Questions and Answers about Lyme Disease, Symptoms and Test Procedures

Marco Haase, Managing Director of the German Chronic Disease Laboratory, answers the 10 most important questions about the multi-systemic disorder Lyme disease in an interview.

What is Lyme disease?

Lyme disease is a chronic inflammatory disease transmitted by Borrelia bacteria. It affects the whole body. There are numerous species of Borrelia bacteria, which are frequently transmitted together with other infections. The disease is transmitted by infected ticks which suck the host's blood, remain attached to his body and "vomit". This happens if the blood is pressed back into the host's body as a result of the tick being removed incorrectly. About one in every 100 tick bites will cause Lyme disease.

Other methods of transmission, e.g. by mosquitoes, horse flies or sexual intercourse, are possible but have not been proven.

What happens if I am infected?

When the Borrelia bacteria penetrate the human body, the body produces antibodies to fight the infection. In some people, these antibodies do their job successfully and prevent the Borrelia bacteria from spreading throughout the body. However, others develop a wide variety of symptoms. These may only appear months or years later, long after the tick bite was forgotten.

What symptoms can appear?

The symptoms are very varied. The patient may develop a fever, headaches, conjunctivitis and swollen lymph nodes. However, forgetfulness, difficulty finding words, inflamed joints and nerves, depression and even paralysis may appear. Quite often, these symptoms are not immediately associated with Lyme disease. Patients therefore often receive the wrong treatment.

How can I protect myself from tick bites?

During the first 8 hours following the tick bite, you can be fairly sure that there is no risk of the Borrelia infection being transmitted. The longer the tick remains attached to your body, the higher the risk of transmission. This is why it is important to check your body immediately after spending time outdoors and, if necessary, to remove any ticks with special tick forceps, being careful not to squash them. Afterwards, the wound should be disinfected and any remains removed with a cannula tip. It's advisable to wear light clothing which covers the body whenever you are outdoors. This makes ticks easier to recognise.

What should you do if you think you've been infected?

Usually, the first thing to do is to see your family doctor. However, there are also doctors who specialise in Lyme disease. The doctor will start by taking a detailed case history. If the suspicion becomes more concrete, the doctor will take a blood sample and send it to a laboratory.

How is Lyme disease diagnosed?

A blood sample is tested in the laboratory. If you have contracted Lyme disease, so-called Borrelia antigens can be used to find out whether your blood contains antibodies, as these will bind the antigens. At the next stage of testing, the Borrelia antibodies are made visible by means of a binding reaction. However, the results of standard tests are often inaccurate.

Why are the standard tests so inaccurate?

This is due to the nature of the tests and the Borrelia bacteria themselves, as there are many different species. One tick can transmit several types of bacteria simultaneously. Borrelia bacteria are also masters of disguise: they can change their surface structure in the body and are found in different places.

Then there is the test problem. Each test contains just one antigen for detecting the presence of Borrelia. This antigen can only bond with certain Borrelia antibodies. However, there are many different kinds of Borrelia and consequently many different antibodies. If you only test for A, you will miss B and C. What's more, every laboratory uses different test kits. The test result may therefore be negative in one laboratory and positive in another. Imagine a woman is pregnant but her doctor only tests for boys. It's the same principle with the Lyme disease tests. They are actually the biggest source of error.

Are there any other possibilities or better procedures?

Yes, the B16+ test procedure from the German Chronic Disease Laboratory. The B stands for Borrelia, the 16+ for the number of tests combined. The B16+ Lyme disease tests therefore differ significantly from the tests normally used to diagnose Lyme disease. They facilitate a more reliable diagnosis and a higher detection rate. This massively increases the probability of obtaining an accurate result. The tests also facilitate purposeful monitoring and follow-up checks.

How is Lyme disease treated?

The disease is usually treated with a lengthy course of antibiotics. However, there are also other methods of treatment, for example naturopathic treatments with fungi and herbs.

Can Lyme disease be cured?

If the disease is treated promptly in the early stages, the chances of a cure are very high (more than 85 percent). In later stages, irreversible deficits particularly in the joints may lead to permanent damage requiring symptomatic treatment. If the patient has no symptoms for two years, and another test yields negative results, it is highly likely that he is cured.

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