Lyme Disease – Important Facts

What is Lyme disease? Lyme disease or Lyme borreliosis is named after the town of Lyme in Connecticut, USA, where the disease was first associated with tick bites in the 1970s. In Europe, Lyme borreliosis is the most common tick-borne infectious disease. It is transmit ted by the common wood tick (Ixodes ricinus). In 1981, bacteriologist Willy Burgdorfer discovered the bacterium Borrelia burgdorferi. It is transmitted from ticks to humans when they feed on blood from humans. Borrelia are mobile, spiral-shaped bacteria. So far, six subspecies are known: B. burgdorferi sensu stricto, B. afzelii, B. garinii, B. bavariensis, B. spielmanii and B. mayonii. In Europe, all subspecies are found except B. mayonii.

Where do infected ticks most frequently occur? Ticks infected with Borrelia are found throughout Germany, but the frequency varies from region to region. In some areas of southern Germany, up to 37 % of adult ticks carry the pathogen. Younger animals (larvae and nymphs) are less likely to carry the disease. The risk of getting Lyme disease after a tick bite lies between 0.3 and 1.4 % in Germany.

How does transmission take place? The Ixodes ricinus tick lives in grass, under bushes, hedges and in forests. People usually come into contact with them during outdoor activities – for example, while jogging, hiking or sitting on the ground. However, tick bites occur just as often in the garden or in a park in the middle of the city. Animals, such as dogs or cats, can bring ticks into the home. When an infected tick bites it does not necessarily transfer Borrelia. The pathogens are located in the animal‘s intestine. They only migrate to the salivary gland during the sucking act, from where they are released into the bite wound with the saliva in a cocktail of anticoagulant, tissue-dissolving and immune system-inhibiting substances. The longer the tick remains in the skin, the greater the risk of infection. A transmission from human to human is not possible.

What are the symptoms? Most Borrelia infections (40 %) go undetected. Only every third or fourth infected person develops any signs of illness at all. Several symptoms are typical:

Erythema migrans

The most common symptom of Lyme disease (80–90 %) is usually manifested by a so-called migratory erythema (erythema migrans), a red circular non- itchy spot or ring with sharply demarcated redness around the tick bite that spreads in a ring-like pattern until it reaches a diameter of at least five centimeters. This usually occurs a few days to weeks after the bite. Sometimes, however, nonspecific flu-like symptoms also occur – such as muscle pain, fatigue or fever. If skin changes occur, a physician should always be consulted (even if the redness does not visibly migrate). In some Lyme disease patients, round or oval redness occurs simultaneously in several areas of the skin (multiple erythemata migrantia).

Borrelia lymphocytoma

Less frequently, a mostly single blue-red nodule appears in the skin, the so-called Borrelia lymphocytoma (blue-red skin nodule). The painless, soft nodules may occur on any part of the body, but are most commonly found on the ear, nipples or genital area, and very rarely on the nose. They are more common in children.

Neuroborreliosis

In 3 – 15 % of all cases Borrelia can infect the nervous system. Several weeks may pass between the tick bite and the neuroborreliosis symptoms. In some people, an erythema migrans appears beforehand , but it can also occur without skin changes. It is accompanied by burning and stabbing pain, which occurs mainly at night. Other symptoms are numbness , severe headaches, visual and hearing disturbances, and paralysis (especially of the facial nerves i.e., facial paresis).

Inflammation of the heart

Very rarely there can be inflammation of the heart with cardiac arrhythmias.

Chronic inflammation of the joints , skin and nervous system

If Lyme disease is not treated with antibiotics, the pathogens can persist in the body and cause late symptoms after months or years. The late stages of Lyme disease are rare and primarily affect the joints, skin and nervous system. Typically, an individual joint or a few large joints become inflamed – most commonly the knee joints, less commonly ankle and elbow joints. This is typically met with massive swelling (Lyme arthritis). The symptoms may occur in episodes. Similarly, acrodermatitis chronica atrophicans may occur (mainly affecting older women).

How to prevent Lyme disease? The tick should be removed as early as possible. There are usually hours between the tick bite and the transmission of the borrelia, but it is only after 10 hours that the tick begins to draw blood and the transmission of the pathogens likely starts. The tick should not be squeeze d during removal, as this increases the likelihood that it will release the pathogens into the bite wound. The use of tick tweezers/forceps is recommended

Is the disease easily treatable? There is no vaccine against Lyme disease and once you have had Lyme disease, you can always be re-infected; the infection does not induce a lifelong immunity. Borrelia usually responds well to antibiotic treatment and Lyme borreliosis heals completely in most cases. Severe cases are rare. In order to safely render the Borrelia bacteria harmless, the antibiotics should be taken as prescribed by the doctor. Depending on the form of the disease and the antibiotic used, treatment lasts for 10 – 30 days.

EXERCISE:

1. There is a vaccine against Lyme disease A True B False

2. What are some symptoms for Lyme disease? A Neuroborreliosis B Borellia Lymphozytoma C Inflammation of the heart D Erythema migrans E Nausea

You’ll find the answer below.

BIBLIOGRAPHY 1. www.awmt.org 2. http://dict.leo.org 3. www.dict.cc 4. www.infektionsschutz.de 5. www.rki.de 6. www.webster-dictionary.org

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTA. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten.

Kontakt: mail@lobitz-seminare.de

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Lösung für Exercise:

1. B

2. A–D

Lyme Disease – Important Facts

What is Lyme disease?

Where do infected ticks most frequently occur?

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Lyme Disease – Important Facts

What is Lyme disease?

Where do infected ticks most frequently occur?

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