Lyme Disease

1. Lyme Disease By Kim Sommerhaug, RN

2. What is Lyme Disease (LD)? • LD is a bacterial infection caused by Borrelia burgdorferi, which is a spirochete very similar to the spirochete that causes syphilis. • The bacterium is carried by Deer ticks (East of the Rockies) and Western Black-legged ticks (West of the Rockies). The infected tick can transmit the spirochete to humans and animals through it’s • bite. It is the most common • arthropod-borne illness in the U.S. • The ticks normally do not begin • transmission of the spirochete • Until it is attached for 36 hours. • (Pictured Right: Borrelia burgdorferi)

3. Deer Ticks(Pictured: Left=Adult, Top=Larva, Right=nymph) • Deer ticks are much smaller than most other ticks. Most people may not be aware they are even there. Their sizes range from that of a poppy seed to that of a sesame seed or apple seed. They are most active from Spring to Fall and with temperatures that exceeds 45 degrees F. All sizes of ticks are capable of transmitting Lyme disease. • These ticks inhabit lawns, gardens, shady moist ground litter, tall grasses, brush and shrubs. Any contact with vegetation, even playing, can result in exposure to ticks.

4. Risk of LD in California • Northern California has a moderately high risk for LD. This risk may be higher, as many cases are not reported to the CDC. It is mandatory to report any cases to the CDC.

5. Clinical Presentation • Diagnosis and treatment can be challenging for clinicians, due to it’s diverse manifestations and the limitations of currently available serological tests. • Initially, there will be a red papule where the tick has attached. • After this, the classical signs include a large rash called erythema migrans (EM). This rash will slowly spread and then clear in the middle section making a “bulls eye”.

6. Erythema Migrans (EM)