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'''Lyme Disease''' is caused by ''[[borrelia burgdorferi]]'', a pathogen transmitted by the black legged tick.<ref name="WebMD">{{Cite news | url=http://www.webmd.com/rheumatoid-arthritis/arthritis-lyme-disease | title = Lyme Disease: Symptoms, Causes, Diagnosis, Treatment, Prevention|work=WebMD|access-date=2018-08-13|language=en-US}}</ref> It is treatable but can become [[Chronic Lyme disease|chronic lyme disease]]. A bulls-eye rash can appear at the site of a deer tick bite but can be in different forms<ref>{{Cite news | url=http://www.bayarealyme.org/blog/lyme-disease-bullseye-rash/ | title = Does Everyone Get the Telltale Bullseye Rash? {{!}} Bay Area Lyme Foundation | date = 2014-09-12|work=Bay Area Lyme Foundation|access-date=2018-08-13|language=en-US}}</ref> while some people never recall having a rash; 30% of lyme patients never get a rash.<ref name="WebMD" /> == Symptoms == The signs and symptoms of lyme disease vary and usually appear in stages.<ref name="mayo" /> [[File:Lyme Rash.jpg|300px|thumb|right|Classic bulls-eye rash from the bite of a deer tick]] ===Early signs and symptoms=== * Erythema migrans (Bull's eye rash) (Rash can be in other forms and 30% of the time no rash is present.)<ref name="bayarea">{{Cite news | url=http://www.bayarealyme.org/blog/lyme-disease-bullseye-rash/ | title = Does Everyone Get the Telltale Bullseye Rash? {{!}} Bay Area Lyme Foundation | date = 2014-09-12|work=Bay Area Lyme Foundation|access-date=2018-09-03|language=en-US}}</ref><ref>{{Cite news | url=https://www.webmd.com/rheumatoid-arthritis/arthritis-lyme-disease | title = Lyme Disease: Symptoms, Causes, Diagnosis, Treatment, Prevention|work=WebMD|access-date=2018-09-06|language=en-US}}</ref> * [[Flu-like symptoms]] ===Later signs and symptoms=== * Erythema migrans * [[Joint pain]] * [[Neurological]] problems{{citation needed | date = 2022}} ===Other signs and symptoms=== * [[Nausea]] and [[vomiting]] * Diffuse [[skin rash|rashes]] (rather than a single bull's-eye rash commonly associated with Lyme disease)<ref name="bayarea" /> ===Less common signs and symptoms=== * Heart problems, such as [[arrhythmia|irregular heartbeat]]. * Eye inflammation * Liver inflammation (hepatitis). * Severe [[fatigue]]<ref name="mayo">{{Cite news | url=http://www.mayoclinic.org/diseases-conditions/lyme-disease/basics/symptoms/CON-20019701 | title = Lyme disease - Symptoms and causes|work=Mayo Clinic|access-date=2018-09-03|language=en}}</ref> == Blood and other laboratory tests == === United States === * Two-step Laboratory Testing Process<ref>{{Cite web|url=http://www.cdc.gov/lyme/diagnosistesting/labtest/twostep/index.html | title = Two-step Laboratory Testing Process {{!}} Lyme Disease|website=[[Centers for Disease Control and Prevention]]|language=en-us|access-date=2018-09-03 | date = |last = | first = | authorlink = |archive-url=|archive-date=|url-status=}}</ref> * Types of Lyme Disease Tests<ref>{{Cite web|url=http://lymediseaseguide.org/types-of-lyme-disease-tests | title = Types of Lyme Disease Tests|last = | first = | date = May 27, 2011 | website = lymediseaseguide.org|language=en-US|archive-url=|archive-date=|url-status=|access-date=2018-09-03}}</ref> * Laboratory tests that are not recommended<ref>{{Cite web|url=http://www.cdc.gov/lyme/diagnosistesting/LabTest/OtherLab/index.html | title = Laboratory tests that are not recommended {{!}} Lyme Disease|website=[[Centers for Disease Control and Prevention]]|language=en-us|access-date=2018-09-03 | date = |last = | first = | authorlink = |archive-url=|archive-date=|url-status=}}</ref> * [https://www.usatoday.com/story/news/nation/2018/11/16/lyme-disease-congress-report-better-testing/2031063002/ Tests for Lyme disease don't work well enough to diagnose illness early, federal panel says]<ref>{{Cite news | url=https://www.usatoday.com/story/news/nation/2018/11/16/lyme-disease-congress-report-better-testing/2031063002/ | title = Tests for Lyme disease don't work well enough to diagnose illness early, federal panel says|last = Carino|first = Jerry | date = Nov 16, 2018|work=USA TODAY|access-date=2018-11-26|archive-url=|archive-date=|url-status=|language=en}}</ref> === United Kingdom === * BBC1 Lyme Disease Discussion - Some patients have waited up to 30 years for a correct diagnosis. [[National Health Service]] (NHS) services have only correctly identified the disease in a quarter of the patients. The blood tests are unreliable and often come back negative. The development of an accurate blood test is in need of research funding.<ref>{{Cite web|url=https://www.youtube.com/watch?v=R1-a8kowVkE&app=desktop | title = BBC1 Lyme Disease 27.02.2016|last = Loukas | first = Demetrios | date = Feb 27, 2016 | website = YouTube|publisher=Katherine Allman|via=|archive-url=|archive-date=|url-status=|access-date=}}</ref> * [[Department of Health and Social Care (UK)]] Testing for Lyme Disease<ref name=":0">{{Cite web|url=http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_106528.pdf | title=Testing for Lyme Disease|last = Donaldson | first = Liam | date = 2009 | website = webarchive.nationalarchives.gov.uk | page = 4|type=PDF|archive-url=|archive-date=|url-status=|access-date=}}</ref> === False positives === Several herpesviruses including [[varicella zoster virus]]<ref name="Feder1991">{{citation | last1 = Feder | first1 = HM Jr | authorlink = | last2 = Gerber | first2 = MA | authorlink2 = | last3 = Luger | first3 = SW | authorlink3 = | last4 = Ryan | first4 = RW | authorlink4 = | title = False-positive serologic tests for Lyme disease after varicella infection|journal=N Engl J Med|volume=325|issue=26 | page = 1886-7 | date = Dec 1991|pmid=1961232|url=http://www.ncbi.nlm.nih.gov/pubmed/1961232}}</ref><ref name="Woelfle1998">{{citation | last1 = Woelfle | first1 = J | authorlink = | last2 = Wilske | first2 = B | authorlink2 = | last3 = Haverkamp | first3 = F | authorlink3 = | last4 = Bialek | first4 = R | authorlink4 = | title = False-positive serological tests for Lyme disease in facial palsy and varicella zoster meningo-encephalitis|journal=Eur J Pediatr|volume=157|issue=1 | page = 953-4 | date = Nov 1998|pmid=9835449|url=http://www.ncbi.nlm.nih.gov/pubmed/9835449}}</ref>, [[cytomegalovirus]], [[Epstein-Barr virus]],<ref name="Goossens1999">{{citation | last1 = Goossens | first1 = HA | authorlink = | last2 = Nohlmans | first2 = MK | authorlink2 = | last3 = van den Bogaard | first3 = AE | authorlink3 = | title = Epstein-Barr virus and cytomegalovirus infections cause false-positive results in IgM two-test protocol for early Lyme borreliosis|journal=Infection|volume=27|issue=3 | page = 231 | date =May 1999|pmid=10378140|url=http://link.springer.com/article/10.1007%2FBF02561539}}</ref> and [[Herpes simplex virus#HSV-2|HSV-2]]<ref name="Strasfeld2005">{{citation | last1 = Strasfeld | first1 = L | authorlink = | last2 = Romanzi | first2 = L | authorlink2 = | last3 = Seder | first3 = RH | authorlink3 = | last4 = Berardi | first4 = VP | authorlink4 = | title = False-Positive Serological Test Results for Lyme Disease in a Patient with Acute Herpes Simplex Virus Type 2|journal=Clin Infect Dis|volume=41|issue=12 | page = 1826-1827 | date = 2005|pmid=16288417|doi=10.1086/498319|url=http://cid.oxfordjournals.org/content/41/12/1826.full}}</ref> may cause false positives on Lyme Disease tests. === News media on unapproved tests === * 2005, Unproved Lyme Disease Tests Prompt Warnings<ref>{{Cite news | url=http://www.nytimes.com/2005/08/23/health/policy/unproved-lyme-disease-tests-prompt-warnings.html?_r=0 | title = Unproved Lyme Disease Tests Prompt Warnings|last = Santora | first = Marc | first2 =Dan | last2 =Hurley|publisher =New York Times |access-date=2018-09-03|language=en}}</ref> - New York Times * 2013, Many tests to diagnose Lyme, but no proof they work<ref>{{Cite news | url=https://www.bostonglobe.com/lifestyle/health-wellness/2013/10/20/many-tests-diagnose-lyme-but-proof-they/ISjAcxmZxkk2disi94ENfI/story.html | title = Many tests to diagnose Lyme, but no proof they do|last = Daley|first = Beth | date = Oct 21, 2013|work=The Boston Globe|access-date=2018-09-03|archive-url=|archive-date=|url-status=|quote=}}</ref> - The Boston Globe * 2013, Lyme Culture Test Causes Uproar<ref>{{Cite web|url=http://www.medscape.com/viewarticle/778482 | title = Lyme Culture Test Causes Uproar | last = | first = | date = | website = Medscape |url-access=registration|archive-url=|archive-date=|url-status=|access-date=2018-09-03}}</ref> - Medscape * 2014, Federal Loopholes Compromise Lyme Disease Testing<ref>{{Cite news | url=http://news.wgbh.org/post/federal-loopholes-compromise-lyme-disease-testing | title = Federal Loopholes Compromise Lyme Disease Testing|last = Daley|first = Beth | date = 2014-06-17|work=WGBH 89.7|access-date=2018-09-03|archive-url=|archive-date=|url-status=|language=en}}</ref> == Treatment == [[File:Borrelia burgdorferi-cropped.jpg|225px|thumb|right|Spirochete, or “corkscrew-shaped” bacteria known as Borrelia burgdorferi]] *[[Centers for Disease Control & Prevention]] (CDC) on Treatment ::Patients treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Antibiotics commonly used for oral treatment include [[doxycycline]], [[amoxicillin]], or [[cefuroxime axetil]]. Patients with certain neurological or cardiac forms of illness may require intravenous treatment with drugs such as [[ceftriaxone]] or [[penicillin]].<ref name="CDC-treatment">{{Cite web|url=http://www.cdc.gov/lyme/treatment/index.html | title = Treatment {{!}} Lyme Disease {{!}} CDC | date = 2017-12-13 | website = [[Centers for Disease Control and Prevention]]|language=en-us|access-date=2018-08-13}}</ref> * 2006, [http://cid.oxfordjournals.org/content/43/9/1089.full The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America]<ref name="guidelines2006">{{Cite journal|last = Wormser | first = Gary P. | last2 = Dattwyler | first2 = Raymond J. | last3 = Shapiro | first3 = Eugene D. | last4 = Halperin | first4 = John J. | last5 = Steere | first5 = Allen C. | last6 = Klempner | first6 = Mark S. | last7 = Krause | first7 = Peter J. | last8 = Bakken | first8 = Johan S. | last9 = Strle | first9 = Franc | date = 2006-11-01 | title = The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America|url=https://academic.oup.com/cid/article/43/9/1089/422463|journal=Clinical Infectious Diseases|language=en|volume=43|issue=9|pages=1089–1134|doi=10.1086/508667|issn=1537-6591}}</ref> == Notable studies == *2013, A Manganese-rich Environment Supports Superoxide Dismutase Activity in a Lyme Disease Pathogen, Borrelia burgdorferi<ref name="Aguirre2013">{{Cite journal | title = A Manganese-rich Environment Supports Superoxide Dismutase Activity in a Lyme Disease Pathogen, Borrelia burgdorferi* | date = 2013-03-22|url=https://www.jbc.org/article/S0021-9258(19)33493-3/abstract|journal=Journal of Biological Chemistry|volume=288|issue=12 | pages = 8468–8478 | last = Aguirre | first = J. Dafhne | last2 = Clark | first2 = Hillary M. | last3 = McIlvin | first3 = Matthew | last4 = Vazquez | first4 = Christine | last5 = Palmere | first5 = Shaina L. | last6 = Grab | first6 = Dennis J. | last7 = Seshu | first7 = J. | last8 = Hart | first8 = P. John | last9 = Saito | first9 = Mak | last10 = Culotta | first10 = Valeria C.|language=English|doi=10.1074/jbc.M112.433540|pmid=23376276|issn=0021-9258}}</ref> - [https://www.jbc.org/article/S0021-9258(19)33493-3/fulltext (Full text)] *2016, County-Scale Distribution of Ixodes scapularis and Ixodes pacificus (Acari: Ixodidae) in the Continental United States<ref name="Eisen2016">{{Cite journal | title = County-Scale Distribution of Ixodes scapularis and Ixodes pacificus (Acari: Ixodidae) in the Continental United States | date = 2016-03-01|url=https://doi.org/10.1093/jme/tjv237|journal=Journal of Medical Entomology|volume=53|issue=2 | pages = 349–386|last = Eisen | first = Rebecca J. | last2 = Eisen | first2 = Lars | last3 = Beard | first3 = Charles B.|doi=10.1093/jme/tjv237|issn=0022-2585}}</ref> - [https://academic.oup.com/jme/article/53/2/349/2459744 (Abstract)] *2016, Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study<ref name="Pritt2016">{{Cite journal | title = Identification of a novel pathogenic Borrelia species causing Lyme borreliosis with unusually high spirochaetaemia: a descriptive study | date = 2016-05-01|url=https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00464-8/abstract|journal=The Lancet Infectious Diseases|volume=16|issue=5 | pages = 556–564 | last = Pritt | first = Bobbi S. | last2 = Mead | first2 = Paul S. | last3 = Johnson | first3 = Diep K. Hoang | last4 = Neitzel | first4 = David F. | last5 = Respicio-Kingry | first5 = Laurel B. | last6 = Davis | first6 = Jeffrey P. | last7 = Schiffman | first7 = Elizabeth | last8 = Sloan | first8 = Lynne M. | last9 = Schriefer | first9 = Martin E. | last10 = Replogle | first10 = Adam J. | last11 = Paskewitz | first11 = Susan M.|language=English|doi=10.1016/S1473-3099(15)00464-8|pmid=26856777|issn=1473-3099}}</ref> - [https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00464-8/fulltext (Abstract)] *2016, Longitudinal transcriptome analysis reveals a sustained differential gene expression signature in patients treated for acute Lyme disease<ref name="Chiu2016">{{Cite journal | title = Longitudinal Transcriptome Analysis Reveals a Sustained Differential Gene Expression Signature in Patients Treated for Acute Lyme Disease | date = 2016-03-02|url=https://journals.asm.org/doi/10.1128/mBio.00100-16|journal=mBio|volume=7|issue=1|last = Bouquet | first = Jerome | last2 = Soloski | first2 = Mark J. | last3 = Swei | first3 = Andrea | last4 = Cheadle | first4 = Chris | last5 = Federman | first5 = Scot | last6 = Billaud | first6 = Jean-Noel | last7 = Rebman | first7 = Alison W. | last8 = Kabre | first8 = Beniwende | last9 = Halpert | first9 = Richard | last10 = Boorgula | first10 = Meher | last11 = Aucott | first11 = John N.|doi=10.1128/mbio.00100-16|pmc=PMC4791844|pmid=26873097|issn=2161-2129}}</ref> - [https://journals.asm.org/doi/10.1128/mBio.00100-16 (Full text)] *2015, Emerging horizons for tick-borne pathogens: from the 'one pathogen-one disease' vision to the pathobiome paradigm<ref name="VayssierT2015" /> - [http://www.futuremedicine.com/doi/abs/10.2217/fmb.15.114 (Full text)] ==== Pathobiome Paradigm ==== Some future research will focus on a spectrum of pathogens instead of a "one pathogen-one disease" vision.<ref name="VayssierT2015">{{Cite journal | last1 = Vayssier-Taussat | first1 = M | authorlink1 = | last2 = Kazimirova | first2 = M | authorlink2 = | last3 = Hubalek | first3 = Z | authorlink3 = | last4 = Hornok | first4 = S | authorlink4 = | last5 =Farkas | first5 = R | authorlink5 = | last6 = Cosson | first6 = JF | authorlink6 = | last7 = Bonnet | first7 = S | authorlink7 = | last8 = Vourch | first8 = G | authorlink8 = | last9 = Gasqui | first9 = P | authorlink9 = | last10 = Mihalca | first10 = AD | authorlink10 = | last11 = Plantard | first11 = O | authorlink11 = | last12 = Silaghi | first12 = C | authorlink12 = | last13 = Cutler | first13 = S | authorlink13 = | last14 = Rizzlo | first14 = A | authorlink14 = | title = Emerging horizons for tick-borne pathogens: from the 'one pathogen-one disease' vision to the pathobiome paradigm | journal = Future Microbiol | volume = 10 | issue = 12 | page = 2033-43 | date = Nov 19, 2015 | pmid = 26610021 | doi = 10.2217/fmb.15.114 | url = http://www.futuremedicine.com/doi/abs/10.2217/fmb.15.114 }}</ref> === United States Congressional Report === * 2018, [https://drive.google.com/viewerng/viewer?url=https://www.hhs.gov/sites/default/files/tbdwg-report-to-congress-2018.pdf Tick-Borne Disease Working Group - 2018 Report to Congress]<ref>{{Cite web|url=https://drive.google.com/viewerng/viewer?url=https://www.hhs.gov/sites/default/files/tbdwg-report-to-congress-2018.pdf | title=Tick-Borne Disease Working Group - 2018 Report to Congress | last = Aucott | first = John N | last2 = Honey | first2 = Kristen T | date = 2018 | website = drive.google.com|language=en|others=Allen Richards; Robert Sabatino; Vanila Singh; Patricia Smith; Robert Smith|archive-url=|archive-date=|url-status=|access-date=2018-11-26 | last3 = Adams | first3 = Wendy | last4 = Beard | first4 = Charles Benjamin | last5 = Cooper | first5 = Captain Scott | last6 = Dixon | first6 = Dennis | last7 = Horowitz | first7 = Richard | last8 = Jones | first8 = Captain Estella | last9 = Nigrovic | first9 = Lisa E}}</ref> ==News and articles== *2016, [http://www.sciencedaily.com/releases/2016/02/160208135440.htm Researchers identify new Borrelia species that causes Lyme disease] *Apr 23, 2014, [http://www.perthnow.com.au/news/western-australia/lyme-disease-a-ticking-timebomb-that-health-authorities-say-does-not-exist/story-fnhocxo3-1226886911487 Lyme disease — a ticking timebomb that health authorities say does not exist] - PerthNow *Jul 31, 2016, [http://www.bbc.co.uk/news/magazine-36923336 How I was floored by a tick] - BBC News ==See also== *[[Alpha-gal allergy]] *[[Borrelia burgdorferi]] *[[Chronic Lyme disease]] *[[Vagus nerve infection hypothesis]] ==Learn more== *[https://www.nationalgeographic.com/animals/invertebrates/d/deer-tick/ About the Deer Tick] - National Geographic *[http://www.columbia-lyme.org/ Lyme and Tick-Borne Diseases Research Center] - Columbia Lyme *[https://blausen.com/en/video/lyme-disease/ Lyme Disease] - Video Short *[https://www.nejm.org/doi/full/10.1056/NEJMp1807870#.W4x9XYBX_Qg.twitter Tickborne Diseases — Confronting a Growing Threat] - New England Journal of Medicine == References == {{Reflist}} [[Category:Diagnoses]] [[Category:Potential comorbidities]] [[Category:Infectious diseases]] [[Category:Bacterial diseases]]
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