1. L YMES D ISEASE symptomology

2. C ONTRACTING L YMES D ISEASE The bite of an infected nymph or adult tick can only transmit Lyme disease after it attaches to the host for 36 – 48 hours the generation time of bacteria Borrelia Burgdorferi: ~ 12 hours Spirochetes waiting in the mid-gut of the tick begin to multiply as the tick starts its blood meal then migrate to the salivary glands where they are discharged into the host with the tick's saliva. It takes several hours before a large enough infectious dose of spirochetes can penetrate the new host.

3. L YMES D ISEASE

4. S YMPTOMOLOGY OF L YMES D ISEASE Lyme is a multisystem inflammatory disease affects the skin in the early stage and then spreads to the joints, nervous system and may eventually affect the organ systems. The symptoms are divided into three stages, each stage being more advanced than the previous.

5. S YMPTOMOLOGY Stage 1 – Early localized infection Skin Rash Around Tick Bite 40 -75% present with rash Mild Illness Flu-like Symptoms Fevers Chills Swollen Lymph Nodes Headache Stiff Neck Muscle Fatigue Initial sign and symptoms of Lyme disease include an appearance of a rash, which has the appearance of being solid red or bull’s eye rash with flu like symptoms. These symptoms may appear up to a month after infection.

6. S YMPTOMOLOGY Stage 2 – Early Disseminated Infection Neurological Problems Meningitis Encephalitis Within weeks of stage one symptoms, the bacterium may spread to other parts of the body through the bloodstream. infected individuals may start having acute neurological problems such as Bell's Palsy. *15% of untreated patients progress to this stage. Meningitis, as well as mild Encephalitis is common at this stage, leading to memory loss, sleep disturbances, or changes in mood or affect.

7. S YMPTOMOLOGY Stage 3 – Late Persistent Infection Polyneuropathy Pain and Numbness Cognitive Impairment Arthritis Acrodermatitis chronica atrophicans (primarily in Europe) The third and the most severe stage may occur months to years after initial infection. Symptoms at this stage are primarily rheumatologic and neurologic, and mostly untreatable. R ESOURCES : HTTP :// WWW. NATURE. COM / NRMICRO / JOURNAL / V 3/ N 2/ FULL / NRMICRO 1086. HTML