1. Lyme’s Disease
By: Jena Hendricks

2. History
In early 1970’s, a mysterious group of children rheumatoid arthritis cases occurred in Lyme, Connecticut
It was not until 1981 that National Institute of Allergy and Infectious Diseases (NIAID) researchers in Hamilton, Montana connected the deer tick to the disease
In November 1981, the two scientists found that a spirochete cause both Lyme disease and erythema migrans (EM)
The spirochete was later named Borrelia burgdorferi in honor of Dr. Burgdofer’s role in the discovery.

3. Interesting Factoid
In 2011, 96% of Lyme Disease cases were reported from 13 states
Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Vermont, Virginia and Wisconsin.
Lyme Disease does not occur nationwide and is concentrated heavily in the northeast and Midwest.

4. Lyme Disease case Who: John from Virgina
What: John contracted Lyme disease from a tick bite, while out in the woods with his son’s boy scout troop
When: Occurred in July 2011
Where: First noticed an itch on right hip, but didn’t think much about it. Later he found out he had contracted Lyme disease from that bit
Why: John sought treatment from his Doctor, Dr. Heaton (Family Practice Physician in Virginia) after knowing something was not right; completed first (and only) round of doxycycline medication
Website link – “One Man’s Experience”

5. Case of Lyme Disease - WHEN
Timeline/Incubation:
Wednesday
Felt itch on hip, but shrugged off as insect bite
Checked himself before bed, but did not notice any ticks
Friday
Started to not feel well, but still did not connect the two events together
Saturday (morning)
Felt lethargic, tired and a little achy
While taking a shower, John noticed a red “bullseye” rash on his right hip
He knew something was wrong, so decided to go to the Doctor
Received round of medical: doxycycline
(Following) Saturday
Felt fantastic, back to old self again

6. Transmission Lyme disease is a bacterium
Genus: Borrelia
Species: burgdoferi
Spread through a bite of an infected ticks
Blacklegged tick (or deer tick)
Ticks can attach to any part of the body
Often found in hard to see areas such as; groin, armpit and scalp
In most cases, the tick must be attached for hours (or more) before the Lyme Disease bacterium can be transmitted

7. Tick Size
Most transmission of Lyme disease occurs from bites of immature ticks, called nyphms
Harder to detect, unlike larger adult ticks

8. Other modes of transmission?
There is NO evidence that Lyme disease is transmitted from person-to-person
There is no credible evidence that Lyme disease can be transmitted through air, food, water or from the bites of mosquitoes, flies fleas or lice
Scientists have found that Lyme disease bacteria can live in blood that is stored for donation
Although no cases of Lyme disease have been linked to blood transfusion
After an individual has completed antibiotic treatment, they can be considered as a potential blood donor

9. Virulence Factors
The spirochetes have outer surface proteins called endoflagella located in the periplasm that allows them to remain hidden from the host

10. Bacterium Characteristics
Spiral-shaped bacteria 20 to 30 micrometers long
Gram-negative microaerophiles

11. Description of Disease
Bacterium is injected into the skin by the bite of an infected tick
Tick saliva, which accompanies the spirochete into the skin during the feeding process, contains substances that disrupt the immune response at the site of the bite.
This creates a protective environment where the spirochete can establish infection and begin to spreads outward within the dermis

12. Bodies Reaction to Lyme disease
The spirochete has been found in many tissues, including the skin, heart, joints, peripheral nervous system and central nervous system
Many of the symptoms of Lyme disease are a consequence of the inflammatory response to the presence of the spirochete in those tissues.

13. Signs and Symptoms Incubation period (3-30 days post-tick bite)
Typical first signs:
Fatigue, chills, fever, headache, muscle and joint aches and swollen lymph nodes
Red, expanding rash called erythema migrans (EM), also known as a “bullseye” rash
ER could take up to 30 days to appear

14. Signs and Symptoms
Untreated, the infection may spread from the site of the bite to other parts of the body, producing an array of specific symptoms that may come and go, including:
Additional EM lesions in other areas of the body
Bell’s Palsy (loss of muscle tone on one or both sides of the face)
Severe headaches and neck stiffness due to meningitis (inflammation of the spinal cord)
Pain and swelling in the large joints (such as knees)
Shooting pains that may interfere with sleep
Heart palpitations and dizziness due to changes in heartbeat
**Many of these symptoms will resolve over a period time (weeks to months), even without treatment.

15. Tick Removal
Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible
Pull upward with steady, even pressure
Don’t twist or jerk the tick, this can cause the mouth-part to break off and remain in the skin
After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water
**Avoid folklore remedies such as petroleum jelly, or using heat to make the tick detach from the skin. Better to remove the tick as quickly as possble.

16. Diagnostic Process
Laboratory blood testing can be an important aid in the diagnosis of Lyme disease
Blood test measures antibodies made by white blood cells in response to infection
Lab tests are not recommended for patients who do not have symptoms, typical of Lyme disease

18. Treatment Antibiotics commonly used for oral treatment include;
Doxycycline, amoxicillin, or cefuroxime axetil
Approximately 10 – 20% of patients treated for Lyme disease with a recommended 2-4 week course of antibiotics will have lingering symptoms, such as;
Fatigue, pain, or joint and muscle aches

19. Cases in United States
Top 5 confirmed cases in the US (confirmed cases per 100,000 population)
New Jersey = 3398
Wisconsin = 2408
Connecticut = 2004
Minnesota = 1185
Massachusetts = 1801
Total = 24,364
**Hawaii has had zero cases for last 9 years.

20. Cases in Oregon
Confirmed cases (confirmed cases per 100,000 population)
** Oregon = 9
The highest concentration of infected ticks in Oregon are located from the western end of the Columbia Gorge, near the mouth of the Deschutes River.

21. Why Worry?
Lyme disease is a real threat to families across the U.S., especially during the months that families play outside most frequently.

22. Bibliography
Lyme disease. (2012, JULY 26TH). Retrieved from
Lyme disease. (2012, OCTOBER 09). Retrieved from
derstanding/pages/intro.aspx
3. Lyme disease. (2010, April 26). Retrieved from
4. Lyme disease. (2012). Retrieved from