Lyme Disease: Capstone Project
As shown in the video, Lyme disease according to the Center for Disease Control and Prevention “is the most common vector-borne disease in the United States. Lyme disease is caused by the bacterium Borrelia burgdorferi and rarely, Borrelia mayonii. It is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system.”
Untreated Lyme disease can produce a wide range of symptoms, depending on the stage of infection. These include fever, rash, facial paralysis, neuropathy, and arthritis. Early signs and symptoms (3 to 30 days after a tick bite) include fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of a rash. Erythema migrans (EM) rash (see photo below) occurs in 70 to 80 percent of infected people. It can expand gradually of several days reaching up to 12 inches or more across. It will often clear as it enlarges, resulting in a target or “bull’s-eye” appearance.
Later signs and symptoms (days to months after tick bite) include:
- Severe headaches and neck stiffness
- Additional EM rashes on other areas of the body
- Facial palsy (loss of muscle tone or droop on one or both sides of the face)
- Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
- Intermittent pain in tendons, muscles, joints, and bones
- Heart palpitations or an irregular heartbeat (Lyme carditis)
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
- Nerve pain
- Shooting pains, numbness, or tingling in the hands or feet
Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat.
When assessing a patient for Lyme disease, health care providers should consider:
- The signs and symptoms of Lyme disease
- The likelihood that the patient has been exposed to infected blacklegged ticks
- The possibility that other illnesses may cause similar symptoms
- Results of laboratory tests, when indicated
CDC currently recommends a two-step testing process for Lyme disease. Both steps are required and can be done using the same blood sample. If this first step is negative, no further testing is recommended. If the first step is positive or indeterminate (sometimes called “equivocal”), the second step should be performed. The overall result is positive only when the first test is positive (or equivocal) and the second test is positive (or for some tests equivocal).
People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Early diagnosis and proper antibiotic treatment of Lyme disease can help prevent late Lyme disease.
Treatment regimens listed in the following table are for the erythema migrans rash, the most common manifestation of early Lyme disease. These regimens may need to be adjusted depending on a person’s age, medical history, underlying health conditions, pregnancy status, or allergies. Consult an infectious disease specialist regarding individual patient treatment decisions.
Lyme disease is caused by infection with the bacterium Borrelia burgdorferi. Although most cases of Lyme disease can be cured with a 2- to 4-week course of oral antibiotics, patients can sometimes have symptoms of pain, fatigue, or difficulty thinking that lasts for more than 6 months after they finish treatment. This condition is called Post-Treatment Lyme Disease Syndrome (PTLDS). As seen in the video, all of the interviewees have/are experiencing Post-Treatment Lyme Disease Syndrome.
Why some patients experience PTLDS is not known. Some experts believe that Borrelia burgdorferi can trigger an “auto-immune” response causing symptoms that last well after the infection itself is gone. Auto–immune responses are known to occur following other infections, including campylobacter (Guillain-Barré syndrome), chlamydia (Reiter’s syndrome), and strep throat (rheumatic heart disease). Other experts hypothesize that PTLDS results from a persistent but difficult to detect infection. Finally, some believe that the symptoms of PTLDS are due to other causes unrelated to the patient’s Borrelia burgdorferi infection. Unfortunately, there is no proven treatment for PTLDS.
Lyme disease is the most common vector-borne disease in the United States. A recently released estimate based on insurance records suggests that approximately 476,000 Americans are diagnosed and treated for Lyme disease each year. In addition to a large burden of illness, areas where Lyme disease is common are expanding.
Lyme is one of the fastest growing infectious diseases in the country and yet Lyme research is dramatically underfunded. It receives less than 2% of public funding for West Nile and 0.2% of funding for HIV/AIDS, despite the fact that the annual case count for Lyme dwarfs either disease. There are now nearly half a million new cases of Lyme disease annually in the US — this is more than HIV/Aids, West Nile virus and Malaria combined.
With over one million patients struggling with persistent Lyme disease, it’s sad to see that this illness is so underfunded and takes several months or years for patients to get diagnosed. Although the CDC claims to be improving their prevention and treatment for the disease, much of their information on Lyme is from around 2014. I hope that Heather, Steve, and Mitch’s stories give you some insight on how debilitating this disease can be on a day-to-day basis and that more research and time needs to be put into better prevention and treatment for a disease that affects 476,000 people.
Sources:
