Lyme Disease Case Study

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Case Study C
Maggie Moon
University of Maryland University College

When the climate begins to change and temperatures drop, we know winter is soon to follow bringing an involuntary time for inside captivity, but once the temperatures become warm again, people emerge from their winter slumber to enjoy the great outdoors. Unfortunately, there is a tiny and dangerous insect that likes to come out and enjoy the warmer weather too-- ticks. In the early 1970’s, strange cases of adolescent rheumatoid arthritis began occurring in children in Lyme, Connecticut. Dr. Allen Steere and his colleagues began deciphering the possible causes, paying close attention to where the children lived, played and when symptoms first began appearing (Understanding Lyme disease). Their findings suggested that the epidemiology of the possible cause for the disease was transmitted by an arthropod vector, the deer tick (Ixodes scapularis), primarily based on the tick’s regional location and seasonal appearances of onset symptoms. Physicians were informed of the signs and symptoms, (the most common one being a weird, spreading red rash or Erythema Migrans) of this new found disease, called Lyme disease (Understanding Lyme disease); although, it wasn’t until the early 1980’s that scientist Willy Burgdofer identified the etiological causative agent of the disease. He found that the infected ticks were carriers of the spirochetes class of genus Borrelia. Burgdofer took immune serum from patients with Lyme disease which showed the reaction of the spirochetes. Later, the bacterium was given the name Borrelia burgdorferi after its discoverer (Understanding Lyme disease). Lyme disease is now one of the most rampant reported tick-borne illnesses in the United States, with most cases occurring in costal and riparian regions. According to the CDC, it was the 6th most prevalent Nationally Notifiable Disease in 2013 (CDC: Lyme disease).
Borrelia burgdoferi is not identified as either Gram-positive or Gram-negative. When Gram-stained and put under the microscope, cells stain noticeably weak or inconclusive solely due to safrin being the last dye used. B. Burgdoferi has an outer and inner membrane, and a periplasmic area that consists of a layer of peptidoglycan (a polymer of sugar and amino acids that is the outer structure of a mesh-like plasma membrane of bacteria, composing its cell wall). Eubacterial phylum Spirochetes is the causative agent of Lyme disease (Borrelia burgdorferi and Lyme disease). This group of entities shares a distinct morphology, endoflagella. Rather than descending into its environment, endoflagella spirals securely around the cell of spirochetes forming an axial filament that enables a “corkscrew” like movement through the cells medium. Because of their morphology and motility, spirochetes can easily adapt and travel through heinous settings, such as “aquatic sediments, biofilms, mucosal tissues and the intestinal tracts of animals” (Borrelia burgdorferi and Lyme disease). This cripples other bacterial species by allowing the flagella of pathogenic spirochetes to hide from its host immune defenses and penetrate its tissues. The difference between free-living bacteria and B. burgdorferi is that it’s an “obligate parasite,” meaning it lacks the mechanisms for “synthesizing nucleotides, amino acids, fatty acids, and enzyme cofactors” (Biology of Infection with Borrelia burgdorferi). Ticks go through a four-phase lifecycle (egg, larvae, nymph, and adult); Lyme disease is transmitted to humans by a bite during the nymph phase. Because nymph ticks are so minuscule, they are rarely noticeable on a person’s body, thus having a copious amount of time to feed and spread the infection. The bacterium resides in the tick’s mid-gut and can pass from host-to-host if the tick is to feed again (Borrelia Burgdorferi: Pathogen Life Cycle). Ticks typically attach themselves in hidden or hairy areas of the body like the groin, armpits and scalp; they have to
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