Lyme disease is one of the least understood diseases. It is also contested; that is, scientists, doctors, …., often have very different points of view. However, it is a disease that affects more and more people all over the world. Our goal is to give you the most information about this disease. To make the right decisions, you need to have as much information as possible.
Modes of transmission of Lyme disease
The tick bite, is the first vector of Borrelia.
Ticks are the main vector of Lyme disease. Ticks of all sizes and ages – whether it is in the larvae, nymph or female adult stage – ,are able to carry Borrelia and other strains of this spirochete and co-infections through its bite.
A tick remains infected throughout its life and is able to transmit the bacteria to all its offspring. A single spawn can contain nearly 20.000 eggs.
Other insect vectors of Lyme disease.
Officially, the tick is the only known vector capable of transmitting Borrelia and co-infections. However, research has provided evidence to the contrary. Other insects such as biting flies, fleas, mosquitoes, horseflies, spiders and others … can also carry it. The only difference is that the bite of these insects is particularly painful and easy to detect, unlike that of the tick that goes almost unnoticed.
There are other modes of transmission of Borreliosis and co-infections.
Research on other modes of infection of Borreliosis suffer from major gaps in obtaining relevant data.
However, studies have shown, among other things, that the spirochete of Borreliosis is present in the vaginal fluid or in the sperm of an infected person. It is thus possible to envisage a mode of sexual transmission during unprotected sexual intercourse.
An infected pregnant woman may also infect her fœtus or baby by placental infection and breastfeeding.
And since this bacteria is present in the blood, what about blood transfusion and organ donation ?
Then there is also the food products from infected animals, what happens when we consume them ?
Denial of public authorities
A denial that causes medical shortcomings.
There is a denial about the chronic form of Lyme disease !
In addition, Lyme disease is considered an emerging infection and most doctors do not yet have the knowledge to effectively meet the needs of patients.
Indeed, the notion of this disease in its chronic form is not yet included in medical school training.
Denial of inefficiency of approved tests.
This is found first with a screening protocol that no longer meets the current need. Indeed, it has been shown that the ELISA serological test is far from reliable for the simple reason that it was developed to detect American strains, not European strains. The test results are often negative, despite real clinical symptoms. And as the next steps in diagnosing Lyme disease can rest entirely on the test results, a false negative result can mean the end of any possible Lyme disease diagnosis. In some cases the Western Blot (a more reliable) test is used to confirm the infection. The Elispot is an even more reliable test but is not done in all countries.
Controversies around Lyme Disease
Lyme disease is so unique and enigmatic that it has managed to divide medical experts around the world into two distinct groups : IDSA and ILADS.
The opinions of these two medical associations diverge on almost everything related to this condition, whether it is about its modes of transmission, its diagnosis, its different stages of development or its treatments.
Lyme disease in the eyes of IDSA
Firstly, IDSA argues that Lyme disease is difficult to catch and that only the tick is able to transmit it to humans.
In addition, its members believe that it is possible to treat this disease with a simple antibiotic therapy of short duration, since it is actually a simple acute infection.
As for diagnosis, IDSA recommends only serological tests which have been found to have reduced reliability, especially when used for the secondary and tertiary phase of Lyme disease.
Lyme disease in the eyes of ILADS
For ILADS, the borrelia spirochete that is responsible for Lyme disease is easy to catch and can be transmitted by more than just a tick bite. They believe other insects are also vectors and that there are also other modes of transmission (blood transfusion, unprotected sex, placental contamination, breastfeeding, food of animal origin).
This group also contends that Lyme disease is difficult to diagnose and that the official screening protocol is thus insufficient.
Some practitioners use their knowledge of the multiple symptoms of the disease to correctly diagnose this condition.
This is the case of Dr. Richard Horowitz who has developed a questionnaire that allows to achieve this.
Entities working with ILADS also support the presence of aggravating factors and co-infections that cause some persistent clinical manifestations.
As for the treatments, they think that a combination of antibiotics over a prolonged period could eradicate this disease and that the co-infections must be treated individually until the disappearance of symptoms.
However things are changing in the recommandations.
The IDSA recommendations on the management of Lyme disease are moving in the right direction.
The 2006 IDSA Guidelines were delisted from the US National Guidelines Clearinghouse (NGC) and are now in the withdrawn guidelines category (February 2016).
The recognition of chronic Lyme disease, the poor quality of diagnostic tests and the need to treat patients outside the obsolete recommendations of the Infectious Diseases Society of America (IDSA) gain more support every day.
The US Centers for Disease Control and Prevention’s (CDC) show that most US doctors are currently not following IDSA’s recommendations, but instead follow the ILADS guidelines.
ILADS was originally a group of field physicians who challenged against the simplistic and non-evidence-based recommendations of IDSA.
Recently, the official recognition of chronic Lyme disease has been marked by an extraordinary leap forward with the passage of legislation in Canada as well as in three US states (Virginia, Vermont, New York).
The National Guidelines Clearinghouse (NGC), the US federal database, providing information on the management of diseases for health professionals and insurance companies has already posted the ILADS guidelines for the management of Lyme disease and related diseases on its official website.
In addition, the NGC has withdrawn IDSA’s recommendations that, against all scientific evidence , have become mainstream for years.
This is a huge victory for ILADS whose recommendations become the only guidelines officially recognized by the NGC. When will it be the same in Europe ?
Preventing Lyme Disease
The best way to protect yourself against Lyme disease is to avoid being bitten by ticks.
During walks in high risk areas wear clothes that offer maximum protection, trousers and shirt, … with long sleeves.
It is also advisable to wear shoes.
To be more careful, it is better to wear your socks over the bottom of your trousers.
When it hasn’t fed, a tick is small and almost invisible. To detect it more easily, wear light colored clothing. After you have been outdoors, remember to thoroughly check all parts of your body, including the scalp, to make sure there are no ticks. Do the same thing for children, as well as for pets.
Removing the tick.
In the case where a tick is embedded in the skin, it is imperative to remove it before a maximum delay of 8 hours, to avoid infection.
It is best to use a tick twister or tick card to remove the tick
In the absence of this tool, use tweezers.
Whatever the case may be, it must be done with caution, by grasping the tick’s head as close to the skin as possible.
Then slowly pull upward, paying attention that the rostrum does not separate from the body.
Then carefully disinfect the site of the bite.
Repellents and other precautions.
The use of repellents helps prevent contact with ticks.
Be careful to re-apply repellants regularly so to ensure full effectiveness..
These products not only keep ticks away, but also other insects such as mosquitoes, flies, spiders and horseflies that can also transmit Borrelia.
Ticks like to live or hide in grass and under dead leaves.
This is why it is necessary to regularly cut the grass and sweep up leaves as a way to prevent the proliferation of ticks.
You should keep bird feeders and wood piles as far away as possible from the house as they are places ticks thrive?
Symptoms of Lyme Borreliosis : many and diverse
Lyme disease is a multi-systemic disease that attacks all systems of the body.
In some cases, it shows no clinical manifestation in a person carrying Borrelia.
There are three stages of development in general for Lyme disease.
Symptoms of the primary phase of Lyme disease.
The primary phase is the one that occurs between 3 to 30 days after the tick bite.
It is characterized by the appearance of cutaneous lesions in the form of an erythema migrans, but not always !
This is an oval spot of red color surrounding the bite. also known as the bulls eye rash.
Its dimension can reach 50 cm. At this point, you may experience fatigue, fever, headache, stiff neck, ganglionic hypertrophy, back pain, and joint pain that suggests flu.
Without appropriate antibiotherapy, erythema migrans manifests first, then disappear after a few days or even weeks.
The symptoms of the secondary phase of Lyme disease.
This second phase of Lyme disease starts a few weeks or months after the first stage.
It is at this point that frequent joint inflammations or arthritis appear.
Cardio-vascular disorders, such as heart failure, unconsciousness, palpitations, tachycardias, myocardias, …
In other cases, we can discern neurological disorders resulting in meningitis, unexplained tremors, chronic fatigue, partial paralysis, sensory disorders, eye damage, … If the patient still does not receive care during this period, their case could worsen even further and move towards the tertiary phase.
Acute symptoms of the tertiary phase of Lyme disease.
This last phase of Lyme disease is most often manifested by severe cardiac, neurological, muscular, circulatory, respiratory, digestive symptoms, … attacks that strongly debilitate the patient.
Neurological disorders affect the brain and spinal cord, causing various neuropsychiatric and cognitive signs, such as memory loss, stuttering, narcolepsy, sleep apnea, mood changes …
This phase causes significant effects on the general well-being of the patient, on their sexuality, their mental and physical abilities …
Borreliosis and co-infections
Ticks cause many diseases.
The Borrelia responsible for Lyme disease is mainly transmitted by ticks via their bites.
Unfortunately, these ticks can also transmit several other varieties of pathogens (bacteria, viruses, fungi, parasites).
In one bite, an infected tick can transmit Lyme disease and other co-infections.
It is therefore a simultaneous infection with two or more types of pathogens that complicate the recovery of the infected person.
It should be noted that co-infections that accompany Lyme disease are also not all carried by ticks.
They can be caused by the weakening of the body’s natural defense system.
Many of these co-infections are more common in a patient with Lyme disease. Such is the case of anaplasma, babesiosis, tuléramie, bartonelloses, rickettsioses, erhlichiosis, pneumonia chlamydia, etc …
In addition, the clinical signs of most of these conditions are similar to those of Lyme disease and also make it difficult to screen.
They usually manifest themselves as headaches, joint and muscular pains, diarrhea, persistent tiredness, ganglionic hypertrophy, fever, sight disorders, memory disorders …
It is difficult to differentiate them without the help of a laboratory blood test.
A long-term individualized treatment protocol is therefore recommended to eliminate each type of pathogen.
In addition to co-infections frequently associated with Borreliosis, there are many tick-borne diseases, including mycoplasma, Colorado Rocky Mountain tick fever, tick-borne fever, Powasan, tick paralysis. Associated with Lyme disease, it is not easy to diagnose them only according to their symptoms.
Often we have a bad diagnosis
The diagnosis of Lyme disease is far from easy despite the efforts sometimes made to achieve it.
A doctor must make a careful evaluation of the clinical signs, which will complete the blood tests done in a specialized laboratory.
Late or non-existent symptoms.
The first cause of misdiagnosis is that most patients do not remember being bitten by a tick.
Indeed, the bite of this insect is painless, since its saliva contains a powerful anesthetic
In this case, the physician must explore other avenues based on the observation of symptoms.
This can be challenging.
In the absence of erythema migrans, the diagnosis will generally move towards diseases similar to Lyme disease.
The reason is simple, this pathology is multi systemic and can reach all organs.
It can present itself as arthritis, Alzheimer’s disease, Multiple Sclerosis, fibromyalgia, prostatitis, colitis or other conditions…
Faced with this multitude of symptoms, the doctor would be lucky if they can detect Lyme disease.
While blood tests can identify the disease, tests in most labs are far from reliable.
The fact is that the Elisa Test relies for example on the detection of antibodies linked to Borrelia.
As a result, it would be impossible for the result to be positive since in the primary stage of Lyme disease, the immune system does not yet produce antigen.
This is also the case for the Western Blot test which detects the disease only after a few weeks of its development.
To top it off, both types of exams can present false negatives and false positives.
Official treatment of Borreliosis with mixed results
Early cure with antibiotics.
The official care protocol for treating Lyme disease is based on short-term antibiotic therapy that can be prolonged if symptoms persist.
Unfortunately, this procedure leaves something to be desired as the results only cure patients during the primary phase of the condition.
Early administration is however necessary during this period to eradicate Borrelia.
But despite this, the risks of relapse and treatment failures are frequently reported.
Restricted actions of conventional treatment.
The biggest flaw in the conventional treatment of Lyme disease is that the antibiotics used are not suitable for all strains that may be the cause.
In addition, some forms and actions of Borrelia including its ability to hide in the very cells of the body can make a course of antibiotics ineffective.
These factors complicate recovery from the chronic form of Lyme disease, which very existence is denied by many specialists.
Adding to this, there are a lot of side effects with these antibiotherapies.
Indeed, antibiotics can destroy the intestinal flora that is essential to prevent other infections.
Antibiotics also have adverse effects on the heart, kidneys, liver and spleen, since their massive uses are highly toxic to the body.
In addition, the official treatment focuses only on Lyme disease, forgetting the existence of aggravating factors, such as the other pathogens transmitted by ticks.
The limits of the official treatment.
Unlike antibiotic-resistant bacteria, which are resistant to antibiotics through mutation, “persistent” bacteria get into a sort of sleep state if exposed to the antibiotic. When the treatment is stopped, the bacteria wake up.
When it does, the conventional care protocol has no effect on it.
It can also take a cystic form or wrap with a biofilm to escape the immune system and antibiotics.
In addition, these bacteria can infiltrate inside the cells, inaccessible to antibiotics. In case the Borrelia destroyed under the attack of antibiotics, they can harm the body by releasing a considerable amount of toxin.
The endotoxin they discharge during their destruction can cause brain disorders, as well as muscle, joint and neurological pain in the patient.
This reaction usually occurs after a few days of treatment and is called Jarisch-Herxheimer phenomenon.