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Health talk: A closer look at Lyme disease

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By In 1975, a mother’s concern over her children suffering from what was known at the time as “juvenile onset rheumatoid arthritis” in a small town of Lyme, Connecticut, led to an investigation by the Centers of Disease Control and Prevention’ Epidemic Intelligence Services officers and Yale University researchers.

The team, led by Dr. Alan Steere, was the first to describe the classical syndrome of what is now known as Lyme Disease.

The investigators found that along with the joint pains and swelling, a quarter of these patients had an expanding rash known as erythema migrans. Attempts to isolate a disease-causing microorganism were unsuccessful, but with past experience in Europe, it was known that disease is acquired from tick bites and it responds to antibiotics, like penicillin, suggesting it was bacterial in nature.

It was not until 1982 that the microorganism was discovered in ticks by Willy Burgdorfer and his group. It was cock screw-shaped bacteria known as spirochetes and eventually was named Borrelia Burgdorferi in honor of Burgdorfer.

In our area, Lyme Diseaseis transmitted by the deer tick. The nymphal tick, which is less than 2 millimeters in size, feeds on the white tail mouse and acquires the Borrelia organism. This organism is now known to cause a variable of clinical signs, including early localized disease with possible rash, early disseminated disease with multiple skin lesions or neurological and cardiac manifestations.

Late Lyme disease can present with joint swelling, infection of the brain known medically as encephalopathy, and infection of your nerve fibers called polyneuropathy.

Fortunately for us, the organism is very susceptible to antibiotics. In most cases, a very effective form of treatment is the antibiotic doxycycline. In children younger than 8, amoxicillin is mostly used. For patients with recalcitrant joint infection or central or peripheral nervous system involvement, intravenous antibiotic, ceftriaxone, is effective.

Bell’s Palsy, which is the facial paralysis of the seventh cranial nerve, is one of the neuropathies that can be treated with oral doxycycline effectively. Patients can be co-infected with a parasite, Babesia, and a bacteria known as Anaplasma phagocytophilum from the same tick, which can also transmit a virus called Powassan, which causes encephalitis.

Infection can be avoided by preventing tick bites in spring and summertime by staying away from wooded and bushy areas, walking in the center of trails and using tick repellents (DEET or permethrin). After coming indoors, wash off and remove any visible ticks.

Dr. Sheikh Parviz is an infectious disease specialist at his practice, Carlisle Infectious Disease. He specializes in the diagnosis and treatment of infectious diseases, with expertise in general infectious disease, HIV/AIDS, treatment of chronic hepatitis C, infection control and epidemiology and the proper use of antibiotics.

Parviz is one of five Carlisle Regional Medical Center physicians contributing to the weekly Health Talk column, to appear in The Sentinel every Sunday.

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