Lyme Disease Update Review
Information on lyme disease symptoms,sign,diagnosis,treatment and complication.This is an infectious disease caused by ticks infected with Borrelia burgdorferi.
Lyme Disease Prevention
Prevention
The best prevention against Lyme disease is to avoid being bitten by ticks. Individuals who spend a lot of time outdoors should be aware of the danger and make it a habit to regularly check their bodies for ticks. The tick requires time to attach itself and begin feeding. It is possible to remove ticks before they are able to transmit the disease. Ticks should be grasped with tweezers at the point where their mouthparts enter the skin and pulled straight out with firm pressure. Immature ticks are small and difficult to detect; often they appear as a freckle or mole.
- Stay out of dense undergrowth unless absolutely necessary. Walk on closely mowed grass or paved walkways whenever possible.
Lyme Disease Microbiology
Microbiology. Of spirochetes in the Borrelia genus, B burgdorferi is the longest and narrowest , and has the fewest flagella. This organism can be grown from skin biopsy and other specimens on an artificial medium called Barbour-Stoenner-Kelly at 33 C. The B burgdorferi surface membrane is studded with lipoproteins called outer-surface proteins (OSPs) A, B, C, D, E, and F; other prominent flagellar antigens include flagellar protein, heat shock protein, and protoplasmic cylinder antigen. B burgdorferi is capable of altering its surface lipoproteins by recombining gene cassettes in a manner that resembles the mechanism of antigenic variation among the relapsing fever borreliae. The antigenic variability seen among different isolates has important implications for serologic tests and vaccine development. In the United States, most strains belong to the genomic group B burgdorferi sensu stricto, and in Europe most strains belong to the groups known as B garinii and B afzelii.
Prophylaxis of Lyme Disease
Routine use of antimicrobial prophylaxis after a tick bite is not recommended. However, some experts recommend amoxicillin for pregnant women who remove an engorged deer tick after exposure in an endemic area. Persons who develop a rash or illness within a month after a tick bite should seek prompt medical attention. Strategies to prevent Lyme disease include avoiding tick habitats, wearing protective clothing, using repellents to avoid tick attachment, promptly removing attached ticks, and using community measures to reduce tick abundance.
The Lyme disease vaccine is made from recombinant OSP-A of B burgdorferi. Antibodies produced in response to the vaccine destroy spirochetes in the gut of the engorged tick before they can be transmitted. It is indicated for use in adults, in three doses intramuscularly at 0, 1, and 12 months. Ideally the third dose should be given in March because the tick season in the Northeast and upper Midwest usually begins in April. The efficacy of the vaccine has been reported to be 76% after the third dose; however, the long-term safety, timing of booster doses, and cost effectiveness are unknown. Use of this vaccine should be limited to persons with frequent or prolonged exposure to tick habitats in endemic areas.
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Control of Lyme disease
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History and Epidemiology of Lyme Disease
Lyme disease was first documented in the United States in 1975. The organism that causes Lyme disease is transmitted by the bite of a tick. Lyme disease is named for the town in Connecticut where some of the first cases in the U.S. occurred. Lyme disease cases have since been documented in about 43 states, with over 15,000 cases reported annually between 1998 and 2004. Over 153,000 cases have been reported in the U.S. between 1993 and 2002. During 2002, 23,763 Lyme disease cases were reported, making this the peak year. Several cases of Lyme disease have been reported in Florida
