It is usually transmitted by ticks and can be fatal in the late stages. We are talking about Lyme disease. The most common form of Lyme disease in the northern hemisphere, and thus also in Germany, is Lyme disease, which was first described in the town of Lyme in Connecticut, USA.
According to the Robert Koch Institute (RKI), about 6-35% of ticks in Germany are infected with borrelia. There is a south-north gradient, with most infectious ticks living in Bavaria. A tick bite by an infected tick leads to an infection with the bacterium Borrelia burgdorferi in about 2-6% of cases.
The Lyme disease becomes externally recognizable only in the late stage, because at this time a so-called acrodermatitis chronica athropica (short AKA) occurs, which is considered as proving. It is a chronic skin inflammation. In earlier stages, a “wandering redness”, a skin rash that appears after a tick bite, can also occur, but is often confused with an allergic reaction, and often does not occur at all.
Studies even show that it occurs in only a good quarter of cases. An external recognition is therefore relatively difficult, and usually only possible in the late stages. Blood tests using Borrelia serology can help.
For this purpose, any antibodies formed by the body against Borrelia are measured. There must therefore be an immune reaction of the body against borreliosis, otherwise the detection is negative. This can mean that the patient is not infected or that his body has simply not (yet) reacted to the Borrelia bacteria.
This can be the case especially in the early stages (stage 1), when the pathogen has not yet spread beyond the bite site. In stage 2, the scattering stage, the pathogen is detected in 70-90% of cases. In any case, detection is not easy, and usually relatively costly and labor-intensive, so it is not performed routinely.
In justified cases a serological examination is of course indispensable. As already mentioned, Lyme disease infection is divided into three different stages: First, the early stage. This describes the time immediately after the tick bite.
After an incubation period of 5-29 days, a local reaction of the skin, the so-called migratory redness, can occur. It does not have a specific form or expression, which makes a diagnosis difficult. It can itch and impresses like a rash around the tick bite the size of a hand.
It can also be absent altogether. In this stage Lyme disease can be treated with antibiotics, but the stage is usually missed, especially as the flush often disappears after one or two weeks. In addition, headaches, fever and a general feeling of illness can occur.
In the second stage, the scattering stage, the pathogen spreads from the initially still localized region around the tick bite to the rest of the body. This stage usually occurs 4-16 weeks after the tick bite. As in stage one, flu-like symptoms, general feeling of illness and fever occur.
Typical for this stage are heavy sweating and the infestation of internal organs: Lyme disease is spreading more and more. In the third stage, the late stage, the symptoms become chronic. Typical is the affection of the nervous system, with paralysis, mainly in the face (so-called “facialis paresis”).
This affection of the nervous system is also called neuroborreliosis. It is characterised by meningitis – i.e. inflammation of the meninges, polyneuropathy – the decline of nerve tracts, and inflammation of the brain (so-called encephalitis). Detailed information on brain and nerve involvement can also be found on our website: these symptoms are the signs of neuroborreliosis.
In addition to neuroborreliosis, chronic Lyme disease typically also leads to Lyme arthritis. This is – named after Lyme disease – an arthritis based on Lyme disease. Lyme arthritis can occur in any joint, but is preferably manifested in the knee joint.
It is also typical for the chronic stage that phases of freedom from symptoms alternate with phases of illness. Some symptoms, such as acrodermatitis chronica athropicans (often abbreviated as AKA), often appear years later. This is a chronic recurrent skin disease in the course of Lyme disease.
