Lyme Disease





What Is Lyme Disease?
Lyme disease is an infection caused by bacteria called Borrelia burgdorferi (Bb)
How is it transmitted?
In the US, the bacteria are transmitted to people and animals by the bite of an infected blacklegged tick, Ixodes scapularis, commonly called the deer tick, and Ixodes pacificus (western black legged tick) in the West. Although other types of ticks such as the Dermancentor variabilis (american dog) and some insects have been shown to carry the Lyme bacteria, to date, transmission of Lyme through those vectors has not been proven.
The bacteria can also be passed through the placenta of a pregnant woman to the fetus—congenital transmission.
The DNA of the bacteria has been found in breast milk, but no transmission has been proven to date in humans.
The Lyme bacteria have been proven to survive blood banking conditions; however, to date, no transmission has been proven through blood transfusions in humans. Studies have shown transmission through this route in mice in the lab.
There is no proof to date that Lyme is sexually transmitted, although some preliminary studies have found PCR positives for the DNA of the Lyme bacteria in semen and in cervical tissue. These findings do not prove sexual transmission, but some physicians feel because the Lyme and syphilis spirochete (bacteria) are similar, Lyme may be sexually transmitted.
Lyme disease is found in approximately 65 countries world wide, although different types of ticks and different strains of bacteria may be involved.
Where can Lyme disease be found in the body?
Lyme is a multi-systemic disease, and the Lyme disease bacterium, Borrelia burgdorferi (Bb), may be found in many different organs, although it is often difficult to test for and to culture. 

A Brief History
Lyme disease was first reported in medical literature in Europe in 1883. The first case in the United States was in Wisconsin in 1969, years before it gained official recognition as a tick-borne illness in Lyme, Conn.  The history of Lyme disease in Connecticut began in 1975 when a cluster of children and adults residing in the Lyme, Connecticut area all started experiencing strange arthritic symptoms.
A woman named Polly Murray, was crucial in getting Lyme Disease recognized when she noticed not only her child but other children in her neighborhood were all coming down with juvenile arthritis. She contacted authorities and went to the media. In 1977, there were 51 cases of Lyme arthritis, and eventually the Ixodes scapularis (black-legged) tick was linked to the transmission of the disease. Then in 1982, Willy Burgdorfer, Ph.D discovered the bacterium that causes Lyme disease.

What causes Lyme Disease?

Lyme disease is a spirochetal infection caused by Borrelia burgdorferi. It is caused by a type of bacterium called a spirochete.  An infected tick can transmit the spirochetes to the  humans and animals it bites. There is some debate to whether other bugs can transmit it, or if it is sexually transmitted. It is however transmitted in utero. It is a multi systemic inflammatory infection. If left untreated it will travel from your skin, through the bloodstream, joints, organs, and will establish itself in various body tissues, and can cause a number of symptoms incuding neuropsychiatric manifestations.

The Symptoms of Lyme Disease

There are three stages to Lyme Disease. 

Stage 1 

The Erythema Migrans or Bullseye Rash may only present itself in less than 30% of cases.

Early localized infection (The first month) Bull’s eye rash (erythema migrans) The rash is usually circular and has a fading spot in the center. Less then half the people infected will develop a rash. 

Note: Some people will never have any symptoms in this stage.

Flu like symptoms (Usually the first symptoms)
Fever
Headache
Stiff neck
Muscle and joint pain
Swollen lymph nodes
Fatigue

Stage 2

Early disseminated infection (1 to 4 months)
If Lyme disease is not detected and treated while early symptoms are present, the infection may disseminate and affect the skin, joints, organs, nervous system, and heart.
Extreme fatigue
Rashes
Migrating pain (pain that changes locations and comes and goes)
Weakness and/or numbness in the arms or legs.
Twitching muscles
Bells Palsy

Severe and recurring headaches
Fainting or vaso vagal attacks
Poor memory and concentration problems
Irritability Vision problem
Internal buzzing feeling
Heart palpitations
Panic Attacks
Mood disorders

 

Stage 3 Late Persistent Infection

Late disseminated Lyme  
Swelling and pain in the joints
Numbness and tingling in the extremities
Severe fatigue
Insomnia
Bells Palsy (partial paralysis of the face)
Getting lost in familiar places
Problems speaking,
Word retrieval problems,
Word block

Migrating pain and symptoms
Heart damage
Pericarditis
Meningitis
Depression
Panic Attacks
Bladder problems
Tinnitus, ear ringing or feeling of fullness
Poor balance
Shortness of breath
Rib and sternum soreness
Fevers/sweats
Vertigo
Upset stomach and GI problems
Burning and stabbing pains

This is just a generalized short list of symptoms. Lyme disease can cause almost any symptom because it is a multi systemic disease. It can travel anywhere including your central nervous system (spine and brain). One of the common complaints of patients with Lyme Disease is that the symptoms come and go and change locations frequently.  You can take a group of several people infected with Lyme, and all might be  experiencing different symptoms. The time frames of each stage are generalized also. Each patient moves through these stages at different timing. One  person may not show symptoms for several months while another may get stage three symptoms rather quickly. It all depends on strains, co-infections, and your own immune system.
Lyme Disease has become an umbrella term for several different infections, viruses, parasites passed on by ticks, other bugs such as dust mites, congenitally,  and possibly sexual transmission. Please educate yourself further if you have lingering symptoms that doctors are having a hard time explaining.

Lyme Disease Testing Methods

Elisa

This Enzyme-Linked Immunosorbant Serum Assay is the simplest, least expensive, easiest to perform, and most common Lyme test ordered. It is a test based on detecting the antibodies that our bodies make in response to being exposed to Borrelia burgdorferi (Bb).
The ELISA test can be primed to be very specific for some of the spirochetes antibodies. This is done by taking a lab sample of the bacteria and breaking the sample down into fragments. These fragments, or know as antigens, are then embedded on the side of a reagent vessel like a test tube. Then the patient’s serum is added, and any free antibodies specific for the test strain will then bind to the antigens, which are linked to special enzymes that will change color when antibodies are present. The sample is continually diluted until the reaction no longer occurs and no color change can be detected. The sample is then reported as a dilution ratio, such as one part serum to 256 parts water, or 1:256.

Test Results are Read As Follows

< or = 0.90 negative

0.91 – 1.09 equivocal

> or =1.10 positive




Western Blot

This is a blood test. To understand what the blood test tests for you must understand a little about Immunoglobulin type M and G.
IgM:  This is the first antibody our body makes against infection is the immunoglobulin type M (IgM).  This antibody takes four to eight weeks for there to be  enough quantities to be measured or detected, and only lasts for about six months then usually drops to a low level that cannot be detected. If  you have a consisitant positive IgM, this is an indicator of chronic infection.
IgG: This antibody start at about four to eight works weeks to form and is gone in less then a year. This antibody is like the ‘forefront fighter” of the immune system. It can kill bacteria by attacking it directly, or it can tag it so when killer T cells come along, it will be marked for them to kill.
The Western Blot essentially makes a map of the different antibodies the immune system produces to the bacteria. The map separates the antibodies by the weight of their respective antigens and are reported in units called kilo daltons or kDa.  A Western Blot will report what bands are positive. It will report bands 22, 23, 25, 31, 34, 39, and 41 kDa. Each of these bands represents an antibody response to a specific protein found on the spirochete. The 41 band indicates an antibody to the flagella 41 kDa protein and is nonspecific. The 31 kDa band represents the OSPA protein and is specific for just a few species of Borrelia, as is the 34 band OSPB, and 23 kDa OSPC.
Some bands are Lyme Specific, some are not. For example, band 41 can represent Lyme spiroch
etes or gum disease spirochetes. Here is a general list of what each band means.
On the outer surface of the Lyme bacteria are various proteins. As they have been discovered, they have been assigned letters, such as outer surface proteins A, B, and C.
Each band is an antigen complexed (bound together) with an antibody made by the immune system, specifically for that antigen (part) of Borrelia burgdorferi.
18: An outer surface protein.
22: Possibly a variant of outer surface protein C.
23-25: Outer surface protein C (osp C).
28: An outer surface protein.
30: Possibly a variant of outer surface protein A.31: Outer surface protein A (osp A). 34: Outer surface protein B (osp .37: Unknown, but it is in the medical literature that it is a borrelia-associated antibody. Other labs consider it significant.39: Unknown what this antigen is, but based on research at the National Institute of Health (NIH), other Borrelia (such as Borrelia recurrentis that causes relapsing fever), do not even have the genetics to code for the 39 kDa antigen,much less produce it. It is the most specific antibody for borreliosis of all.41: Flagella or tail. This is how Borrelia burgdorferi moves around, by moving the flagella. Many bacteria have flagella.
This is the most common borreliosis antibody.
45: Heat shock protein. This helps the bacteria survive fever. The only bacteria in the world that does not have heat shock proteins is Treponema pallidum, the cause of syphilis.
58: Heat shock protein.
66: Heat shock protein.
This is the second most common borrelia antibody.
73: Heat shock protein.
83: This is the DNA or genetic material of Borrelia burgdorferi. It is the same thing as the 93, based upon the medical literature. But laboratories vary in assigning significance to the 83 versus the 93.
93: The DNA or genetic material of Borrelia burgdorferi.

For Positive Results you must have:

An lgG Western Blot must have five or more of these bands: 18, 21,28, 30, 39, 41,,45, 58, 66 and 93 kDa.

An lgM Western Blot must have two or more these three bands: 23, 39, 41.



Other Testing Options

Getting the Most Out Of Lab Testing For Lyme Disease 

It is important to know how to maximize the information from lab testing. Because the two most common tests used for Lyme testing are unreliable it is important to get testing done through a lab that has expertise on Lyme and its co-infections. 

Previously recommended:
 IGeneX Laboratory,
 www.igenex.com 
(ph) 1-650-424-1191,
 (fax) 1650-424-1196