Lyme and Tick-Borne Diseases (TBD)
Lyme and tick-borne diseases are preventable infectious diseases transmitted through a tick bite. Ticks can carry bacteria, viruses and parasites. Each tick-borne disease presents with distinct signs and symptoms and may sometimes cause changes in laboratory markers.
From Preventing Lyme and Tick-Borne Diseases Online Course by Alexis Chesney, 2024.
Preventing Lyme and Tick-Borne Disease is Imperative
In 2022, approximately 63,000 cases of Lyme disease were reported to the CDC by state health departments and the District of Columbia. However, recent estimates using other methods suggest that approximately 476,000 people may be diagnosed with Lyme disease each year in the United States (Source: Center for Disease Control and Prevention). Lyme disease is a growing concern, with 10-20% of those diagnosed continuing to experience chronic symptoms, known as Post-Treatment Lyme Disease Syndrome (PTLDS) (PMID: 1845280).
Studies show that Lyme disease costs approximately $1.3 billion annually in medical costs in the United States (Source: Johns Hopkins Bloomberg School of Public Health, 2015). Despite the significant impact of tick-borne diseases (TBD) on physical, mental, emotional, social, and economic health, federal funding for TBD is less than for other diseases. The NIH and CDC spend $97,648 on each new surveillance case of HIV/AIDS and $47,522 on each new case of Hepatitis C, compared to just $1,070 on each new case of Lyme disease (Source: Tickborne Disease Working Group – US Dept of Health and Human Services).
Health care providers are increasingly challenged by the complexity of Lyme and tick-borne disease cases. Ending the Lyme and TBD epidemic through prevention is essential!
Studies show that Lyme disease costs approximately $1.3 billion annually in medical costs in the United States (Source: Johns Hopkins Bloomberg School of Public Health, 2015). Despite the significant impact of tick-borne diseases (TBD) on physical, mental, emotional, social, and economic health, federal funding for TBD is less than for other diseases. The NIH and CDC spend $97,648 on each new surveillance case of HIV/AIDS and $47,522 on each new case of Hepatitis C, compared to just $1,070 on each new case of Lyme disease (Source: Tickborne Disease Working Group – US Dept of Health and Human Services).
Health care providers are increasingly challenged by the complexity of Lyme and tick-borne disease cases. Ending the Lyme and TBD epidemic through prevention is essential!
Lyme Disease
Lyme disease is the most common tick-borne disease. It was first identified in 1975 in Lyme, Connecticut by Dr. Alan Steere, following an unusual number of juvenile arthritis cases. In 1982, Willy Burgdorfer discovered the bacteria in ticks on Long Island that causes Lyme disease.
Lyme disease is caused by an atypical bacterium called Borrelia. It is classified as a spirochete, meaning it has a helical, corkscrew-like shape. Spirochetes are unique among bacteria due to their arrangement of flagella, which gives them motility. The Borrelia bacterium can express a variety of lipoproteins on its outer membrane, known as outer membrane surface proteins (Osp), which change depending on its environment, such as within the tick or host, and in response to the host’s immune system. This variability enhances its ability to invade the host effectively.
While Borrelia burgdorferi and Borrelia mayonii are the species that cause Lyme disease in North America, the following species cause Lyme disease throughout the world: B. afzelii, B. garini, B. spielmanii, B. bavariensis, B. bissettii, B. lusitaniae, B. valaisiana.
Once in the human host, Borrelia can change forms into round bodies which evade the immune system and antibiotics when used to treat Lyme disease. Additionally, a community of Borrelia spirochetes can come together and create a structure around themselves called biofilm, which protects this "city" of pathogens.
After a tick bite (from a tick that may transmit Lyme disease, like the blacklegged tick or the Western blacklegged tick in North America), watch for the following signs and symptoms which may manifest from three to 30 days after the bite:
Lyme disease is caused by an atypical bacterium called Borrelia. It is classified as a spirochete, meaning it has a helical, corkscrew-like shape. Spirochetes are unique among bacteria due to their arrangement of flagella, which gives them motility. The Borrelia bacterium can express a variety of lipoproteins on its outer membrane, known as outer membrane surface proteins (Osp), which change depending on its environment, such as within the tick or host, and in response to the host’s immune system. This variability enhances its ability to invade the host effectively.
While Borrelia burgdorferi and Borrelia mayonii are the species that cause Lyme disease in North America, the following species cause Lyme disease throughout the world: B. afzelii, B. garini, B. spielmanii, B. bavariensis, B. bissettii, B. lusitaniae, B. valaisiana.
Once in the human host, Borrelia can change forms into round bodies which evade the immune system and antibiotics when used to treat Lyme disease. Additionally, a community of Borrelia spirochetes can come together and create a structure around themselves called biofilm, which protects this "city" of pathogens.
After a tick bite (from a tick that may transmit Lyme disease, like the blacklegged tick or the Western blacklegged tick in North America), watch for the following signs and symptoms which may manifest from three to 30 days after the bite:
- Rash (erythema migrans) (see below for photos): a pink or red rash surrounding the tick bite that:
- May or may not feel warm to the touch
- May or may not be circular with central clearing (bull’s eye)
- May be flat or raised
- Usually spreads in a centrifugal fashion from around the bite outward
- May manifest as multiple bull’s-eye rashes across the body (known as disseminated erythema migrans)
- Flu-like symptoms (fever, chills, sweats, unusual fatigue, headache)
- Swollen lymph nodes
- Joint pain and/or swelling
- Muscle pain
- Fatigue
- Headache
- Stiff neck
- Heart symptoms: chest pain, shortness of breath, palpitations, fainting
- Eye symptoms: redness of eyes, itchy or burning eyes, discharge, floaters
- Neurological symptoms: Bell’s palsy or facial nerve (cranial nerve VII) palsy ( the dropping of one or both sides of the face due to loss of muscle control), numbness, tingling, burning, shooting pain, weakness, cognitive changes, memory loss, mood changes, personality changes, seizures, confusion, pain with eye movement, double vision, ringing in ears, hearing loss, vertigo, problems walking, difficulty with balance
Photos courtesy of CDC.
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Changes on laboratory testing may include: elevated erythrocyte sedimentation rate, mildly elevated hepatic transaminases, microscopic hematuria or proteinuria.
Early diagnosis and comprehensive treatment of Lyme disease offer numerous benefits, including preventing more serious disseminated symptoms, avoiding the development of chronic illness, facilitating a quicker recovery, and minimizing disruptions to work, school, and family life.
If you are experiencing symptoms or think that you might have a tick-borne infection, please seek professional medical advice from a licensed healthcare professional. To find a Lyme-literate practitioner, consult any of the following organizations, which are dedicated to Lyme and tick-borne disease education, advocacy, and research.
–Global Lyme Alliance: https://globallymealliance.org/
–International Lyme and Associated Diseases Society (ILADS): https://www.ilads.org/
–LymeDisease.org: https://www.lymedisease.org/
While Lyme disease is the most common tick-borne disease, there are many other tick-borne diseases and each of them is treated in a specific manner. To learn more about ticks from around the world, the diseases they carry, laboratory testing, prevention and treatment, click here.
To consult with Dr. Alexis Chesney, schedule an appointment here.
Early diagnosis and comprehensive treatment of Lyme disease offer numerous benefits, including preventing more serious disseminated symptoms, avoiding the development of chronic illness, facilitating a quicker recovery, and minimizing disruptions to work, school, and family life.
If you are experiencing symptoms or think that you might have a tick-borne infection, please seek professional medical advice from a licensed healthcare professional. To find a Lyme-literate practitioner, consult any of the following organizations, which are dedicated to Lyme and tick-borne disease education, advocacy, and research.
–Global Lyme Alliance: https://globallymealliance.org/
–International Lyme and Associated Diseases Society (ILADS): https://www.ilads.org/
–LymeDisease.org: https://www.lymedisease.org/
While Lyme disease is the most common tick-borne disease, there are many other tick-borne diseases and each of them is treated in a specific manner. To learn more about ticks from around the world, the diseases they carry, laboratory testing, prevention and treatment, click here.
To consult with Dr. Alexis Chesney, schedule an appointment here.