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! style="width: 80px; background: #4479BA; text-align: center;" colspan="2" |{{fontcolor|#FFF|Disease}}
'''To go back to Lyme disease main page, click [[Lyme disease|here]]'''  
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Organism}}
 
! style="width: 80px; background: #4479BA; text-align: center;" |{{fontcolor|#FFF|Vector}}
{{CMG}}; {{AE}}{{Anmol}}
! style="width: 720px; background: #4479BA; text-align: center;" | {{fontcolor|#FFF|Symptoms}}
 
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==Overview==
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="2" | {{fontcolor|#FFF|'''Bacterial Infection'''}}
* [[Lyme disease]] is a condition commonly caused by bite of a [[tick]] infected with [[Borrelia burgdorferi]].
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==What are the Symptoms of Lyme Disease?==
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| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | ''[[Borreliosis]] ([[Lyme disease|Lyme Disease]])'' <ref name="Lyme CDC”">Lyme Disease Information for HealthCare Professionals. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/lyme/healthcare/index.html Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Borrelia burgdorferi]]'' sensu lato complex and ''[[Borrelia mayonii|B. mayonii]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[I. scapularis]]'', ''[[I. pacificus]]'', ''[[I. ricinus]]'', and ''I. persulcatus''
| style="background: #DCDCDC; padding: 5px;" |[[Erythema migrans]], flu-like illness([[fatigue]], [[fever]]), [[Lyme arthritis]], [[neuroborreliosis]], and [[carditis]].
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| style="background: #F5F5F5; padding: 5px; text-align: center;" rowspan="2" | ''[[Relapsing Fever]]'' <ref name="TBRF CDC”">Relapsing Fever Information. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/relapsing-fever/ Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" |Tick-borne relapsing fever (TBRF):
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Borrelia duttoni'', ''Borrelia hermsii'', and ''Borrelia parkerii''
| style="background: #F5F5F5; padding: 5px; text-align: center;" |''Ornithodoros'' species
| style="background: #DCDCDC; padding: 5px;" rowspan="2" | Consistently documented high [[fevers]], flu-like illness, [[headaches]], [[myalgia|muscular soreness]] or [[joint pain]], [[altered mental status]], [[painful urination]], [[rash]], and [[rigors]].
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| style="background: #F5F5F5; padding: 5px; text-align: center;" |Louse-borne relapsing fever (LBRF) :
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Borrelia recurrentis]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" |''[[Pediculus humanus]]''
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| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="2" | {{fontcolor|#FFF|'''Typhus (Rickettsia)'''}}
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| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | ''[[Rocky Mountain Spotted Fever]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Rickettsia rickettsii]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Dermacentor variabilis]]'', [[Dermacentor andersoni]]
| style="background: #DCDCDC; padding: 5px;" | [[Fever]], [[altered mental status]], [[myalgia]], [[rash]], and [[headaches]].
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| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" |  ''[[Helvetica Spotted Fever]]'' <ref name="RMSF CDC”">Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/rmsf/  Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Rickettsia helvetica''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ixodes ricinus]]''
| style="background: #DCDCDC; padding: 5px;" | [[Rash]]: spotted, red dots. Respiratory symptoms ([[dyspnea]], [[cough]]), [[myalgia|muscle pain]], and [[headaches]].
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| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | ''[[Ehrlichiosis Anaplasmosis|Ehrlichiosis (Anaplasmosis)]]'' <ref name="Ehrlichiosis CDC”">Disease index General  Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''Ehrlichia chaffeensis, Ehrlichia ewingii''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Amblyomma americanum]], [[Ixodes scapularis]]''
| style="background: #DCDCDC; padding: 5px;" | [[Fever]], [[headache]], [[chills]], [[malaise]], [[myalgia|muscle pain]], [[nausea]], [[confusion]], [[conjunctivitis]], or [[rash]] (60% in children and 30% in adults).  
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| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | ''[[Tularemia]]'' <ref name="Tulameria CDC”">Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015).  \http://www.cdc.gov/tularemia/index.html  Accessed on December 30, 2015</ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Francisella tularensis]]''
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Dermacentor andersoni|''Dermacentor andersoni'']]'', [[Dermacentor variabilis]]''
| style="background: #DCDCDC; padding: 5px;" | Ulceroglandular, [[glandular]], oculoglandular, oroglandular, pneumonic, typhoidal.
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| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="2" | {{fontcolor|#FFF|'''Viral Infection'''}}
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* It's important to know the symptoms of [[Lyme disease]] and to seek medical help if you think have [[Lyme disease]].
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*'''Early signs and symptoms (3 to 30 days after [[tick]] bite):'''
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | Tick-borne [[meningoencephalitis]] <ref name="TBE CDC”">General Disease Information (TBE). Centers for Disease Control and Prevention (2015).  http://www.cdc.gov/vhf/tbe/ Accessed on December 30, 2015</ref>
**The first symptom is usually a red rash at the site of [[tick]] bite, which may look like a bull's eye. But not all people with Lyme disease have a [[rash]]. The rash is called [[erythema chronicum migrans]] or [[erythema migrans]] (EM).
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''TBEV virus''
***EM occurs in approximately 70 to 80 percent of [[infected]] persons.
| style="background: #F5F5F5; padding: 5px; text-align: center;" | ''[[Ixodes scapularis]]'', ''[[I. ricinus]]'', ''I. persulcatus''
***EM begins at the site of a [[tick]] bite after a delay of 3 to 30 days (average is about 7 days).
| style="background: #DCDCDC; padding: 5px;" | Early Phase: Non-specific symptoms including [[fever]], [[malaise]], [[anorexia]], [[myalgia|muscle pains]], [[headaches]], [[nausea]], and [[vomiting]]. Second Phase: [[Meningitis]] symptoms, [[headache]], [[stiff neck]], [[encephalitis]], [[drowsiness]], sensory disturbances, and potential [[paralysis]].  
***Em expands gradually over a period of days reaching up to 12 inches or more (30 cm) across.
|-
***EM may feel warm to the touch but is rarely [[itchy]] or [[painful]].
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | [[Colorado tick fever|Colorado Tick Fever]] <ref name="GenTickDis CDC”">General Tick Deisease Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/coloradotickfever/index.html Accessed on December 30, 2015</ref>
***Sometimes, EM clears as it enlarges, resulting in a target or “bull’s-eye” appearance.
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''CTF virus''
***EM may appear on any area of the body but majority of times present in areas including [[axilla]], [[inguinal region]], [[popliteal fossa]], or along belt line.
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''[[Dermacentor andersoni]]''
**The rash may or may not be associated with flu-like symptoms including:
| style="background: #DCDCDC; padding: 5px;" |Common symptoms include [[fever]], [[chills]], [[headache]], [[body aches]], and [[lethargy]]. Other symptoms associated with the disease include [[sore throat]], [[abdominal pain]], [[vomiting]], and a skin [[rash]]. A biphasic [[fever]] is a hallmark of Colorado Tick Fever and presents in nearly 50% of infected patients.  
***[[Fever (patient information)|Fever]] and/or [[chills]]
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***[[Headache (patient information)|Headache]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | [[Crimean-Congo Hemmoragic Fever|Crimean-Congo Hemorrhagic Fever]]
***[[Body aches]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''[[CCHF virus]]''
***[[Arthralgia (patient information)|Joint aches]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  '' Hyalomma marginatum'', ''Rhipicephalus bursa''
***[[Headache (patient information)|Headaches]]
| style="background: #DCDCDC; padding: 5px;" |Initially infected patients will likely feel a few of the following symptoms: [[headache]], high [[fever]], [[back pain|back]] and [[joint pain]], [[stomach pain]], [[vomiting]], flushed face, red throat [[petechiae]] of the [[palate]], and potentially changes in mood as well as sensory perception.
***[[Neck stiffness/pain (patient information)|Stiff neck]]
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***[[Fatigue (patient information)|Fatigue]]
| style="font-size: 14px; background: #7d7d7d; text-align: center;" colspan="2" | {{fontcolor|#FFF|'''Protozoan Infection'''}}
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[[Image:Classic Lyme disease rash.jpg|thumb|250px|center|Classic Lyme disease rash - [https://www.cdc.gov/lyme/signs_symptoms/rashes.html Source: CDC.gov]]]
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*'''Late Signs and Symptoms (days to months after tick bite):'''
**Severe [[Headache (patient information)|headaches]] and [[Neck stiffness/pain (patient information)|neck stiffness]]
***Multiple [[erythema migrans]] rashes on other areas of the body.
***[[Arthritis (patient information)|Arthritis]] with severe [[Arthralgia (patient information)|joint pain]] and [[Swelling (medical)|swelling]], particularly the [[knees]] and other large joints.
***Facial palsy (loss of muscle tone or droop on one or both sides of the face).
***Intermittent pain in [[tendons]], [[muscles]], [[Joints (anatomy)|joints]], and bones.
***[[Heart palpitations]] or an irregular [[heart beat]] ([[Lyme carditis]]).
***Episodes of [[Dizziness (patient information)|dizziness]] or [[Dyspnea (patient information)|shortness of breath]].
***[[Inflammation]] of the [[brain]] and [[spinal cord]].
***[[Nerve pain]].
***Shooting [[pains]], [[numbness]], or [[tingling]] in the [[hands]] or [[feet]].
***Problems with short-term [[memory]].
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===Notes===
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*[[Fever]] and other flu-like symptoms may occur in the absence of [[rash]].
| style="background: #F5F5F5; padding: 5px; text-align: center;" colspan="2" | [[Babesiosis]] <ref name="Babesiosis CDC”">Babesiosis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/parasites/babesiosis/disease.htmlAccessed December 8, 2015.</ref>
*A small bump or redness at the site of a [[tick]] bite that occurs immediately and resembles a [[mosquito]] bite, is common. This irritation generally goes away in 1-2 days and is not a sign of [[Lyme disease]].
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''[[Babesia microti]], [[Babesia divergens]], Babesia equi''
*A [[rash]] with a very similar appearance to EM occurs with [[Southern tick-associated rash illness (patient information)|Southern Tick-associated Rash Illness]] (STARI), but is not Lyme disease.
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  ''[[Ixodes scapularis]],  ''[[I. pacificus]]
*[[Ticks]] can spread other organisms that may cause a different type of [[rash]].


==What Causes Lyme disease?==
| style="background: #DCDCDC; padding: 5px;" |Non-specific flu-like symptoms.
* [[Lyme disease]] is caused by a [[bacterial infection]] you get from bite of an infected [[tick]].
*The majority of [[Lyme disease]] in North America is caused by bite of [[Ixodes scapularis|black-legged tick]], or [[deer tick]] (''[[Ixodes scapularis]]'').
*Other ticks that transmit Lyme disease are [[Ixodes ricinus|sheep tick]], [[Ixodes ricinus|castor bean tick]], or [[Ixodes ricinus|European castor bean tick]] (''[[Ixodes ricinus]]'') in the Europe; [[Ixodes pacificus|Western black legged tick]] (''[[Ixodes pacificus]]'') in the Pacific region of North America; taiga tick (''Ixodes persulactus'') Europe, Central and Northern Asia, China, and Japan.
*Only 20% of individuals [[Infection|infected]] with [[Lyme disease]] by the [[Ixodes scapularis|deer tick]] are aware of having had any [[tick]] bite.
|
[[Image:Ixodes scapularis.png|center|200px|thumb|'''''I. scapularis'', the primary vector of Lyme disease in Eastern North America''' - Source: Gross L (2006) A New View on Lyme Disease: Rodents Hold the Key to Annual Risk. PLoS Biol 4(6): e182. https://doi.org/10.1371/journal.pbio.0040182
]]
|}
|}
==Who is at Highest Risk?==
Individuals who spend time outdoors and/or have pets that go outdoors in [[Endemic (epidemiology)|endemic]] regions are at risk for [[tick-borne disease]].
* Exposure to ticks:
**Individuals with frequent exposure to dogs and who reside near wooded areas or areas with high grass may also be at increased risk of [[tick-borne infection]].
**Individuals with outdoor occupations and who work outside with bare or exposed [[skin]] are at a high risk of contracting Lyme disease.
**Failing to remove a [[tick]] as soon as you see it on your [[skin]] (the longer a [[tick]] is attached to your skin, the greater your risk of developing [[Lyme disease]]) also increases risk of developing Lyme disease.
* Endemic Regions:
**About 95% of all reported cases are confined to 14 states including Connecticut, Delaware, Maine, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin.
**Any individual traveling or living within these five geographic areas including New England, Mid-Atlantic, East-North Central, South Atlantic, and West North-Central is at a heightened risk of exposure to [[Lyme disease]].
* Seasonal Variation:
**The majority of [[Lyme disease]] cases are reported during the summer months of May to August.
**Case incidence increases in May, peaks in June and July, and tapers off in August.
* Rarer forms of Transmission:
** Cases of [[blood transfusion]] and [[organ transplantation]] have been recorded as methods of [[Transmission (medicine)|transmission]] but this is a rare mode of transmission.
==Diagnosis==
Following points should be taken into consideration in order to make a diagnosis of [[Lyme disease]]:
*A history of exposure to potentially infected [[ticks]], especially in areas of the country known to have [[Lyme disease]].
*Symptoms, including physical findings such as the characteristic rash ([[erythema migrans]]).
*Results of blood tests that check for [[antibodies]] to the [[bacterium]] that causes [[Lyme disease]].
==When to Seek Urgent Medical Care?==
You should seek medical care if:
*You are bitten by a tick.
*You have a rash similar to erythema  migrans (even if you donot remember tick bite).
*After removal of tick with proper procedure.
==Treatment Options==
*According to CDC, patients treated with [[antibiotics]] in the early stages of the infection usually recover rapidly and completely.
*Antibiotics commonly used for oral treatment include [[doxycycline]], [[amoxicillin]], or [[Cefuroxime axetil (oral)|cefuroxime axetil]] ([[Ceftin]]).
*Patients with certain [[neurological]] or [[cardiac]] forms of illness may require [[Intravenous therapy|intravenous]] treatment with drugs such as [[Ceftriaxone Sodium Injection (patient information)|ceftriaxone]] or [[penicillin]].
==Where to find Medical Care for Lyme Disease?==
Medical care for [[Lyme disease]] can be found [https://www.google.com/maps/search/hospitals/ here].
==Prevention==
*Educate yourself about [[Lyme disease]], and try not to get bitten by ticks.
*More specifically:
**Avoid wooded, brushy, and grassy areas, especially in May, June, and July. (Contact the local health department or park/extension service for information on the [[prevalence]] of [[Tick|ticks]] in specific areas.)
**Wear light-colored clothing so that you can see ticks that get on you.
**Wear long pants and long-sleeved shirts.
**Wear shoes that cover the entire foot. Tuck pant legs into socks or shoes, and tuck shirts into pants.
**Wear a hat for extra protection.
**Spray insect repellent containing [[DEET]] on clothes and exposed skin other than the face, or treat clothes with [[Permethrin (patient information)|permethrin]], which kills [[ticks]] on contact.
**Walk in the center of trails to avoid brush and grass.
**Remove your clothing, and wash and dry them at high temperatures after being outdoors.
**Do a careful body check for ticks after outdoor activities.
*If a tick is attached to you, remove it!
**Using tweezers, grasp the [[tick]] close to the skin, pull straight back, and avoid crushing the tick's body.
**Save the [[tick]] for possible identification by a doctor or the local health department.
==What to expect Prognosis?==
*For early cases, prompt treatment is usually curative.
*However, the severity and treatment of Lyme disease may be complicated due to:
**Late diagnosis
**Failure of antibiotic treatment
**Coinfection with other tick-borne diseases including [[Ehrlichiosis (patient information)|Ehrlichiosis]] and [[Babesiosis (patient information)|Babesiosis]]
**[[Immune suppression]] in the patient
*Some patients with [[Lyme disease]] have [[Fatigue (patient information)|fatigue]], [[Arthralgia (patient information)|joint]] and/or [[Myalgia (patient information)|muscle pain]], and [[neurocognitive]] symptoms persisting for years despite [[antibiotic]] treatment.
*Patients with late stage [[Lyme disease]] have been shown to experience a level of physical disability similar to that seen in [[Congestive heart failure (patient information)|congestive heart failure]].
*Though rare, [[Lyme disease]] can be fatal.
==Possible complications==
*Late [[Lyme disease]] can cause long-term [[Joint (anatomy)|joint]] [[inflammation]] ([[Lyme arthritis]]) and [[heart rhythm]] problems. [[Brain]] and [[nervous system]] problems are also possible, and may include:
**Decreased concentration
**Memory disturbances
**[[Nerve damage]]
**[[Numbness]]
**[[Pain(patient information)|Pain]]
**[[Paralysis]] of the face muscles
**Sleep disorders
**Vision problems
==Sources==
* https://medlineplus.gov/lymedisease.html
* https://www.cdc.gov/lyme/index.html
* https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm049298.htm
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Revision as of 14:35, 8 August 2017

Disease Organism Vector Symptoms
Bacterial Infection
Borreliosis (Lyme Disease) [1] Borrelia burgdorferi sensu lato complex and B. mayonii I. scapularis, I. pacificus, I. ricinus, and I. persulcatus Erythema migrans, flu-like illness(fatigue, fever), Lyme arthritis, neuroborreliosis, and carditis.
Relapsing Fever [2] Tick-borne relapsing fever (TBRF): Borrelia duttoni, Borrelia hermsii, and Borrelia parkerii Ornithodoros species Consistently documented high fevers, flu-like illness, headaches, muscular soreness or joint pain, altered mental status, painful urination, rash, and rigors.
Louse-borne relapsing fever (LBRF) : Borrelia recurrentis Pediculus humanus
Typhus (Rickettsia)
Rocky Mountain Spotted Fever Rickettsia rickettsii Dermacentor variabilis, Dermacentor andersoni Fever, altered mental status, myalgia, rash, and headaches.
Helvetica Spotted Fever [3] Rickettsia helvetica Ixodes ricinus Rash: spotted, red dots. Respiratory symptoms (dyspnea, cough), muscle pain, and headaches.
Ehrlichiosis (Anaplasmosis) [4] Ehrlichia chaffeensis, Ehrlichia ewingii Amblyomma americanum, Ixodes scapularis Fever, headache, chills, malaise, muscle pain, nausea, confusion, conjunctivitis, or rash (60% in children and 30% in adults).
Tularemia [5] Francisella tularensis Dermacentor andersoni, Dermacentor variabilis Ulceroglandular, glandular, oculoglandular, oroglandular, pneumonic, typhoidal.
Viral Infection
Tick-borne meningoencephalitis [6] TBEV virus Ixodes scapularis, I. ricinus, I. persulcatus Early Phase: Non-specific symptoms including fever, malaise, anorexia, muscle pains, headaches, nausea, and vomiting. Second Phase: Meningitis symptoms, headache, stiff neck, encephalitis, drowsiness, sensory disturbances, and potential paralysis.
Colorado Tick Fever [7] CTF virus Dermacentor andersoni Common symptoms include fever, chills, headache, body aches, and lethargy. Other symptoms associated with the disease include sore throat, abdominal pain, vomiting, and a skin rash. A biphasic fever is a hallmark of Colorado Tick Fever and presents in nearly 50% of infected patients.
Crimean-Congo Hemorrhagic Fever CCHF virus Hyalomma marginatum, Rhipicephalus bursa Initially infected patients will likely feel a few of the following symptoms: headache, high fever, back and joint pain, stomach pain, vomiting, flushed face, red throat petechiae of the palate, and potentially changes in mood as well as sensory perception.
Protozoan Infection
Babesiosis [8] Babesia microti, Babesia divergens, Babesia equi Ixodes scapularis, I. pacificus Non-specific flu-like symptoms.
  1. ↑ Lyme Disease Information for HealthCare Professionals. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/lyme/healthcare/index.html Accessed on December 30, 2015
  2. ↑ Relapsing Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/relapsing-fever/ Accessed on December 30, 2015
  3. ↑ Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/rmsf/ Accessed on December 30, 2015
  4. ↑ Disease index General Information (2015). http://www.cdc.gov/parasites/babesiosis/health_professionals/index.html Accessed on December 30, 2015
  5. ↑ Rocky Mountain Spotted Fever Information. Centers for Disease Control and Prevention (2015). \http://www.cdc.gov/tularemia/index.html Accessed on December 30, 2015
  6. ↑ General Disease Information (TBE). Centers for Disease Control and Prevention (2015). http://www.cdc.gov/vhf/tbe/ Accessed on December 30, 2015
  7. ↑ General Tick Deisease Information. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/coloradotickfever/index.html Accessed on December 30, 2015
  8. ↑ Babesiosis. Centers for Disease Control and Prevention (2015). http://www.cdc.gov/parasites/babesiosis/disease.htmlAccessed December 8, 2015.
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