The tick responsible for Lyme disease in the USA

November 2nd, 2010

This tiny little tick is the one responsible for spreading Lyme disease.  It is called the blacklegged tick, and is also known as the Lyme disease tick, by virtue of being the carrier of this disease. As can be seen from the photo of the black legged tick below, its markings are quite obvious.

The blacklegged tick is the tick responsible for spreading lyme disease

However, the lyme disease tick in the USA comprises two ticks:The Eastern blacklegged tick distribution

The Ixodes scapularis tick of the Eastern USA, and the Ixodes pacificus tick of the western USA.

Western blacklegged tick distribution in the USA

Both these lyme disease ticks look pretty much the same and are both called the blacklegged tick.

Although popularly referred to as insects, the lyme disease tick has 8 legs, and is therefore an arachnid, like a spider is.

So, how do you know if the tick that bit you is a lyme disease tick?

It’s size, but mostly it’s appearance is the big give away:

Showing the difference between the black legged tick and the other ticks in the USA

The lyme disease tick has a pronounced darker area around the top half or more of it’s body, the other two ticks do not.

The Life Cycle of the Lyme disease tick:

Lifecycle of the lyme disease tick - When is it the possible carrier of the lyme disease

AS you can see from this lovely picture of the lyme disease tick lifecycle, the eggs and larva are not considered to be greatly  infectious for lyme disease.  Rather, it is only when the lyme disease tick is in the nymph stage that they pose the greatest real risk to humans – presumably because, as adults, it is no longer feeding to grow.

Essentially any animal can act as a host for the lyme disease tick, including robbins, deer, foxes, mice … Come autumn and winter, and the lyme disease tick poses little risk of infection.

How do you remove a tick?

Carefully, as you don’t want to leave the head attached into your skin, which can easily happen if you yank on the body.

Tick removal done right

So, with a pair of fine, pointy tweezers, you grasp the tick around the head region, and lift it up off the skin steadily. This can be a bit of a challenge given the small size of a lyme disease tick, and the way it sticks its head into your skin.

Should we coat the tick with vaseline or try burning it or do something else to it? The CDC says not to do anything to the tick prior to its removal, as you could cause the tick to inject more saliva into you, thereby increasing your risk of catching lyme disease etc.

Why is the removal of the head from the skin so important?

I believe it is because that when a tick feeds, it does so by a tube it inserts into the skin, and the blood then flows up the tube into its body.  The problem is that blood animals have blood that coagulates to seal off breaks in the blood vessels and capilleries. So, the blood coagulates to prevent the tick from from taking the blood.  In order to get round this, the tick automatically excretes it’s saliva into the blood vessel to prevent the blood from coagulating at that point.  It is believed, that via this saliva,  the lyme disease is carried into the human body.  So, if you remove the tick body and leave the head, the first thing your leaving there is the tube and head that are responsible for the saliva being pumped in in the first place.

Secondly, infection can set in where the tick head is left behind.

Thirdly, if you grasp the tick round the body, your likely to force more saliva from the tick into you, and increase the risk of catching lyme disease from it, if the tick is likewise infected.

Maps, diagrams, drawings  and photos courtesy of www.cdc.com.  You may also find http://www.anaes.med.usyd.edu.au/venom/spiders.html a useful page on tick removal.

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Lyme Disease Vaccination

November 1st, 2010

What some of you may not be aware of is that their is a vaccine that has been made and tested, and found to be effective against Lyme disease.

The Lyme disease vaccine is called LYMErix and is made by TM SmithKline Beecham Pharmaceuticals.  It is available to residents of the USA aged 15 to 70 years.

Clinical trials have been fruitful and the side effects rather few, and I will describe those side effects in another post to come.

This post is to describe the results and recommendations made in relation to this Lyme disease vaccine, by a document appearing on the CDC web site (originally posted in 1999).

Firstly, the Lyme disease vaccine requires you to have three vaccinations with LYMErix:

With 2 vaccinations you have a 49% chance of being protected against the Lyme disease YOU HAVE ALREADY CAUGHT; with 3 vaccinations that climbs to 76% chance that the Lyme disease YOU HAVE ALREADY CAUGHT will be defeated.

Although no stats are obviously apparent, the value of the Lyme disease vaccine for non-infected persons is determined by the density of  Lyme disease carrying ticks in the environment  and the amount of contact the person is likely to have in the area where those ticks are.   The medical opinion of that document is one of cost analysis to a large degree, but I would argue that the human suffering of those who do become infected, warrants a wider group of people having access to the vaccine than would otherwise be recommended medically speaking.

Specifically these learned people argue that the vaccine is NOT recommended for those in low risk groups, whereas this should be for the person to decide.  As Katelyn, the previous author of LymeAdvocate.com found, the family dog was considered to have negligible risk of catching Lyme disease, because it was a house dog, not an outdoors dog.  Well, the dog went outside, got bitten by a lyme carrying tick, and later died.  Although I am not talking about pets on this page as such, the juxtaposition of pet dog and human is very worthwhile mentioning and pointing out, for the same goes for people in low risk groups – they are still open to becoming infected by Lyme disease infected ticks.

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Lyme Disease Map – Maryland

November 1st, 2010

The Maryland lyme disease map, shows the distribution of reported Lyme disease cases throughout Maryland – map courtesy of the CDC

Maryland Lyme disease map, showing the prevalence of Lyme disease through out Maryland

The map regrettably does not give the color coding for incidence of lyme disease, and this is a problem with the actual CDC map of Maryland.  I suspect that the darker the color, the higher the incidence of lyme disease for that Maryland zipcode.

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Lyme Disease Map: California

November 1st, 2010

The Lyme disease distribution map for California – again, courtesy of the CDC, and again only refers to the reported number of cases – the unreported/undiagnosed ones obviously are not included in these California Lyme Disease map statistics.

The distribution map of Lyme disease reported cases over California

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Lyme Disease Map – United States

November 1st, 2010

Lyme disease map of the USA shows the incidence level of lyme disease across the United Stated.  It needs to be pointed out that the Lyme Disease map refers to the cases reported by doctors to the CDC – Centers for Disease Control and Prevention.  Most Lyme disease maps come from the CDC, as do the following Lyme disease maps:

Map of Lyme disease reported cases

Lyme disease incidence across the USA

Lyme disease - reported cases on map in 2003Maps of lyme disease reported cases over 2009

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The Signs and Symptoms of Lyme Disease

October 26th, 2010

What are the Signs and Symptoms of Lyme Disease?

 

Lyme Disease causes numerous symptoms, but none of them are unique to lyme disease, which makes diagnosing Lyme disease on the basis of presenting symptoms extremely difficult.
Further, it has also been identified, that each of the 4 Borrelia burgdorferi bacteria groups can and do generate different symptoms of Lyme disease to each other, making it damn near impossible to identify Lyme disease purely on the basis of presenting symptoms alone.

There are, however, 3 common symptom stages in the progress of Lyme disease in humans, and each stage of Lyme disease comes with its own kind of general symptoms:

Stage 1 Symptoms of Lyme Disease:

Within 2-3 weeks of the Lyme infection:
High temperature, fatigue, headaches, muscle pains, joint pains (not arthritis) and enlarged lymph glands, typically shows.

Lyme disease rash / infection

Lyme disease infection - the red bulls-eye

A red bulls-eye looking infection often shows within one month of being bitten by an infected tick, normally at the same spot where the tick bit you. You can see this bulls-eye characteristic in the following picture. Matter of fact, this characteristic is the only symptom totally unique to Lyme disease infection in humans, that when you get it, your doctor can diagnose the condition on that symptom alone. Alas though, not everyone who becomes infected with Lyme disease gets this unique symptom, only about 60 to 80% of Lyme infected persons in North America do so.


Stage 2 Symtpoms of Lyme Disease:


After a number of weeks, or even months, the common Lyme disease symptoms can include:
Inflammation of the heart, chronic inflammation of the tissues surrounding the brain or spinal cord, inflammation of a nerve often with pain and occasionally loss of function (eg Bell’s palsy) and inflammation of the outer surface of the eye. Pain in joints and pain in muscles are often prominent.

Stage 3 Symptoms of Lyme Disease:

The symptoms that can occur months / years after contracting Lyme disease:

Lyme disease arthritis – Lyme arthritis

In the USA and Canada the main Lyme disease symptom is significant arthritis of the large joints, especially the knees.

Acrodermatitis chronica atrophicans

In Europe, the main symptom to appear at this stage is acrodermatitis chronica atrophicans, which is a skin condition generally affecting the hands and feet. The skin being chronically inflamed, which leads the skin to become extremely thin, dry and fragile, with areas of hardening and thickening.

 These stages of Lyme disease symptoms are vital to diagnosing and treating Lyme disease.

If you try and treat Lyme disease without knowing what symptom stage the Lyme disease is in, there is a good chance you will treat the lyme disease with the wrong treatment.

Much of this information on Lyme disease came from http://medent.usyd.edu.au/fact/lyme%20disease.htm – a rather dry piece of academic work, but full of information.

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Lime Disease FAQ – Questions and Answers

October 26th, 2010

 What is Lyme Disease?

Lyme disease – sometimes abbreviated to Lyme disease – is an animal disease which can be transferred to humans by ticks. Lyme disease is actually a bacteria, named Borrelia burgdorferi, and there are four varieties of the Borrelia burgforferi bacteria which were identified in the laboratory. To spell that out a bit more, there are actually four varieties of Lyme disease that humans can get!

How Common is Lyme Disease?

Since being recognised in the mid 1970’s, Lyme disease has become the most commonly identified tick-borne disease to infect humans across the globe.

Where can you catch Lyme Disease?

Lyme disease has been recorded in each continent of the earth (except Antarctica) in spite of the fact that uncertainty remains as to whether Lyme disease occurs south of the equator, such as in Australia.

How is Lyme Disease Spread?

Short and sweet, Lyme disease is transferred to humans, from animals, by ticks. Any tick that feeds on an animal infected with Lyme disease – whether the tick be laraval, nymphal or adult – will then carry the bacteria, and spread the bacteria to any host it decides to feed upon, whether animal or human. The common animal host for the ticks are small and warm blooded creatures, such as a mouse, though deer infected with Lyme disease have also been known to pass the infection on to humans by tick as well.

Can any tick spread Lyme Disease?

Not all ticks are the same when it comes to being responsible for spreading Lyme disease onto humans. In the northern hemisphere, there are only four species of ticks known to pass lyme disease on to humans: Ixodes scapularis and Ixodes pacificus in the United States, Ixodes ricinus in western Europe, and Ixodes persulcatus in eastern Europe and Asia. No Ixode specie lives in Australia, so Australia is free of Lyme disease for the most part.

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Lyme Disease Diagnosis

October 26th, 2010

Lab work must always be undertaken to confirm any suspicion of lyme disease and also to rule out other conditions that have similar symptoms.

Using a Culture/PCR to diagnose Lyme disease

The lab work typically requires a small skin biopsy taken from the edge of the bulls-eye infection, which is then cultured in the lab. In can take up to 8 weeks for the lyme disease bacteria to reach sufficient numbers to be identified via the culture. Alternatively, using a technique called the Polymerase chain reaction (PCR), the lyme disease may be diagnosed in as little as 24 hours.

Using blood tests to diagnose Lyme disease

Blood testing for Lyme disease is not so good, and is unreliable. Blood tests are used in the two latter stages of Lyme disease, NOT the start.

Sometimes people will be found to have Lyme disease in the latter stages, who in fact do not have Lyme disease. The unreliability of blood tests is due to other conditions that give similar results to Lyme disease on the tests. There is no Lyme disease blood test as such. Screening tests are to catch people who may be more likely to have Lyme disease, not to diagnose Lyme disease.

Using DNA type testing to diagnose Lyme disease

Were you found to be positive or borderline on the screening test for advanced Lyme disease?

Any borderline or positive results should be confirmed by using the Western immunoblot (WB) test, on a tissue sample ( a biopsy of tissue is taken from the patient, and it is tested in a simialr way to DNA, except they are checking for proteins specific to Lyme disease, rather than human DNA)

The Western immunoblot test can detect advanced Lyme disease – but is more costly and time consuming than the blood screening tests.

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Lyme Disease Treatment with antibiotics

October 26th, 2010

Stage 1 and Stage 2 Lyme Disease Treatment with Antibiotics 

The antibiotic treatment for early Lyme disease typically results in full recovery. A two week treatment with oral doxycycline or amoxycillin during Stage I and a third generation cephalosporin for Stage II are the popular treatments.

Chronic lyme disease treatment with Antibiotics

 Treatment for stage 3 Lyme disease is not as worthwhile with the chronic infection remaining resilent to treatment, and some of those who do seem to benefit may experience bouts of relapse. A third generation cephalosporin over 3 weeks is considered worthwhile.

However,with stage 3 Lyme disease symptoms, treatment with appropriate antibiotics may continue for up to two month.  Generally, once the arthritis symptoms are gone, the treatment is deemed successful.  Some people will not get over their arthritis, even with the two months antibiotic treatment.

Most cases of Lyme arthritis, by the way, are non-destructive, so people with Lyme arthritis  have complete recovery.

Prevent Chronic Lyme arthritis and other such lyme related conditions

It is important to realise that early antibiotic treatment in stage 1 may prevent the chronic conditions of eg Lyme arthritis from taking hold.  Even if you have a mild case and you and your doctor don’t feel antibiotics are needed then, you need to realize that the infection continues in your body and does continue to do damage, hence early antibiotic treatment is considered best, even in mild cases of the disease.

Why is antibiotic treatment used for Lyme infections?

Well, in this photo below, you can see just one of those  little critters

Close up of a Lyme disease bacteria

and in this photo below, you can see a large number of them,

A microscope perspective of what the lyme disease bacteria look like

and those critters are bacteria.

Appropriate antibiotics will trigger the body to make antibodies to attack that specific bacteria, vis-a-vis Lyme disease.

You must always complete the course of antibiotics that you are prescribed for your Lyme disease, as if you do stop the antibiotics prematurely, the  body may not yet have wiped out the bacteria completely, and any bacteria remaining may still be able to breed up.  If they do that, the antibiotics you previously used may not work the second time round, as the bacteria adapts to the antibodies that were attacking it, but failed to kill the infection completely.  This is called antibiotic resistence, and you may inadvertantly breed up a strain of Lyme disease that is hard to kill off – all because you couldn’t be bothered taking the full course of the antibiotic to start with, because you started to feel well.

Photos of the Lyme disease bacteria courtesy of  www.cdc.com , and the antibiotic info largely from http://medent.usyd.edu.au/fact/lyme%20disease.htm

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Prevention of Lyme Disease

October 26th, 2010

Take heart, the transmission of the Lyme disease bacteria normally occurs after the tick has attached itself to the host for around 24 hours. So if the tick has been attached for much less time, there is every reason to feel a bit more safe about not having caught it.

The prevention of Lyme disease is primarily achieved by:

1… by avoiding tick infested locations,

2… by avoiding tick bites through the application of repellents,

3… by dressing in light colored clothing. The light colored clothing is to make it easier to see a tick, should one get on the clothes – obviously, if you see the tick, you should remove and dispose of it quickly.

 

Antibiotics to Prevent Lyme Disease 

Antibiotic use to try and prevent Lyme disease appears to have little value, and is therefore apparently not considered worthwhile at this time.

 

Lyme Disease Vaccine

Vaccines for Lyme disease are continuing to be researched, but no vaccine yet is cost effective enough to be used by the entire populace.

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