Lyme disease is a bacterial infection that is spread through the bite of a tick. If not diagnosed and treated immediately, Lyme disease can cause multiple health problems.

Vector-borne diseases account for more than 17% of all infectious diseases, causing more than 700,000 deaths worldwide each year, which can be caused by parasites, bacteria, or viruses, according to the World Health Organization (WHO). Among this large group is Lyme disease which, although it is more prevalent in the northern hemisphere, that is, in countries such as the United States, Canada, and even in many parts of Europe and Asia, in Peru, as evidenced in an article in the Peruvian Journal of Experimental Medicine and Public Health, between 1992 and 1999, six cases of this disease were reported in our country.

Certainly, this disease is almost non-existent at the national level; however, as expressed by Julio Cachay, a specialist in infectious diseases and internist of Clinica Ricardo Palma to Bienestar de El Comercio, it is considered an emerging disease, because nowadays with the globalization of human beings, diseases that used to be limited to certain geographical areas, can now be imported to other areas with greater ease. For this reason, it is important to be alert and know the most characteristic symptoms that give us an initial orientation and, subsequently, a differential diagnosis.

What is Lyme disease and what are its main causes?

First, this disease is a zoonosis caused by the spirochete Borrelia burgdorferi sensu lato, which is transmitted by ticks harbored in biological species, such as deer and rodents, and the human being becomes an accidental host. Basically, when its biological cycle occurs in nature, if a person enters the vector’s habitat, mainly in rural and peri-urban areas, he or she can suffer a bite from an infected tick and contract this disease, the specialist explained.

For example, Lyme disease is the most common vector-borne condition in the U.S. with approximately 500,000 new cases per year, and as reported by the Johns Hopkins Medicine Lyme Disease Research Center, the geographic scope of the tick-borne epidemic is expanding as these vectors spread to new regions.

What are the most common symptoms of Lyme disease?

Characteristic of this disease is a dermal manifestation called erythema migrans, which is a red macule at the site of the tick bite, which grows over the course of days and can reach an average of 10 to 15 centimeters in diameter. In addition, Cachay specified that, in this initial context, it can also be associated with a fever, headache, muscular and joint pain, decay, and a series of non-specific signs; however, what leads us to think about the infection are mainly the skin lesions.

What are the stages of Lyme disease?

According to the physician of Clinica Ricardo Palma, this disease is divided into three stages: the first is called the early or localized phase, in which the bacteria has not yet spread throughout the body, followed by the early dissemination stage that occurs due to the lack of specific diagnostic studies, as the bacteria continues to spread throughout the body and can generate bacteremia, so when entering the body it spreads faster, thus causing greater health problems in those who suffer from it. Finally, the late dissemination phase, which can occur up to one year after the tick bite, can generate rheumatological conditions, such as arthritis, since 60% of the cases show a development in the following months or even up to two years after the onset of the disease.

How should Lyme disease be approached correctly?

Erythema migrans are diagnosed clinically, as it develops before serological tests are positive. Consequently, the diagnosis of Lyme disease depends on both test results and the presence of clinical manifestations. Specifically, the blood tests performed are the basic Lyme test, ELISA (enzyme-linked immunosorbent assay), which is used to detect antibodies, and if this is positive, it must be subsequently confirmed with an immunoblot test, in this case, the Western blot, said Harvard Health Publishing.

Regarding treatment, the internist pointed out that, as this is caused by bacteria, antibiotics are usually prescribed for two or three weeks, with doxycycline being the drug par excellence to treat this disease and, alternatively, others can also be prescribed, such as amoxicillin and cefuroxime, which belong to the beta-lactam family.

“In reality, full recovery depends on a lot if a diagnosis has been made in the first phase, after observing the erythema migrans and immediate treatment with antibiotics has been started for a few weeks, which considerably improves the person’s prognosis, since the bacteria are prevented from spreading. On the other hand, if it is identified after a year or more, of course, the disease will evolve and will continue to compromise various tissues, which is why the treatment may last longer, even up to two cycles of four weeks each, but the prognosis for recovery is significantly lower. In fact, there are people who enter a post-Lyme state, where the person continues to present symptoms, and it is still not well determined whether it is an asthenic syndrome, a convalescence, or if it is due to persistence of the infection”.

What are the recommended prevention methods to avoid Lyme disease?

Although in Peru it is not a disease that prevails among our population, it is important to know the prevention measures, as they are usually very similar to any other exposure to vectors, such as the case of dengue. Therefore, the specialist recommends, trying to avoid contact with tick-infested areas, such as soil, leaf debris, and vegetation; however, if one works in the garden or is outdoors, it is important to wear soft-colored clothing to be able to visualize ticks more easily, as well as to wear long pants, long-sleeved shirt, and closed shoes. You may also consider using insect repellent and if, after checking your clothes and body, a tick is detected, it is important to remove it immediately.

Dr. Julio Cachay
Internist and Infectious Diseases Physician at Clinica Ricardo Palma

Source: elcomercio.pe