Most cases are the result of a bite from a tick infected with the Spirochette, Borrelia Burgdorferi (Bb). Because ticks often carry several diseases, both Lyme disease and co-infections are usually transmitted at the same time. The result is an acute illness that, over time, develops into a chronic condition. Frequently seen symptoms are severe immune system correlates, with various infections leading to the production of biological toxins, hormonal and metabolic imbalances and a severe form of Chronic Fatigue Syndrome.
Early treatment of Lyme is essential for the most successful treatment outcomes. Unfortunately, Lyme disease is often misdiagnosed and progresses to the chronic state, wherein severe morbidity, even mortality, may result. The most severe implication is in cases of neurological Lyme Disease.
Co-infections associated with Lyne Disease are
- Borrelia Burgdorferi, Afzeli Garimii
- Mycoplasma Species
- Chlamydia Pneumoniae
- Rickettsias Species
- Bartonella Species
- Babes Species
- Ehrlichia
- Anaplasmosis
- Chronic viral infections including HHV-6, CMV and HBV
VECTORS
Most common vector for transmission is tick bite. Any biting insect that feeds on blood is a possible carrier of Lyme Disease, including bedbugs, leaches, march flies and midges.
Sexual Transmission
Definite evidence exists, especially in patients with chronic Lyme disease.
Pregnancy
Direct transmission via the placenta to unborn child has been observed.
Blood Transfusion
Highly likely to transmit Lyme disease
Intravenous Drug Use and Non-Sterile Tattooing
Known to transmit Lyme Disease
Diagnostic Tests
The diagnosis is frequently reached by default, as Lyme Disease is rarely suspected unless the patient tells the doctor “I was bitten by a tick and I have this big rash”… If the patient has the EM rash, (it is called Erythema Migrans) and if the doctor knows how to recognize it, an early diagnosis is possible. The first and most likely observation will be positive sero conversion, IgG and IgM positive, a positive tissue microscopy, a positive Western Blot and a positive PCR test.
There are many tests that can assist with the diagnosis of Lyme and its co-infections and in determining the extent and severity of infection. Here are some tests which may be helpful on the way to diagnosis.
FBC, ESR, CRP, MBA-20, CK, ANA, ENA, ANCA, Rheumatoid factor, CCP antibody, Iron studies, Vitamin B12, Plasma Zinc, Copper, red cell folate, TSH, T4, T3, Reverse T3, Anti-thyroid antibodies, TRAN, insulin, ASOT, Anti-DNase, ACE, IgA, IgG and Subset, CD57, Tissue Transglutamase, plus Rickettsia, Q Fever, Borrelia, Bartonella, Mycoplasma and Chlamydia Pneumoniae antibodies. Also Ross River Virus, Barmah Forest Virus, Flavivirus, EBV, CMV and Toxoplasmosis. 250H Vit D. 125DiOH, CD57 and CRP are very useful in the diagnosis and management of Lyme Disease. A high CD57 probably indicates something other than Lyme, such as a co-infection.
Difficulty of Diagnosis.Firstly, recognition and acknowledgement of the disease in Australia. Many doctors do not consider Lyme Disease and therefore, they do not order the appropriate tests. Some of the testing for Lyme is specialized and not performed by standard pathology labs. The most effective path lab in Australia (at the time of writing) is Australian Biologics in Sydney. Tests take between 4-6 weeks.
An article on living with Lyme, treatment options and likely outcomes will follow soon and will be posted on the website.