At the request of a few site members to put information about Lyme/Borreliosis on the forum here goes. It is going to be in some detail so you can follow the development of the disease so you don't end up with a chronic infection.
Ticks have a 3 host cycle. This means that each stage of their life they must have a blood meal. If that host is carrying an infection it infects the tick for the rest of its life even going through the egg stage.(vertical transmission ) You can have all 3 different stages on the same host although the Larvae ( 6 legs ) and a lesser extent Nymphs ( 8 legs ) so called seed ticks as they are so small, feed on smaller animals. Adults ( 8 legs ) and Nymphs feed on larger animals and that includes you.Ticks do what is called questing ie they climb to a high point on vegetation and wave their front legs in the air at a disturbance and latch on to a passing host.After each meal they drop to the ground and develop to the next stage.Adult females mate and drop off to lay eggs on the ground Normally a 3 year cycle. In the life cycle you have a spring and autumn rise in tick activity although on the West Coast of Scotland they are active throughout the year. So you have spring cycling and autumn cycling ticks.
The bacteria causing the disease are
Borrelia burgdorferi ( Bb )...................Mainly arthritis
Borrelia garinnii ( Bg )........................Mainly nervous complaints
Borrelia afzelii (Ba )............................Mainly skin complaints
but there is considerable overlap.
This infection can be passed on from an infected tick biting you. Tick saliva is anaesthetic, anticoagulant and a recently discovered protein called Salp15 which at the time of the bite coats the bacteria as it passes into your system. This enables it to evade the immune system until the infection is welll established and means there is a slow build up of antibodies. NOTE THIS.
In the tick the Borrelia are attached to the gut and the blood releases them and they move to the salivary glands. ( the tick moves from ground temperature to blood heat ) At the same time they ( bacteria ) change their coat ( OSP A to OSP C).Outer Surface Protein This is the reason the tick has to be attached for more than 36 hours although some research suggests can be passed on sooner. Also throughout the infection the bacteria is changing its coat ( many other surface proteins ) so that the immune system is playing catch up the whole time
Here are microscope pictures of the bacteria.
Clinical Signs and Symptoms.
All diagnoses start off by talking of Erythem Migrans ( EM ) This is a circle of redness radiating from the tick bite at a rate of 2/5 mm a day from 7-42 days afterward. This is non painful and isn't raised. This occurs in less than 30% of patients. If a tick bites you and there is an immediate swelling/redness which disappears in a day or 2 NORMAL bacterial infection. Not Lyme disease.
EM photos courtsey Smith Kline Biological.
Other symptoms are flu like ,stiff neck,swollen glands extreme fatigue, intermittent temperature , muscle and joint pains, eye dysfunction..
Consultation with GP. Now the ? fun starts. Don't have a clue as they do not have lectures on Zoonosis at University. Unfortunately the guidelines given by the HPA are those of the CDC American protocol and are useless for this country as they only have Bb. Take a blood sample for Laboratory diagnosis. This is too soon as immune system hasn't reacted yet. Negative..,.. NO LYME Disease .... WRONG.
May have given you a short course of antibiotics for rash depresses immune system as well. Negative WRONG
In some cases may give a positive result on first test go onto a second if you are lucky. This is called a Western Blot ( immunoblot ). The lab staff then interpret the bands as positive or negative.
Each lab has their own protocol and it seems hit or miss. They tried to formulate a European Standard for the labs but it was unsuccessful.
The Scottish Reference lab at Raigmore Hospital Inverness have grown 2 out of 3 local bacterial Bb, Ba types and are using a mixture for testing with improved results.
GPs must diagnose on clinical grounds with may be lab confirmation.
The guidelines also suggest a short course of antibiotics as sufficient. Unfortunately they should be high dosage and last a minimum of 3-4 weeks or until you respond. Anyone needing more info pm me.
Other Reference Laboratories are Southampton , Swansea and Dublin
Only in Scotland is Lyme/Borreliosis a notifiable disease.
Quoting HPS Weekly Report October 2008
Zoonosis in the UK-Annual Report.
In Scotland 232 lab confirmation in 2007
96 in 2005
177 in 2006
813 in 2008
863 in 2009
905 in 2010
My words Is the infection increasing or are Doctors improving their diagnosis ?
England and Wales
797 confirmed cases in 2007 acquired 705 locally 92 abroad
How was this confirmed if the diagnosis is a clinical one ? My words.
"Chronic Lyme Disease is the latest in a series of syndromes that have been postulated in an attempt to attribute medically unexplained symptoms to particular infections "
The New England Journal of Medicine. 2007
A Critical Appraisal of "Chronic Lyme Disease "
Chronic Lyme Disease
A Review: Adriana Marques
Tick Borne Diseases.
Part 1 Lyme Disease
Infectious Disease Clinics of North America 2008
All this info is on evidence based peer reviewed articles.