Infectious diseases specialists diagnose and treat infections from bacteria, viruses, fungi, and parasites, focusing on fevers, antibiotics, and vaccines.
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Lyme disease, also known as Lyme borreliosis, is a complex infection caused by the bacteria Borrelia burgdorferi and, in some areas, Borrelia mayonii. At Liv Hospital’s Department of Infectious Diseases, it is seen as more than just a skin reaction to a tick bite. Instead, it is recognized as a systemic illness that can affect the nervous system, joints, and heart. The bacteria belong to the Spirochaetaceae family and have a spiral shape that helps them move through body tissues and spread from the bite site to other organs.
Lyme disease involves a complex relationship between the bacteria, the tick that carries it, and the person who gets infected. It is spread only through the bite of infected Ixodes ticks, also called black-legged or deer ticks. Unlike many bacteria that cause quick and severe illness, Borrelia burgdorferi hides from the immune system by changing its surface proteins. This ability helps it avoid detection and can lead to long-lasting infection if not treated early.
To fully comprehend the definition of Lyme disease, one must appreciate the sophisticated architecture of the spirochete. The bacterium possesses periplasmic flagella, which are internal propulsion mechanisms located between the outer membrane and the protoplasmic cylinder. This internal arrangement protects the flagella from host antibodies and enables the bacterium to move efficiently through the extracellular matrix of the skin and connective tissues. This motility is a critical virulence factor, distinguishing Lyme borreliosis from infections caused by non-motile organisms. The spirochete’s ability to migrate away from the initial bite site results in an expanding rash characteristic of early disease and, eventually, seeding into joints, the heart, and the nervous system.
The medical community stratifies Lyme disease into three distinct clinical stages, although these phases can overlap and do not always occur in a linear progression. Understanding these definitions is essential for accurate clinical assessment and management.
Lyme disease is fundamentally an ecological phenomenon that spills over into human health. The life cycle of the Lyme spirochete involves a complex interplay among the tick vector and various reservoir hosts, primarily small mammals such as the white-footed mouse and birds. Humans are considered accidental or dead-end hosts, meaning they can acquire the disease but do not contribute to the transmission cycle. The increasing prevalence of Lyme disease is often attributed to ecological changes, such as forest fragmentation and reductions in predator populations, which allow reservoir hosts to thrive in proximity to human habitation. Consequently, the medical definition of the disease is expanding to include considerations of environmental exposure and One Health perspectives, acknowledging the interconnectedness of human, animal, and ecological health.
Some patients continue to have symptoms even after finishing antibiotics. This is called Post-Treatment Lyme Disease Syndrome (PTLDS) and is different from an ongoing infection. Experts believe PTLDS is due to changes in the immune system or nervous system, not because the bacteria are still present. This means treatment should focus on support and rehabilitation, not more antibiotics. At Liv Hospital, doctors carefully check for other causes before diagnosing PTLDS.
While initially identified in Old Lyme, Connecticut, the disease is now recognized as a global health concern, with strains prevalent across continents. In Europe and Asia, different genospecies of Borrelia, such as Borrelia afzelii and Borrelia garinii, are more common and are associated with distinct clinical presentations, including a higher incidence of neurological or cutaneous manifestations, compared to the arthritis that is more common in North America. The definition of Lyme disease continues to evolve as new pathogenic species are discovered, requiring infectious disease specialists to maintain constant vigilance and adapt diagnostic protocols.
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The primary organism responsible for Lyme disease is the spirochete Borrelia burgdorferi. In some regions, a closely related species, Borrelia mayonii, has also been identified as a cause. These bacteria are spiral-shaped and highly motile, allowing them to move through tissues and evade the immune system.
Lyme disease is not contagious and cannot be transmitted from person to person. You cannot contract the disease through touching, kissing, or sexual contact with an infected individual. It is a vector-borne illness that requires the bite of an infected tick to transfer the bacteria into the bloodstream.
Lyme disease is specifically caused by the Borrelia bacteria transmitted by the black-legged tick. Other tick-borne illnesses, such as Babesiosis, Anaplasmosis, or Rocky Mountain Spotted Fever, are caused by different parasites or bacteria and may be transmitted by various tick species. However, it is possible to be co-infected with multiple pathogens from a single tick bite.
Lyme disease is often referred to as the Great Imitator because its symptoms are diverse and non-specific, frequently mimicking other conditions. The fatigue, joint pain, and neurological issues associated with Lyme can resemble chronic fatigue syndrome, fibromyalgia, multiple sclerosis, or rheumatoid arthritis, making clinical diagnosis challenging without specific testing.
No. Hepatitis C is not a vector-borne disease. Mosquitoes, ticks, or other insects cannot spread it. The virus is specific to humans and cannot replicate in insects, so it cannot be transmitted via a bite. It is spread only through contact with infected human blood.
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