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The Lyme Boom

Up to 50,000 people a year fall ill from Lyme disease. While the therapy is well established in the early stages, a divorce in return for more recent infections of the ways.

"deathly ill," according to "image" of the bank robbers and racketeers Thomas Wolf. Last year was "Germany's most wanted criminals" as an encore to his sins also kidnapped a banker's wife and was then immersed with 1.8 million euro ransom. During his flight, Wolf hid for weeks in the woods, where he also buried parts of its prey. Only by referring to his ex-girlfriend he was finally arrested. In the next few days is now at the Regional Court of Wiesbaden begin the process. But Wolf's attorney reports that his client is seriously ill and was not fit to stand trial: cardiac rhythm disturbances, nerve paralysis and skin discoloration make him create. Even before the police, the result of the medical examination, should have been taken by Wolf a Lyme infected tick.
had a similar experience in February, the Hollywood star Ben Stiller, in which the infection caused an arthritis-thrust. "My knee swelled up, was very stiff and hurt like hell," the actor said. As there was no better, ordered his doctor to laboratory tests and met with the explanation: The Lyme test was positive, and the comedian was prescribed antibiotics. Send to a tick bite could not remember Stiller. But still: from the knee swelled.
was less lucky the Vienna master plumber Robert Wessely. With him it was the eye doctor, who ordered after a recurring conjunctivitis a Lyme disease test. "It does not come from outside, that comes from within," she told her patient. Wessely was then hospitalized for two weeks and subjected to antibiotic Intesivkur. But the treatment was of little use. The Borrelia fought his heart and has since suffered from chronic Wessely arrhythmias and heart failure.
Wessely can - do not remember a tick bite - as 40 percent of Lyme victims. The characteristic eye rash that radiates concentrically of the sticking point was made, with him not to. In contrast to
Pharmacist Maria Theresia of Neulengbach Aigner (Austria). She found a tick in July in the act in her knee and removed them with tweezers. When she had almost forgotten the tick bite already appeared - three weeks later - the ever-growing circle.

Lyme disease is booming and spreading - not least because of global warming - is increasing. Wherever it is not too cold or too dry to get below an altitude of about 1300 meters from ticks. And the French GP after Amédée Borrel named bacteria are their most prominent and most feared of freight. Studies in the intestine of the spiders were counted parasites that - depending on the region - between two and 50 percent of the ticks harbor Borrelia, in Austria, the national average of 22 percent.
The close relatives of syphilis have been during the evolution perfectly to the ticks. You are their most important proliferation helper. "Approximately one in four tick transmits the Lyme disease blood eyes," the immunologist Gerold Stanek explained by the Institute of Hygiene, Medical University of Vienna. Each year adds to the approximately 50,000 cases of disease. "All of Austria is concerned, the east a little stronger." TBE as much better known tick disease, it brought in 2009 on relatively modest 79 cases of illness.

Disease What so special is its indeterminacy. While the eye rash as a definitive sign of a disease at an early stage is, and a therapy here - without any antibody test - makes sense, no doubt Lyme disease expert. But already in the second phase will begin on uncertainties. That disease can cause severe diseases is known, but based on the U.S., this diagnosis is increasingly becoming a statement for a whole myriad of vague symptoms become. Of weakness and chronic fatigue, depression, chronic pain for undetermined lot of Lyme disease is attributed. A positive test is considered by many physicians to secure the diagnosis to be considered. But if the subsequent antibiotic therapy does not bring relief, is the hangover large and curious term consequences. In the United States complained about the health support groups to finance lifelong antibiotic therapy. How little
The issue is a positive Lyme disease test, impressively, one study conducted by Gerold Stanek using the burgendländischen Landesjagdverband. For more than a thousand hunters the blood were examined for antibodies to Borrelia. The result was an almost linear function of age: 50-year-old Hunter had a 50 percent chance of a positive test, among the 70-year 70 percent had antibodies to Borrelia. "We had very few hunters who reported any health problems," says Stanek. The symptoms of advanced Lyme disease

physicians are well known. Such as the characteristic rash especially in older women, bright red swollen earlobes and nipples, mysteriously from one joint to another "jumping" or inflammation of facial paralysis. The fact that such different symptoms are a common cause, but we know only recently. Around the town of Lyme in Connecticut as it was in the second half of the Seventies years to come an extraordinary accumulation of arthritis in children. Several years examined a "Task Force" all possible causes, finally fell to the suspicion of the ticks. The bacteriologist Willy Burgdorfer isolated in 1982 from the gut finally the spirochetes and Allen Steere, rheumatologist nearby Yale University showed that these thick on the knees of children in Lyme were to blame.
relatively quickly developed a vaccine against Lyme disease and 1999 registered in the U.S.. Because the dominant species in the U.S. "Borrelia burgdorferi" in Europe is quite rare, work began on a wider European vaccine effective. But then published Steere a work in which he expressed the suspicion that the vaccine could trigger autoimmune disorders. As a result, the market collapsed and the manufacturer, GlaxoSmithKline took the product off the market in 2002. Just as dogs vaccine a system based on the same principle product is still available - even in Europe.
work now several companies, including two Austrian companies are hard on a comeback of the Lyme disease vaccine. Analysts certify their enormous market potential.

However, in case of research about the disease no specific commitment to determine. "There are an incredible number of questions open," says Grazer Elisabeth Aberer dermatologist. Ticks and the German expert Dieter Hassler stated lack of interest in the pharmaceutical industry: "This is probably because most of the antibiotics that the disease is treated, long-patent are available.

Hassler caused a stir recently with the thesis that the human immune system will never cope with a Lyme infection. In a person over 20 years by survey he was drawing from each of the 4,000 citizens of his home town in Baden-Württemberg Kraichtal blood and examine the samples had antibodies to Lyme disease. At 16.7 percent of the test was positive. "And by after eight years at each tested positive were also symptoms of the disease. "Hassler treated it back long past cases as a rule with high-dose antibiotic regimens.
For Gerold Stanek is not traceable. "Lyme disease is still predominantly a self-limiting disease, the antibodies are an expression of their own defense," says Stanek. "If the vote would be that the organism is never finished with the bacteria, would have half the population suffer from Lyme disease." Also, a preventive treatment after a tick bite, as recommended in the U.S., in part, rejects Stanek. "We would avoid three cases of eye rash, But while 97 percent of people treated unnecessarily. "If the rash occurs, it is still early enough to start treatment.

But again, opinions differ widely. When asked Maria Theresia Aigner with their fresh Lyme disease from several doctors for advice, her confusion grew with each additional advice received opinion: "I have been called by all physicians different preparations of the antibiotics and I was to take long as 50 days."
For Stanek guidelines is not compliant. "Comparative studies have clearly shown that the short-term treatment with a duration of ten to fourteen days of the long-term Therpie absolutely equal." When antibiotics were taken unnecessarily too long, causing injury to own only the intestinal flora unnecessary and also contributes to the development of resistance. Positive news, however it is
for those people who respond to tick bites with a particularly intense and prolonged itching. "The stronger the itching, the lower the risk of infection with Lyme disease," says Elisabeth Aberer, summarizing the outcome of a recent study. "The tick bite with these people seems to make a local inflammation, which activates the immune system so strong that it prevents transmission of the Borrelia consistently."


"The Diagnosis is booming, "

The Graz disease expert Elisabeth Aberer warns that a positive test can easily lead to a wrong track.

profile: If the disease is actually a normal condition?

Aberer: No, it is very difficult to diagnose. Symptoms such as chronic fatigue, pain, tension can just come from a flu or a burn-out. But then determine if the person leaves and the antibodies that are positive, then it says "you have Lyme disease. But this is absolutely no evidence, because a very high proportion the population without any medical disease antibody is positive.

Profile: How high is the proportion of the population that would respond positively to a Lyme test - thus have endured ever had an infection?

But: In healthy blood donors are positive about 10 percent, forestry workers and orienteers to get to 30 percent. With age, the prevalence is increasing. In a Burgenland study showed that fifty-year hunters are measured positive to about 50 percent and seventy year-old hunter to 70 percent. Of these, hardly anyone has had complaints.

profile: Many doctors prescribe antibiotics for safety.

But I think this is very risky. If no disease activity is, no antibiotics should be given. For these drugs there is always the risk of an allergic reaction and other side effects. The most common is diarrhea, but it is also changes in blood count or problems with the liver.

profile: Is Lyme disease in recent years become more frequent or it is now merely a contemporary?

Aberer: That the diagnosis is booming, one can say. Almost every doctor is trying to determine antibody when describing the specific patient complaints. It is simply much too often studied. The positive test results often on the wrong track. The clear clinical pictures, such as neuroborreliosis or Lyme arthritis-specific are very clearly defined. At rest, there is a huge gray area.

profile: The most reliable evidence of Lyme infection is the eye rash that spreads concentrically from the puncture site of the tick.

But yes, it occurs in the period of four to 20 days after the bite of an infected tick. If antibiotics are given here in time, the probability is more than 90 percent said the infection is cured it. In a small part, about five percent, however, can stay for a while general appeal.

profile: can transmit Borrelia gel or brakes too?

But this is unlikely because Borrelia need a microclimate in which they survive can - and because of the tick gut is ideal. It has indeed been found in some cases, Lyme disease in Gelsenkirchen, but it is thought that taken by chance, the bug has so stung just a mouse that had the spirochetes in their blood. Borrelia can not live for long periods in these animals, or even through the winter, as is the case with the ticks.

profile: So theoretically can cause quite a gel or a brake one eye rash?

But yes, the patients report that credible. Happen quite often tick bites but also unnoticed. In principle, this does not play a role, as occurs when the eye rash, then should we treat them.

Elisabeth Aberer is head of the outpatient clinic for dermatology at the Medical University of Graz immune and one of the authors of the German guidelines for the treatment of Lyme borreliosis

This text was published in the edition of 23 August 2010 in the news magazine profil .