Lyme disease or Lyme borreliosis is an infectious disease that is transmitted primarily by ticks or wood ticks and is triggered in humans. Here, the causative bacteria are the so-called Borrelia.
What is Lyme disease?
A tick bite or tick bite can transmit various diseases into the host organism. The best known of these is Lyme disease. Lyme disease, or colloquially Lyme disease, is an infection with the bacterium Borrelia burgdorferi or related species. The name of the tick-borne disease, which is responsible for a variety of different, sometimes severe symptoms, is derived from the name of the town of Lyme in the U.S. state of Connecticut, where Lyme disease was first described in 1975, and the name of the French bacteriologist Borrel. In 1982, the Swiss Willy Burgdorfer succeeded for the first time in detecting and cultivating the bacteria called Borrelia burgdorferi in the following.
Causes
Lyme disease is transmitted by tick bites. In Europe, the common wood tick (also known as ticks) is considered the main vector of Lyme disease. In parts of southern Germany, up to 50% of ticks are contaminated with the pathogen. The longer the tick remains in the skin, the greater the risk of infection. About a quarter to half of all people infected with the pathogen actually contract Lyme disease. The number of infections is also increasing in northern Europe, for which climate changes, but also an increased level of awareness of the disease are blamed.
Symptoms, complaints, and signs
Lyme disease is sometimes difficult to detect because it does not necessarily cause symptoms in the early stages. Normally, the disease progresses in three stages:
- Stage 1
The first sign of Lyme disease may be a wandering redness (erythema migrans) near the bite site a few days or weeks after a tick bite, possibly associated with flu-like symptoms, headache/limb pain, and fever. Symptoms easily confused with summer flu. The bite site should be observed for a while as a precaution.
- Stage 2
Through the bloodstream, the pathogens reach various organs and can cause discomfort where they settle, in children often meningitis or paralysis of the facial or cervical nerves. In general, the pathogens can cause pain and paralysis in the nerves and cause inflammation and conduction disorders in the heart.
- Stage 3
After months to years, Lyme disease can cause joint inflammation in the affected joints (Lyme arthritis), usually in the knee joint. The pain can occur in episodes, but also persist permanently. Bluish discoloration of the skin may occur on the arms and legs. Another symptom can be chronic inflammation of the spinal cord and brain with paralysis as a late consequence. In the worst cases, the disease can become chronic.
Course
Because Lyme disease can affect all organs and often “hides” in connective tissues or joints, a variety of rather nonspecific symptoms can occur. However, there are also typical signs: for example, erythema migrans, the migratory redness that appears within days to weeks around the injection site, is characteristic of the local infection and thus the first stage of the disease. In the second stage, the pathogen spreads and subsequently spreads over the entire body. In the beginning, Lyme disease often presents with the typical symptoms of a flu-like infection. In neuroborreliosis, paralysis of the facial muscles and severe nerve pain may occur. In the case of joint infestation, those affected have “jumping” joint pain and recurrent inflammation in individual or several joints, known as Lyme arthritis. Heart muscle inflammation can also be attributed to Lyme disease. The third stage of the disease is characterized by the chronicity and worsening of the above symptoms. Even after long symptom-free periods, recurrent meningitis and irreversible nerve damage may occur.
Complications
In Europe and North America, Lyme disease is most commonly Lyme borreliosis. Other Lyme diseases, such as relapsing fever, occur almost exclusively in the tropics.If left untreated, Lyme borreliosis can lead to significant complications that are difficult to treat in the late phase, because the triggering borrelia bacteria often not only hide from the immune system, but also cannot always be detected by treatment with antibiotics. If the bacteria manage to enter the bloodstream after infection, they can spread throughout the body and predominantly affect joints, heart, nerves and meninges with a sometimes unfavorable prognosis. In particular, the fact that they are able to cross the blood–brain barrier can lead to the development of so-called neuroborreliosis. The disease is associated with irreversible, severe sensory and movement disorders, some of which take years to develop. Post Lyme borreliosis syndrome, which is referred to as chronic fatigue syndrome in Anglo-Saxon usage, is also discussed. However, the symptoms are non-specific and can also be caused by other diseases or deficiency symptoms. If Lyme disease is treated early with antibiotics, which is initially noticeable by a circular erythema around the site of the tick bite, the chances of success are good. Further complications are then no longer to be feared.
When should you go to the doctor?
The symptoms of Lyme disease are nonspecific and do not always directly indicate the disease. If a few days to a few weeks after a tick bite a circular red spot appears near the site of the bite, which feels warm and increasingly spreads, a visit to the doctor should be made immediately. Even if this characteristic symptom is absent, it is advisable to seek medical advice in case of unclear fever, severe and recurrent joint pain and headache, and swollen lymph nodes. This applies not only if a previous tick bite is known, but also if there is a mere suspicion that an infection may have occurred. If numbness, sensory disturbances and signs of paralysis occur in the hands, legs or face, the route should also lead to the doctor as soon as possible. In the weeks following a tick bite, even quite inconspicuous symptoms can provide initial indications of Lyme disease: In order to diagnose an infection at an early stage, a visit to the doctor is also advisable in case of unusually pronounced fatigue, excessive irritability or indefinable general feeling of illness. At the latest in the second stage of the disease, which is often accompanied by nerve inflammation, extensive redness, massive joint swelling and, in some cases, psychological impairment, medical attention must be sought immediately to avoid serious complications.
Treatment and therapy
The diagnosis of Lyme disease is considered difficult because laboratory methods commonly used today cannot detect the bacterium with a high degree of reliability. Even years after a person has had Lyme disease, antibodies against the pathogen can still be found in the blood without an active infection. Lyme disease is considered curable in the first two stages if sufficient antibiotics are given over a longer period of time. In this case, cellular antibiotics are preferable, since Borrelia burgdorferi can also colonize intracellularly. The drugs of choice in the early stages are tetracyclines (especially doxycycline), while cephalosporins (such as ceftriaxone) are used in advanced disease. However, these drugs do not always work reliably. In 10 to 50 percent of cases, therapy remains unsuccessful and must be repeated. The third stage of the disease is considered difficult to treat. Despite the difficulty in diagnosing Lyme disease, the prognosis is generally favorable. Severe chronic courses are rare. However, as a multisystemic infection, Lyme disease should not be underestimated and must be treated consistently and as early as possible to ensure effective control of Borrelia burgdorferi.
Outlook and prognosis
The course of Lyme disease can vary widely. In patients with a very well-developed immune system, the disease either does not break out at all after infection or runs almost without symptoms. In this case, even without medical treatment, no late effects are to be feared. If the so-called migratory rash appears, most patients experience flu-like symptoms some time later, especially fever and headaches and aching limbs.If Lyme disease is correctly diagnosed and adequately treated at this early stage, the prognosis for the affected person is very good. Only in rare cases does the pathogen not respond to the antibiotics administered, so that treatment must be repeated with a different agent. This can result in the side effects often associated with antibiotic therapy being more severe than usual. In the next stage, the pathogen spreads throughout the body, very often causing symptoms such as facial paralysis, nerve pain, and joint inflammation. Even at this stage, the disease can still be treated successfully. The patient usually recovers completely from Lyme disease after antibiotics are administered. However, if the disease reaches the third stage and becomes chronic, recurrent meningitis and irreversible nerve damage must be expected, even years after the initial infection.
Follow-up
Once Lyme disease has been completely cured with antibiotics, no further treatment is needed. Long-term therapy is limited to ensuring that the pathogen is completely gone through regular checkups. After three months, the first step is to check whether the disease has broken out again. If this is not the case, the Lyme disease is considered to be cured. Chronic Lyme disease requires regular treatments and examinations at intervals of four to six months. After a few sessions of antibiotic administration, the general symptoms should first disappear before the specific symptoms of Lyme disease slowly subside. Regular treatments will further reduce the number of pathogens, which is why symptomatic symptoms can be expected to improve in the long term. Should complications occur after months or years, which indicate a renewed outbreak of the disease, the doctor must be consulted. It may be necessary to initiate therapy with antibiotics to destroy residues of the pathogen. In this context, aftercare may also include rest and recuperation. Through good observation and regular contact with a doctor, any complaints can be detected at an early stage and treated by the doctor in charge. In the case of chronic complaints, psychotherapy can also be part of the aftercare.
What you can do yourself
A Lyme disease infection can not be completely cured until today. However, some self-measures and remedies can make life with the disease easier. For example, general measures such as cooling itchy areas, lying with the head elevated (for headaches and nerve pain), and taking it easy are recommended at first. In general, the symptoms can be alleviated by dietary measures such as avoiding vinegar, alcohol and milk proteins. Depending on the symptoms, various globules can also be tried. For example, for reddened rash, paralysis and rheumatism, the preparations Ledum palustre and aconitum help. For twitching and cramps of the muscles Atropa belladonna promises relief. Which globule is suitable in detail should be discussed with the family doctor beforehand. Further contacts are alternative practitioners and specialists for the respective ailment. In addition, psychological counseling is recommended for those affected after diagnosis. In a conversation with a therapist, the fears and worries associated with a Lyme disease infection can be worked through. In this way, self-help measures can be worked out in the short term and the quality of life can be improved in the long term. Conversations with other sufferers also help in dealing with the infection.
