Case Study of Lyme Disease

Lyme disease is an infectious disease transmitted by ticks, and distributed in North America and across a wide area of Eurasia. It is considered one of the major emerging diseases from a public health perspective. An outbreak of Lyme disease was first reported in the United States in the 1970s. The presence of Borrelia burgdorferi, its causative organism, in the skin results in the development of the characteristic expanding red skin lesion, erythema migrans (EM). The EM may be associated with cardiac and neurologic abnormalities. The arthritis, neurologic and skin manifestations may persist for several years and became chronic in a small percentage of patients. Studies on the classification of B. burgdorferi resulted in the identification of three closely related species, namely B. burgdorferi sensu stricto, B. garinii and B. afzelii, and different clinical manifestation of Lyme disease have been linked to the infecting species. The diagnosis of Lyme disease should be based primarily on the clinical manifestations, the epidemiological background and serological tests. Lyme disease serodiagnosis tests have been standardized, and a two-step approach is available which utilizes a sensitive first test followed by confirmatory western immunoblotting of serum samples with equivocal or positive first test results. Antimicrobials are effective in the treatment of Lyme disease in most patients. However, the primary or secondary preventions such as avoidance of tick infested area, early detection and removal of attacked ticks, and diagnosis and treatment of disease are recommended.