Borrelia burgdorferi*

Synonyms:

Lyme disease spirochete

Classification:

aerobic or microaerophilic, gram- bacteria, spirals

Diseases

Sites and Sources

Diagnostic Factors

Virulence Factors

Treatment and Prevention

Commentary

Lyme disease was first seen in this country in 1975 in Lyme, Conn. as an epidemic of juvenile arthritis. The disease is transmitted by ticks and begins with a unique skin lesion, erythema chronicum migrans, at the site of the bite. The lesion is a red ring with a white center which grows progressively larger with time. It has been described as a bull's eye rash.

This is followed in most, but not all, individuals by development of significant cardiac, neurologic, and\or arthritic complications. Non-specific symptoms such as fever, chills, arthalgia, and headache are also usually present. The disease is very common in some places along the northeastern Atlantic coast, Long Island and Nantucket for instance, but occurs to some extent all over the country. The course of the disease is not unlike syphillis in that an initial skin lesion may be followed by pathological changes in almost any organ system, and as is the case with syphillis, the pathogenesis is not well understood. Much of the symptomology may be due to the host immune response. It has been postulated that B. burgdorferi undergoes antigenic variation to evade clearance by the host, but this has not been proven. In 1998, a vaccine against Lyme disease was liscensed and is expected to be available early in 1999.