Presentation by: JT CabreraHUB32

LYME DISEASE

HISTORY- for thousands of years- 5,300 year-old mummy- Alfred Buchwald - first described the

chronic skin rash (erythma migrans) more than a 130 years ago

- recognized in the US in the 1960s to 1970s.

- Borrelia burgdorferi wasn't classified until 1981

The 1970sA group of children and adults in Lyme, Connecticut, had

symptoms that included swollen knees, paralysis, skin rashes, headaches, and severe chronic fatigue. Hospital cases of similar symptoms among people were common.

Families were left undiagnosed and untreated for years. Two mothers from Connecticut were persistent in finding out about the disease. They began to take notes, conduct their own research, and contact scientists.

The medical establishment began to study the symptoms and looked for several possible causes. Was it airborne or waterborne? The children had reported skin rashes followed by arthritic conditions, and they had all recalled being bitten by a tick in the region of Lyme, Connecticut.

By the mid-70s, researchers began describing the signs and symptoms of this new disease. They called it Lyme, but the cause was still unknown.

The 1980sWilly Burgdorfer, who was studying Rocky Mountain Spotted

Fever, began to study Lyme disease, and found the connection between the deer tick and the disease. He discovered that a bacterium called a spirochete, carried by ticks, was causing Lyme. The medical community honoured Dr. Burgdorfer’s discovery in 1982 by naming the spirochete Borrelia burgdorferi.

Doctors began to use several antibiotics to treat Lyme disease. This treatment is currently accepted by the medical profession and has been largely successful, especially for those with early-stage Lyme disease. However, there continues to be heavy debate on the long-term use of antibiotics for Lyme that has progressed or appears resistant to a short course of antibiotics.

MORPHOLOGY

• weakly-staining Gram-negative, tick-borne spirochetal bacterium

• length: 20 μm - 30 μm, width 0.2 μm to 0.3 μm in width • axial filament composed of flagella, to move in a corkscrew

fashion• optimally grown and isolated at 32°C in a microaerophilic

environment• outer surface proteins (Osp) involved in it's virulence and

transmission

Borrelia burgdorferi

GEOGRAPHICAL DISTRIBUTION• areas having high deer

population• New York,

Pennsylvania, Connecticut, New Jersey, Rhode Island, and Maryland

• community near woodlands and forest

• deer tick or blacklegged tick• larvae - either mice or deer, feed on blood• egg to adult - two years• tick is introduced to a human host, pathogen

disseminates into the salivary glands of the tick and enters host

• 2 to 3 weeks after infection, bacteria is spread throughout the body

INFECTION

• The bacterium is a master of immune evasion. It changes its surface antigens while it is in the tick and again after it has transmitted to a mammalian host

• During early tick feeding, this pathogen remains within the gut, dividing within the blood nutrients being procured by the parasite.

• Antibodies in the blood of vaccinated individuals bind to the Lyme disease organism during tick feeding and inactivate the spirochete before it can be transmitted to human hosts.

• In 2001 the vaccine was removed from the market because of unacceptable toxicity and side-effects

INTENSITY OF INFECTION

SIGNS & SYMPTOMSERYTHEMA OF SKIN; SUFFER FATIGUE,

MUSCLE AND JOINT

STIFFNESS

SWOLLEN LYMPH NODES OFTEN

RESEMBLING FLU LIKE

SYMPTOMS

IF UNTREATED - SPREAD TO JOINTS, THE HEART, AND

THE NERVOUS SYSTEM

MENINGITIS AND

ABNORMAL HEART

RHYTHMS

LYME NEURO-BORRELIOSIS

LYMPHOCYTIC MENINGITIS

CHRONIC INFECTION - MUSCLE AND

NERVOUS SYSTEM

DAMAGE, HEART FAILURE, AND

PARALYSIS

Early treatment - 14 to 21 day course of oral antibiotics; eliminate all traces of infection.

Medications used:- doxycycline for adults and children older than 8 years old- cefuroxime and amoxicillin for adults, younger children,

and women who are breast-feeding

Persistent or chronic Lyme disease - intravenous antibiotics for a period of 14 to 21 days, eliminates infection but improvement of symptoms occurs more slowly.

TREATMENT

In 2012, Lyme disease was included as one of the top ten notifiable diseases by the Centers for Disease Control and Prevention (CDC).

The CDC estimates that there are 300,000 new cases of Lyme disease each year in the US; one of the fastest-growing vector-borne infections .

While it was primarily an East Coast phenomenon in the beginning, it has since been reported in all states except Hawaii. And diagnostic tools are still unreliable — as of yet there is no definitive cure for those with late-stage Lyme.

Bay Area Lyme Foundation is determined to drive new research and accelerate the day when Lyme disease is easy to diagnose and simple to cure.

LATER STUDIES

• http://www.orkin.com/other/ticks/deer-ticks/• http://www.ppdictionary.com/bacteria/bwum/burgdorfei.htm• http://www.nytimes.com/health/guides/disease/lyme-disease/overview.html• http://www.bayarealyme.org/about-lyme/history-lyme-disease/• https://www.lymedisease.org• http://www.cdc.gov/niosh/topics/lyme/• http://www.cdc.gov/lyme/transmission/index.html

REFERENCES