In this article, we will talk about the signs and symptoms of Lyme disease in humans. We will also touch on the other essential aspects of this disease.
The bacterium Borrelia burgdorferi is transmitted by the bite of an infected tick. Lyme disease or “Lyme borreliosis” is a worldwide infectious disease caused by a bacterium called Borrelia burgdorferi, transmitted through an infected tick bite. This zoonosis can affect several organs and systems, the skin but also the joints and the nervous system. Untreated, it evolves over several years or decades in three stages more and more serious. The treatment is based on the use of antibiotics, it will be all the more effective that it will be administered quickly.
Lyme disease has been “rediscovered” during an outbreak of childhood inflammatory arthritis in Old Lyme, Connecticut (USA). In 1972, there were the first cases of epidemic arthritis simulating rheumatoid arthritis attacks in young people in three communities east of Connecticut: Lyme, Old-Lyme, and East Haddam, hence the name of Lyme disease in the USA and Lyme borreliosis, in Europe.
1 – Signs and Symptoms of Lyme Disease in Humans
The signs and symptoms of Lyme disease in humans occur in three stages. within three to thirty days after the tick bite by a red, inflammatory plaque, appearing on the skin around the stinging point, which most often sits on the lower limbs. The plaque will extend parallel to the healing of the center which will give a kind of ring extension, called “chronic erythema migrans”. This plaque may be accompanied by fever, then disappear spontaneously in a few weeks.
After the cutaneous inoculation of the bacteria during tick bite, The signs and symptoms of Lyme disease in humans occur in three stages. three major phases, separated by asymptomatic periods (absence of signs of the disease).
*** Primary Phase
The primary phase is characterized by a skin lesion: chronic erythema migrans. This lesion occurs within 3 and 30 days after the tick bite. It is an erythematous (red) papule centered by the stinging point, progressively extending centrifugally. It is usually non-itchy (no scratching) and preferentially sits on the lower limbs (sometimes the upper limbs, or even the face in the child).
General manifestations (headache, joint pain, mild rise in body temperature, fatigue) and lymph nodes close to the cutaneous lesion may be associated, reflecting the spread of the bacteria in the body. In the absence of treatment, the erythema evolves for a few weeks (progressive extension) and disappears without sequelae.
If Lyme disease is not treated at this stage, the signs may fade spontaneously and, during a period of clinical latency, the infection will diffuse and activate the immune system.
*** Secondary Phase
The secondary phase occurs several weeks or months after the disappearance of the erythema but can reveal the disease. This phase is characterized by:
– Cutaneous manifestations: these are lesions similar to those observed during the primary phase of the disease;
– Joint manifestations: frequent joint pain. Arthritis is less common and affects large joints (knee);
– Cardiac manifestations: syncope (loss of consciousness), palpitations (feeling of heartbeat in the chest), chest pain, and especially disorders of atrioventricular conduction (the “electric current” normally circulating from the atria to the ventricles is interrupted sporadic that can lead to serious heart problems). These cardiac manifestations most often evolve towards healing without sequelae;
– Neurological manifestations: hyper-Algic radiculitis (very painful inflammation of the roots of the nerves innervating the territory of the tick bite). The facial nerve is frequently affected. Meningitis can also be observed.
*** Tertiary Phase
It occurs months or years after the start of infection with:
– Skin disorders: Pick Herxheimer’s disease (cutaneous inflammation evolving to atrophy of the skin), benign cutaneous lymphocytoma (purplish, rounded nodules, with sharp contours, firm, localized on the forehead, the ear lobe, and regressing spontaneously in a few months);
– Joint lesions: identical to those observed in the second phase;
– Neurological disorders: affecting the spinal cord or the brain (various neuro-psychiatric manifestations).
This stage of the disease corresponds to sequelae that are not very regressive and will last for years.
After the acute infection, which is mainly cutaneous, the untreated infection can pass through a dormant phase and then affect most organs (joints, heart, ganglia and nervous system), acute and / or chronic, with effects different organs and patients (important role of immunity).
Sequelae and relapses are possible and there may be an overlap between the phases. The disease, over the course of “infection-inflammation-scarring cycles”, can finally lead to scars responsible for definitive physical and mental handicaps.
*** The Most Common
Signs and Symptoms of Lyme Disease in Humans
These signs vary according to the stage of the disease, with the possibility of overlapping stages, and depending on the immune field.
There may be a complete absence of symptoms in some people. Others may experience severe symptoms, but only weeks after the bite.
The main signs will be an association at different levels of fatigue, fever (with or without chills), large ganglia, rash, headache, muscle weakness, numbness or tingling, joint pain or arthritis, disorders of the nervous system (paralysis ), cognition disorder (difficulty thinking) and irregular heartbeat.
In the absence of antibiotic treatment, signs can last for months or even years.
2 – Epidemiology
This disease is mainly transmitted by the bites of infected ticks. This borreliosis shows a distribution limited to the northern hemisphere and at an altitude of less than 1000 m.
The risk of being bitten by a tick increases when the temperature warms in the woods in the spring and continues through the fall. Ticks can, however, be active in the winter, if it is mild and there is little snowfall.
The reservoir of germs is very large: ticks, domestic mammals (dogs, horses, cattle), and wild (squirrels, deer, field mice, voles).
Ticks are not naturally infected, they contaminate themselves by feeding on the blood of infected wild animals. Ticks do not move far by themselves. However, the spread of tick populations by different vectors (rodents, migratory birds, domestic animals) makes it possible to get bitten outside the woods and natural areas. For example, they may stick to migratory birds and fall far from their original location.
3 – Diagnosis and Tests
The difficulty of diagnosing Lyme disease is that it affects many organs and when most signs appear, the tick bite is usually cured and forgotten. Sufferers do not necessarily make the connection between the disease and a tick bite.
These infectious attacks of different organs and systems can occur alone or in combination, which complicates the diagnosis. Especially, that at this stage, the diagnosis is often difficult because there is more trace of the sting.
The diagnosis of Lyme disease is essentially based on the clinical signs observed.
To clarify the diagnosis, it is possible to perform tests that can highlight in the blood antibodies – serologies – testifying to a response of the body to the bacterial infection.
In the laboratory, the biological diagnosis is based on two tests carried out in two stages: a screening stage – screening – by an ELISA technique, necessarily confirmed by a second reaction called immunoblot or “Western Blot” according to the recommendations.
An examination by PCR (Polymerase Chain Reaction), is the reference technique: it allows to highlight the DNA of the bacteria. PCR is indicated in doubtful cases, particularly those with discrepancies between clinic and serology.
In cases of nervous system damage, the search for antibodies in the fluid surrounding the brain – cerebrospinal fluid – by lumbar puncture (in the lower back) may help to make the diagnosis in case of meningo-radiculitis or of meningoencephalitis.
4 – Treatment of Lyme Disease
In the first phase of the disease, the aim of the treatment is to ensure the disappearance of the first symptoms of the disease and to prevent the occurrence of late manifestations by eradicating the germ from the organs that can be infected.
Thus, for each phase and according to the severity of the disease, the treatment may vary and may require hospitalization. It consists of administering an antibiotic (amoxicillin or doxycycline) possibly associated with a corticosteroid.
In the absence of treatment, the disease can cause, some weeks, months, or years later, joint pain or arthritis and other cutaneous, cardiac or neurological lesions in case of disorders of the atrioventricular conduction.
The Borrelia responsible for this disease is treated with antibiotics, but the treatments are heavy and do not always eliminate it. Part of the fastest and most mobile bacteria known, it can lodge in all tissues of the human body, making itself invisible and, therefore, unattainable by antibiotics. Throughout the course of treatment, it can be localized as a spongy cyst, attracting white blood cells that eventually clump together and hide it. The bacterium survives safely, leaving lesions created by the cluster of white blood cells.
Bacteriophages cannot really kill Borrelia, but they do much to weaken it. By dislodging it, the phage helps to expose the bacteria to the action of antibiotics which can then destroy it.
5 – Prevention of Lyme Disease
The best way to protect yourself from Lyme disease is to avoid tick bites.
When walking through wooded or overgrown areas from spring to fall, it’s best to wear closed shoes, pants, and long-sleeved shirts. It may even be advisable to tuck your pant legs into socks in areas where Lyme disease is particularly prevalent. Under these circumstances, it may even be necessary to use insect repellent to apply to the exposed skin.
It is generally advisable to wear light-colored clothing in order to spot ticks more easily and to make them fall before they get under the clothes.
Ticks attach to the skin but removal within 24 to 36 hours usually prevents infection. Inspections of the bodies of children and dogs for ticks should be done after a walk in the forest. Taking a shower or bath after the trip is a good way to do it.
6 – Reduce the Presence of Ticks near Your House
To prevent ticks from settling near dwelling houses (if they are located near a wilderness area or woods), it is advisable to regularly mow the lawn and maintain the yard. Leaves, brush, and weeds should also be removed from the edge of the lawn and near the stone walls.
The activity of rodents must be prevented by cleaning and sealing the stone walls and small openings around the house.
Pets should be prevented, especially dogs, from going into the woods and possibly putting tick repellents on pets.