Lyme/Borreliosis in Deer Stalkers

morena

Well-Known Member
Lyme/Borreliosis is a zoonotic disease spread by the bite of a tick infected with spirochaetal bacteria Borrelia species (which apart from the normal nucleolar DNA have plasmids . These are separate entities of DNA in the body of the bacteria)

Ticks have a 3 stage lifecycle over a 3 year period. Eggs hatch into larvae (6 legs) blood meal,nymph (8 legs ) blood meal,adult (8 legs) blood meal egg laying. If at any stage the ticks pick up an infection that line of ticks carry the infection through all stages ( vertical transmission ) blood meals are normally taken from mammals and birds When an infected tick bites a patient, say human a sequence of events takes place.Borrelia species are attached to the tick gut and the blood releases them to move to the salivary glands ( tick moves from ground temperature to body heat ) Simultaneously the outer surface protein changes from OSP A to OSP C. This is the reason the tick must be attached for 36 hours or more Tick saliva is anaesthetic,anticoagulant and contains a protein SALP15 ( homologues in Ixodes ricinus ticks) which coats the bacteria as they pass into the host's body and is disseminated by the blood throughout the body. This protein protects the bacteria from triggering an immediate immune response.This is a SIGNIFICANT FEATURE

Borreilia bacteria causing disease

Borrelia burgdorferi ( Bb ).....mainly arthritis
Borrelia garinii ( Bg )...mainly nervous
Borrelia afzelii ( Ba )...mainly skin

newly diagnosed species

Borrelia valaisiana ( Bv )...skin ?
Borrelia spielmanii ( Bs )....skin ?

Symptoms of Lyme/Borreliosis

Stage 1 Early localised disease.

Symptoms start one to two weeks after the tick bite. Earliest sign is Erythema migrans so-called " bull's eye " rash.A central spot of red which is warm to touch. not raised and non painful, as it progresses outwards centre goes pale.
This is pathognomonic (definite Lyme /Borreliosis ) Only occurs in 30-80 % of cases.A blood sample at this stage is useless as body immune response delayed ( refer SALP15 ) FALSE NEGATIVE

Stage 2 Early disseminated Lyme/Borreliosis

Occurs weeks after the tick bite.
Flu like symptoms
Chills
Fever
Sweating
Enlarged lymph glands
Vision changes
Sore throat
Fatigue
headaches
General malaise
Rash may appear over the body other than the position of the tick bite

Neurological signs Numbness, tingling in muscles, Bell's palsy and cardiac disturbance

Stages 1 and 2 can overlap.

Stage 3 Late disseminated disease

Severe headaches
Arthritis in one or more large joints
Disturbance of heart rhythm
Short term memory loss
Difficulty concentrating
Mental fogginess
Problems following conversations
Numbness in arms,legs,feet

Diagnosis

CLINICAL EM diagnostic
Blood tests Elisa initial test confirmed by Western blot
polymerase chain reaction PCR

As the symptoms are non specific mainly full history and lifestyle assessment is paramount. If in doubt treat.

Recommended treatment high dose doxycycline. Most effective 200mg twice daily for a month.
Precautions.
Photosensitisation protect against strong light.No alcohol. Marmite to supplement gut products lost by gut sterilisation

Criticisms of diagnostic criteria

Blood samples submitted to laboratory are taken before antibodies develop ( delayed immune response )
Specific challenging material ( probes ) Bg has 7 different serovariants
Dedicated protocols: American protocols not appropriate for European diagnoses
Lyme/Borreliosis is the most common tick borne disease in Europe, must be taken seriously as grossly under diagnosed

Only in Scotland and Rep of Ireland a notifiable disease not rest of UK

Reference papers
Clinical Microbiology Review 2005 July 18 (3) 484-509
Journal of Clinical Microbiology Dec 1999 vol 37 no 12 4086-4092
J Clin Micro 2014 Oct 52 (100 3755-3762
J Clin Micro 2000 June vlo 38 no6 2097-2102
FEMS Immun Med Microbiology 49 ( 2007 ) 13-21
Clinical Infectious Diseases 2013 57 93) 333-340
 
Grateful thanks from Admin Norman for this useful and valuable post. I have put an announcement up on the Deer Stalking general page drawing attention to your post.
 
Morena/Norman

Many thanks for the time & effort you have dedicated to this topic

It is because people like of you and others on this site that enables us to direct our health professionals to the correct diagnosis & treatment.

I have taken the liberty of printing off a copy of this topic, just in case I...or my friends need to refer to the same

Once again many thanks

patrickt
 
Wow! great article. Just wondered if this info is available and brought to the attention to all GP's
 
Really interesting and useful post for anyone with concerns, since, where else would you get an opinion if most doctors are unable to recognise the condition.
Good as a 'sticky'.
 
One key thing - ticks carry the Boreallis bugs in their guts. Thus if you lift them off the skin, risk of vomiting into you and thus transmitting the disease is low. Trying to remove them with fingers, tweezers, cigarrettes etc causes them to vomit the disease into you.

Use a tick hook or tick card to lift them off. Buy one and keep it in your wallet.

And treat your clothing with spray on Permethrin to stop them getting onto you in the first place.
 
Thanks very much for this very interesting read. The land i manage isnt usually too bad for ticks but I had four on me after my last trip, im certainley going to be more vigilint from now on.
 
Use a tick hook or tick card to lift them off. Buy one and keep it in your wallet.

From the description and images I have seen, a tick's jaws work in such a way that a 'straight pull' will cause them to lock up, thus greatly increasing the likelihood of a body 'squeeze' ... the last thing you want, as Heym says above.

A tick lasso can go round the body/skin junction and then be twisted - because a tick's jaws can't lock against a twist - and simultaneously pulled away gently but firmly.

Once it is out in one piece you are free to inflict as much revenge as you like :)
 
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Informative... and terrifying. Any idea of a rough percentage of the buggers that carry Lyme? On the basis that Ive removed 11 off me this week im nervous as well as very itchy!
 
Hi Norman and Malcolm
I frequently treat patients with a current (active) or past history of having contracted Lymes disease, who are still struggling with the symptoms of the infection - sometimes many months or years after infection. It is an extremely unusual and tricky condition, as you have pointed out, and thus very complex to treat. I mostly employ natural medicine protocols once the condition is "entrenched" in a patient (I.E once the acute infection phase has passed and when antibiotic treatment outcomes appear less effective in isolation). In the acute phase it still may be wisest to treat this with conventional AB treatments.

Fortunately I have had some excellent success with patients, but it is important to stress, as you have done so well here Norman, that this illness can be very serious. I think what is not made apparent is the bacteria can spread from mother to unborn foetus in utero of humans. I have also had cases where it seems the infection passed to the foetus, even though the mother had contracted Lymes years before she fell pregnant. Suggesting mothers can be carriers an dpass this bacterial infection across the placental barrier, which is unusual.

I have recently been treating a patient who has tested positive for Borreliosis .sp antigens (of the bacteria, and thus suggesting he may have contracted Lymes). Unusually however he appears to have contracted this sexually, from his wife who contracted Lymes in the US a number of years ago. At this stage he seems mildly symptomatic so it is unclear how serious this is, but owing on the fact his wife has been debilitated by this for years we are taking no chances and treating him anyway.

All the best and please do keep us posted

Thank you so much for keeping us informed
 
So heres an interesting one...

A friend of mine asked me for some advice....he knew I had had Lyme disease...he had been bitten by several ticks and was now suffering joint pain.

I advised him to get a test ASAP, and to follow it up with further tests even if it were initially negative.

He went to his GP...in Alyth, so in the heart of 'tick country', his GP would not test because she told him the ticks were too small to give him Lyme Disease, and he had had no 'bullseye' rash.

Any views? How can you insist your GP does something if they wont?
 
Get him to print off the guidance from the Gov.uk and LDA websites and show her that - ticks any size can carry Lyme and bacteria due to transovarial transmission are somewhat smaller than even the smallest tick by several orders of magnitude- she might also want to enrol on microbiology 101 whilst she's at it! Failing that the Lyme reference lab in Inverness could probably confirm to her that cases of lyme have arisen in her practice catchment area previously.

Richard
 
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