Spring has finally arrived and many of us feel like going for a nice walk outside. This is where we can draw energy after a long winter. But, in addition to recharging our batteries and making memories, we can also bring home a completely unplanned and unwanted souvenir.
It's not only us who are happy with the first warm days, but so are ticks, who are, year after year, trying to break their previous record number of bites on human hosts. If this inconvenience happens to you, then this applies: the sooner you act the better. Specifically, the sooner you remove the attached tick, the more you reduce the risk of infection by communicable diseases, such as Lyme disease. The longer the tick is attached, the greater the risk of transmitting an infection.
The signature spot
The originator of Borreliosis (Lyme disease) is a spiral-shaped bacteria Borrelia burgdorferi and others of its genus. The clinical manifestations of the infection are varied. Borrelia can affect various tissues of the body, most commonly the skin, the nervous system, muscles, bones, and more rarely other organs.
"The first stage of borreliosis is characterized by the formation of a circular redness at the site of the tick's bite, typically with a faded central area, giving it the appearance of a bull's eye. This skin symptom occurs in about 70-80 percent of infected people,"explains Dr. Naďa Klocoková, internist at the Canadian Medical clinic in Prague. This is a common, but not the only, possible course of borreliosis showing on the skin. The spot may not have a faded central area, it may look like a red-purple flare-up similar to a nodule. "This nodule - borrelial lymphocytoma - is then most often found on the earlobe, nipple or scrotum. Skin lesions usually appear about a week after the infection. However, they can manifest even a month or more later. A phenomenon which is characteristic of Lyme disease - erythema migrans, in which the skin irritation moves around various parts of the body – is rare in Europe," Dr. Klocoková says.
Long lasting issues
Skin manifestations may or may not precede neurological problems. "Borreliosis has three stages: Early localized, early disseminated and late disseminated. Typical for the first stage are skin manifestations, which can be accompanied by non-specific general symptoms, such as weakness, malaise and fatigue. In the second stage, which occurs weeks to months after infection, neurological symptoms appear - for instance facial palsy, muscle twitching, tingling, skin burning, visual disturbance, but also serious complications such as aseptic meningitis and encephalitis. Patients whose muscles are affected feel muscle pain and weakness. If joints are affected, we feel pain in them, and in case of the typical oligoarthritis (inflammation of one or a few joints, most often the knee) we also see swelling and redness. If the heart is affected, it can cause heart rhythm disorders or long-term damage of the heart muscle. The liver or the kidneys can also be affected.
The late stage comes months to years after infection. Its characteristic symptom is acrodermatitis chronica atrophicans, causing gradual degeneration of the subdermal tissue. The skin is thin, developing an appearance like tissue paper of a blue-red colour and easily irritable. Other long-term symptoms include damage to peripheral nerves, chronic encephalomyelitis or chronic inflammation of joints and tendons," elaborates Dr. Klocoková.
When the defense fails
Borieliosis is spread mainly by ticks living in the habitat of small infected rodents. Man is merely an occasional host. The disease is also transmitted by early developmental stages of ticks - nymphs. They are very small, almost invisible to the naked eye. Therefore, if characteristic symptoms appear, borreliosis should be considered, even if the patient does not report a tick bite.
There is speculation that other species of blood-sucking insects are also carriers, but this has not yet been confirmed. And because there is currently no vaccination against it, the only protection are the so-called barrier measures – i.e. clothes and repellents. The transfer of bacteria from ticks to humans takes 24 hours. Timely removal of ticks is therefore also a relatively reliable form of prevention.
If you do encounter this disease, you don't have to worry about infecting people around you. But given the health problems it causes, you should definitely see a doctor if you suspect you may be infected. "Lyme disease is treated with antibiotics. The treatment should not be shorter than three weeks," adds Dr. Naďa Klocoková.
Lyme borreliosis is named after the town of Old Lyme in the state of Connecticut in the United States, where several cases of the disease were first recorded in 1975. In most cases, the infection goes away after antibiotic treatment, especially if the disease is detected at an early stage. However, delayed or insufficient treatment can lead to the onset of much more serious symptoms.