Lyme Disease

This is a vector borne disease caused by the bacterium Borrelia burgdorferi and occasionally Borrelia mayonii. It is transmitted to humans from the bite of the blacklegged tick. Symptoms include fever and a characteristic rash call erythema migrans, however if unrecognized and untreated can infect the heart, joints and nervous system and thus cause a wide variety of symptoms. It is usually treated with antibiotics. Post Treatment Lyme Disease Syndrome exists which results in long term pain and fatigue the cause of which is not known.

Incubation period
3 – 30 days

Transmissibility
The bacterium is transferred from the bites of infected ticks. They can attach to any area of the body but commonly attach in hard to see areas such as the groin and the scalp. For it to transmit the disease it must be attached from 36 – 48 hours and thus early removal greatly reduces the risk of getting the disease. Most cases are transmitted by the young form of the tick call nymph as this is approximately 2mm in size and thus harder to spot.

Signs and Symptoms 
These are divided into early and late. Early symptoms include fever, muscle aches, swollen lymph nodes and a characteristic rash with a Bull’s Eye appearance that expands gradually. Later symptoms include headache, joint pain and swelling, neuralgias, facial palsy, central nervous system inflammation, heart palpitations and shortness of breath.

Diagnosis 
This is based on the signs and symptoms together with the history especially if there is travel to vector endemic areas. Serological tests can be used to further confirm the diagnosis.
 
Treatment
This is with antibiotics such as doxycycline, amoxicillin or cefuroxime, the choice, route and duration of which depending on the symptoms present.
 
Prevention
This is largely based on preventing tick bites and spotting them as early as possible. Measures to reduce ticks on pets and in yards are all effective.