Lyme Disease: The Basics

What is Lyme Disease? | Transmission of Lyme | Symptoms of Lyme | Naming evolution

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Lyme disease patients in Australia, including those with a suspected Lyme or other tick-borne infection, should be aware that the Australian Government’s perspective and guidelines on Lyme differ from those of the Lyme Disease Association of Australia (LDAA), and other governments and authorities internationally. While we touch on the Australian Government’s approach throughout this site, you can read a full explanation about the Lyme disease situation in Australia on the Australian Lyme page.

What is Lyme disease?

Lyme disease is a bacterial infection caused by a spiral-shaped bacterium (spirochete), Borrelia burgdorferi (Bb). Lyme disease is also known as Lyme Borreliosis or simply Borreliosis.

There are roughly two dozen species in the Borrelia burgdorferi “sensu lato complex” (which means in the broadest sense). Not all are human pathogens. 

Spirochetes (spy-ro-keets) are high-functioning and invasive pathogens. They are often relapsing in nature, difficult to detect, and are great imitators of other diseases. Syphilis, Relapsing Fever and Leptospirosis are other examples of spirochetal diseases.

Acute Lyme disease symptoms include (but are not limited to) a rash, joint pain and headaches. Arthritic pain, cognitive difficulties, fatigue and other debilitating symptoms characterise Late stage or Chronic Lyme disease. Lyme, early or late, has a profound effect on a patient’s life.

If treated early, some patients might not experience ongoing symptoms. Lyme disease often becomes chronic, and this is a multi-systemic, debilitating illness that affects the immune system and physical condition. Lyme can affect every tissue and organ in the body.

Lyme disease is poorly understood, complex and and viewed in some quarters as controversial – despite significant published research demonstrating otherwise.

Watch this 50 second video explaining Lyme disease.

“I take a broad view of what Lyme disease actually is. Traditionally, Lyme is defined as an infectious illness caused by the spirochete, Borrelia burgdorferi (Bb). While this is certainly technically correct, clinically the illness often is much more than that…

I think of Lyme as the illness that results from the bite of an infected tick. This includes infection not only with B. burgdorferi, but the many co-infections that may also result.”

Dr Joseph Burrascano, International Lyme and Associated Diseases Society (ILADS) 2008

Lyme locations (endemicity)

According to the European Centre for Disease Control and Prevention, Lyme disease is currently endemic in North America, parts of Europe and Northern Asia.

However, infections of Lyme disease have been reported in many other countries, including Australia.

For detailed information on Lyme disease locations read:
Where in the world is Lyme disease? [PDF 810KB]

Transmission of Lyme

Humans usually contract Borrelia via the bite of an infected Ixodes tick, and the tick contracts the infection from another host species.

Most Lyme patients contract other tick-borne diseases (co-infections) because ticks can transmit multiple pathogens (infections, e.g. bacteria and viruses) via a single bite.

Borrelia can be transmitted via other methods, preliminary scientific studies suggest. These include:

• other vectors (e.g. insects – mosquitoes, midges and others)
• human body fluids
• placental transfer and breast milk.

Currently, the Australian Government does not recognise these other transmission methods of Lyme disease.

Symptoms of Lyme

The International Lyme and Associated Diseases Society (ILADS) lists the following common Lyme disease symptoms and signs.

Common symptoms of early Lyme disease (and some co-infections) include:

• Erythema Migrans rash (EM) or other kind of rash
• Fatigue, malaise
• Flu-like symptoms, including fever, headache, arthralgias (joint pain), myalgias (muscle aches)
• Stiff neck
• Dysesthesia (painful burning, prickling, or aching feeling)
• Lymphadenopathy (lymph nodes abnormal in size or consistency)
• Facial nerve dysfunction leading to weakness or paralysis of facial muscles (often mislabeled as Bell’s palsy).

Either a solid, spreading rash, resembling a bacterial infection/cellulitis or spider bite, or a bullseye rash is present in approximately 50 percent of those with Lyme disease. Sometimes there is no rash at all.

LEFT: The bullseye rash, Erythema Migrans (EM) is a “classic” sign of Lyme but only occurs in 20-25 percent of patients. (Dr Richard Horowitz)

Common symptoms of late stage or chronic Lyme include:

• Fatigue
• Multiple red rashes
• Severe headaches and neck stiffness
• Joint swelling and/or pain
• Neuropathic symptoms – nerve pain, numbness, hot/cold sensations, tingling
• Cognitive dysfunction
• Memory impairment
• Unprovoked pain which may interfere with sleep
• Palpitations or chest pain, shortness of breath
• Light-headedness, fainting
• Gastrointestinal symptoms
• Psychiatric symptoms- including depression, anxiety, and mood changes.

Lyme disease patients almost always have co-infections and other pathogens besides Borrelia and may experience the reactivation of latent viruses (e.g. Epstein Barr virus) and will commonly have parasitic and fungal infections as well. Rickettsia, Bartonella and Babesia are common tick-borne co-infections.

The overall ‘symptom complex’ may include: immune dysfunction; inflammation; environmental toxicity; allergies; nutritional and enzyme deficiencies, with functional medicine abnormalities in biochemical pathways; mitochondrial dysfunction; neuropsychological issues, autonomic nervous system dysfunction, endocrine abnormalities, sleep disorders; gastrointestinal abnormalities, with abnormal liver functions; and issues with pain, drug use and physical deconditioning.

Dr Richard Horowitz

Symptoms (by Dr. Richard Horowitz):

Fatique, tiredness, unexplained fevers, sweats, chills or flushing, unexplained weight change, either loss or gain, unexplained hair loss, swollen glands, sore throat, testicular pain (men), pelvic pain (women), unexplained menstrual irregularity, unexplained milk production, breast pain, irritable bladder or bladder dysfunction, sexual dysfunction or loss of libido, upset stomach, change in bowel function (constipation or diarrhea), chest pain or rib soreness, shortness of breath, cough, heart palpitations, pulse skips, heart block, any history of a heart murmur or valve prolapse, joint pain or swelling, stiffness of joints, neck or back, muscle pain or cramps, twitching of the face or other muscles, headaches, neck cracks, neck stiffness, tingling numbness, burning or stabbing sensations, facial paralysis (Bell´s palsy), double, blurry or floaters of the eyes/vision, buzzing, ringing of the ears/hearing, ear pain, increased motion sickness, vertigo, light-headedness, wooziness, poor balance, difficulty walking, tremor, confusion, difficulty thinking, difficulty with concentration or reading, forgetfulness, poor short-term memory, disorientation: getting lost, going to wrong places, difficulty with speech or writing, mood swings, irritability, depression, disturbed sleep: too much or too little sleep or early awakening, disturbed sleep: too much or too little sleep or early awakening (continued), exaggerated symptoms or worse hangover from alcohol.

Naming evolution

In 1977, an unusual outbreak of illness occurred in the American town of Lyme, Connecticut. Thought to be a form of juvenile arthritis, it was given the name “Lyme arthritis”.

Investigation revealed the illness to be more complicated. It included “a combination of cardiac, neurologic and rheumatologic presentations, including heart block, meningitis and Bell’s palsy.” The more general name of Lyme disease replaced Lyme arthritis because of this. The cause of the illness was then unknown.

Borrelia was discovered as the cause of Lyme disease in 1982 so the name was further refined to Lyme Borreliosis.

Some doctors began to use ‘Lyme disease’ as an overarching term that included co-infections. The International Lyme and Associated Diseases Society (ILADS) members agreed to extend the definition of Lyme disease to include co-infections.

In 2018 the Australian Department of Health named Chronic Lyme disease (contracted in Australia), which they consider to be a mystery illness, “Debilitating Symptom Complexes Attributed To Ticks (DSCATT)”. They had previously referred to it as “Lyme-like illness”.

However, DSCATT is not considered to be a diagnosis. (See also Australian Lyme).

The Lyme Disease Association of Australia (LDAA) uses the terms Australian Lyme or Lyme disease for the Lyme and co-infection complex, depending where it was contracted.

See also: Lyme Co-infections

You may also be interested in Lyme-Ed for Patients.

Copyright Lyme Disease Association of Australia