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Local epidemiology and clinical manifestations of Lyme disease

Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans by the bite of infected black-legged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks (Figure ​(Figure1);1); laboratory testing is helpful in the later stages of disease. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics However, there is no acquired immunity after the recovery and there is no current useful vaccine available. In Italy the vaccine for Lyme disease was withdrawn in the 2002. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, landscaping, and integrated pest management. The ticks Ixodes ricinus that transmit Lyme disease can occasionally transmit other tick-borne diseases as well.