RETROSPECTIVE
History: Lyme disease Physicians in Europe have described symptoms associated with Lyme disease for over 100 years. Correctly speculated as transmitted by the bite of a tick in the early 1900s, treatments with antibiotics in the 1950s pointed to a bacterial pathogen. But it was not until 1976 that a misdiagnosis of juvenile rheumatoid arthritis first gave the disease its popular name.
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t was not until 1981 that the entomologist Willy Burgdorfer managed to isolate a spirochete bacterium, later named Borrelia burgdorferi (Bb) after him. Born and educated in Basel, Switzerland, Willy Burgdorfer was familiar with European medical publications. Burgdorfer, Jorge Benach and Edward Bosler examined black-legged (deer) ticks for pathogens. Finally, they observed a poorly stained, spiral-formed bacteria in tick body fluid, and then in patients with Lyme disease. These spirochetes proved to be the major diseasecausing agent of Lyme disease. Multiple linked symptoms
now known as Erythema migrans (EM). Subsequently, many other physicians observed EM associated with flu-like symptoms. Sometimes this was followed by arthritic joint pains, neurological problems, psychiatric symptoms, benign lymphocytomas and cardiac problems. Antibiotic clue In the 1920s French physicians Garin and Bujadoux postulated that various symptoms following a tick bite were caused by a spirochetal infection. Swedish dermatologist Carl Lennhoff observed spirochete structures in skin samples in 1948. This inspired experiments with penicillin in the 1950s, which showed success in treating these conditions. Confirming that
As early as 1883, a skin condition now associated with Lyme disease was first described by the physician Alfred Buchwald in Wroclaw, Poland (then Breslau, Germany). Later, Arvid Afzelius reported his work on a ring-like skin rash at a Swedish Society of Dermatology meeting in 1909. His published results implicated the bite of an Ixodes tick as being responsible for the circular rash
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PUBLIC HEALTH JOURNAL 20/2009
LYME DISEASE is named after a town in Connecticut.
Willy Burgdorfer
bacteria cause this disease, treatment today is based on a range of tetracycline or penicillin-derived antibiotics. Reaching the USA In 1970, Rudolph Scrimenti diagnosed the first case of EM in the US and based on European results, treated the tick-bitten patient with penicillin. Researchers in Connecticut identified clusters of an arthritic disease in 1975, including cases in the towns of Lyme and Old Lyme. This is why Allen Steere and colleagues called this condition “Lyme arthritis”. When US patients with Lyme arthritis were also discovered to have EM, this condition was recognized as being the same tick-borne disease found in Europe. Since 1976 the disease is usually called Lyme disease, Lyme borreliosis or just borreliosis. It is now the most common tick-borne disease of North America and Europe – and the number of cases and endemic regions are increasing. More www.lyme.org
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