Symptoms Of Lyme Disease Research Articles

Recognising the signs and symptoms of Lyme disease

Lyme disease, which is a tick-borne bacterial infection, is becoming increasingly common and early recognition depends on awareness of the risk factors and early symptoms. Prompt effective tick removal is key to primary prevention, and early antibiotic treatment is essential for improving treatment outcomes. Late-stage Lyme disease in the UK generally causes neurological problems, with relapsing remitting pain and fatigue, and may be associated with a significant degree of disability for both adults and children. Increased awareness, research to clarify the scale of the problem in the UK, and improved diagnostics and treatment are urgently needed. Borreliosis is a bacterial zoonitic infection that is found mainly in the northern hemisphere. Its incidence is increasing, but it can be difficult to spot. Sandra Pearson advises on how to identify the early signs to ensure prompt treatment and avoid potential neurological problems

Cutaneous manifestations of Lyme disease : Pitfalls in the serological diagnostic workup

Serology, the detection of B.burgdorferi-specific IgM and IgG serum antibodies, is the most common laboratory test to diagnose cutaneous manifestations of Lyme disease. In atwo-tiered approach, an ELISA is used as ascreening test. Apositive or equivocal ELISA result needs confirmation by aspecific immunoblot. The sensitivity of this approach reaches 80-95%. The diagnosis of erythema migrans is based on its typical clinical appearance. Serology is only indicated in atypical cases. In contrast, serology is mandatory in the diagnostic workup of borrelial lymphocytoma and acrodermatitis chronica atrophicans. Apositive serology can persist for many years, even after adequate antibiotic treatment. Apositive serology is no indication for antibiotic treatment if typical symptoms of Lyme disease are absent.

Detection of Lyme Disease Bacterium, Borrelia burgdorferi sensu lato, in Blacklegged Ticks Collected in the Grand River Valley, Ontario, Canada.

We document the presence of blacklegged ticks, Ixodes scapularis, in the Grand River valley, Centre Wellington, Ontario. Overall, 15 (36%) of 42 I. scapularis adults collected from 41 mammalian hosts (dogs, cats, humans) were positive for the Lyme disease bacterium, Borrelia burgdorferi sensu lato (s.l.). Using real-time PCR testing and DNA sequencing of the flagellin (fla) gene, we determined that Borrelia amplicons extracted from I. scapularis adults belonged to B. burgdorferi sensu stricto (s.s.), which is pathogenic to humans and certain domestic animals. Based on the distribution of I. scapularis adults within the river basin, it appears likely that migratory birds provide an annual influx of I. scapularis immatures during northward spring migration. Health-care providers need to be aware that local residents can present with Lyme disease symptoms anytime during the year.

Ceftriaxone Pulse Dosing Fails to Eradicate Biofilm-Like Microcolony B. burgdorferi Persisters Which Are Sterilized by Daptomycin/ Doxycycline/Cefuroxime without Pulse Dosing.

Although the majority of Lyme disease patients can be cured, at least 10–20% of the patients continue to suffer from persisting symptoms such as fatigue, muscular and joint pain, and neurologic impairment after standard 2–4 week antibiotic treatment. While the causes for this post-treatment Lyme disease symptoms are unclear, one possibility is due to Borrelia burgdorferi persisters that are not effectively killed by current antibiotics such as doxycycline or amoxicillin used to treat Lyme disease. A previous study showed that four rounds of ceftriaxone pulse dosing treatment eradicated B. burgdorferi persisters in vitro using a relatively young late log phase culture (5 day old). In this study, we investigated if ceftriaxone pulse dosing could also eradicate B. burgdorferi persisters in older stationary phase cultures (10 day old) enriched with more resistant microcolony form of persisters. We found that ceftriaxone pulse dosing could only eradicate planktonic log phase B. burgdorferi spirochetal forms and round body forms but not more resistant aggregated biofilm-like microcolony persisters enriched in stationary phase cultures. Moreover, we found that not all drugs are suitable for pulse dosing, with bactericidal drugs ceftriaxone and cefuroxime being more appropriate for pulse dosing than bacteriostatic drug doxycycline and persister drug daptomycin. We also showed that drug combination pulse dosing treatment was more effective than single drug pulse dosing. Importantly, we demonstrate that pulse dosing treatment impaired the activity of the persister drug daptomycin and its drug combination against B. burgdorferi persisters and that the most effective way to kill the more resistant biofilm-like microcolonies is the daptomycin/doxycycline/ceftriaxone triple drug combination without pulse dosing. Our findings indicate pulse dosing may not always work as a general principle but rather depends on the specific drugs used, with cidal drugs being more appropriate for pulse dosing than static or persister drugs, and that drug combination approach with persister drugs is more effective at killing the more resistant microcolony form of persisters than pulse dosing. These observations may have implications for more effective treatment of Lyme disease. Future studies are required to validate these findings in animal models of B. burgdorferi persistence.

Facts about Wildlife Diseases: South Tick Associated Rash Illness or "STARI"

Southern tick-associated rash illness (STARI) is a human tick-borne disease that occurs following the bite of Amblyomma americanum, the lone star tick, which is the most common and aggressive human-biting tick in the South, accounting for over 90% of human tick bites in the region. STARI is often described as a “Lyme-like illness” because it causes a rash like the “bulls eye” rash associated with Lyme. Other symptoms of STARI that are similar to symptoms of Lyme disease include headache, fatigue, and muscle and joint pain. Scientists know the tick vector and that some wildlife species play a role in maintaining the disease in nature, but very little else is understood about this mysterious illness. This 4-page fact sheet provides the basic facts we do know, the differences between STARI and Lyme disease, plus advice for tick-bite sufferers and strategies to avoid tick bites. Written by Katherine Sayler, Carisa Boyce, and Samantha Wisely, and published by the Department of Wildlife Ecology and Conservation, August 2016.

Prolonged Therapy for Persistent Lyme Disease Symptoms

Whether prolonged treatment reduces persistent Lyme disease symptoms is controversial. To resolve this issue, investigators in the Netherlands conducted a multicenter, randomized, double-blind, placebo-controlled trial involving 280 Lyme disease patients with persistent musculoskeletal pain, arthritis, arthralgia, neuralgia, sensory disturbances, dysesthesia, …

Community Partnership Designed to Promote Lyme Disease Prevention and Engagement in Citizen Science.

The goal of this project is to promote Lyme disease prevention and to cultivate an interest in science through a citizen-science project coordinated by researchers at a public university and teachers at rural high schools. The lesson plan is designed to increase student interest in pursuing a science career through participation in an authentic research experience, utilizing a topic that has implications on the health of the surrounding community. Students are introduced in the classroom to zoonotic diseases transmitted by the Ixodes tick, the health risks of Lyme disease, and disease prevention strategies. Students then participate in a research experience collecting field data and ticks from their community, which are used in university research. To measure changes in student knowledge and attitudes toward Lyme disease and science careers, students completed surveys related to the learning objectives associated with the experience. We found participation in the activity increased student confidence and ability to correctly differentiate a deer tick from a wood tick and to recognize the symptoms of Lyme disease. In addition, students reported increased interest in pursuing a science degree in college or graduate school. Authentic research experience related to a disease relevant to the local community is effective at enhancing high school student engagement in science.

Supervised Resistance Exercise for Patients with Persistent Symptoms of Lyme Disease.

The rapidly increasing incidence of Lyme disease has become a serious public health problem. Persistent symptoms of Lyme disease occur in over 40% of the 300,000 new cases diagnosed annually in the United States and often include debilitating musculoskeletal pain, fatigue, and poor health-related quality of life. No clinical practice guidelines for Lyme disease currently include resistance exercise partly because of concern over its safety and feasibility in this population. The goal of this pilot study was to evaluate the feasibility and preliminary efficacy of a supervised, low-intensity resistance exercise program in a sample of patients with persistent symptoms of Lyme disease. An uncontrolled resistance exercise intervention was conducted under the supervision of an exercise professional. Participants performed three exercise sessions per week for 4 wk. Each exercise session consisted of one set of varying repetitions of the leg press, seated row, vertical chest press, standing heel raise, and supine abdominal crunch. Outcomes were assessed at baseline and the end of each week of intervention and included musculoskeletal pain, fatigue, health-related quality of life, vitality, and exercise performance. ANOVA and t-tests were performed to assess changes in the study outcomes. Eight patients participated in the exercise intervention. All participants successfully completed the intervention, and there were no adverse events related to exercise. Statistically significant improvements (P ≤ 0.05) were noted in exercise performance and in the number of days out of the past 30 d feeling healthy and full of energy (0.6 at baseline and 4.5 at end of intervention). Although larger and controlled studies are necessary, supervised resistance exercise was feasible and may benefit patients with persistent symptoms of Lyme disease.

Long-term Assessment of Post-Treatment Symptoms in Patients With Culture-Confirmed Early Lyme Disease.

Lyme disease patients with erythema migrans are said to have post-treatment Lyme disease symptoms (PTLDS) if there is persistence of subjective symptoms for at least 6 months following antibiotic treatment and resolution of the skin lesion. The purpose of this study was to characterize PTLDS in patients with culture-confirmed early Lyme disease followed for >10 years. Adult patients with erythema migrans with a positive skin or blood culture for Borrelia burgdorferi were enrolled in a prospective study beginning in 1991 and followed up at 6 months and annually thereafter to determine the long-term outcome of this infection. The genotype of the infecting strain of B. burgdorferi was evaluated in subjects with PTLDS. One hundred twenty-eight subjects with culture-confirmed early Lyme disease, of whom 55% were male, were followed for a mean ± SD of 14.98 ± 2.71 years (median = 15 years; range = 11-20 years). Fourteen (10.9%) were regarded as having possible PTLDS, but only 6 (4.7%) had PTLDS documented at their last study visit. Nine (64.3%) had only a single symptom. None of the 6 with PTLDS at their last visit was considered to be functionally impaired by the symptom(s). PTLDS was not associated with a particular genotype of B. burgdorferi. PTLDS may persist for >10 years in some patients with culture-confirmed early Lyme disease. Such long-standing symptoms were not associated with functional impairment or a particular strain of B. burgdorferi.

Arthropod-Borne Diseases: The Camper's Uninvited Guests.

Arthropod-borne diseases are a major problem whenever outdoor activities bring arthropods and people into contact. The arthropods discussed here include arachnids (ticks) and insects. Most arthropod bites and stings are minor, with the notable exception being bee-sting anaphylaxis. Ticks cause the most disease transmission. Key hard tick vectors include black-legged (Ixodes), dog (Dermacentor), and lone star (Amblyomma) ticks, which transmit Lyme and various rickettsial diseases. Insect repellents, permethrin sprays, and proper tick inspection reduce this risk significantly. Lyme disease and the milder southern-tick-associated rash illness (STARI) are characterized by the erythema migrans rash followed, in the case of Lyme disease, by early, disseminated, and late systemic symptoms. Treatment is with doxycycline or ceftriaxone. Indefinite treatment of "chronic Lyme disease" based on subjective symptoms is not beneficial. Rickettsial diseases include ehrlichiosis, anaplasmosis, and Rocky Mountain spotted fever, which are characterized by fever, headache, and possible rash and should be empirically treated with doxycycline while awaiting laboratory confirmation. Tularemia is a bacterial disease (Francisella) spread by ticks and rabbits and characterized by fever and adenopathy. Treatment is with gentamicin or streptomycin. Babesiosis is a protozoal disease, mimicking malaria, that causes a self-limited flu-like disease in healthy hosts but can be life threatening with immune compromise. Treatment is with atovaquone and azithromycin. Other tick-related conditions include viral diseases (Powassan, Colorado tick fever, heartland virus), tick-borne relapsing fever (Borrelia), and tick paralysis (toxin). Mosquitoes, lice, fleas, and mites are notable for their annoying bites but are increasingly significant disease vectors even in the United States.

Preventive behaviors and knowledge of tick-borne illnesses: results of a survey from an endemic area.

Lyme disease (LD) is the most commonly reported vector-borne illness in the United States. With physically and economically burdensome effects, it is a concern of public health officials. To assess knowledge and preventive behaviors of individuals in the endemic area of Martha's Vineyard, Massachusetts, to better understand how sociodemographic data and knowledge correlate with preventive behaviors, and to update previous island studies. A 30-item paper-based anonymous survey in either English or Portuguese based on language preference. The island of Martha's Vineyard and the ferry between island and mainland. A total of 946 participants were recruited at 1 of 4 island locations. The majority of participants were traveling by ferry to and from Martha's Vineyard. To reach 2 populations potentially at high risk, that is, youths and outdoor workers, 3 additional venues included the island high school, an English-as-a-Second-Language class, and a local Brazilian church. Four specific preventive behaviors as well as an overall composite prevention score. Participants' knowledge of tick-borne illnesses was poor, and the frequency of practicing preventive behaviors was low; the most commonly reported behavior was checking one's skin for ticks (45%). Approximately one-third of respondents (37%) stated that they did not know the late symptoms of untreated LD, nor did they know early LD treatment options (49%). The 2 high-risk groups reported little participation in preventive measures. In multivariate analyses, only 4 characteristics-older age, confidence in telling deer tick from wood tick, seeing tick-borne illness as a serious threat, and certainty in ability to identify LD symptoms-attained significance associated with preventive behavior as an overall composite score. Public health interventions focusing on accurately communicating risk, improving knowledge both of LD symptoms and of ticks that carry the disease, as well as teaching preventive behaviors may help reduce tick-borne illness rates.

Editorial Commentary:Life After Lyme Disease

<i>Editorial Commentary:</i>Life After Lyme Disease

Health care costs, utilization and patterns of care following Lyme disease.

BackgroundLyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome – a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States.Objectives1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization.MethodsThis study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure.ResultsLyme disease is associated with $2,968 higher total health care costs (95% CI: 2,807-3,128, p<.001) and 87% more outpatient visits (95% CI: 86%-89%, p<.001) over a 12-month period, and is associated with 4.77 times greater odds of having any PTLDS-related diagnosis, as compared to controls (95% CI: 4.67-4.87, p<.001). Among those with Lyme disease, having one or more PTLDS-related diagnosis is associated with $3,798 higher total health care costs (95% CI: 3,542-4,055, p<.001) and 66% more outpatient visits (95% CI: 64%-69%, p<.001) over a 12-month period, relative to those with no PTLDS-related diagnoses.ConclusionsLyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization.

Lyme disease: Knowledge and practices of family practitioners in southern Quebec.

Public health authorities in Quebec have responded to the progressive emergence of Lyme disease (LD) with surveillance activities and education for family physicians (FPs) who are key actors in both vigilance and case management. To describe FPs' clinical experience with LD, their degree of knowledge, and their practices in two areas, one with known infected tick populations (Montérégie) and one without (regions nearby Montérégie). In the present descriptive cross-sectional study, FPs were recruited during educational sessions. They were asked to complete a questionnaire assessing their clinical experience with Lyme disease, their knowledge of signs and symptoms of LD, and their familiarity with accepted guidelines for diagnosing and treating LD in two clinical scenarios (tick bite and erythema migrans). A total of 201 FPs participated, mostly from Montérégie (n=151). Overall, results revealed a moderate lack of knowledge and suboptimal practices rather than systematically insufficient knowledge or inadequate practices. A majority of participants agreed to more education on LD. As expected, FPs from Montérégie had a higher clinical experience with tick bites (57% versus 25%), better knowledge of LD endemic areas in Canada and erythema migrans characteristics, and better management of erythema migrans (72% versus 50%). The present study documented the inappropriate intention to order serology tests for tick bites and the unjustified intention to use tick analysis for diagnostic purposes. Such practices should be discouraged because they are unnecessary and overuse collective laboratory and medical resources. In addition, public health authorities must pursue their education efforts regarding FPs to optimize case management.

Treatment of Lyme Diseasewith Human Embryonic Stem Cells: A Case Series

Background: Lyme Disease (LD) is a tick-borne disease caused by Borreliaburgdorferi (Bb) and transmitted in humans by Ixodesscapularis. LD can affect any organ of the body. The present study evaluated the efficacy and safety of human embryonic stem cell (hESC) therapy for the treatment of LD. Methods: Patients included in the present study had experienced symptoms of LD to varying degree of severities and intensities. The study consisted of treatment phases separated by gap phases in-between. Results: Improvement in symptoms was observed receiving hESC therapy. hESC therapy showed considerable improvement in the condition of the patients who were unable to walk straight or maintain balance while sitting and standing. These patients had regained their balance and had started to perform their regular activities with less effort after receiving hESC therapy. In addition, patients showed improvement in blurred vision, tremors, had higher energy levels, improved stamina, appetite, decreased numbness in the upper limb, decreased stiffness, regained balance, and had no slurring of speech after receiving hESC therapy. Conclusion: In conclusion, hESC therapy has shown significant improvement in patients with LD. Improvement in patients was observed without any adverse events.

Putting Heart Block Back in the “Lyme Light”

We report a case of syncope in a young patient who presented with high-degree, variable atrioventricular heart block. Despite having no other classic manifestations of Lyme disease, she was treated with intravenous ceftriaxone for Lyme carditis on high clinical suspicion due to geographic location. The heart block resolved within 24h of treatment. Although rare, we demonstrate the importance of considering Lyme carditis in patients who present with new-onset heart block and a history of living in an endemic area. Initiation of empiric antibiotic therapy can lead to rapid resolution of this condition.<Learning objective: Although uncommon, Lyme carditis may present without any other classic signs or symptoms of Lyme disease. It should be considered in any patient who presents with new-onset atrioventricular heart block and a history of living in an endemic area. Prompt initiation of empiric antibiotic therapy can be both diagnostic and therapeutic.>

Lyme disease: authentic imitator or wishful imitation?

Lyme disease: authentic imitator or wishful imitation?

A Bite of Reality

You have accessThe ASHA LeaderFirst Person on the Last Page1 Aug 2014A Bite of RealityAn SLP’s bout with Lyme disease helped her better understand the frustrations of clients undergoing similar medical uncertainty. Lori DuncanMS, CCC-SLP Lori Duncan Google Scholar More articles by this author , MS, CCC-SLP https://doi.org/10.1044/leader.FPLP.19082014.88 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In After finding and removing a tick from the back of my head, I gave little thought to how that bite would change my life forever. I recall initially being concerned, but no immediate problems arose so I dismissed the thought of any ill effects. Weeks after discovering the tick, I began experiencing frequent headaches, infections, flu-like symptoms and fatigue. As months progressed, I was diagnosed with Bell’s palsy and began experiencing slurred speech, facial numbness, fluctuating global muscle weakness, vision changes, dizziness, swallowing problems, muscle and joint pain, and muscle twitching. I was extremely concerned by this time because doctors could not figure out what was wrong with me. At my worst, I experienced brain fog, memory and attention problems, and word-finding and spelling difficulties. My neurologist ordered multiple MRIs, CT scans and blood panels, which all came back with no answers. Medications made little to no improvement in my symptoms; in fact, the symptoms persisted and worsened. The symptoms’ severity fluctuated, and some days my body seemed to be healing while other days seemed dismal and worsening. Depression began to root into the symptoms, and I withdrew and isolated myself from social interaction. I also was isolated because of the fatigue and other symptoms, which allowed me to function only for short periods of time every day. I began treating my Bell’s palsy and swallowing problems with speech intervention. It took mental and physical energy to articulate words precisely because of the muscle and nerve involvement. It was extremely frustrating and embarrassing. I had never seen one of my patients experiencing these symptoms without an etiology, so I was very concerned. I began researching disorders and their symptoms when my energy level would allow. One day, I discovered the signs and symptoms of Lyme disease and read stories of patients suffering from it. It was one disease I had not been tested for. I asked my neurologist to run the Lyme panel. I had markers for the disease and many of the symptoms. I did not know how I was going to get better. Most patients with Lyme disease take long-term rounds of antibiotics, and I had already taken many rounds of antibiotics as my symptoms persisted. I felt my immune system could not tolerate any more, and that antibiotics were not the answer to my healing. I wanted to boost my immune system so it would fight for me. During my illness, I was reunited with a friend from college who is a chiropractor. We established a care plan to allow my body to heal. My care plan addressed diet changes, supplementation, an exercise program, stress-reduction strategies and taking care of my nervous system. Postural changes were also part of the plan, and I continued speech intervention. I rediscovered that I suffered from a moderate degree of scoliosis, so I underwent intensive corrective chiropractic care to help straighten my spine. This treatment helped with my pain management and helped me function daily. Healing was not immediate and required dedication, but I am a testament that my body has healed. Today I feel better than I did before I was infected. As speech-language pathologists and audiologists, we need to know the causes for the symptoms our patients are exhibiting. I have been a patient with a communication and swallowing disorder. I have personally experienced how frustrating and socially isolating it can be, especially when there is no known reason for it. I have learned to be more compassionate toward and empathetic for my patients because I know how difficult it is to slowly become disabled. We must become more aware of the symptoms of Lyme disease, as we may be the first avenue to help diagnose it. Author Notes Lori Duncan, MS, CCC-SLP, is a clinician in a private practice clinic in Texarkana Texas. [email protected] Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 19Issue 8August 2014 Get Permissions Add to your Mendeley library History Published in print: Aug 1, 2014 Metrics Downloaded 1,765 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2014 American Speech-Language-Hearing AssociationLoading ...

New insights into stages of lyme disease symptoms from a novel hospital-based registry.

Western Connecticut Health Network created the Lyme Disease Registry in response to the community's request and clinical need for more Lyme disease research. The registry includes acute, recovered, and persistently symptomatic patients to better define the different stages of the disease. The design of the registry was guided by community and clinician input through a community-based participatory research process. Registry participants are asked questions regarding their diagnosis, symptoms, treatments, recovery, and satisfaction with the Registry. A blood specimen is also collected and stored at the initial appointment. The Lyme Disease Registry has enrolled 256 participants, 24% are acute cases, 45% are persistently symptomatic cases, and 31% are recovered cases. The symptoms experienced by the group of patients with persistent symptoms had unexpectedly strong overlap with those experienced by acutely infected patients. The difference between symptoms in the acutely infected patients and those experiencing persistent symptoms is not as large as initially thought.

Lyme disease: clinical diagnosis and treatment.

Lyme disease is an emerging zoonotic infection in Canada. As the Ixodes tick expands its range, more Canadians will be exposed to Borrelia burgdorferi, the bacterium that causes Lyme disease. To review the clinical diagnosis and treatment of Lyme disease for front-line clinicians. A literature search using PubMed and restricted to articles published in English between 1977 and 2014. Individuals in Lyme-endemic areas are at greatest risk, but not all tick bites transmit Lyme disease. The diagnosis is predominantly clinical. Patients with Lyme disease may present with early disease that is characterized by a "bull's eye rash", fever and myalgias or with early disseminated disease that can manifest with arthralgias, cardiac conduction abnormalities or neurologic symptoms. Late Lyme disease in North America typically manifests with oligoarticular arthritis but can present with a subacute encephalopathy. Antibiotic treatment is effective against Lyme disease and works best when given early in the infection. Prophylaxis with doxycyline may be indicated in certain circumstances. While a minority of patients may have persistent symptoms, evidence does not demonstrate that prolonged courses of antibiotics improve outcome. Clinicians need to be aware of the signs and symptoms of Lyme disease. Knowing the regions where Borrelia infection is endemic in North America is important for recognizing patients at risk and informing the need for treatment.