Living with Lyme Disease — Luigi Franciosi Explains What It Is and How It Can Be Treated/Managed

As travel becomes easier and more affordable, it is important for patients to keep in mind that certain areas are more prone to certain diseases, as is the case with Lyme disease. As the most common tick related illness, patients are advised to always keep an eye out for tick bites, or ticks still attached to the skin, as undetected and untreated infections can lead to serious complications. Being in the pharmaceutical industry, Dr. Luigi Franciosi understands the importance of early detection and treatment and advises that patients seek healthcare services as early as possible if they experience signs and/or symptoms, or feel that they may have been bit/infected.

What is Lyme Disease?

Lyme disease is an infectious disease caused by the bacteria Borrelia burgdorferi that is transmitted to humans through the bite of infected ticks. In most of North America, the tick is the Ixodes scapularis, the deer tick, and attachment to human skin for great than 36 hours can lead to infection, whereas in most parts of Europe it is the Ixodes ricinus, the caster bean tick, and can occur in less time. Most patients who get the disease recall having been out hiking or camping, especially in the Northeast, including States such as Maine, Connecticut, New Hampshire, Vermont, and Massachusetts. Other common locations for infection include Maryland, Minnesota, and Wisconsin.

Signs and Symptoms

Initial signs and symptoms include a classic “bullseye” (erythema migrans) rash in the area of the tick bite, as well as vague flu-like symptoms including but not limited to fever, fatigue, body aches/headache, and respiratory concerns. Dr. Luigi Franciosi reminds patients that it is important to keep in mind that not everyone experiences the same signs and symptoms, and do so to varying degrees, and it is important to visit a local clinic or emergency room if there is concern for Lyme disease. If unsuspected, or left untreated, Lyme can progress to early-disseminated disease within a few days to weeks following initial presentation of the erythema migrans rash, and can cause neurological issues, such as facial palsy, or even radiculopathy. A major concern of Lyme disease is Lyme carditis, which is inflammation of heart tissue, and can lead to palpitations, dizziness, or chest pain. Late-disseminated disease can occur months after the original tick bite, and more than 50% of patients present with Lyme arthritis, while others may experience neurological issues, and some may progress to encephalomyelitis.

Treatment/Management

Early detection and treatment of Lyme disease is important as it can help prevent progression to complications of disseminated disease. The mainstay of treatment is antibiotic use, with doxycycline being the most commonly used in patients 8 years and above, and amoxicillin in those below 8, and pregnant women. Luigi Franciosi explains that doxycycline is used as it has excellent coverage against Borrelia burgdorferi, as well as coverage against other infections carried by ticks. Treatment and management can last anywhere between 1 to 4 weeks of oral antibiotics, whereas for patients with disseminated disease, intravenous ceftriaxone is recommended. Patients that progress to having Lyme carditis may need to have a temporary pacemaker placed to allow for properly electrical conduction of impulses throughout the heart to keep sinus rate and rhythm. Prognosis of patients is typically very good, with more than 65% recovering fully by the end of treatment, and about 90% recovery fully at 30 months. Most times lingering symptoms are those of joint pain and fatigue, and are non-life threatening, or disabling. Preventative measures such as the use of DEET, soaking clothes in permethrin, and use of long sleeved clothing is suggested, as well as checking for attached ticks and/or bites when out in areas known to have ticks.

Dr. Luigi Franciosi is an established pharma consultant and adjunct professor at the University of British Columbia. Located in Coquitlam, British Columbia.

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