Lyme disease is a common vector borne disease. Rebman et., al (2017) observes that cases of the disease is in increase and the areas that cause it are also increasing. Lyme disease is caused by Borrelia burgdorferi. The transmission of the disease occur rapidly through a bite of an infected tick. Even though without treatment the infecting pathogen remains in the body, when the disease is diagnosed and the appropriate care given in the acute stages, the patients fully recover. Doxycycline is often the preferred for oral treatment because of its activity against other tick-borne illnesses. Rebman et., al further point out that preventive measures include avoiding areas with high tick burdens, wearing protective clothing, using tick repellants, performing frequent body checks and bathing following outdoor activities (2017). The purpose of this journal is to describe the symptoms of the disease, the diagnostic tests which appropriate, possible treatment and strategies for preventing and controlling spread the disease which nurses can share with the patients.
Body
Lyme disease is caused by spirochetal microorganism B. burgdoferi and transmitted by ticks (Rebman et., al 2017). The nymphs and adults of ticks can transmit the organism. The nymphs are most active during the late springs and summers and that is when infection occurs most though there are cases of infection throughout the year. After the transmission the tick attaches itself, it feeds and becomes more engorged, discharging its saliva into the wound. For this reason the transmission of B burgdorferi requires between 36 to 48 hours of attachment. Lyme disease occur at any age and in both sexes though the males are at more risk of infection. In patients with more severe symptoms that those seen with B burgdorferi alone show a high grade fever lasting more than 48 hours, leucopenia and anemia which show coinfection with another pathogen.
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Ideally, the symptoms of Lyme disease are shown after two weeks. Patton & Phillips, (2018) point out that the common symptoms of Lyme disease include: development of erythema migrans rush on the skin, back or abdomen by patient. Other symptoms include malaise, fatigue, lesions, fever, chills and myalgia. Patients treated at this stage usually fully recover. After this stage the bacteria disseminate into the blood. Maloney, (2017) asserts that if untreated, the Lyme disease rash resolves spontaneously within four weeks and the most common sites of extracutenuos involvement include the joints, cardiovascular system and the nervous system. Late Lyme disease dissemination to extracuteneous sites may be prevented using oral antibiotic treatment at the acute stages (Patton & Phillips, 2018). Most patients diagnose with this disease develop arthritis. Lyme arthritis show between weeks to years after the onset of the infection. Lyme arthritis is associated with pain and swelling in one of the large joints (knee), facial nerve palsy atrioventricular block and cardiac complications.
According to Patton & Phillips, (2018), the diagnosis of Lyme disease involves two method, the direct and indirect method. Direct method involves techniques that detect B. burgdorferi specific nucleic acid or proteins, which show whether the patient is infected or not. Indirect method involves testing the serum to detect antibodies. Obtaining the serologic test at the time of the tick bite does not help since there is positive relation between the infection and the duration taken before the test (Patton & Phillips, 2018) . If the infection has persisted for weeks then the result is usually positive with the immunoblot. Patients with Lyme arthritis have the biggest sensitivity for Lyme disease. Testing for cerebrospinal fluid is best for them. Though their Lyme urine may sometimes give high false positive results.
Patton & Phillips, (2018) note that L yme disease is treated by the clinical manifestations of the disease. In the early stages when the disease is localised, oral regimes of antibiotic therapy can well treat the and hence destroy the vector. Patients who remain with the symptom for months can still use the antibiotics though its prolonged use is discouraged by specialists who cite lack of biologic evidence for the existence of B. burgdorferi among patients after receiving the recommended treatment. Intravenous regimes are given to patient with symptoms of neurology, refractory arthritis and in cases of symptomatic cardiac disease. Experts recommend doxycycline for oral treatment because it acts against other diseases brought by ticks which occur in up to ten percent of patients Lyme disease.
According to Maloney, (2016) prevention is an important part of management of the Lyme disease particularly for those in areas of high risk. The best preventive measure is avoiding areas with high tick burdens. For those living in highly infested areas wearing light protective clothing is the best preventive measure. Using tick repellents, performing frequent body checks, bating after outdoor activities and modifying environmental landscape to reduce the tick burden are other preventive measures. Removal of ticks before 36 hours can also help prevent the disease since the disease cannot be transmitted before that time. This is because engorged ticks or ticks that have been presumed to be attached for 36 hours or longer, a dose of doxycycline is recommended for adults if it can be given within 72 hours of tick removal and there is at least a 20 percent rate of tick infection with B. burgdorferi in the area ( Rebman et., al 2017) . Children eight years or older also may be given a single dose of doxycycline can help.
Conclusion
In conclusion, if the Lyme disease is diagnosed early enough and treated well then the outcome will be better (Cox & Mungall, 2017) . Therefore whenever anyone is bitten by a tick they should rush to the nearby healthcare to get medical attention. If the above signs and symptoms of the disease ate sited with anyone they should be rushed to the hospital to get medical care.The increasing risk of exposure to Lyme disease ensures the need to educate the patients to prevent the disease and other tick borne diseases. A safe vaccine and effective one will ensure it prevention. Education on how to identify the tick, the symptoms of the disease, the diagnostic tests and the advantages and disadvantages of the recommended treatment regimens is vital in providing quality patient care (Cox & Mungall, (2017) .
References
Cox, J., & Mungall, I. (2017). Rural healthcare . CRC Press.
Maloney, E. L. (2016). Controversies in Persistent (Chronic) Lyme Disease. Journal of Infusion Nursing , 39 (6), 369.
Patton, S. K., & Phillips, B. (2018). CE: Lyme Disease Diagnosis, Treatment, and Prevention. AJN The American Journal of Nursing , 118 (4), 38-45.
Rebman, A. W., Aucott, J. N., Weinstein, E. R., Bechtold, K. T., Smith, K. C., & Leonard, L. (2017). Living in limbo: contested narratives of patients with chronic symptoms following Lyme Disease. Qualitative health research , 27 (4), 534-546.
