Lyme Disease should be taken serious!

There has been an increasing spread of ticks in the German speaking areas and all over Europe as well.  The main risk comes from the black-legged or deer tick (Lyme disease due to a tick bite transmitting bacteria) which can be found all over Europe.  At the moment the potential infection risk due to the fast increasing number of Dermacentor reticulatus, a tick type that is clearly more active than the deer tick, is also monitored.

Support groups estimate that about 500,000 to 600,000 people are chronically infected by Lyme disease in Germany.  New infections every year: 50,000 to 60,000. 

The pathogen of this malicious infectious disease is a bacteria called Borrelia which is transmitted to the human blood via a tick bites.  If Lyme disease is not diagnosed early enough, the infection can become chronic resulting in symptoms such as arthralgia (joint pain) and can also damage the myocardal muscle.  In contrast to the tick-borne encephalitis (a virus,TBE) it is not yet possible to get vaccinated against Lyme disease. That is the reason why it is so important to recognize this disease at an early stage.

Lyme disease (transmitted by bacteria during a tick bite or sti

• the most important pathogens of Lyme disease - Borrelia burgdorfi, Borrelia garinii and Borrelia afzelii - are closely related to the syphilis agent Treponema pallidum.
• After the infection the body is affected in nearly all organs, including the synovial skin.
• The disease is like a "chameleon" and poses high demands for diagnosis and therapy.

During the generalisation phase the body’s immune system starts to fight the pathogen. Antibodies are formed and the cellular immune response (white blood cells) drastically reduces the number of Borrelia. The borrelia in general only survive in those parts of the body which are difficult to reach for the immune system, for example in the connective tissue, where it also difficult for the antibiotics to reach them. There the Borrelia survive in small numbers and can lead to a re-occurrence of the disease symptoms in irregular intervals. These may occur months and years after the beginning of the infection.

It is important to recognise a Lyme disease infection early.  The earlier it is diagnosed, the easier is the treatment (usually antibiotics) and the shorter is the suffering for the patient.

This is how you can diagnose Lyme disease -based on symptoms and ailments of the 3 stages of the disease (time specification after the tick bite):

(1)   Stage I

(acute / after days or weeks): „bull’s eye rash“ („Erythema chronicum migrans“, only  in 40-70% of all cases), Borrelia-lyphocytoma, headache, fever, sweating, fatigue, summer flu (ca. 20% of the cases), facial paralysis (especially in children)

(2)   Stage II

(acute organ manifestation:  after weeks up to months): inflammation of the brain; meninges; spinal cord; all nerves in the body, arthritis, joints and muscle pain, inflammation of the eyes, liver, kidneys, cardiac muscle, pericordium, cardiac arrhythmia

(3)   Stage III

(chronic:  after months up to years): Thinning of the skin at the back of the hand,  („Acrodermatitis chronica atrophicans“), Borrelia-Lymphocytoma (ear, nose, scrotum), loss of verve, clouding of consciousness, paresthesia, inflammation of muscles and joints and turgors, tendinitis, bursitis, inflammation of blood vessels, infection of the cardial muscle, depression

In contrast to classic organ disease the symptoms of Lyme disease occur in thrusts with changing intensity and location.  Many patient also experience slight fever during these thrusts.  Co-infections with other bacteria and viruses have been increasing extremely for the past years and lead to more complicated forms of the disease.  Often the tick bite is not noted early enough or the doctor does not treat an acute bite effectively.  People developing chronic Lyme disease then often experience real suffering as besides the physical and mental ailments, they often do not get a proper diagnosis of their disease or are even not taken serious.

There are three main reasons for a Lyme disease infection to be unidentified and therefore no early treatment is undertaken:

1. There is no "Bull's Eye Rash" (Erythema chronicum migrans)!  Studies have shown that symptom (which is considered to be common for Lyme disease) only occurs in 40% to 70% of all cases.
2. No tick bite was noticed!  Tick bites can even result from very small ticks (larvae(.  Or it was not recognised because no skin reaction occured.  Furthermore, the scientific literature suspects Borrelia to also be transmitted by insects.
3. Only standard blood tests were undertaken.  These either were done too early *only about 6 weeks after a tick bite occured, antibodies react positive), there was not antibody production in the body at all or the cellular level was not or not efficiently tested for (necessary are:  Elispot®-LTT and CD3-/CD57+ cells)

There is not only Lyme disease:  co-infections with other bacteria (Ehrlichia, Babesia, Bartonella, Rickettsia, Chlamydia and Mycoplama) and viruses are increases and lead to more complicated disease patterns.

Interesting links for patients and doctors:

Patient Organisations with further information about Support Groups:

• German Lyme Disease and TBE Society (www.borreliose-gesellschaft.de)
• Association for Tick-borne Diseases Germany (www.bzk-online.de)

Medical Organisations:

• German Borreliosis Society (www.borreliose-gesellschaft.de)
• ILADS - International Lyme and Associated Diseases Society (www.ilads.org)
• IDSA - Infectious Diseases Society of America (www.idsociety.org)

Particularly in the case of complex disease patterns of chronic Lyme disease and co-infections the therapy should not only be limited to medicine (usually highly dosed antibiotics).  According to the guidelines by J.J. Burrascano (ILADS) the medicine therapy should be supported by "accompanying therapies", change of diet, selected dietary supplements, and necessary changes to lifestyle of the patient ("self-help").  The chronic inflammations are often neglected and also have to be treated besides the Lyme disease infection.

Unfortunately, health insurance companies cover such "accompanying therapies" and dietary supplements only in a very limited manner or not at all.  Additionally, we have noticed that patients often need support with "self-help" measures (incl. mental coaching).

Note:  The attending doctor can only suggest therapy recommendations in terms of the medical services.  Every patient is free to obtain the therapy services and possible dietary supplements somewhere else (pharmacy, general practitioner, physiotherapists, etc.)