Lyme borreliosis (LB) is the most commonly reported tick-borne infection in Europe and North America. The disease is a multi-system disorder, which can affect a complex range of tissues including the skin, heart, nervous system, and to a lesser extent the eyes, kidneys and liver. The illness is caused by a spirochaete (spiral-shaped bacteria), which is transmitted during the blood feeding of ticks of the genus Ixodes.
The term Lyme disease was first used following investigation into a geographical cluster of juvenile rheumatoid arthritis in the town of Old Lyme, Connecticut, USA, in the mid 1970’s. Subsequent studies led to the isolation from the deer tick, Ixodes scapularis (dammini) of a gram-negative spirochaete, which was named Borrelia burgdorferi.
The disease has, however, been known in Europe under a variety of names (including erythema migrans, acrodermatitis chronica atrophicans, Bannwarth’s syndrome) since the 1880’s. In 1909, Afzelius had associated a red rash (erythema migrans) with the tick, Ixodes ricinus. In 1948, spirochaetes were observed in erythema migrans (EM) biopsies and in 1951 a Swedish clinician, Hollstrom, successfully treated EM infected patients with penicillin. Also in 1951, it was suggested that EM, with associated meningitis, was probably the result of an infection by a tick- or other insect-borne bacterium. A transmittable bacterial aetiology for EM had also been indicated by the EM biopsy transplant experiments carried out by Binder et al. in 1955, and Asbrink et al. in 1978. However, EM was considered a relatively harmless condition with no connection made between the lesion and subsequent symptoms caused by the same bacterium.
It is now known that Lyme borreliosis occurs as a significant disease in thousands of European patients every year