Lymes Disease Borreliosis By Christer Suvatne Introduction Spread

Lymes Disease (Borreliosis) By Christer Suvatne

Introduction • Spread by Ticks • Caused by bacteria (borrelia) (Borrelia Burgdorferi) • It causes borreliosis (lymes disease) • The disease is multisystemic – involvement of skin, heart, joints and CNS • Affects mostly young and middle-aged people

TICKS Blacklegged Tick (deer tick) (spreads Lyme disease) adult male adult female Wood Tick (dog tick) (does not spread Lyme disease)

Adult (male) Adult (female) Nymph • Can lead to disease: 40 -60% adult 20 -30% nymph 0% larva Larva

Two-Year Life Cycle of Blacklegged Tick EGGS MEAL 1 • Mouse • Bird LARVAE NYMPHS Eggs laid, adults die MEAL 3 * For adults that did not feed in fall • Person • Deer • Dog MEAL 2 (peak feeding time May-mid July) • Person • Mouse • Dog SPRING SUMMER WINTER FALL Nymphs molt into adults Larvae molt into nymph stage ADULTS MEAL 3 • Person • Deer • Dog Nymphs dormant

Blacklegged Tick Nymph

To Get Lyme Disease • Blacklegged tick must be infected with Lyme disease bacteria • Only the nymphs and adult females can transmit the Lyme disease bacteria • Tick must be attached 24 - 48 hours before it passes bacteria to host

• Most cases are children and middle aged people • 54% is men • Most usual symptoms is neurological (54%) (248 ppl) • Arthritis (15 ppl) • totally 238 people were hospitalized in 2006

Lymes Disease 3 stages

Stage 1 – Early localized infection 3 to 30 days after deer tick bite • Rash (often “bulls-eye”) (red, warm, painless) • • Fever Chills Headache Muscle and joint pain Fatigue Flue like symptoms Can develop Borreliosis even if rash is not present

Erythema migrans (EM) rash characteristic of Lyme disease As the rash increases in size, it clears in the middle and develops a red ring around the outside. This rash: May expand to a very large size, Is usually not painful or itchy, and Often appears on the thighs, groin, trunk, armpit, or back. rash has been reported in about 60 to 80 percent of adults and 50 percent of children

Sometimes do not have bulls eye appearance (redden area without an outer ring) Not everyone gets a rash. . the early sign and symptom. (headache, fever, chills etc) is similar to other diseases, so difficult to diagnose Lymes if have no rash

Stage 2 – Early disseminated infection Days to weeks after illness onset • Multiple rashes • Facial paralysis on one side (bells palsy) • Fever, stiff neck, headache -> meningitis • Weakness, numbness, arm/leg pain • Irregular heart beat • Persistent weakness and fatigue

Multiple Rashes • Reaction as bacteria move through body • Not caused by multiple tick bites

Multiple Rashes • This is another example of a multiple rash.

Stage 3 – Late persistent infection Weeks to months after illness onset • Fatigue • Chronic arthritis (usually affect knees) • Nervous system problems (meningitis) and problems with short term memory, concentration,