HEALTH TIME
ASK DR. MARIANNE
Lyme disease and TBE – tick- borne encephalitis
From May until October is the peak season in Europe of getting tick bites,
and therefore possible Lyme disease and/or TBE – tick-borne encephalitits.
A tick is a ectoparasite dependent on blood from mammals, birds, and occasionally
reptiles and amphibians in order to survive.
Lyme disease is an infectious disease caused by the spirochete Borrelia burgdorferi
commonly found in the USA, Borrelia garinii in Europa and Borrelia afzelli found
typically in Scandinavia. The spirochete is spread when the tick sucks blood
from its various hosts.
Lyme disease typically has three stages. The early stage is characterized typically
with a rash called erythema migrans – EM. EM is the main symptom in Lyme
disease and 60 – 80 % of the people that are infected get this symptom.
It normally shows one – two weeks after the tick has bitten. Some might
catch a fever and local lymph nodes might enlarge. EM typically disappear spontaneously
after two to four weeks. The rash is painless and doesn't normally itch. Early
disseminated disease may manifest itself with various symptoms from the nerve
system by typically meningitis with headaches, loss of sensibility, muscle power
loss, joint pain and swelling, muscle aches and so forth. Late disseminated disease/
chronic disease is when the disease and symptoms mentioned above has not been
treated and lasts for more than 6 months. New symptoms may also appear in the
chronic disease. If there is uncertainty with regards to the diagnosis, there
is possible to take blood samples and also tests of the spinal fluid. Lyme disease
is treated with various antibiotics with regards to the symptoms.
TBE – tick-borne encephalitis is a viral infection in the central nerve
system. In Europe 0,5 – 5 % of the ticks are infested with TBE-virus. In
Europe it is reported 4000 – 5000 cases annually. It is calculated that
1 of every 600 tick bites will transmit this disease. The disease is divided
into two stages. The first stage reveals itself typically 10 – 14 days
after the disease has been transmitted and lasts for 4 – 5 days. Symptoms
might be fevers, head aches and muscle aches. 25 % of the ones in the first stage
will reach the second stage. Symptoms in the second stage might be severe head
aches, vertigo, nausea and vomiting, neck stiffness, and behavioural changes,
confusion and so forth. Mortality is 1 – 2 %. Blood samples and/or test
of spinal fluid can show specific antibodies to the virus. The treatment is basically
to treat the symptoms. Antibiotics will not help, but for some people antiviral
therapy can be of use. There is a vaccine available. It is given to people living
in endemic areas and is also recommended for tourists planning to visit rural
places in endemic areas.
With proper prevention against tick bites, fewer would catch the two diseases.
If you are going hiking in areas where there are ticks, cover your skin with
long sleeved sweaters and long pants. The ticks are easier to spot on light colored
clothes. If possible take a shower after you have been hiking. Have someone check
your skin and hair. If you do find a tick in your skin, pull it straight out
with your fingers or a tweezer. If you do get a skin reaction which looks like
erythema migrans, get joint pain or other symptoms, contact a medical doctor.
Have a wonderful and tick free summer!
Dr. Marianne
MARIANNE
EFSKIND Occupation: intern in public health and family medicine in Vik. |
 |
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