6. What is Lyme Disease?
• Lyme disease is caused by Borrelia
burgdorferi and is transmitted to
humans by the bite of infected Ixoid
ticks.
• *Normally lives in mice, squirrels and
other small animals
• Blacklegged (deer) ticks
• Lone star ticks
• American dog ticks
DEEPA BABIN 6
7. EPIDEMIOLOGY
• Transmitted by Ixodes ticks
• Nymph-stage ticks feed on humans-
transmit spirochete
• Endemic areas
– Northeastern coastal states
– Wisconsin & Minnesota
– Coast of Oregon & northern California
DEEPA BABIN 7
8. Methods of Transmission
• Vector-borne disease
• Vector is deer or black-legged tick (Ixodes
scapularis) or by the western black-legged tick
(Ixodes pacificus) on the Pacific Coast.
• Transmits B. burgdorferi while feeding on an
uninfected host
– the spirochetes are present in the midgut and
migrate during blood feeding to the salivary
glands, from which they are transmitted to the
host via saliva.
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9. Larva, nymph, and adult female and male Ixodes dammini ticks
They are smaller than we think
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10. Symptoms
• The early symptoms are
mild.IP- 3-30 DAYS
• The first symptom is usually
an expanding rash.
• Called Erythema Migrans.
• a central spot surrounded
by clear skin that in ringed
by an expanding red rash
looks like bull’s eye.
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11. Common presenting symptoms in lyme disease
• Symptoms of early localized Lyme disease (Stage 1) begin days or weeks after
infection. They are similar to the flu and may include:
• Body-wide itching
• Chills
• Fever
• General ill-feeling
• Headache
• Light-headedness or fainting
• Muscle pain
• Stiff neck
• There may be a "bull's eye" rash, a flat or slightly raised red spot at the site of
the tick bite. Often there is a clear area in the center. It can be quite large and
expanding in size. DEEPA BABIN 11
14. Disseminated and Persistant
• Paralysis or weakness in the muscles of the face
• Muscle pain and pain or swelling in the knees and other
large joints
• Heart problems, such as skipped heartbeats
(palpitations)
• Symptoms of late disseminated Lyme disease (Stage 3)
can occur months or years after the initial infection. The
most common symptoms are muscle and joint pain.
• Persistant- months or years later with chronic
arthritis,polyneuropathy,encephalopathy
• DEEPA BABIN 14
15. Prevention of lyme disease
• Take precautions to avoid direct contact with ticks.
Be extra careful during warmer months. Whenever
possible:
• Avoid wooded or bushy areas, or areas with high
grasses and leaf litter..
• Ticks that carry Lyme disease are so small that they
are very hard to see. After returning home, remove
your clothes and thoroughly inspect all skin surface
areas, including your scalp. Shower soon after
coming indoors to wash off any unseen ticks.
DEEPA BABIN 15
16. Borrelia recurrentis- Relapsing fever
• Relapsing fever borreliosis often occurs
with severe bacteraemia.
• Borrelia recurrentis is transmitted by the
human body louse; no other animal
reservoir
• Lice that feed on infected humans acquire
the Borrelia organisms then multiply in
the gut of the louse.
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18. TWO TYPES OF RELAPSING FEVER
• LOUSE BORNE AND TICK BORN
• 1.EPIDEMIC LOUSE BORNE
• 2.ENDEMIC TICK BORNE
DEEPA BABIN 18
19. Tick-borne = Endemic Relapsing Fever
Sporadic cases
Transmitted by soft body ticks
(vectors) from small mammal
reservoir
Ticks can multiply and infect
new human hosts
DEEPA BABIN 19
20. Louse-borne = Epidemic Relapsing Fever
Transmitted person-to-person by human
body lice (vectors) from infected human
reservoir
Infect host only when louse is injured, e.g
during scratching
Therefore, a single louse can only infect a
single person
Lice leave host that develops a fever and
seek normal temperature host
DEEPA BABIN 20
22. Morphology /Diagnosis
• Gram Negative Irregular Spirals With Pointed Ends
• 0.2 to 0.5 microns in width and 5 to 20 microns in
length. visible with light microscopy and have the
cork-screw shape
• Culture-Noguchi s MEDIUM, CAM
• Vector-Pediculus Humanus Corporis
• Ip-2-10 Days
• Febrile Onset Of Sudden Onset, fever Subsides After
3-5 Days And It Lasts For 4-10 Days
• Then Another Bout Of Fever Starts…relapse (3-10
Times) For Months Or Years
DEEPA BABIN 22
23. B.VINCENTII
• Mouth commensel
• Associated with fusiform bacilli
• Malnourished or viral infection it cause
ulcers - Gingivostomatitis
DEEPA BABIN 23
24. Diagnosis
• There are number of blood test available
• Antibody test :ELISA and western blot
tests.
Although there is false positive and negative
results
• Antigen detection tests
• Polymerase chain reaction: this test
multiplies the of Bb DNA to detectable
measurable level DEEPA BABIN 24
25. Diagnosis
• Serologic data by IFA, ELISA and
imunoblotting 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
• Direct Isolation
– Biopsies of the skinDEEPA BABIN may yield the
lesions 25
27. Treatment
• Antibiotic therapy
• Doxycycline and amoxicillin are used for two to
four weeks in early cases
• Doxycycline is also effective
• Cefuroxime axetil or erythromycin can be used for
patients who are allergic to penicillin or who
cannot take tetracycline's.
• More developed cases, may require treatment with
intravenous ceftriaxone or penicillin for 4 weeks
or more
DEEPA BABIN 27
28. Prevention
• 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
DEEPA BABIN 28
30. Control
• 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
• Host management
-Deer feeding stations equipped with pesticide applicators
-Baited devices to kill ticks on rodents
DEEPA BABIN 30
