In the preliminary stages, Lyme disease manifests as skin rashes and flu like symptoms. When the individual is first bitten by ixodid tick, a small red bump may develop in the affected area. After few days, the red bump expands to a larger area resembling “bull’s eye pattern”. Such a kind of rash is known as erythema migrans [8]. Many individuals develop multiple lesions which is also a major characteristic of Lyme disease. In addition to rash, affected individuals would also experience fever, body ache, fatigue and headache.

In the later stages, as the disease progresses, individuals complain of joint pain and neurological problems set in. Neurological conditions such as Bell’s palsy, meningitis, weakness of one or both limbs and impaired muscular movements are some of the grave problems experienced.

Some of the less common signs and symptoms of Lyme disease include inflammation of the liver and eyes, development of cardiac problems and extreme fatigue.

Signs and symptoms of Lyme disease often mimic other disease conditions and therefore the disease is sometimes also referred to as “The great imitator”. The following are the diagnostic procedures employed to detect Lyme disease:

• ELISA test is carried out to detect the antibodies to the bacterium. However, this test can sometimes provide false positive results and is also not useful in the initial stages of the disease [9].
• Western blot test is done for confirming the presence of Lyme disease.
• The polymerase chain reaction (PCR) test involves testing of the bacterial DNA from the fluid that is obtained from the joint of the affected individual.

Lyme disease can be successfully treated when the disease has been diagnosed in the initial stages. Antibiotics are the only way by which the disease can be treated. These are administered either orally or through the intravenous route depending on the condition of the patient. For oral antibiotics, the course duration is as long as 14 – 21 days depending on the severity of the condition [10] [11]. When administered through the intravenous route, the course duration is about 14 – 28 days. However, some studies have postulated that antibiotics given for 10 – 14 days are equally effective.

The prognosis of Lyme disease is usually favorable as the condition can be successfully treated with prompt initiation of strong antibiotic regime. Failure to initiate early treatment can pave way for several unpleasant complications to set in [7].

Lyme disease occurs due to tick bites that are infected by the bacteria known as Borrelia burgdorferi. The disease manifests itself in 2 stages namely the initial stage and the late or the chronic stage [3]. For an infection to occur, the bacterium must gain entry into the human body which is achieved through infected ixodid ticks. The ticks appear so small that it is almost impossible to spot them with naked eye. Once the bacterium gains entry, it spreads through the blood affecting various body organs and systems.

Lyme disease commonly affects individuals of North America and Europe. In the year 2013, it was ranked as the 5th most common nationally identifiable disease. It has been estimated that each year in the United States, as high as 30,000 cases of the disease are reported. In the year 2011 alone, the disease struck about 33,097 individuals of the United States [4].

For an individual to develop Lyme disease, he or she should have been bitten by ixodid ticks infected by bacterium Borrelia burgdorferi. Once the bacterium gains entry into the body it spreads through the blood stream giving rise to unpleasant symptoms. For an infection to occur, the tick must be attached to the skin for about 25 – 36 hours [5]. It is therefore necessary to remove the tick as soon as possible in order to prevent transmission of the disease [6].

Following certain simple steps can help you prevent from Lyme disease. In countries where Lyme disease is a common occurrence, individuals should avoid wandering in areas where ixodid (deer) ticks are common. These include bushy areas with long grass and wooded areas. Individual are advised to wear long pants when exploring such areas. It is also necessary to use insect repellents. When bitten by deer tick, it is necessary to remove the tick as soon as possible to prevent the infection. Individuals are also advised to check their pets for ticks. Whenever they notice tick bites, it should immediately be removed with the help of tweezers.

Lyme disease is caused by the bacterium Borrelia burgdorferi. It is transmitted to humans when they are bitten by ixodid ticks. Lyme disease greatly affects the body organs such as the joints, muscles, hearts, neurological system and gastrointestinal system [2]. Individuals affected with this disease often present with arthritis, fever, rashes, conjunctivitis and many other debilitating conditions. Lyme disease is treated with a strong antibiotic course that works towards elimination of the bacterium from the body. The disease can be successfully treated if treatment is initiated in the early stages.

Definition

Lyme disease is a kind of bacterial infection caused by infected ticks. The bacterium that causes the disease is called as Borrelia burgdorferi. It is the most common form of vector illness in the United States. It has been estimated that about 30,000 cases of Lyme disease are detected each year in the US.

Cause

Infected deer tick is the sole cause of Lyme disease. In this, the bacterium gains entry into the human system through the tick bite and spreads through the blood affecting other body organs and system.

Symptoms

Symptoms of Lyme disease include development of rash which is small and red colored in the initial stages. As the disease progresses, the rash extends in bull’s eye pattern. Other symptoms include joint pain, neurological problems, fever, fatigue, headache and muscle aches.

Diagnosis

Diagnosis of Lyme disease gets difficult as the symptoms often mimic other disease conditions. Many a time physical examination of the rash is enough to confirm the diagnosis. However additional tests such as ELISA test, Western blot test and polymerase chain reaction test may also be necessary to confirm the disease condition.

Treatment

A strong antibiotic course for 14 – 21 days would be enough to successfully treat the condition.

1. Feder HM Jr. Lyme disease in children. Infect Dis Clin North Am. Jun 2008;22(2):315-26, vii. 
2. Steere AC. Lyme disease. N Engl J Med 2001; 345:115.
3. Oschmann P, Dorndorf W, Hornig C, et al. Stages and syndromes of neuroborreliosis. J Neurol 1998; 245:262.
4. Centers for Disease Control (CDC). Lyme disease--United States, 1987 and 1988. MMWR Morb Mortal Wkly Rep 1989; 38:668.
5. Sood SK, Salzman MB, Johnson BJ, Happ CM, Feig K, Carmody L, et al. Duration of tick attachment as a predictor of the risk of Lyme disease in an area in which Lyme disease is endemic. J Infect Dis. Apr 1997;175(4):996-9. 
6. Kalish RA, Kaplan RF, Taylor E, et al. Evaluation of study patients with Lyme disease, 10-20-year follow-up. J Infect Dis 2001; 183:453.
7. Seltzer EG, Gerber MA, Cartter ML, Freudigman K, Shapiro ED. Long-term outcomes of persons with Lyme disease. JAMA. Feb 2 2000;283(5):609-16
8. Steere AC, Bartenhagen NH, Craft JE, et al. The early clinical manifestations of Lyme disease. Ann Intern Med 1983; 99:76.
9. Ang CW, Notermans DW, Hommes M, Simoons-Smit AM, Herremans T. Large differences between test strategies for the detection of anti-Borrelia antibodies are revealed by comparing eight ELISAs and five immunoblots. Eur J Clin Microbiol Infect Dis. Aug 2011;30(8):1027-32. 
10. Steere AC, Angelis SM. Therapy for Lyme arthritis: strategies for the treatment of antibiotic-refractory arthritis. Arthritis Rheum. Oct 2006;54(10):3079-86Steere AC, Sikand VK. The presenting manifestations of Lyme disease and the outcomes of treatment. N Engl J Med. Jun 12 2003;348(24):2472-4.