The information presented in this article is for educational purposes only. Please see your physician regarding diagnosis and treatment of Lyme or any illness.

A fascinating infection for more reasons than one, you could call Lyme disease the mysterious little sister of Syphilis. Like Syphilis, Lyme disease is caused by a spiral shaped bacteria classified as a spirochete. The initial signs of both Syphilis and Lyme manifest as skin lesions. The former disease commences as a genital chancre. The latter begins as a bull’s-eye rash. Like the spirochete that causes Syphilis,Treponema pallidum, the bacteria that causes Lyme, Borrelia burgdorferi has a penchant for saddling up to the nervous system. Left untreated, both diseases can result in secondary skin lesions, heart failure, blindness, and neurological disorders (Tortora, Funke & Case, Microbiology ; California: Benjamin Cummings, 1995>653). Therein, morphology recapitulates pathology. Think of these two corkscrew shaped bacteria as invisible Black & Decker drills boring their way slowly but surely inward. While microscopic invasion occurs, the untreated pathological changes may inflict considerable pain. Fortunately, Syphilis can be diagnosed with a routine Rapid Plasma Reagin test. But unlike Syphilis, Lyme disease is tricky to diagnose. Maladies most commonly associated with Lyme include chronic arthritis, meningitis, and congestive heart failure. (East Norfolk Health Authority, Communicable disease control section. Information for General Practitioners about Lyme Disease, 1996. The actual course of the illness may be extremely complex. Fortunately, protecting yourself from contracting this disease is quite simple. Moreover, since Lyme disease is often misdiagnosed, your very best defense is prevention.

Now, you may be asking yourself, how likely is it that I‘ll catch Lyme disease if I don’t take any precautions? Is it really worth the hassle ? According to the Massachusetts Department of Public Health, Lyme cases continue to rise in Massachusetts, warranting an urgent need for “ public education, improved surveillance, and effective policy...” (Mass Dept. of Public Health, Communicable Disease Update, Lyme Disease Advisory Committee [Vol.6,No.2. Spring,1998] 2). Indeed, more than 99,000 cases of Lyme have been diagnosed since 1982, a 32 fold increase in the last 16 years. This nation’s 1975 birthplace of Lyme disease, Lyme, Connecticut is bloated with the blight. Some towns report 1000 cases per100,000 residents (Communicable Disease Update,2). Disease rates continue to skyrocket at a furious rate. And this humdrum household name, Lyme disease, has a humdinger of an effect.

HISTORY AND ASSOCIATED ILLNESS

While relatively new to this country, disorders similar to Lyme disease were reported as early as 1900 in Europe (Monahan, Drake& Neighbors, Nursing Care of Adults [Pennsylvania: W B Saunders,1994]1403). Lyme disease transmission typically evokes images of the wilderness, whereby Davey Crockett types acquire their infection from the deer tick. It is true that deer ticks harbor the etiological agent of Lyme disease, the spirochete Borrelia burgdorferi (Nagi, Joshi& Thakur, “Cardiac Manifestations of Lyme Disease, A Review” Canadian Journal of Cardiology 12(5)1996:503-506). However, disease transmission is not limited to rural and suburban areas. Indeed, “Lyme disease can occur in wooded urban areas as well as rural areas if ticks and their hosts are present” (Daniels, Falco, Schwartz,Varde, & Robbins, Emerging Infectious Diseases, 3.3[1997]). Daniels etal discovered that white footed mice host the tick, Ixodes scapularis. One might conclude then, that rodent infestation may be at the heart of urban Lyme disease.
Very well then. We know what causes Lyme disease. We know that you can contract Lyme in the city or in the country. And we’ve seen how Lyme is similar to Syphilis. But what exactly is Lyme disease?

According to the East Norfolk Health Authority, “Lyme disease is a multi-system illness which may affect the skin, nervous system, joints, and heart. It can be divided into three clinical stages. Not all stages need appear, and the clinical stages may overlap” (1997). Monahan etal portray Lyme as a “chronic inflammatory disease transmitted by a tick bite”. These authors identify the bear/deer tick, Ixodes dammini as Borrelia burgdorferi’s primary vector. However, a variety of ticks may transmit the disease. This tick variegation is a crucial point. Ticks known to transport the sordid Borrelia burgdorferi include: Ixodes pacificus (Western States); Ixodes ricinus (Great Britain); Ixodes dammini, Ixodes scapularis, and Amblyomma americanum. The last three ticks mentioned work as double agents. Not content to inflict merely Lyme disease upon us lumbering mammals, they relish in their capacity to also spread Ehrlichiosis (MMWR/CDC & Emerging Infectious Disease 1997). Ehrlichiosis is a potentially fatal disease affecting the white blood cells. “Ixodes dammini is a common vector for transmission of both Lyme disease and human granulocytic ehrlichiosis” (Kolbert, Mitchell, Reed, Dumler, Bakken, Telfor&Persing, “Ixodes dammini as a potential vector of human granulocytic ehrlichiosis,” Journal of Infectious Disease 172[1995]:1007-1012). So our double agent ticks may be waylaying researchers who earnestly study Lyme disease. Diagnosticians might consider the plausibility of concomitant illness in the tick bitten patient. A single tick can simultaneously transmit both Borrelia burgdorferi and Ehrlichiosis.

Stages of Lyme disease

STAGE I

Some 3 to 32 days after being bitten by an infected tick, a characteristic bull’s-eye rash, Erythema chronicum migrans (ECM) appears. Look for a reddened circle with a clear center growing 5-20 inches in diameter (Physician’s Plus Health Education, April 1997. http://www.pplus.com/living/library/commun/lyme.htm.). This hallmark rash usually heralds the onset of Lyme disease. Nonetheless, it is important to remember that of those infected by the US strain of Borrelia burgdorferi, only 70% grow the ‘bullseye’. And in Europe, ECM is virtually unheard of. Likewise, ECM does not necessarily arise from the bite site. Several lesions or rashes may appear at this time. Early identification of the illness decreases the likelihood of serious complications. Look for these signs and symptoms of Lyme’s first stage: headache, chills, fatigue, nausea, fever, aching joints, sore throat, itching, and general malaise. When recognized swiftly,Lyme disease is readily amenable to treatment. The problem is, early symptoms mimic a slew of other diseases. And Studies by the Division of Vector Borne Infectious Diseases in conjunction with the FDA and the Association of State and Territorial Public Health Laboratory Directors have determined that “commercially available tests for Lyme disease are unreliable”. For this reason, the prevention of Lyme is fundamental.

STAGE II

Borrelia burgdorferi navigates through mammalian bodies from the heart through the nervous terrain, into the brain and finally the joints. This interstitial voyage may occur anytime from ‘three weeks to several months after the initial exposure’(Physician’s Plus Health Education,1997). Cardiac manifestations include dysrhythmias, atrioventricular heart block, myopericarditis, intraventricular conduction disturbances, bundle branch block, and congestive heart failure(Nagi etal,503). Writers for the Canadian Journal of Cardiology state that despite the severity of these symptoms, the “overall prognosis of Lyme carditis is very good’. Cardiac symptoms might be experienced as palpitations, chest discomfort, shortness of breath, and dizziness upon exercise (East Norfolk Health Authority,1996).

Neurological abnormalities associated with the second stage of Lyme disease include, but are not limited to, meningitis, encephalitis, and Bell’s palsy. A concerned brother posts on the internet: “ My sister was recently diagnosed with Lyme. She has been experiencing back and neck pain ...and was informed that there may only be 80% recovery. Most recently she has had symptoms of Bell’s Palsy: numbness in her gums and one side of her face. Her state of mind is depressed and discouraged”Monahan etal confirm this symptomolgy. They cite subjective symptoms including numbness, tingling, prickling, burning, cutting pain or abnormal sensations on the skin (1994). Musculoskeletal problems emerge during Stage II. The sufferer may experience joint pain (arthralgia), muscle pain (myalgia), myositis (muscle inflammation), and arthritis (joint inflammation) Other clinical manifestations include vision disorders, hepatitis, dry cough, lymphadenopathy, and testicular swelling (East Norfolk Health Authority,1996).

STAGE III

The final result of untreated Lyme disease may be chronic organ dysfunction. Arthritis, especially of the larger joints such as the hips and knees may plague the sufferer (East Norfolk Health Authority, 1996). In this stage, swelling and bluish-red discoloration of the hands and feet can occur. The skin wrinkles, grow slack, and wastes away. This condition is called Acrodermatitis chronica atrophica. Other symptoms of the third stage of Lyme include:

Lyme encephalitis - inflammation of the brainEncephalomyelitis --inflammation of the brain and spinal cord.

Spastic paresis - partial paralysis with muscular rigidity

Ataxia - lack of coordination

Myositis - inflammation of the muscle tissues

So, by now you may be asking, can’t the ticks get by as vegetarians? Well, even if they could, they may choose not to, which is why prevention is your gateway to success.

YOUR GATEWAY TO SUCCESS

Don’t expect to see a big bloater of a tick. Ticks who cause Lyme/ Ehrlichiosis grow to the size of a pinhead, a bit larger when stuffed. The good news is that the tick must be embedded for24-48 hours before it can transmit Lyme disease. Take the time to conduct a tick search of yourself and your family/pets once indoors. Don’t forget that disease causing ticks make their abode in both city parks and country dales. Attire yourself in light colored clothing to facilitate your tick search. For all you Goth-heads out there who would rather die than not wear black, look yourself over very well in the shower. Sources on prevention advise against walking barefoot,or wearing sandals, shorts and short sleeves. Lets be realistic. Unless you are a die-hard tick averter, that advice is difficult to follow in hot weather. The literature also recommends avoiding dense foliage. That’s a great idea if you don’t mind putting aside your entire life. You can easily spray the contents of a 6 ounce aerosol can of Permethrin or Deet on your clothes (not your skin). This will protect you through 5 launderings. Most importantly, check yourself for tiny ticks every day!

REMOVING THE TICK

What if you do find a tick? Physician’s Plus Health Educators teach the following techniques. As close to your skin as possible , grasp the tick with a pair of tweezers and pull straight out. DON’T JERK THE TICK!!!!! You could rip his head clean off of his body. Then you’ll have an alien head embedded in your skin. If this happens, do not attempt to remove the head yourself. Even though you may feel silly, visit your doctor for removal of the head. Otherwise, you run the risk of developing both Lyme disease and a local infection. If you do remove the tick intact, save him in a jar with a moist piece of tissue paper for later identification . Wash and apply antiseptic to the bite site. Lastly, watch yourself for symptoms of illness. Visit your physician promptly should symptoms emerge! With early diagnosis and treatment, Lyme disease is easily controlled.

AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE!