Lyme disease almost twice as common as breast cancer and 6 times more common than HIV/AIDS

Tick

In 2013 the Centers for Disease Control and Prevention (CDC) announced that Lyme disease is much more common than previously thought, with over 300,000 new cases diagnosed each year in the United States. In the last 10 years, Lyme disease has been diagnosed in every state except for Hawaii. However, 96% of all confirmed cases of Lyme were isolated to only 14 states:

Connecticut
Delaware
Maine
Maryland
Massachusetts
Minnesota
New Hampshire
New Jersey
New York
Pennsylvania
Rhode Island
Vermont
Virginia
Wisconsin

Lyme Disease is caused by Borrelia bacteria. Research has shown there are 10 different strains of Lyme disease in the United States with 52 species of Borrelia which includes Burgdorferi. Burgdorferi is most commonly thought to be the strain of bacteria that causes Lyme disease. But with 5 subspecies of Borrelia Burgdorferi, and 300 strains worldwide, there is mounting evidence that at least 10 strains of Borrelia are known to cause Lyme disease.  1 new strain was just identified in 2016 – Mayonni which has atypical symptoms such as vomiting and a spotty rash.

Lyme is called the great imitator because its symptoms mimic many other diseases. It can affect any organ of the body, including the brain and nervous system, muscles and joints, and the heart.

Typical symptoms of Lyme disease include fever, headache, fatigue, and a characteristic skin rash called erythema migrans (also known as the bulls eye).  It’s important to note that the bulls eye rash only happens 20% of the time.

Tests for Lyme disease are indirect tests. They measure a person’s immune response to disease & not the disease itself.

Lyme disease is known to inhibit the immune system and it is for this reason that 56% of patients test negative for a blood test.  According to the CDC, there are two types of blood tests that should be performed on patients suspected of having Lyme disease. The first is a blood test (ELISA) to measure antibody levels. The second test is the Western blot assay which identifies antibodies particular to the bacterium B. Burgdorferi.

Blood tests (ELISA) that check for antibodies to the bacterium that causes Lyme disease are not useful if done soon after a tick bite. It takes 2 to 5 weeks after a tick bite for initial antibodies to develop. 

It’s important to know that there are other tests that are not yet recognized by the CDC that are more sensitive and specific for detecting Lyme disease. Since most tests for Lyme disease are indirect tests, it is very important to capture and have the tick tested if it is found. This does not require a doctors visit.

While chronic Lyme disease is generally an unrecognized diagnosis because the symptoms or illnesses are broad and there is little scientific evidence of any relationship to B. Burgdorferi infection, there are many individuals with long standing symptoms of which 52% test negative by ELISA but positive by Western blot and many who test negative on both tests. It is estimated that 69 out of 100 patients who have Lyme disease may go untreated.

Untreated or undertreated Lyme disease can cause some to develop severe symptoms that are hard to resolve. This condition may be referred to as post-treatment Lyme disease (PTLD).

When patients are treated for Lyme disease, the recommended course of treatment is no less than 21 days of the antibiotic doxycycline. Doxycycline stops the Lyme bacterium from replicating, but it doesn’t kill them. The rest is up to the body’s immune system and since it is estimated that everyone over 50 has a compromised immune system, treatment failure rates range from 16% to 39% for early treatment and 26% to 50% in late treatment.

Some types of the Lyme organism do not have a cell wall. Since antibiotics work by attacking the cell wall and certain Lyme organisms do not have a cell wall,  in some cases antibiotics have no effect.

It is very common to for Lyme patients to have co infections with 50% having 1 co infection and 30% having 2 or more co infections. The most common co infections are Babesia (32%), Bartonella (28%), Ehrlichia (15%), Mycoplasma (15%), Rocky Mountain Spotted Fever (6%), Anaplasma (5%), and Tularemia (1%). Testing for co infections should be performed. If these co infections are left untreated, their continued presence  prevents successful treatment of Lyme disease.

While it is generally recognized that Lyme disease is transmitted by a tick it can also be transmitted  by fleas, biting flies, mosquitos, spiders and fire ants. Lyme disease can be transmitted across the placenta to the unborn child. And there are cases of Lyme disease being transmitted through breastmilk to a nursing infant.

The Lyme Organism

Borrelia burgdorferi is a spirochete unlike any other bacteria that has ever been studied before. It is one of the largest of the spirochetes (the same type as syphilis). It is an amazing organism. It can corkscrew into tissue as well as travel in the bloodstream.  It’s twice the speed of a white blood cell, which is the fastest cell. It’s so strong it can swim against the flow of the bloodstream. It’s an adaptive bug and can avoid the immune system.

Little is understood about its complexity. Contrary to what has long been believed, B. burgdorferi can genetically recombine to create different strains that behave dissimilarly inside the human body. Some strains seem more likely to remain in the skin whereas others are more likely to invade the nervous system or heart.

Like other spirochetes, such as those that cause Syphilis, the Lyme spirochete can remain in the human body for years in a non-metabolic state. It is essentially in suspended animation, and since it does not metabolize in this state, antibiotics are not absorbed or effective. When the conditions are right, those bacteria that survive, can seed back into the blood stream and initiate a relapse.

The organism is difficult to study and the complicated and intricate dance that takes place between the ticks, their spirochetes and their numerous animal and human hosts—is immensely difficult to track and understand.

 

References
IgenX Inc tick testing; Lyme Stats; International Lyme and associated disease society; Lyme Disease Advocacy Education & Research; The Complexities of Lyme Disease A Microbiology Tutorial: Part 1 By Thomas M. Grier, MS; Dr. Nevena Zubcevik, attending physician at Harvard Medical School and co-director of Dean Center for Tick Borne Illness at Spaulding Rehabilitation Hospital in Charlestown (SRH); Johns Hopkins Lyme Research Center