What is Borrelia Burgdorferi (Lyme Disease)?

Borrelia burgdorferi is a type of harmful bacteria that causes Lyme disease and is spread through ticks. This bacteria results in symptoms like a distinctive circular rash, joint inflammation (arthritis), heart inflammation (carditis), and in advanced stages, a condition called encephalopathy that affects the brain.

What Causes Borrelia Burgdorferi (Lyme Disease)?

This kind of bacteria, known as a spirochete, usually lives in small mammals and birds, transmitted mainly by tick bites. Interestingly, even though this bacteria lives in these animals, it does not make them sick. However, when this bacteria infects a human, it can cause Lyme disease.

The bacteria, called B. burgdorferi, mainly spreads through a tick called Ixodes scapularis, which is more commonly known as the black-legged tick.

Risk Factors and Frequency for Borrelia Burgdorferi (Lyme Disease)

B. burgdorferi is the only bacterium responsible for the most common disease transmitted by insects in North America. It is found mainly in the northeast and midwest regions of the United States. In Europe, B. burgdorferi is one out of five species that cause Lyme disease. The other species include Borrelia afzelii, Borrelia garinii, Borrelia spielmanii, and Borrelia bavariensis.

The number of Lyme disease cases in the U.S. has recently increased, going from 25,000 to 30,000 per year.
The disease affects children aged 5 to 9 years old and adults aged 45 to 59 years old the most.
More men than women get infected by this bacterium.

Interestingly, this bacterium was first identified in 1977 when there was a high number of children in Lyme, Connecticut thought to have juvenile arthritis. Later, B. burgdorferi was found in the gut tissues by Dr. Willy Burgdorfer and his team in areas where the disease commonly occurred.

Signs and Symptoms of Borrelia Burgdorferi (Lyme Disease)

When checking for an infection caused by B.burgdorferi, it’s essential to gather detailed information about the person’s travel and recreational activities. This includes paying specific attention to any areas known to be hotspots for the disease that the person might have visited and the outdoor activities they engaged in. Additionally, it’s important to ask about any past insect bites or stings. Sometimes these can be mistaken for skin infections or abscesses. A comprehensive physical examination must accompany this history. This examination should include a thorough check of the person’s neurological health, heart function, and skin condition. Taking a detailed history and conducting a comprehensive physical examination are crucial steps in diagnosing the disease promptly.

Testing for Borrelia Burgdorferi (Lyme Disease)

In the early stages of a disease, a diagnosis is usually based on what your doctor suspects rather than laboratory testing. This is because it often takes some time for your body to respond to an infection and produce antibodies, which are what many tests look for. In cases of the disease progressing or in its late stages, testing will usually be positive due to the immune response.

In situations like this, doctors often use a type of test known as an enzyme-linked immunosorbent assay (ELISA). This test identifies antibodies against B. burgdorferi, the bacterium that causes the disease, in your blood. If this test shows that antibodies are present, another test, called a Western blot, is carried out to confirm the diagnosis.

While these tests can help your doctor determine if you have Lyme disease, neither test alone is enough to confirm or rule out the disease.

Treatment Options for Borrelia Burgdorferi (Lyme Disease)

Early stage Lyme disease that is localized or just starting to spread can be treated with antibiotics like doxycycline, amoxicillin, or cefuroxime axetil. This treatment usually lasts for 14 days.

When Lyme disease is detected early but has already caused neurological problems, the treatment generally involves an antibiotic called ceftriaxone, which is given through an IV, or intravenous injection. The treatment usually lasts for 14 days. If there are heart-related symptoms as a result of early Lyme disease, either oral or parenteral (administered in a way other than through the mouth) antibiotic therapy is used for 14 days.

For Lyme disease that is in its later stages and has led to arthritis, or joint inflammation, the recommended treatment is usually 28 days of antibiotics such as doxycycline, amoxicillin, or cefuroxime axetil.

Though most patients with Lyme arthritis respond well to antibiotics, a small number may continue to experience arthritis, even long after they have completed their antibiotic therapy. This persistent arthritis is not due to an ongoing infection, but is rather a post-infectious outcome and it can take several months or even years to resolve. Late-stage, neurological symptoms should be treated with the antibiotic ceftriaxone for a period ranging from 2 to 4 weeks.

There are several conditions that might be considered when reaching a diagnosis, including:

Bell palsy (a condition causing sudden, temporary weakness in your facial muscles)
Chronic fatigue syndrome (a complicated disorder characterized by extreme fatigue)
Fibromyalgia (a disorder characterized by widespread musculoskeletal pain)
Insect bites (bite from an insect causing a variety of reactions such as itchiness or swelling)
Juvenile idiopathic arthritis (a type of arthritis that causes joint inflammation in children)
Myocarditis (inflammation of the heart muscle)
Pediatric contact dermatitis (a skin reaction in children caused by contact with certain materials)
Systemic lupus erythematosus (an autoimmune disease in which the body’s immune system attacks its own tissues and organs)
Third-degree atrioventricular block (a problem with the heart’s electrical system)
Tick-borne diseases (diseases transmitted to humans by a tick bite)

These conditions all have unique signs and symptoms, so careful consideration must be given to achieve a proper diagnosis.

What to expect with Borrelia Burgdorferi (Lyme Disease)

Patients who receive antibiotic treatment, no matter their symptoms or stage of the disease, generally have a great long-term outcome. If a patient doesn’t respond to the antibiotic treatment, it’s likely that they might have been incorrectly diagnosed with Lyme disease. After beginning treatment, it’s usual to experience flu-like symptoms for a few more weeks. However, just because symptoms persist, it doesn’t automatically mean treatment needs to be repeated.