Lyme Disease: A Clinical Look at a Multisystem Disorder

When you think of “lime,” your mental picture might be one of a cool beverage with a lime slice for taste. This is a refreshing experience on any summer day. When you think of “Lyme disease,” your mental picture might be one of a very unpleasant and potentially lifelong experience that can begin on that same summer day!

Lyme disease is a bacterial infection transmitted by the Deer tick, Ixodes scapularis or I. dammini. Lyme disease was discovered in 1975, after researchers investigated a disease cluster involving children. These children were diagnosed with juvenile rheumatoid arthritis in Lyme, CT, and two other areas.

Investigators discovered that affected children lived near wooded areas likely to resource ticks. They also found that first symptoms typically started in the summer months coinciding with the height of tick season.

Numerous patients reported a strange skin rash prior to developing arthritic symptoms. Many people remembered being bitten by a tick at the rash site. Investigations indicated that Deer ticks were infected with a spiral-shaped bacterium or spirochete (Borrelia burgdorferi). This spirochete was responsible for the outbreak of arthritis in Lyme.

Ticks infected with B. burgdorferi mostly feed and mate on deer during a portion of their lifecycle. Recent growth of deer populations in the northeast coupled with development in rural areas where Deer ticks are found have contributed to an increasing number of people with this disease.

Reported cases of Lyme disease and the number of geographic areas in which it is found have been on a steady rise. Lyme disease has been reported in almost every state. Most cases are concentrated along coastal Northeastern areas, Mid-Atlantic states, Wisconsin, Minnesota and Northern California. Lyme disease is distributed in vast areas of Asia and Europe. Reports suggest that Lyme disease is present in South America as well.

By Stuart Mitchell, DO, PhD, MPH, BCE

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