Lyme Disease

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Erythema migrans (EM) is a red, slowly expanding rash which is associated with the bite of ticks. European physicians observed EM in patients in the early 20th century and theorized that it was caused by a tick-borne bacterium. Later the in the 1970’s a physican observed a clusters of children with arthritis in and around Lyme, Conneticut. After further investigation it was discovered that the arthritis occurred after the presence of tick bites followed by EM rash lesions. It was not until 1984 when conclusive evidence showed that the bacterium spirochete Berrelia burgdorferi caused Lyme disease. In 2002 Lyme disease caused more than 23, 000 infections in the United States (1).
Lyme disease is a zoonotic disease caused by the bacterium spirochete B. burgdorferi that transmitts the bacterium to humans through the bites of western black-legged deer ticks (Ixodes scapularis). This tick is much smaller than a dog or cattle tick and feed by inserting their mouths into the skin of a host and slowly take their blood (1). Early localized Lyme disease occurs 3-30 days after the tick bites. Symptoms include EM, mild muslce aches, fever, headache, and lymphadenopathy. Early disseminated disease occurs 1-4 months after the tick bite. Symptoms include cranial-nerve facial palsy, meningitis, radiculopathy, and heart block. In the late stage of the disease which begins 3-4 months after the tick bite. Symptoms include arthirits in large joints, severe headache, encephalitis and cognitive disorders. Early localized Lyme disease is treated with doxycycline or amoxicillin for 14-21 days. Early disseminated and late Lyme disease are treated for 14-28 days with either oral or parental therapy (ceftriaxone) (2).
In 2002 there were 23,763 cases of Lyme disease. These occurences are concentrated primarily to states in the nothestern, mid-Atlantic and upper northcentral regions of the United States. There are also several counties in n...