Diagnosis | Recognize Lyme disease

Diagnosis

So how can one now recognize a chronic Lyme disease? As in the other stages, the diagnosis of chronic Lyme disease is based on two pillars On the one hand there is the clinical examination, with the various symptoms that Lyme disease can cause in the final stage. These can be: Meningitis, neuroborreliosis, arthritis – mainly limited to one knee joint, and recurrent skin rash.

As these symptoms can also be connected to other diseases, a blood test is essential for a final diagnosis. This is the second pillar of diagnostics. However, the detection of Lyme disease is not entirely straightforward, and is not always successful.

Especially in the early stages of the disease, Lyme disease tests can only detect the Borrelia infection to a good 50%. The reason for this is that the serological tests can only detect the antibodies against the Borrelia bacteria. If these are not yet present – for example because the infection has not yet spread, the blood tests do not work either.

In the late stages the serological blood tests are very accurate. However, they are rarely ordered because the symptoms are usually relatively unspecific, even in the chronic stage, and serological testing is relatively expensive. Of course, the health of the patient is not spared, but expensive tests “into the blue” are avoided. Beforehand one tries to exclude more frequent diseases. These can range from FSME to tumours and systemic diseases.

Prophylaxis of Lyme disease

The prophylaxis of Lyme disease consists mainly of avoiding tick bites. As Lyme disease in Germany is mainly transmitted via ticks, avoiding them is a sensible measure. Although isolated cases have been documented in which transmission has taken place via mosquitoes or horseflies, the rate of transmission of mosquitoes in Germany is far from being as high as that of ticks.

Long clothing that covers the skin as much as possible helps against ticks. When having a picnic in the forest or on meadows, always use a seat cover and avoid sitting directly on the forest floor. A vaccination against borrelia is currently (as of 2015) not yet possible.

Although there are clinical studies that give hope for an early introduction of a vaccine, it will take several years until the vaccine is approved. Until then, increased caution is required, especially in areas with a high incidence of ticks. The RKI (Robert Koch Institute) offers a detailed overview of the occurrence of ticks on its homepage.

Bavaria and Baden- are particularly affected by this. In case of a tick bite, the tick should be removed slowly and in a controlled manner. The tick should be packed close to the head, i.e. directly on the skin.

This prevents the head from getting stuck in the skin. Jerky and quick movements should be avoided, as well as attempts to stun the tick with household remedies in order to remove it afterwards. The best way to remove a tick is to use so-called tick forceps, which are available in pet shops and pharmacies.