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With warm weather upon us many of us are spending time enjoying nature and sunshine. Out in the wilderness we can enjoy blue skies, green trees, and a pain progressing from skin rash to persistent arthritis. Of course we’re talking about Lyme Disease, a growing concern in the United States. Lyme disease cases top 300,000 per year in the US, mostly in the Northeast, and affects mostly children and middle-aged Americans. Lyme disease is spread by one of nature’s grossest bugs, the tick. In case you are lucky enough to be unfamiliar with ticks, they are little arachnids (like spiders) except instead of skittering around and eating flies they hang out in long grasses and grab onto you as you walk by. Then they burrow into your skin and eat your blood while transmitting painful bacteria to your bloodstream.
In Blacklegged ticks, one of those bacteria may be Borrelia. This is a little fusilli-looking bacteria with a long, twisted body and some pretty neat tricks. It has little paddles on the outside called flagella that let it swim around inside your body, aiming for nutrients and avoiding alcohol and other things. Borrelia bacteria live in both ticks and mammals, and change their gene expression and what the surface of their body looks like depending on where they are. They wouldn’t be effective invaders, however, if it weren’t for the ticks. Ticks stab a hole through the skin, which lets Borrelia invade. Tick saliva stops clotting and suppresses our immune system. Borrelia bacteria attach bits of tick saliva to their bodies to help evade detection. This makes it extra difficult for the immune system to fight.
The bacteria themselves don’t produce toxins or dangerous proteins. When Borrelia bacteria successfully take hold, the immune system uses its major immune weapon: inflammation. Borrelia is difficult to fight, probably because of the tick saliva on the outside. This can make the fight long and painful for us. We call the disease Lyme, after the small coastal town in Connecticut where it was first documented in the 1970s.
Lyme disease has three main stages. The early stage is characterized by skin problems around the bite location accompanied with flu-like symptoms. If we are lucky, our immune system wins here and the side effects end. However, many people experience a middle stage of headaches, stiffness, and other problems as the bacteria gets into the nerves and heart. If the bacteria has still evaded the immune system after this, it may hide in the joints, causing arthritis and long-term problems for months or years.
So what can we do about Lyme disease? First and foremost, don’t get bitten by ticks! Avoid long grasses and wear long pants, tucking them into your sock or shoes helps to avoid these miniature monsters. Tick repellant also helps. Remove any ticks you find early! It takes around 36 hours for a tick to transmit Lyme disease to you, so being vigilant and removing ticks is critical. You need to remove the entire tick, including the head which is buried in your skin. After you remove a tick, you can kill it by drowning it in rubbing alcohol. It’s not recommended to squash the tick as it could further expose you to disease.
If you are unfortunate enough to be bitten by an infected tick, medical help might be needed. The symptoms are caused by our immune system failing to win the fight against Lyme disease. Antibiotics boost our immune response and are highly effective against Lyme if administered fast enough. In later stages antibiotics are still effective but may not clear all symptoms. We believe prevention is the best medicine. An effective Lyme disease vaccine would boost our immune response and prevent Borrelia bacteria from gaining the upper hand. There actually was an effective vaccine in the 1990s, but misconceptions on how Lyme was diagnosed and how the disease worked – along with poor sales – caused the vaccine to be pulled from the market. Related vaccines have been available for dogs for decades but, frustratingly, not people. Perhaps with better education and a new generation of vaccines we can keep Lyme disease from souring our walks in the woods.
Staff Writer / Editor Benton Lowey-Ball, BS, BFA
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Aronowitz, R. A. (2012). The rise and fall of the lyme disease vaccines: a cautionary tale for risk interventions in American medicine and public health. The Milbank Quarterly, 90(2), 250-277. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460208/
Steere, A. C., Strle, F., Wormser, G. P., Hu, L. T., Branda, J. A., Hovius, J. W., … & Mead, P. S. (2016). Lyme borreliosis. Nature reviews Disease primers, 2(1), 1-19. https://www.nature.com/articles/nrdp201690