Lyme Disease: An Emerging Threat.

Area of Science:

• Infectious Diseases
• Epidemiology
• Environmental Health

Background:

• Lyme disease (LD) is a tick-borne zoonosis caused by *Borrelia burgdorferi sensu lato* (*B. burgdorferi s.l.*) complex species.
• It is a significant emerging vector-borne disease, particularly in the United States, with increasing reported cases.
• Global warming is expanding tick habitats and activity periods, contributing to the rise in LD incidence worldwide.

Purpose of the Study:

• To review the current understanding of Lyme disease, including its transmission, clinical manifestations, and epidemiology.
• To highlight the impact of global warming on the increasing incidence of LD.
• To emphasize the underdiagnosis of LD in India and advocate for its inclusion in clinical differential diagnoses.

Main Methods:

• Literature review of Lyme disease prevalence, transmission dynamics, and clinical presentations.
• Analysis of epidemiological data on LD incidence in the United States and global trends.
• Examination of factors contributing to LD underdiagnosis, particularly in India.

Main Results:

• LD cases have significantly increased in the US, with an estimated 476,000 cases annually between 2010-2018.
• Clinical manifestations vary by geographic region due to different *B. burgdorferi s.l.* genospecies.
• LD has been reported in at least 12 Indian states, with a recent study confirming seroprevalence in North and Northeast India, yet it remains underdiagnosed.

Conclusions:

• Lyme disease is an escalating global health concern, exacerbated by climate change-driven increases in tick activity.
• Prompt diagnosis and antibiotic treatment are essential for managing early LD and preventing long-term complications.
• Increased physician awareness and improved diagnostic accessibility are critical, especially in regions like India where LD is underrecognized.