LYME DISEASE AS A PUBLIC HEALTH CHALLENGE: A REVIEW OF RECENT EVIDENCE
DOI:
https://doi.org/10.31435/ijitss.1(49).2026.4569Keywords:
Lyme Disease, Borrelia Burgdorferi, Tick-Borne Diseases, Ixodes TicksAbstract
Lyme disease, primarily caused by the spirochete Borrelia burgdorferi transmitted by ticks of the genus Ixodes, is a growing public health problem in many regions of the world. The disease is characterized by a diverse clinical course, including early skin lesions such as erythema migrans, and late joint, neurological, cardiac, and, less frequently, chronic complications. The pathogenesis of Lyme disease is associated with the invasion of tissues by the spirochetes and their ability to evade the host immune response, leading to chronic inflammation. Diagnosis relies on a combination of clinical assessment and serological testing, while considering the limitations of false positive and negative results. Standard treatment includes antibiotic therapy tailored to the stage of disease. Prevention plays a key role and includes the use of repellents, appropriate clothing, environmental monitoring, and public education and awareness in endemic areas. Effective prevention and early diagnosis are essential to reduce morbidity and clinical complications.
References
Mahajan, V. K. (2023). Lyme disease: An overview. Indian Dermatology Online Journal, 14(5), 594–604. https://doi.org/10.4103/idoj.idoj_418_22
Dong, Y., Zhou, G., Cao, W., Xu, X., Zhang, Y., Ji, Z., Yang, J., Chen, J., Liu, M., Fan, Y., Kong, J., Wen, S., Li, B., Yue, P., Liu, A., & Bao, F. (2022). Global seroprevalence and sociodemographic characteristics of Borrelia burgdorferi sensu lato in human populations: A systematic review and meta-analysis. BMJ Global Health, 7(6), e007744. https://doi.org/10.1136/bmjgh-2021-007744
Torbahn, G., Hofmann, H., Allert, R., Freitag, M. H., Dersch, R., Fingerle, V., Sommer, H., Motschall, E., Meerpohl, J. J., & Schmucker, C. (2016). Efficacy and safety of pharmacological agents in the treatment of erythema migrans in early Lyme borreliosis: Systematic review protocol. Systematic Reviews, 5, 73. https://doi.org/10.1186/s13643-016-0251-3
Trevisan, G., Bonin, S., & Ruscio, M. (2020). A practical approach to the diagnosis of Lyme borreliosis: From clinical heterogeneity to laboratory methods. Frontiers in Medicine, 7, 265. https://doi.org/10.3389/fmed.2020.00265
Smith, B. G., Cruz, A. I., Jr., Milewski, M. D., & Shapiro, E. D. (2011). Lyme disease and the orthopaedic implications of Lyme arthritis. Journal of the American Academy of Orthopaedic Surgeons, 19(2), 91–100. https://doi.org/10.5435/00124635-201102000-00004
Fikrig, E., & Narasimhan, S. (2006). Borrelia burgdorferi: Traveling incognito? Microbes and Infection, 8(5), 1390–1399. https://doi.org/10.1016/j.micinf.2005.12.022
Wormser, G. P., McKenna, D., Carlin, J., Nadelman, R. B., Cavaliere, L. F., Holmgren, D., Byrne, D. W., & Nowakowski, J. (2005). Brief communication: Hematogenous dissemination in early Lyme disease. Annals of Internal Medicine, 142(9), 751–755. https://doi.org/10.7326/0003-4819-142-9-200505030-00011
Feder, H. M., Jr. (2008). Lyme disease in children. Infectious Disease Clinics of North America, 22(2), 315–vii. https://doi.org/10.1016/j.idc.2007.12.007
Vasudevan, B., & Chatterjee, M. (2013). Lyme borreliosis and skin. Indian Journal of Dermatology, 58(3), 167–174. https://doi.org/10.4103/0019-5154.110822
Stanek, G., & Strle, F. (2008). Lyme disease: European perspective. Infectious Disease Clinics of North America, 22(2), 327–vii. https://doi.org/10.1016/j.idc.2008.01.001
Bacon, R. M., Kugeler, K. J., Mead, P. S., & Centers for Disease Control and Prevention. (2008). Surveillance for Lyme disease—United States, 1992–2006. Morbidity and Mortality Weekly Report: Surveillance Summaries, 57(10), 1–9.
Nigrovic, L. E., Thompson, A. D., Fine, A. M., & Kimia, A. (2008). Clinical predictors of Lyme disease among children with a peripheral facial palsy at an emergency department in a Lyme disease-endemic area. Pediatrics, 122(5), e1080–e1085. https://doi.org/10.1542/peds.2008-1273
Wright, W. F., Riedel, D. J., Talwani, R., & Gilliam, B. L. (2012). Diagnosis and management of Lyme disease. American Family Physician, 85(11), 1086–1093.
Marques, A. (2008). Chronic Lyme disease: A review. Infectious Disease Clinics of North America, 22(2), 341–viii. https://doi.org/10.1016/j.idc.2007.12.011
Buechner, S. A., Rufli, T., & Erb, P. (1993). Acrodermatitis chronica atrophicans: A chronic T-cell-mediated immune reaction against Borrelia burgdorferi? Clinical, histologic, and immunohistochemical study of five cases. Journal of the American Academy of Dermatology, 28(3), 399–405. https://doi.org/10.1016/0190-9622(93)70058-2
Silberer, M., Koszik, F., Stingl, G., & Aberer, E. (2000). Downregulation of class II molecules on epidermal Langerhans cells in Lyme borreliosis. British Journal of Dermatology, 143(4), 786–794. https://doi.org/10.1046/j.1365-2133.2000.03776.x
Asbrink, E., & Hovmark, A. (1985). Successful cultivation of spirochetes from skin lesions of patients with erythema chronicum migrans Afzelius and acrodermatitis chronica atrophicans. Acta Pathologica, Microbiologica, et Immunologica Scandinavica Section B: Microbiology, 93(2), 161–163. https://doi.org/10.1111/j.1699-0463.1985.tb02870.x
Mygland, A., Ljøstad, U., Fingerle, V., Rupprecht, T., Schmutzhard, E., Steiner, I., & European Federation of Neurological Societies. (2010). EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. European Journal of Neurology, 17(1), 8–e4. https://doi.org/10.1111/j.1468-1331.2009.02862.x
Steere, A. C. (2001). Lyme disease. New England Journal of Medicine, 345(2), 115–125. https://doi.org/10.1056/NEJM200107123450207
Barsic, B., Maretic, T., Majerus, L., & Strugar, J. (2000). Comparison of azithromycin and doxycycline in the treatment of erythema migrans. Infection, 28(3), 153–156. https://doi.org/10.1007/s150100050069
Maraspin, V., Cimperman, J., Lotric-Furlan, S., Pleterski-Rigler, D., & Strle, F. (1996). Treatment of erythema migrans in pregnancy. Clinical Infectious Diseases, 22(5), 788–793. https://doi.org/10.1093/clinids/22.5.788
Steere, A. C. (1989). Lyme disease. New England Journal of Medicine, 321(9), 586–596. https://doi.org/10.1056/NEJM198908313210906
Nadelman, R. B., Nowakowski, J., Fish, D., Falco, R. C., Freeman, K., McKenna, D., Welch, P., Marcus, R., Agüero-Rosenfeld, M. E., Dennis, D. T., Wormser, G. P., & Tick Bite Study Group. (2001). Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. New England Journal of Medicine, 345(2), 79–84. https://doi.org/10.1056/NEJM200107123450201
Steere, A. C., Sikand, V. K., Meurice, F., Parenti, D. L., Fikrig, E., Schoen, R. T., Nowakowski, J., Schmid, C. H., Laukamp, S., Buscarino, C., & Krause, D. S. (1998). Vaccination against Lyme disease with recombinant Borrelia burgdorferi outer-surface lipoprotein A with adjuvant. New England Journal of Medicine, 339(4), 209–215. https://doi.org/10.1056/NEJM199807233390401
Wallich, R., Jahraus, O., Stehle, T., Tran, T. T., Brenner, C., Hofmann, H., Gern, L., & Simon, M. M. (2003). Artificial-infection protocols allow immunodetection of novel Borrelia burgdorferi antigens suitable as vaccine candidates against Lyme disease. European Journal of Immunology, 33(3), 708–719. https://doi.org/10.1002/eji.200323620
Clark, R. P., & Hu, L. T. (2008). Prevention of Lyme disease and other tick-borne infections. Infectious Disease Clinics of North America, 22(3), 381–vii. https://doi.org/10.1016/j.idc.2008.03.007
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