Lyme borreliosis, or Lyme disease, is an infectious disease caused by a bacterium from the Borrelia burgdorferi sensu lato complex, transmitted to humans by bites from infected ticks (Ixodes ricinus). To determine if one might have Lyme disease, it’s essential to consider possible exposure to ticks. Ticks primarily live in wooded and humid areas such as forests, leaf litter, underbrush, as well as meadows and parks.

The symptoms of Lyme disease can vary from person to person. Here is a non-exhaustive list of the main symptoms:

– Chronic fatigue
– Headaches
– Muscle and/or joint pain
– Muscle spasms
– Memory loss
– Inability to think clearly, feeling like being in a fog
– Numbness or tingling in the hands or feet
– Hyperacusis (increased sensitivity to sound)
– Vision problems
– Heart palpitations
– Chills
– Digestive disorders…

Serology is currently the most commonly used technique for detecting Lyme disease. Its goal is to search for specific anti-Borrelia antibodies in the blood. If the serology is positive, it indicates that the patient has indeed encountered Borrelia – without necessarily meaning that the patient has Lyme disease. Before arriving at the diagnosis, the individual might exhibit symptoms of depression or burnout and develop other unexplained pathologies. It is often through medical wandering that the suspicion of Lyme disease leads to serology. The serology process consists of two steps:

1. An ELISA test: If the test is positive or doubtful, the diagnosis can be confirmed by the Western Blot test.
2. A Western Blot test: This test searches for an antibody reaction called immunoblotting. For more severe cases, where Lyme disease is suspected due to joint pain and/or neurological symptoms, PCR tests will be prescribed to detect Borrelia DNA.

According to a group of researchers in an article published in 2018 in the Weekly Epidemiological Bulletin (BEH) titled “Biological Diagnosis of Lyme Borreliosis,” performing blood serological tests is essential for accurate diagnosis.

Lyme disease is prevalent in regions where Ixodes ticks are found, especially in humid and wooded areas below 1,500 meters in altitude, typically inhabited by wild boars, deer, and roe deer. In Europe, the risk is higher during the tick activity period from May to October. However, recent mild winters have allowed ticks to remain active almost all winter. To protect yourself, it is advisable to:

– Wear clothing that covers the arms, legs, and neck and use a repellent (essential oil compositions are now available for sale).
– Spray your clothes and shoes with anti-tick products (while respecting contraindications for children and pregnant women).
– Avoid contact with grass, brush, and low branches.
– Stick to trails and walk in the middle of paths whenever possible.
– Carefully inspect your skin for ticks at the end of the day or during breaks. Transmission of bacteria through tick bites requires at least four to six hours of tick attachment.

Removing the tick should be done as quickly as possible:

– Use a tick remover bought from a pharmacy.
– Disinfect and monitor the bite area for several weeks, as the longer an infected tick remains attached, the higher the risk of disease transmission.
– Consult your primary care physician even if no red rash appears centered on the bite point (which may spread within a month after the bite).
– Contact one of the tick-borne disease competency centers (CCMVT).

What not to do (risk of regurgitation of infectious agents):

– Do not press the tick between your fingers to avoid facilitating the passage of tick saliva containing infectious agents.
– Do not pull on the tick or use tweezers. Besides the risk mentioned above, there’s a high chance of “leaving the head” in the skin, which generally causes a small inflammation, infection, or the formation of a cyst.
– Do not use alcohol, ether, oil, or nail polish.
– Never try to burn the tick with a lighter.

The symptoms of Lyme borreliosis depend on the stage of the disease. According to Santé Publique France (2022), three stages are usually distinguished:

1. Early Localized Lyme Borreliosis
This occurs 3 to 30 days after the tick bite and is characterized by a typical skin manifestation called erythema migrans.

2. Early Disseminated Lyme Borreliosis
This occurs several days to several weeks after the tick bite and can present symptomatically as:

– Multiple erythema migrans
– Neurological manifestations (facial paralysis, isolated meningitis, acute myelitis)
– Less commonly, joint manifestations (arthritis with swelling of a large joint like the knee), skin, cardiac, or ophthalmic symptoms

3. Late Disseminated Lyme Borreliosis
This occurs several months or even years after the tick bite and is characterized by:

– Joint manifestations
– Skin manifestations (chronic atrophic acrodermatitis)
– Rare specific neurological manifestations (encephalomyelitis)

The clinical manifestations of Lyme borreliosis in the early and late disseminated stages only appear in the absence of antibiotic treatment, particularly when early localized Lyme borreliosis has gone unnoticed. This is referred to as chronic Lyme.

Lyme disease is initially treated with antibiotics. The therapeutic approach (choice of antibiotic, dosage, duration of treatment) depends on the patient’s age and the present symptoms, highlighting the importance of a thorough physical examination, including a neurological assessment. However, conventional medical treatment, which relies on antibiotics, does not always relieve patients and their pain. Medical wandering often leads patients to explore alternative solutions and natural remedies.

Antibiotic treatment can cure Lyme borreliosis when detected early (3 to 30 days after the bite). A late diagnosis of the infection requires more comprehensive care, including other treatments in rheumatology, neurology, or psychiatry. In a statement on July 24, 2023, the French Agency for Food, Environmental and Occupational Health & Safety (ANSES) provided hope to many Lyme disease patients by announcing that a vaccine is currently being tested.

In some treated patients, an exacerbation of symptoms is observed, resulting from an inflammatory reaction caused by the lysis of a large number of bacteria. These reactions are known as the Jarisch-Herxheimer reaction. Clinical manifestations include the onset of fever, chills, headache, and muscle aches. These reactions begin within 24 to 48 hours after starting antibiotic therapy and resolve spontaneously. They result from the toxins released by the bacteria as they are attacked by the antibiotics. Despite the pain that may result, it is crucial not to stop the treatment and to consult a healthcare professional if needed.