Chapter 11 : Lyme Borreliosis

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Lyme disease or Lyme borreliosis is recognized as an important infectious disease in North America, Europe, and Asia. The formerly designated has now been subdivided into multiple species, including three that cause human infection. In the United States, the sole cause of infection is . Although all three pathogenic species are found in Europe, most disease there is caused by or ; these two species also seem to be responsible for the illness in Asia. This chapter presents biology and enzootic cycles of and related species. As with other spirochetal infections, human Lyme borreliosis generally occurs in stages, with remissions, exacerbations, and different clinical manifestations at each stage. Early infection consists of stage 1 (localized skin infection), followed within days to weeks by stage 2 (disseminated infection). Late infection, or stage 3 (persistent or progressive infection), usually begins months to years after the disease onset, sometimes following long periods of latent infection. To gain a better understanding of pathogenetic mechanisms, animal models of Lyme disease have been developed in mice, hamsters, guinea pigs, dogs, and nonhuman primates. Each animal model is imperfect in that it does not express all features of human Lyme disease. The plethora of inbred mouse strains, including genetically modified animals, and the depth of knowledge of the murine immune system have made studies of the mouse particularly valuable. The chapter presents the diagnosis, treatment, and prevention of the Lyme disease.

Citation: Steere A, Glickstein L, Coburn J. 2005. Lyme Borreliosis, p 176-206. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch11
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Figure 1

A scanning electron micrograph of spirochetes in the mid-gut of a nymphal tick. The picture was a kind gift of Dr. Willy Burgdorfer.

Citation: Steere A, Glickstein L, Coburn J. 2005. Lyme Borreliosis, p 176-206. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch11
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Image of Figure 2
Figure 2

Western blots of the IgM antibody responses to are shown in 25 patients with EM (a); the IgG responses are demonstrated in 25 patients with Lyme arthritis (b). Patients with EM most commonly had IgM responses to the 23-kDa OspC protein and the 41-kDa flagellar antigen of the spirochete, whereas the patients with Lyme arthritis almost always had IgG reactivity with all 10 bands used for diagnosis with the CDC criteria ( ).

Citation: Steere A, Glickstein L, Coburn J. 2005. Lyme Borreliosis, p 176-206. In Goodman J, Dennis D, Sonenshine D, Tick-Borne Diseases of Humans. ASM Press, Washington, DC. doi: 10.1128/9781555816490.ch11
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