem of infection greater than 1%
No longer commercially available since February 25, 2002
Habitat modification for ticks
-Clear trees and brush
Chemical control of tick populations
-Apply pesticides to residential properties
Habitat modification for deer and rodents
-Keep rodents and deer away from houses and gardens
-Deer feeding stations equipped with pesticide applicators
-Baited devices to kill ticks on rodents
Bacon, R.M., B.J. Biggerstaff, M.E. Schriefer ME, R.D. Gilmore Jr, M.T. Philipp, A.C. Steere, G.P. Wormser, A.R. Marques, B.J. Johnson. “Serodiagnosis of Lyme Disease by Kinetic Enzyme-Linked Immunosorbent Assay Using Recombinant VlsE1 or Peptide Antigens of Borrelia burgdorferi Compared with 2-Tiered Testing Using Whole-Cell Lysates.” Journal of Infectious Diseases . 2003 Apr 15;187(8):1187-99.
Benenson, Abram. Ed. Control of Communicable Diseases Manual . Washington, DC: American Public Health Association, 1995.
Crippa, M., O. Rais and L. Gern. “Investigations on the mode and dynamics of transmission and infectivity of Borrelia burgdorferi sensu stricto and Borrelia afzelii in Ixodes ricinus ticks.” Vector Borne Zoonotic Diseases . 2002 Spring;2(1):3-9.
Durham, Jerry D. and Felissa R. Lashley. Emerging Infectious Diseases: Trends and Issues . New York: Springer Publishing Co., 2002.
Parveen, N., M. Caimano, J.D. Radolf, J.M. Leong. “Adaptation of the Lyme disease spirochaete to the mammalian host environment results in enhanced glycosaminoglycan and host cell binding.” Molecular. Microbiology. 2003 Mar;47(5):1433-44.
Perry, Jerome, James Staley, Stephen Lory. Microbial Life . Sunderland, MA: Sinauer Associates, Publishers, 2002.
CDC Lyme Disease Home Page. http://www.cdc.gov/ncidod/dvbid/lyme/
Zeus Scientific, Inc. “IFA Assays – Bacterial Diseases”. http:// www.zeusscientific.com/ifabact.html . 23 April 2003.