Dr. Harriet Kotsoris, chief scientific officer with Global Lyme Alliance, discusses Lyme disease treatment, prevention, and transmission.
Below is an excerpt from, “Lyme Disease: An Overview”, a podcast with Dr. Kotsoris and Dr. Mayla Hsu, science officer with GLA. Listen to the entire podcast below.
Host: Is Lyme disease treatable? What are some of the common treatments?
Dr. Kotsoris: Lyme disease is what we’d call treatable, the question in everybody’s mind is “Is it completely curable?” In the acute stages, the school of thought is that it is curable with prompt adequate treatment with 3-4 weeks of Doxycycline or Amoxicillin. The longer a person walks around with the disease undetected and untreated the more difficult it is to eradicate. That’s because the Borrelia burgdorferi organism is fleeting in the bloodstream and quickly hides and travels to other organs of the body including the muscles, joints, heart, brain, mostly connective tissue.
It is felt that even in the face of antibiotics these Borrelia burgdorferi bacteria may actually become tolerant, not resistant, but tolerant. That means that they go dormant and hide in the tissues only to reactivate at a later date when the body is put under some type of stress. Again, these issues are quite controversial and this is because many feel that although the bacteria may be viable in the body they’re not culturable. In other words, we cannot prove that there are still living bacteria in these patients with post-treatment Lyme disease syndrome. We’re just hopeful that one day we’ll have better detection methods, both early and late to distinguish acute cases in a prompt fashion, which will then lead to a higher success rate of treatment. Also markers for chronic phase of the illness or post-treatment, or post-infectious Lyme disease, to show whether or not there still are viable bacteria left in this patients body.
Host: How is Lyme disease transmitted?
Dr. Kotsoris: Lyme disease is transmitted by a vector, that is an agent that will a pathogen or disease-producing organism from itself to a host. In the instance of Lyme disease, the human is an accidental dead-end host. In the United States as I mentioned before, the disease is transmitted by the blacklegged tick. The tick crawls around, attaches to a nice warm moist area of the human body and then bites the host, and in doing so transmits the bacterium from the tick belly into the bloodstream of the human being. Dr. Hsu will elaborate more as to the adaptations that are required for this to be a successful event.
Host: What are some adaptations that ticks have that allow them to so successfully transmit Lyme disease?
Dr. Hsu: The tick genome was actually just sequenced this past year, 2016. It revealed all sorts of interesting information about why ticks have evolved to be so successful at transmitting Lyme disease. It turns out that ticks have very efficient olfaction, or smell detectors on their sensory organs. They are able to, as Harriet said, crawl around and look for parts of our body that are damp and hidden, and that they can hide. They attach once they’ve found this good spot, like your belly button or between your toes. They have barbed mouth parts, so they efficiently saw through the skin and they and they attach.
Once they’re attached they can’t detach very easily owing to this barbed penetrating mouth part. Once they start feeding, their saliva is like this very incredible chemical soup that has all kinds of components in it that facilitate disease transmission, but it also where’s it’s supposed to facilitate feeding by the ticks. It has an anesthesia so you cannot feel it. They have also in their saliva a blood thinner, so your blood flows better, blood vessel dilators so you bleed better. The tick itself stays attached for up to 36 hours while it’s feeding on you, and its body size can actually increase by 100 times.
Host: How could you protect yourself from Lyme disease?
Dr. Hsu: I think there are, as Harriet said, it all hinges on that tick bite. There are low-tech protection that you can have, which is just simply to avoid tick bite in the first place, tucking your pants into your boots, wearing bug sprays that contain DEET, which repel ticks, checking yourself for ticks and removing them immediately. Another strategy is to wash our clothes in Picaridin or Permethrin, and these are chemicals that will repel ticks and other mites, bugs from biting us. It’s interesting to note that the Armed Forces are now doing this with their clothes to protect our military.
Host: What are some adaptations that have made the Lyme disease bacterium so successful?
Dr. Kotsoris: Borrelia burgdorferi is quite an intelligent bacterium. Initially, when it first enters the bloodstream it … Actually, because of its shape, the corkscrew shape can penetrate into tissues like a roto-rooter machine. Likewise, the outer surface of Borrelia burgdorferi has a whole host of fatty substances and proteinaceous substances. These proteinaceous substances vary from strain to strain, and so it’s incredibly difficult for the immune system to be able to combat Borrelia burgdorferi effectively. In fact, Borrelia burgdorferi has adapted many mechanisms and actually hijack the immune system that cause certain antibody-producing cells not to operate effectively, so that the bacterium cannot be coated by antibodies and then can’t be mopped up by other immune-related cells in your body.
Listen to entire podcast below:
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