1. Lyme Disease By: Robbie Jackson

2. History “I’ve got more nervous ticks than a Lyme disease research facility” - Sheldon Cooper from The Big Bang Theory In the early 1970’s a mysterious group of rheumatoid arthritis cases occurred among children of Lyme, Connecticut and two neighboring towns Most cases occurred near wooded areas so they focused their attention on dear ticks They concluded that these ticks were the cause of Lyme disease however did not exactly know what caused it In 1981 the NAID researchers found a spirochete, later named Borellia Bugdorferin, was causing Lyme disease

3. What is Borellia Bugdorferin B. Bugdorferin is a bacteria This bacteria is 20-30 um in length and 0.2-0.5 um in width It is a spiral shaped-gram-negative bacteria Its motile success is due to its extraordinary flagella Because it has linear chromosomes, rather than circular, it can survive in a variety of environments The optimal temperature for growth of the bacteria is 32 degrees celcius (body temp)

4. Transmission B. burgdorferin stays in the mid-gut of the tick vector, habitating the microvilli and epithelium of the gut After the tick latches on to a host, bacteria can invade the gut epithelium and make its way into the salivary glands allowing it to infect.

5. Symptoms Typically the first symptom of Lyme disease is a rash around the site of the tick bite Rash is accompanied by other symptoms such as fever, headache, stiff neck, body aches and fatigue. Some patients may develop arthritis, nervous system problems, or heart problems.

6. The Case of Chronic Lyme Disease MB is a 49 year old female diagnosed with Lyme Her symptoms rapidly progress from fatigue to multiple sclerosis (MS) like symptoms such as numbness and tingling in the extremities. In January 1992 she received intravenous (IV) Rocephin for 3 months after which time she was hospitalized for three and one half weeks for a severely low white blood cell, neutrophil and platelet count. This was a side effect due to the drug treatment. She was given a challenge test to see if there was another antibiotic regimen she could tolerate. She was then given Primaxin via IV administration for approximately five and one half months. She developed antibiotic resistant bacteria (C. difficile) and was given Questran as treatment. She also developed dumping syndrome from the Primaxin. She developed nausea which was managed with Compasine administered both IV and as a suppository for one week. She was also given Minocin, Biaxin and Amoxycillin on and off until approximately June 1994. She often had to stop treatment due to the side effect of a very low white blood count. Despite the massive antibiotic treatment her symptoms did not improve. She would get a little better for a short time and then her symptoms would return. She also developed more symptoms during the years of antibiotic treatment including knee pain in both knees, left hip pain and debilitating neuropathy. Her doctor told her there was nothing else he could do for her. (Case Study conducted by Dr. Shari Lieberman)

7. The Spread There were 22,572 confirmed cases and 7,597 probable cases of Lyme disease were reported to the centers of Disease Control & Prevention in 2010 There are 20,000+ cases each year During 2008–2009, 31 confirmed cases and 52 presumptive cases were reported in Oregon. The median age was 42 years. Fifity one (60%) cases were female. Of the cases, 25% were reported in Deschutes, Jackson and Josephine counties.

8. Prevention & Treatment Prevention Know where to expect ticks Use repellent with DEET (N,N- diethyl-m-toluamide) Perform daily tick checks Remove ticks quickly Prevent ticks on animals Treatment Antibiotics such as doxycycline or Amoxicillin taken orally for 2-3 weeks Serious cases may require IV intake of antibiotics

9. Why Lyme Disease Lyme Disease is an important disease to study because it is so hard to diagnose Symptoms are that of the common flu that can be obtianed by all individuals or arthritis which is common in the elderly. Because of this it is very important that we study it so we can differentiate between Lyme Disease and many other diseases or infections.

10. References “Lyme Disease.” www.CDC.gov. Centers for Disease Control and Prevention. 14 June, 2013.Web. 8 July, 2013. Zeelman, David. “Arthritis and Lyme Disease.” www.WebMD.com. 1 Oct. 2012.Web. 9 July, 2013. “Summer Safety Tips.” www.co.marion.or.us. Marion County Oregon. 3 June, 2013.Web. 11 July, 2013. “Lyme Disease Transmission Research.” www.Niaid.gov. National Institute of Allergy and Infectious Diseases. 5 Dec. 2007.Web. 6 July, 2013 Joyce, Kaitlyn. “Borellia burgdorferi, the cause of Lyme Disease.” http://bioweb.uwlax.edu/bio203/s2007/joyce_kait/. 2007. Web. 12 July 2013http://bioweb.uwlax.edu/bio203/s2007/joyce_kait/