Table of Contents
Introduction 11
Chapter 1 What Is Lyme Disease? 13
History and Expansion of Lyme Disease 13
The Rise in Lyme Disease 19
Borrelia burgdorferi: The Lyme Disease Bacteria 22
Summary 32
Chapter 2 Transmission and Prevention 33
All about the Tick 33
How Is Lyme Disease Transmitted? 45
Cycle of Infection 47
Tick Removal 52
Repellants and Pesticides 54
Summary 57
Chapter 3 Signs and Symptoms 59
Stages of the Symptoms 59
Erythema Migrans, or the "Bull's-Eye" Rash 61
Lyme Neuroborreliosis 66
Lyme Carditis 70
Lyme Arthritis 71
Lyme Disease in Europe 74
Reinfection 74
Summary 76
Chapter 4 Complications of Lyme Disease 77
Posttreatment Lyme Disease Syndrome 78
Chronic Lyme Disease 87
Summary 94
Chapter 5 Diagnosing Lyme Disease 97
Early Recognition 98
Finding the Right Doctor 98
Diagnostic Tests 102
PCR Tests and Lyme Disease 106
The Two-Tiered Test: ELISA and the Western Blot 108
Other Tests 116
Summary 120
Chapter 6 Treatment for Lyme Disease 123
Antibiotics 123
Recommended Treatment for Lyme Disease 127
Appropriate Length of Treatment 133
Complementary and Alternative Approaches 136
Treatments to Avoid 145
Summary 150
Chapter 7 Lyme Disease Advocacy 153
The Lyme Community 153
Lyme Disease Advocacy Causes 154
Online Resources 159
Scientific Concerns with Lyme Disease Advocacy 159
Summary 163
Chapter 8 Potential Coinfections 165
Coinfections 165
Babesiosis 166
Anaplasmosis 171
Powassan Virus 175
Borrelia miyamotoi 184
Borrelia mayonii 188
Bartoneliosis 189
Coinfections and the Severity of Lyme Disease 190
Summary 195
Chapter 9 Research for the Future 197
Ecological Prevention 197
Diagnostic Improvements 202
Effective Treatment 208
Lyme Disease Vaccination 209
Insights Into the Disease 214
Future Outlook 217
Summary 218
Appendix A Further Resources 221
Advocacy Groups 222
Appendix B Bibliography 223
Appendix C Infections Transmitted by Other Ticks 229
Ehrlichiosis 229
Heartland Virus 231
STARI (Southern Tick-Associated Rash Illness) 233
Rocky Mountain Spotted Fever 234
Tick-Borne Relapsing Fever 236
Tularemia 237
Colorado Tick Fever 237
Bourbon Virus 238
Appendix D Lyme Disease Timeline 239
Appendix E Glossary 243
Index 251