By D. Maan, Jadetimes News
Climate Change Fuels Global Surge in Lyme Disease, Posing Diagnostic Challenges for Physicians
Lyme Disease on the Rise
Climate change fuels global spread of Lyme disease, but its symptoms are tough to spot for most physicians. As it happens, ticks in the lead of the vectors transmitting Lyme disease are the second most common arthropods for infection caused in human beings, next only to mosquitoes. Such blood sucking parasites, at times no bigger than an apple seed, have been capable of transferring different pathogens, including the bacteria that cause Lyme disease: Borrelia burgdorferi.
The Stealthy Bite of Ticks
Ticks secrete an anti inflammatory chemical that 'hides' the feeding from the host, which then allows entry of the pathogen into the host circulation. The helically shaped bacterium, Borrelia burgdorferi, was first isolated in 1975 in Lyme, Connecticut, following several residents who complained of 'arthritis-like' symptoms. In truth, Lyme disease can cause so many, divergent symptoms that these symptoms will grow even more far ranging if treatment is postponed.
The Diverse Nature of Lyme Disease Symptoms
Lyme disease infects many parts of the human body, thus complicating diagnosis. "It's a type of bacteria that penetrates every tissue in the body," says Jack Lambert, a consultant in infectious diseases and professor of medicine at University College Dublin. "It goes to the brain, joints, muscles, nervous system, peripheral nervous system, bladder, and gut." Symptoms can include facial paralysis, heart problems, severe fatigue, and painful pins and needles in hands and feet, leading to varied and often misdiagnosed presentations.
Challenges in Early Diagnosis
Early misdiagnosis has been quite persistent. "Early in the days of Lyme disease, there was a big debate," says Brian Fallon, director of the Lyme and Tick Borne Diseases Research Center at Columbia University. "Are patients making it up? Are they hypochondriacs? That's what led to a lot of struggles in the early 1990s with how to treat these patients."
Misdiagnosis and Its Consequences
Lyme disease is very hard to diagnose. When he was first diagnosed, the Welsh rapper Ren was told that he had bipolar disorder and chronic fatigue syndrome. He lay bedbound for years, dropping his music after coming out with a collection of music before finally being diagnosed with Lyme in 2015. Early treatment with antibiotics is critical, but the first manifestations notably the spreading erythema migrans rash are very often misinterpreted. "The bullseye rash is not always a bullseye," says Lambert. "It can be elliptical, solid, blistering, or bruising. On dark skin, it doesn't look like a bullseye at all."
A Personal Struggle with Lyme Disease
My own bout with Lyme disease began June 2023 after a tick bite, likely during a wildflower walk. Despite the classic, and growing, rash, three different doctors misdiagnosed me with consequent ineffective treatments. Finally, I was diagnosed in the US where the disease is considerably more prevalent. A month long course of antibiotics cleared my symptoms, but the delay in diagnosis had caused a good deal of distress.
Celebrity Cases and Global Prevalence
Public figures, such as Justin Bieber, Shania Twain, and Avril Lavigne, have revealed their struggles with Lyme disease; this really brought the condition into the public eye. According to a review of the British Medical Journal Global Health, in 2022, probably more than one in ten persons globally has suffered from Lyme disease infection; the regions most affected were East Asia, Central Europe, and Western Europe.
Chronic Symptoms and Contentious Treatment
Some patients, despite treatment, go on to develop persistent symptoms called post-treatment Lyme disease syndrome. Part of the problem is that the standard diagnostic tests are designed to detect antibodies, not live infection, so results often turn up falsely negative for people who actually have the disease. The use of herbal remedies for chronic Lyme disease is a controversial issue, as it is an area that has not been comprehensively scientifically validated.
The Need for Better Treatments and a Vaccine
There used to be a vaccine for Lyme disease, LYMERix, which was pulled off the market in 2002 because the sales became too low due to negative media coverage. Brian Fallon remarked, calling for a new vaccine, that currently is undergoing phase three trials. "The good news is that most people can get better over time," he says. "We're at an era in history where medicine is advancing at an incredibly rapid rate. There will be tremendous advances in the next five to 10 years."
In these times of increasing incidence, which is further exacerbated by climate change, Lyme disease indeed creates a challenge when it comes to diagnosis and treatment. Enhanced awareness, correct diagnosis, and prompt treatment form the hallmarks of the management of this complex disease. Perhaps with continued research into this disease, improved treatments and preventive measures will be on the horizon, including a new vaccine.
