Lyme disease: tracking an epidemic

Article Abstract:

Lyme disease is a complicated and mysterious illness caused by the spirochete Borrelia burgdorferi, and spread by the ticks Ixodes dammini and Ixodes pacificus. Cases are concentrated in the northeast and the Pacific coast states where these ticks are most prevalent. In the article by Dennis White and his colleagues in the September 4, 1991 issue of the Journal of the American Medical Association, the spread of I. dammini in New York State is described, but it is not clear whether the spread is transient or indicates an established presence. Because the diagnostic criteria are not clear and laboratory tests are not standardized, states have established different criteria for diagnosis, and these criteria have changed over the years. On January 1, 1991 a uniform case definition was established, and reporting is mandatory in most states, making it easier to track the disease. The spread of Lyme disease is probably a result of the resurgence of deer herds, which now roam freely in wooded suburban backyards; however, White and his colleagues suggest that I. dammini may also be spread by mammals and birds, and advise that migration-control strategies be discussed, although control of bird and mammal migration is not feasible. Research has concentrated on finding ways to kill the ticks with chemicals, but it is more effective for individuals to avoid tick-infested areas, use repellents and acaricides (tick-killing chemicals), wear protective clothing, and examine their skin and clothing for ticks. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Disease transmission, Tick-borne diseases, editorial

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Current perspective on lyme borreliosis

Article Abstract:

Lyme borreliosis, or Lyme disease, was first identified in 1975 in residents of Old Lyme, Connecticut. Individuals with Lyme disease experience a variety of symptoms including fever, chills, headache, sore throat, anorexia and nausea. A rash or skin lesion appears on most patients with Lyme disease soon after infection. Lyme disease can also affect the heart, the nervous system and the musculoskeletal system. Lyme disease occurs in woody or grassy areas in the US and Europe, and is transmitted by ticks that feed on mammals. Laboratory diagnosis of individuals with Lyme disease is difficult. The bacteria that causes Lyme disease is difficult to isolate from patients, and other diagnostic tests need to be improved. During the early stages of infection, patients can be effectively treated with oral antibiotics for up to three weeks. Intravenous therapy with antibiotics may be necessary in patients with more advanced infections. Many cases of Lyme disease can be avoided by preventing tick bites.

Case studies

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Long-term Outcomes and Management of Patients With Lyme Disease

Article Abstract:

Newer tests for Lyme disease may help identify and treat patients with clearcut symptoms of the disease. As of Feb, 2000, there is no standard blood test for Borrelia burgdorferi, the organism that causes Lyme disease. So doctors usually diagnose patients based on their symptoms and risk factors for Lyme disease. However, some symptoms are not specific to Lyme disease and the bacterium might also cause other diseases. A study found that most patients who were treated recovered and had no greater disability than a group of patients without Lyme disease.

Editorial, Prognosis

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