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Lyme disease or Lyme borreliosis is an infectious tick-borne disease, caused by the Borrelia spirochete, a gram-negative microorganism. more...

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Lyme disease is so named because it is generally believed to have first been observed in and around Old Lyme and Lyme, Connecticut in 1975. Before 1975, elements of Borrelia infection were also known as "tick-borne meningopolyneuritis", Garin-Bujadoux syndrome, Bannwarth syndrome or sheep tick fever. It is transmitted to humans by the bite of infected ticks.


The disease was first documented as a skin rash in Europe in 1883. Over the years, researchers there identified additional features of the disease, including an unidentified pathogen, its response to penicillin, the role of the Ixodes tick (wood tick) as its vector, and symptoms that included not only the rash but additional ones that affected the nervous system.

Researchers in the US had been aware of tick infections since the early 1900s. For example, an infection called tick relapsing fever was reported in 1905, and the wood tick, which carries an agent that causes Rocky Mountain spotted fever, was identified soon after. However, the full syndrome now known as Lyme disease, was not identified until a cluster of cases thought to be juvenile rheumatoid arthritis occurred in three towns in southeastern Connecticut, in the United States. Two of these towns, Lyme and Old Lyme, gave the disease its popular name.

In 1982 a novel spirochete was isolated and cultured from the midgut of Ixodes ticks, and subsequently from patients with Lyme disease. The infecting agent was first identified by Jorge Benach, and soon after isolated by Willy Burgdorfer, a scientist at the National Institutes of Health who specialized in the study of spirochete microorganisms. The spirochete was named Borrelia burgdorferi in his honor. Burgdorfer was the partner in the successful effort to culture the spirochete, along with Alan Barbour.


The disease is caused by the parasite Borrelia, which has well over three hundred known genomic strains but is usually cultured as Borrelia burgdorferi, Borrelia afzelii or Borellia garinii. Different Borrelia strains are predominant in Europe and North America.

The disease has been found to be transmitted to humans by the bite of infected Ixodes ticks. Not all ticks carry or can transmit this particular disease. The disease may also, in a few cases, be transmitted by mosquitoes, fleas or blackflies. However, other Borrelia strains (e.g. B. garinii) are probably transmitted this way.

Other tick-borne infections may be transmitted simultaneously with Lyme, including Bartonella, Babesiosis, Ehrlichiosis, and Rickettsia.

Borrelia burgdorferi resembles other spirochetes in that it is a highly specialized, motile, two-membrane, spiral-shaped bacterium which lives primarily as an extracellular pathogen. One of the most striking features of Borrelia burgdorferi as compared with other eubacteria is its unusual genome, which includes a linear chromosome approximately one megabase in size and numerous linear and circular plasmids.


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Tick-Borne Diseases of Humans
From Emerging Infectious Diseases, 11/1/05 by Robert P. Smith

Jesse L. Goodman, David T. Dennis, and Daniel E. Sonenshine, editors

ASM Press, Washington, DC, 2005 ISBN: 1-55581-23-4 Pages: 440, Price: US $119.95

During the past 2 decades, the scientific landscape of tickborne diseases has changed remarkably. In part because of advances in molecular biology, more than 10 new rickettsial diseases, several ehrlichial diseases, and novel agents of Borrelia and Babesia genera have been recognized. This renaissance of interest in tickborne infections benefits from advances in molecular phylogenetics and diagnostics, immunology, and informatics that provide tantalizing insights into the complexities of vectorborne infection. Tick-Borne Diseases of Humans is a well-referenced textbook that encompasses these new insights in vector biology and reviews the emerging epidemiology and clinical science of these diseases as they occur across the globe. The editors' goal of providing a "comprehensive" resource is admirably fulfilled.

The book, consisting of 20 chapters by 40 contributors, is divided into 3 sections. The first section includes excellent reviews of tick biology and systematics, tick-pathogen interactions, host responses, and vector management. This section provides a superb overview. While thorough and up-to-date, occasional redundancy occurs between chapters by different authors that could have been streamlined with additional editing. A concise and well-written chapter on the clinical approach to diagnosis and management of these diseases also seems misplaced; it would fit in better at the start of the next section.

Section 2 of the book includes summaries of major and lesser known tickborne infections. These chapters each provide detailed information on specific vectors and pathogens and on the epidemiology and clinical characteristics of the diseases they cause. While the description of the molecular biology and vector ecology of these infections is generally excellent, the clinical discussions often lack the nuance and detail of current infectious diseases texts. Nevertheless, each chapter provides current and well-referenced information on disease manifestations, diagnosis, and treatment. Several chapters, i.e., those on anaplasmosis, relapsing fever, and Lyme borreliosis, are superb in all aspects.

Section 3 includes a series of global maps that depict the distribution of different tick vectors or the diseases they cause. While useful overall, maps on this scale do not convey the focality of tick distribution, and their organization in the text (i.e., mixing of vector maps with disease maps) could be improved. The maps are followed by a color atlas of tickborne diseases with plates depicting typical skin lesions and other clinical findings along with examples of microscopic pathology. This part of the book is visually compelling, although the reproductions of microscopic pathology are often small and therefore difficult to view in detail. Section 3 concludes with an almanac of the geographic distribution of ticks and the diseases they cause. This information is often difficult to find, and its inclusion in a chapter of the text is useful.

In summary, Tick-Borne Diseases of Humans is an excellent resource for a diverse audience. Vector biologists (whether molecular or ecologic in focus), infectious disease physicians, and those involved in the public health surveillance and control of these diseases will find this book to a valuable addition to current texts.

Robert P. Smith, Maine Medical Center, Portland, Maine, USA

Address for correspondence: Robert P. Smith, 22 Bramhall, Portland, ME 04102, USA; fax: 207-662-6116; email:

COPYRIGHT 2005 U.S. National Center for Infectious Diseases
COPYRIGHT 2005 Gale Group

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