- A spirochete
0.2 to 0.5µm X 3-30µm that can be seen by Giemsa or Wright staining.
- Microaerophilic (def).
- Found in infected ticks of the
genus Ixodes, white-footed mice, and deer.
- The larval and nymph forms of
the tick pick up the spirochete from its primary host, the white-footed mouse.
Adult ticks infest the white-tailed deer.
- Typically the larval form of the
tick becomes infected by feeding on the mouse reservoir. As the larva molts
to a nymph stage in late spring, humans can become an accidental host of the
infected nymph. (The nymph stage of the tick is responsible for approximately
90% of the human Lyme disease reported.) The nymphs mature to adult ticks
in late summer and the adult tick feeds on the white-tailed deer and sometimes
- B. burgdorferi is the
species that causes Lyme disease in in the U.S. and Europe.
- In 1999, over 13,300 cases of
Lyme disease were reported in the U.S.
- Lyme disease is the most common
vector-borne disease in the U.S.
- After an incubation period of
3-30 days, a lesion beginning as a papule usually appears at the site of the
tick bite and progressively enlarges to an area from 5cm to 50cm in diameter.
The lesion, called erythema migrans, typically has a flat red border with
a clearing in the center. Other early signs include fever, chills, malaise
severe fatigue, headache, myalagias (def),
musculoskeletal pain, and lymphadenopathy
(def). Early symptoms last around 4 weeks. During this time, however,
the spirochetes penetrate into blood or lymph vessels and disseminate via
the lymphatics and blood.
- In around 80% of patients with
untreated Lyme disease late manifestations appear. These can appear from within
a week after initial infection to over 2 years later. The first phase of late
infection, seen in 10%-15% of patients includes neurological symptoms such
as encephalitis (def),
and peripheral nerve neoropathy (def)
as well as cardiac dysfunctions such as heart block (def),
and congestive heart failure (def).
The second phase is characterized by arthritis (def)
and arthralgias (def)
that can persist from months to years. This is the most common serious complication
in untreated Lyme disease.
Disease , by John Meyerhoff, MD, Assistant Professor, Department of Internal
Medicine, Johns Hopkins University School of Medicine.