Lyme Disease

1. Lyme Disease Lyme Disease Shannon Ingraham NAU

2. What is Lyme Disease? • Currently there are 300,000 cases of Lyme disease diagnosed each year in the United States. Surprisingly, estimates are a staggering 10 times greater than the number of cases that are reported. Just in the last few decades, 360,000 cases were reported in Western Europe annually, alarming most experts to the real threat of Lyme disease (Kuehn, B. M., 2013). • There are two types of ticks that carry Lyme disease and are currently spreading rapidly across the United States. Recent studies have shown that over the past twenty years the two species of Lyme-caring ticks have spread into half of all counties in United States (Asher, C., 2016, January 28). The LC. (2008, August). Retrieved from http://thelc.typepad.com/the_lc/the_lc_guide/

3. The Deadly Bacteria Responsible for Lyme Disease • The bacteria that causes Lyme disease is Borrelia burgdorferi, which is essentially a type of corkscrew-shaped bacteria known as a spirochete (OrganicOlivia., 2016). • There are different types of borrelia on each continent of North America and Europe resulting in different forms of Lyme disease (due to B afzelii). • In North America, the infection is due to the subspecies B burgdorferisensustricto and most often causes Erythema migraines and Lyme arthritis (due to B afzelii). • In Europe however, the infection is due to the subspecies B burgdorferisensustricto, B afzelii and B garinii, and can cause Erythema migraines, Borrelial lymphocytoma, Acrodermatitischronicaatrophicans (due to B afzelii) and Lyme neuroborreliosis (Trust, D. N. Z., 2016).

4. Signs to Look for • Ticks can attach and feed on and in any part of the human body and may go unnoticed due to the fact that most tick bites are painless (Trust, D. N. Z., 2016). • The first phase of Lyme disease is the infection due to the bite. It is at this time where most cases of Lyme disease can be cured. If caught right away, antibiotics can rid Borrelia bacteria (Trust, D. N. Z., 2016). • A red ring or bull's-eye rash will appear in 75% of those who have been bitten by a tick infected with Lyme disease (Trust, D. N. Z., 2016).

5. Where Might you Find Ticks? • Animals like deer and rats perpetuate the spread of ticks that transmit this infection. Unfortunately, the spread of Lyme disease has spread furiously from tree-filled woods to the suburbs (Pearson, S., 2015). • Rates have been known to be much higher in Scotland than in England possibly due to a more moist and humid coastal climate (Kayne, S., 2014). • In the US, Lyme disease predominantly lives in the Northeast, invading areas all the way through Main to Virginia (CDC., 2015, March 4).

6. Lyme Disease is a Real Threat • Lyme disease is a debilitating flu-like illness that can often mimic ALS, Myasthenia gravis and other autoimmune conditions (Kayne, S., 2014, July 18). . • Mortality rates from chronic Lyme disease is hard to trace; however, Lyme symptoms are responsible for numerous deaths such as debilitating heart problems, paralysis and arthritis as well as neurological impairment and even suicide (Kayne, S., 2014, July 18). • Within the years of 2001 and 2010, the number of confirmed cases of Lyme disease has sharply risen from 20 to 308; however, the real numbers reported by experts say that the figures could be 10 times as high (Kayne, S., 2014, July 18).

7. Reported Cases of Lyme Disesase • There are currently 30,000 cases of confirmed Lyme disease in 2008 and 60,000 cases occurring worldwide affecting children mostly ages five to nine. 95% of all cases in 2012 were reported in 13 states (Lyme disease: Pharmacists can help., 2014). • The 13 states most effected states were Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Vermont, Virginia, and Wisconsin (Lyme disease: Pharmacists can help., 2014). Cases of Lyme Disease reported in 2013. Map accessed via CDC website.

8. Cases of Lyme Disease in Europe • Understanding what to look for when diagnosing Lyme disease is essential for fast treatment. Lyme disease can manifest with ailments ranging from lymphocytic meningitis, painful cranial neuritis and peripheral neuropathy (Makhani, N., Morris, S. K., Page, A. V., Brophy, J., Lindsay, L. R., Banwell, B. L., & Richardson, S. E., 2010). • The sure tell signs of European Lyme borreliosis is different from US Lyme disease. Erythema migrans is usually slower to effect European cases. More commonly European neuroborreliosis exhibits three syndromes called the Banworth’s syndrome which includes Lymphocytic meningitis, cranial neuropathy and painful radiculitis. In the US, aseptic meningitis usually presents by it’s self rather than the triad of Banworth’s syndrome. If untreated, European Borrelia genospecies will develop into a chronic low grade encephalitis (Makhani, N., Morris, S. K., Page, A. V., Brophy, J., Lindsay, L. R., Banwell, B. L., & Richardson, S. E., 2010). Fig.1 Number of Lyme Cases in Europe as reported to WHO Centralized Data System for Infectious Diseases (CISID)

9. Ways of Transmission • After being bit by a tick caring Lyme disease, Borrelia bacteria can quickly spread into the blood and lymphatic system causing a multisystem inflammatory disease (Trust, D. N. Z., 2016). Borrelia bacteria spreads by systemic dissemination. Systemic dissemination is an infection that enters a single area of the body, spreads throughout the body and effects other important areas of the body. Systemic dissemination of Borrelia bacteria is crucial for the spread of numerous infectious diseases such as Lyme disease and is responsible for most deaths due to bacterial infections (Ebady, R., Niddam, A. F., Boczula, A. E., Kim, Y. R., Gupta, N., Tang, T. T., … Moriarty, T. J., 2016). • Fig.1. Lyme Disease Transmission. Accessed via CDC website

10. Ways of Transmission cont. • The second stage of Lyme disease usually happens somewhere within one month to six months after the initial infection. At this time, neurological abnormalities can arise like cranial neuritis, encephalitis and meningitis along with manifestations of facial palsy. In some cases, Lyme can spread to the heart causing cardiac problems. • In the third stage of Lyme disease symptoms can take several months to even years to manifest. Lyme disease can lay dormant inside the body and become attached to intercellular spaces. In this stage, patients may develop chronic arthritis, neurological and cardiac impairments and other autoimmune-like symptoms that can lead to hospitalization and even death (Liotta, J., Gathany, J., O, S. P. C., Library, T. B. A., Images, K., Phelps, J., & Society, N. G., 2014). Retrieved November 29, 2016, from https://columbiamosquitosquad.wordpress.com/tag/black-legged-ticks-columbia-sc/

11. How to Protect Yourself From Lyme Disease • As it stands currently, there are no vaccines available for Lyme disease. Long sleeves and protective clothing should be worn as well as tick repellent when hiking in forest areas. • Wearing protective clothing like trousers and long-sleeved shirts as well as using repellents are the easiest ways to prevent a tick bite. • Long sleeves and protective clothing should be worn as well as tick repellent when hiking in forest areas (European Center for Disease Prevention and Control., 2016).

12. How to Protect Yourself From Lyme Disease cont. • When a tick does attach itself to skin, remove as soon as possible. Skin should be checked for attached ticks periodically when traversing through areas where ticks are found (European Center for Disease Prevention and Control., 2016). • When examining the body for ticks, the groin, armpits, under breasts, back of knees and waist bands should be checked. Permethrin coated clothing can be worn if one is exposed to ticks on a regular basis (European Center for Disease Prevention and Control., 2016). Written, Roth, E., & CirinoMedically, E. (2005). Is it Lyme disease? Check your symptoms. Retrieved November 29, 2016, from http://www.healthline.com/health/lyme-disease-symptoms

13. How to Protect Yourself from Lyme Disease cont. • Tweezers should be used when removing a tick and should be pulled gently upwards so the mouth of the tick doesn’t separate. A disinfectant should be used after a tick is removed to prevent a pyogenic infection (European Center for Disease Prevention and Control., 2016). • Written, Roth, E., & CirinoMedically, E. (2005). Is it Lyme disease? Check your symptoms. Retrieved November 29, 2016, from http://www.healthline.com/health/lyme-disease-symptoms

14. How to Protect Yourself from Lyme Disease cont. • Borrelia bacteria is transmitted from the middle of the infected tick to the attached skin which usually takes 36–48 hours (Trust, D. N. Z., 2016). • Most ticks carry 10-12 co-infections along with Lyme disease. Testing can be difficult to accurately conclude that someone is infected with Lyme disease. Lyme cells can alter their outer surface protein and evade detection during testing. Also, different spirochetes can cause symptoms that look like Lyme however, are not. Borrelia burgdorferi has been found in both male and female secretions (Trust, D. N. Z., 2016). Ticked off about Lyme disease- natural remedies that healed my 9-Year-Old nephew, 2016

15. Conventional Treatment for Lyme • As it stands now, there is only one pharmacological method in treating Lyme disease which is Antibiotics. Sadly there are many cases of Lyme disease that show that prolonged course of antibiotics does not show effective results (Palmieri, J., King, S., Santo, A., & Case, M., 2013). Retrieved 29, 2016, from http://ispNovemberectrummagazine.com/wp/?p=3810

16. Problems with Antibiotics • Antibiotics may be shown to be effective in some cases; however, sometimes the potential cure can be life-threatening. In many cases, prolonged even short term use of antibiotics can cause what is known as a Herxheimer reaction. This reaction occurs when toxins and wastes are released due to the death of bacteria (spirochetal pathogen) and cell tissues. Endotoxins are released when antibiotics kill their target. This may be too much for the body to take and flush out and even more severe sickness can follow. In some cases, the spirochetal pathogen will use healthy tissue like a shield as a defense against the antibiotics therefore causing an autoimmune condition (Corriher, T. C., 2014). • The LC. (2008, August). Retrieved from http://thelc.typepad.com/the_lc/the_lc_guide/

17. Problems with Antibiotics cont. The septic type of reaction from antibiotics may cause patients with Lyme disease to discontinue their antibiotics. The Herxheimer reaction has shown to increase inflammatory cytokines. Anti-inflammatory medication is often used; however, may not be enough to stop patients with Lyme disease from discontinuing their antibiotic therapy (Maloy, A. L., Black, R. D., & Segurola, R. J., 1998). • The LC. (2008, August). Retrieved from http://thelc.typepad.com/the_lc/the_lc_guide/

18. Lyme Disease Continues to Rise • Three types of epidemiological measures are used for tracking Lyme disease have helped to reveal a more realistic number of Lyme cases. The new methods of measuring and gathering information has helped reveal the true number of Lyme cases (Kuehn, B. M., 2013). • Scientists from the CDC analyzed data from six years ago, uncovering claims made to insurance companies regarding Lyme symptoms as well as gathered information on the frequency of how often Lyme disease tests are ordered in labs (Kuehn, B. M., 2013). • Lastly, the CDC analyzed data gathered in the national survey regarding the reported cases of Lyme (Kuehn, B. M., 2013). Fig.1. Cases of Lyme Disease reported in 2013. Map accessed via CDC website

19. Alternative Theories Regarding Lyme Disease's Origins • There are also some controversial findings that seem to suggest where Lyme disease originated. There is some speculation that the emergence of the disease was released at Plum Island Animal Disease Center on Long Island eight miles off the city Lyme. It has been documented by high ranking authorities that post World War II experiments on Plum Island involving ticks as disease vectors for germ warfare were tested and carried out. Many discoveries and research findings have created more questions to the origin, transmission and cures regarding Lyme disease (Liotta, J., Gathany, J., O, S. P. C., Library, T. B. A., Images, K., Phelps, J., & Society, N. G., 2014). • There is also compelling evidence showing the possibility that infections like Lyme disease may be transmitted sexually like syphilis and produce a reaction that leaves debris in the brain causing Alzheimer’s disease (Kolata, G., 2016). One thing is for sure, Lyme disease has caused disastrous effects on human health. Retrieved November 29, 2016, from https://columbiamosquitosquad.wordpress.com/tag/black-legged-ticks-columbia-sc/

20. Alternative Solutions • Treating Lyme disease is not an easy task. There are many different alternative approaches such as MSM, Colloidal Silver, Parasite Cleanse and B vitamins. Methylsulfonylmethane, or MSM, competes and occupies receptor-sites located along mucous membranes and binds with some proteins causing a clearance of waste buildup and also relieves nerve damage (Corriher, T. C., 2014, July 15). As it stands now, Antibiotics are the number one conventional way in treating Lyme disease.

21. THE END

22. References