Dr. Atul Gupta, Asstt.

Professor, VPH & Epidemiology

LYME DISEASE

SYNONYMS: ECM (Erythema Chronic Migrans), Lyme Arthritis, LB (Lyme

Borreliosis)

HISTORY: Lyme disease was 1st recognized in Connecticut in 1975 when cases of
arthritis were noticed among children in Lyme and old Lyme town and, accordingly the
disease was named. Borrelia, named after French bacteriologist Amede Borrel;
burgdorferi, named after its discoverer, Willy Burgdorfer.

ETIOLOGY: It is caused by a spirochete, Borrelia burgdorferi.

EPIDEMIOLOGY:

i. Occurrence: It is considered as one of the most common vector borne bacterial disease
in the world. The disease has also been recorded in USA, Europe, UK & Asia including
India.

ii. Hosts: Cattle, sheep, birds, dogs, horses and humans. Deer are the preferred host for
ticks. White tailed deer, small mammals, raccoons and birds acts as reservoir of infection.

iii. Transmission: By the bite of infected tick of the genus Ixodes via saliva or
regurgitated gut contents during tick feeding. Transplacental transmission of organism
can also occur through in utero infection especially in foals and calves.

CLINICAL FINDINGS:

In Animals: It has been associated with polyarthritis & encephalitis in dogs, cows and
horses.

In Humans: It is a multi systemic disease with 3 sequential stages:

1. Stage I: ECM (Erythema Chronic Migrans), a painless rash which begins as small
red macule/papule at the site of tick bite. This redness after 3-23 days spreads

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 Dr. Atul Gupta, Asstt. Professor, VPH & Epidemiology

centrifugally giving it a Bull’s eye appearance. This stage is accompanied with

fever, chills, fatiqueness, headache, myalgia, lymphadenopathy and stiff neck.
2. Stage II: There is irregular heart beat due to cardiac involvement.
3. Stage III: Swelling and pain of large joints (Knee, shoulder, elbow, ankle and
jaw).

DIAGNOSIS:

1. Based on clinical signs (ECM etc.) & history of tick bite.

2. Detection of organism using dark field microscopy or silver staining technique.
3. Use of serology (ELISA, IFA) and molecular diagnostic tools (PCR, DNA probes
etc.)

TREATMENT: Use of antibiotics like Tetracycline, Penicillin and cephalosporins.

CONTROL & PREVENTION:

1. Use measure to avoid tick bites.

2. Immunization:
a. OspA vaccine can be used in high risk groups in endemic areas.
b. There is now a vaccine (Lymerix) available to prevent Lyme disease.