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Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
Published on: February 4, 2018
Lyme disease in the United Kingdom
Simon W Dubrey1, Ajay Bhatia, Sarah Woodham
1Department of Cardiology, The Hillingdon Hospital, , Uxbridge, UK.
Abstract:
Lyme disease, while still an uncommon disease in the UK, is on the increase. Case numbers have increased by 3.6-fold since 2001, with over 950 cases reported by the Health Protection Agency (HPA) in 2011, compared with less than 500 cases annually pre-2004. HPA indications of the true incidence are suggested to be closer to 3000 cases/year, of which around 82% of cases are indigenously acquired. Three genospecies, Borrelia burgdorferi sensu stricto, Borrelia afzelli and Borrelia garinii, represent the predominant pathogenic variants in the UK. Erythema migrans is the commonest manifestation, occurring in 60%-91% of cases. In the UK, neuroborelliosis is the most common complication, while myocarditis is unusual, and death from either conduction disease or carditis is extremely rare. The role of Borrelia infection in chronic dilated cardiomyopathy in the UK remains unproven. Controversy over the existence of either 'chronic Lyme disease' and/or 'post-Lyme disease syndrome' continues unabated. National medical societies, patient advocacy groups, insurance companies, lawyers, doctors, the private health medical sector and scientific journals have all become embroiled in this bitter controversy. New developments include diagnostic tests able to detect Lyme disease at an earlier stage, shorter durations of antibiotic therapy and potential advances in vaccines against Borrelia.
Insights
Lyme disease cases are increasing in the UK, with over 950 reported in 2011. While Erythema migrans is common, neuroborreliosis is the most frequent complication, and deaths are rare.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Lyme disease incidence in the UK has significantly increased since 2001.
- Over 950 cases were reported in 2011, with an estimated true incidence closer to 3000 cases annually.
- The primary pathogenic Borrelia genospecies in the UK are B. burgdorferi sensu stricto, B. afzelli, and B. garinii.
Purpose of the Study:
- To review the current epidemiology and clinical manifestations of Lyme disease in the UK.
- To highlight the common presentations and complications of Lyme disease.
- To discuss ongoing controversies and emerging developments in Lyme disease diagnosis and treatment.
Main Methods:
- Review of reported case numbers from the Health Protection Agency (HPA).
- Analysis of clinical manifestations and complications based on available data.
- Discussion of scientific literature and ongoing debates regarding Lyme disease.
Main Results:
- Lyme disease cases in the UK have risen 3.6-fold since 2001.
- Erythema migrans is the most common symptom (60%-91%), followed by neuroborreliosis as the most frequent complication.
- Myocarditis and death are rare, and the link to chronic dilated cardiomyopathy is unproven.
Conclusions:
- Lyme disease is an increasing public health concern in the UK.
- Early diagnosis and appropriate treatment are crucial for managing Lyme disease.
- Ongoing research into diagnostics, therapies, and vaccines holds promise for future management.
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