Lyme disease

Quick Overview

• What is Lyme disease? Bacterial infection, which is transmitted by tick bites (in 1-6% of all tick bites in Germany), usually in summer.
• Incubation period: From the sting to the onset of the first symptoms, one to several weeks pass.
• Distribution: Everywhere in wooded and plant-populated Europe and North America
• symptoms: First extensive reddening of the skin (“flushing”), flu-like symptoms with headache, body aches, fever. Possible long-term consequences (late borreliosis) are abnormal sensations, paralysis, nerve pain (neuroborreliosis), arthritis.
• diagnosis: Proof of blood and / or brain water examination (CSF examination)
• Treatment: Antibiotics (doxycycline), in pregnant / breastfeeding amoxicillin or cefuroxime; in late stages also ceftriaxone or cefotaxime
• Prevention: Skin inspection after all outdoor activities, timely and professional removal of the tick

Lyme Disease: Description

The group of Lyme disease is caused by mobile, helical bacteria: the Borrelia. They infect humans and other mammals. For infection, however, they need blood-sucking insects as carriers. The bacteria can only get into the skin of other organisms through the bites of these parasites:

In most cases, this country is by a tick bite Borreliosis transmitted by the common wood buck (Ixodes ricinus). Rarely, the infection takes place on other bloodsuckers such as horse brakes, mosquitoes or fleas. The direct transmission from person to person is not possible.

In Europe and North America comes almost exclusively the Lyme disease in front. The lice or tick relapsing fever occurs mainly in the tropics or subtropics. It is rarely brought by travelers to Germany.

Lyme disease

Lyme disease or Lyme disease is the most common tick-borne disease in Europe. It is caused by certain bacteria (Borrelia burgdorferi).

About five to 35 percent of the ticks are infected with Lyme disease pathogens. In Germany, however, only about one to six percent of tick bites infection. In addition, only a small proportion of infected people actually get Lyme disease.

But if that happens, quick action is advisable: If the disease is detected early and treated, there are good chances of recovery. But if this is not the case, the Lyme disease can result in long-term consequences.

Lyme disease can heal spontaneously and on its own at any stage, especially at an early stage.

Lyme Disease: Occurrence

There are no typical areas of Lyme disease, such as those of the TBE (early summer meningo-encephalitis). Lyme disease occurs in all wooded and plant-growing areas in Europe and North America.

Since only ticks can trigger Lyme disease in a human, there is one seasonal accumulation of the disease, In this country, one can get infected with Lyme disease from March to October (in warmer weather also earlier or later in the year). Most infections occur in the summer months.

Lyme Disease: incubation period

It takes days to weeks between the tick bite and the occurrence of typical skin redness and any general symptoms such as fever (early stage of Lyme disease). “Incubation time” is what doctors call this period between contagion and outbreak. Because it is relatively long in Lyme disease, many patients can no longer remember the tick bite. Often, this was not even noticed.

Lyme disease: symptoms

The clinical picture of Lyme disease can be very diverse. Many people with Lyme disease initially show no symptoms. Others develop erythema at the tick bite site, which slowly grows larger. Doctors speak here of the “migrans“Accompanying flu symptoms such as headache and body aches and fever.

In the further course, the Borrelia can spread over the blood in the body and infect various organs. Corresponding symptoms only appear weeks to months after the tick bite:

The infection often attacks the nervous system. Then an acute develops Neuroborreliose (see below). Less commonly, the Borrelia infects other body organs such as the heart muscle.

When late effects Lyme disease can cause a variety of complaints months to years after infection. These include chronic inflammation of the joints (Lyme arthritis) or skin (Acrodermatitis chronica atrophicans Herxheimer). It is also possible chronic borreliosis of the central nervous system (chronic neuroborreliosis).

You can read more about the typical signs of Lyme disease and possible long-term consequences in the article Lyme Disease – Symptoms.

Neuroborreliose

Neuroborreliosis develops when the Borrelia affect the nervous system. The nerve roots of the spinal cord (radiculitis) often become inflamed, causing tormenting, burning nerve pains. They are noticeable especially at night.

In addition, neuroborreliosis may be associated with flaccid paralysis (such as in the face) and neurological deficits (sensory disturbances). Especially children often develop meningitis.

Neuroborreliosis is usually curable. In severe cases, however, damage can be left behind.

Everything important about symptoms, diagnosis and therapy of neuroborreliosis can be read in the article Neuroborreliosis.

Lyme Disease: Causes and Risk Factors

The causative agent of Lyme disease is the bacterium Borrelia burgdorferi, It is transmitted from ticks to humans. A direct infection from person to person is not possible, That’s why no person with Lyme disease is contagious!

The older a tick is, the higher the risk that it carries the Lyme disease pathogens. Because the tick has to catch itself first with the bacteria: it infects with small rodents and other forest inhabitants, who carry the Borrelia in itself.

The bacteria do not make the tick sick, but survive in the stomach. This can be dangerous for people who have been selected by the tick as the next “victim”: Ticks live especially on grasses, leaves and bushes. There they are waiting for a passing person (or an animal) to fall for to suck blood. The tick migrates to warm, moist and dark areas of the body. Particularly popular are, for example, the armpits and the pubic region. Ticks can also bite on any other body site.

While a tick sucks blood on a human, it can transmit the borrelia. The borreliosis transmission does not take place until the end of the blood meal: when the tick is full, it chokes some stomach contents into the wound of the victim, and with it the bacterium Borrelia burgdorferi.

This means: The risk of infection increases with the duration of the Saugaktes. If a tick absorbs a human for less than 24 hours, the risk of Lyme disease transmission is low. It does, however, increase if the suction lasts longer than 24 hours.

If you poison or smother a skin-sucking tick with oil or other substances, you increase the risk of infection! Because the danger that the tick in the fight for survival gastric contents, is great.

Borrelia: Difficult opponent for the immune system

Many people wonder why our immune system can not simply remove the bacterium from the body after infection. For some people this may be the case. They show no symptoms, although their immune system was confronted with the pathogen at some point in time.

However, the Lyme disease bacterium has some clever mechanisms to escape the human immune system. For example, it can change its surface so that the body’s defense does not comply with the detection of the pathogen.

In addition, the bacteria literally hide from the immune system: On the one hand, they colonize areas of the body that are poorly controlled by the immune system, such as the brain or joints. On the other hand, the bacteria invade human cells in order to escape detection and control.

Lyme disease: examinations and diagnosis

Tick ​​bite – yes or no? The answer to this question is important for the doctor in order to clarify the suspicion of Lyme disease. Since symptoms of the disease often occur weeks or months after the infection, but many patients do not remember the tick bite. But you can at least tell the doctor if it was possible: If you walk in woods or meadows or weed in the garden, you can easily catch a tick.

In addition to the possibility of tick bites, the doctor is also interested in the exact complaints of the patient: In the early stages of the disease, it is above all the “migrans“Too general symptoms such as head and limb pain should inform the doctor. In the late stages, patients often report chronic joint pain or neurological complaints.

The suspicion “Lyme disease” finally gets through laboratory tests hardening. For example, in a blood or nerve water sample (in neuroborreliosis), the doctor may search for antibodies to borrelia. However, the interpretation of such laboratory results is not always easy.

Read more about the diagnosis of Lyme disease in the article Lyme disease test.

Lyme disease: treatment

Borrelia are like other bacteria antibiotics fight. The type, dose and duration of use of the drugs depend primarily on the stage of Lyme disease and the age of the patient. Thus, adults in the early stages of the disease usually receive tablets with the active ingredient doxycycline. For children and pregnant women, however, this antibiotic must not be used. Instead, the doctor here prescribes amoxicillin or cefuroxime.

In later stages of the disease (chronic neuroborreliosis, etc.) patients are often treated with antibiotics such as ceftriaxone or cefotaxime. The medications can be given as an infusion.

The success of antibiotic therapy depends on the start of treatment: In the early stages of Lyme disease treatment is usually more effective than in later stages.

Read more about the treatment of Lyme disease in the article Lyme disease – Therapy.

Lyme disease: disease course and prognosis

One fast therapy start is very important in Lyme disease. The course and prognosis of the disease are significantly influenced by whether the bacteria had time to spread and multiply in the body. It also depends on whether secondary damage remains after the Lyme disease. The best chances for a complete recovery without consequences exist, if a Lyme disease in the early stage (“Wanderröte”) is recognized and treated.

In many patients, however, the typical skin redness is missing, which is why the Lyme disease is often recognized and treated late. The bacteria then had enough time to spread through the bloodstream in the body and infect organs. For example, Lyme disease in children more often than in adults leads to an infestation of the brain with meningitis. The treatment of Lyme disease in such advanced stages of the disease is often difficult.

Once recovered, Lyme disease, which heals spontaneously or under therapy, does not provide immunity. This means that you can later become infected with Lyme disease and get sick.

Post-Lyme disease syndrome

This is particularly popular in health magazines or the media Post-Lyme disease syndrome, It is often called “chronic fatigue syndrome”. However, there is no clear definition that describes this condition. The media often reports indefinite pain, fatigue, weakness or muscle aches. In fact, Borrelia could cause this condition, but it also affects a variety of other diseases.

A chronic Borrelia infection is usually shown by skin changes (Acrodermatitis chronica atrophicans Herxheimer), joint inflammation (Lyme arthritis) or nerve changes (chronic neuroborreliosis). They are more likely to be recognized and caused by Borrelia than nonspecific symptoms such as persistent fatigue or muscle aches. Therefore, many experts doubt that the supposed “post-borreliosis syndrome” is actually linked to a Borrelia infection. According to the medical guidelines should be in such a case no Lyme disease blood test be made, as it recognizes only very inaccurate Lyme disease.

Rather, one should try to relieve the patient’s discomfort and look for another cause of the symptoms. In some cases, there is even a hidden depression or a viral disease as the cause of chronic fatigue or lack of concentration.

Lyme Disease & Pregnancy

If it comes to a Lyme disease during pregnancy, early treatment is particularly important. The bacterium Borrelia burgdorferi may colonize the placenta and possibly disturb the child’s development. The exact effects have not been well studied, but organ damage and stillbirth have been implicated in Lyme disease.

Although the association has not been proven beyond doubt, Lyme disease should be used during pregnancy antibiotics be treated. The doctor chooses active ingredients that do not harm the unborn baby.

Lyme Disease: Prevention

Ticks offer the only starting point for the protection against Lyme disease: Prevent tick bites or remove an already sucking tick as quickly as possible. The following tips apply:

If you’re out and about in the woods and meadows or doing gardening, you should if possible bright (white) clothes wear. Ticks are easier to recognize and dark textiles on it. Also, the arms and legs should be covered by clothing, so that the little bloodsucker not so easily find skin contact.

You can also Tick ​​or insect repellent Apply (Repellents). Keep in mind, however, that these do not provide 100 percent protection against a tick bite and last only a few hours.

In any case, after a stay in the outdoors you should thoroughly clean the whole body search for ticks, Take control of yours too Pets on possible ticks: The parasites could switch over to you from your cat or dog.

If you find a sucking tick on your skin, you should take it promptly and remove professionally: Grasp the tick directly over the skin with a pair of fine tweezers or a pair of tweezers and pull it out slowly without twisting. In doing so, press as little as possible so as not to press stomach contents of the animal into the wound. Also check that you have not accidentally ripped off the body while the parasite’s head is still in the wound.

Then you should have the puncture wound disinfect, Although this does not protect against Lyme disease, but prevents wound infection (such as with tetanus bacteria).

As a precaution, taking antibiotics after a tick bite (without a diagnosis of Lyme disease infection) will not recommended.

A preventive vaccine against Lyme disease there is not any.

Additional information:

guidelines:

• S2k guideline “Cutaneous Lyme borreliosis” of the German Dermatological Society (as of 2016)
• S1 guideline “Neuroborreliosis” of the German Society of Neurology (as of 2012)
• S1 guideline “Lyme-Arthritis” of the Society for Pediatric and Adolescent Rheumatology and the German Society for Paediatrics (as of 2013)

Support Groups:

Lyme disease and FSME Federation Germany e.V. – Federal Association of Lyme disease self-help

https://www.borreliose-bund.de

Federal Association of Tick Diseases e.V.

Werrastr. 60, 64625 Bensheim

https://www.bzk-online.de/