Lyme disease is caused by a bacterium named Borrelia burgdorferi, whose reservoir is the common tick, specifically Ixodes ricinus. The bite of this arthropod causes the transmission of the disease, which as we have read in many articles, can cause very annoying and in some cases severe symptoms.
In Italy, the regions most affected are those close to the Alps.
Recent data extrapolated from SIMIWEB report 312 confirmed cases from 2010 to 2014, including 2 in Abruzzo, 3 in Sicily, 9 in Valle d'Aosta, and 298 in Veneto.
http://www.associazionelymeitalia.org/
Recently, some entertainment personalities, such as Justin Bieber, have also been affected with serious repercussions on their health and work activities. We quote below the article that discusses this.
https://www.agi.it/estero/justin_bieber_malattia_lyme-6852449/news/2020-01-09/
The first manifestation of the infection is usually an erythematous patch at the site of inoculation, which may present with the typical rosette appearance: a darker erythematous center and a broader, concentric reddish ring with a tendency to widen, so it is termed "migrating." The most affected skin regions are often located near the folds: groin, armpits, neck.
Symptoms
The initial symptoms are those of a viral disease, including fatigue, headache, muscle aches, fever and chills. However, Lyme disease can progress into the later stages in a sneaky manner, that is, without these symptoms and even in the absence of a rash. Other initial symptoms may include fever, headache and fatigue. If left untreated, symptoms may include paralysis of facial muscles, joint pain, severe headaches with neck stiffness and/or heart palpitations, among others. Months or years later, repeated episodes of joint pain and swelling may occur. Occasionally, people develop excruciating pain or tingling in the arms and legs.
In spite of appropriate treatment, about 10-20% of people develop joint pain, memory problems, and fatigue for at least six months. Subsequently, clinical developments in the nervous system, cardiovascular system, and joints, with a picture of chronicity, may occur, especially in cases who have not undergone antibiotic treatment or have had inadequate treatment.
Diagnosis
In these cases, the symptomatology is characterized by weakness and severe fatigability, joint pain, motility disorders, speech, character and mood changes. To complicate the situation even more, it is reiterated that most patients do not remember the mark left by a tick bite or sting, and the erythematous rash may not appear with the rosette appearance or be accompanied by other symptoms.
Further aspects regarding diagnosis, drug treatment, and clinical manifestations are a specialist's responsibility.
Pharmacological treatment
.In this post it suffices to say that the most effective antibiotics, to be taken of course under specific medical supervision, are doxycycline, amoxicillin, cefuroxime, and azithromycin.
Prevention
With regard to the issue of prevention, which is of particular concern to travelers and trekkers, tick bites should be avoided as much as possible, such as wearing clothing that covers arms and legs and spraying or slathering exposed skin with DEET-based insect repellents. The use of pyrethroid-based insecticides to sanitize the environment and, in the case of camping, impregnating tents with 5 percent permethrin before use is also effective. Pay attention to the removal of ticks with tweezers, which should be done by experienced hands and with proper tools, respecting asepsis.
A single dose of doxycycline may be recommended as pharmacological prophylaxis in tick-stung individuals. In children under 12 years of age, in whom doxycycline is ruled out, azithromycin may possibly be administered.
Vaccine - withdrawn from the market
.A recombinant vaccine against Lyme disease has been developed, based on the outer surface protein A (ospA) of B. burgdorferi. In clinical trials involving more than 10,000 people, the vaccine, called LYMErix, has been shown to confer protective immunity to Borrelia in 76% of adults and 100% of children with mild to moderate and transient adverse effects. LYMErix was approved on the basis of these studies by the Food and Drug Administration (FDA) on December 21, 1998. After the vaccine was approved, its entry into clinical practice was slowed for a number of reasons, including its cost, which was often not recognized as reimbursable by insurance companies. Subsequently, hundreds of vaccine recipients reported developing autoimmune diseases and other side effects. With the legal support of advocacy groups, claiming that the vaccine was the cause, numerous lawsuits were filed against the pharmaceutical manufacturer. However, these claims have been scientifically refuted by the FDA and the Centers for Disease Control, which have found no link between the vaccine and the complained of autoimmune diseases. Despite the insubstantiality of the allegations, however, sales plummeted and LYMErix was withdrawn from the market due to negative media coverage and fears of side effects of the vaccine, which then fell victim to persecution solely based on bias and the fabrication of false evidence.
