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My Packs: (UWO) (MICROIMM 2500) > (Section C: Bacteriology) Lecture 24 > Flashcards

(Section C: Bacteriology) Lecture 24 Flashcards

1
Q

When was Lyme Disease first recognized?

A

1975 in rural communities surrounding Lyme, Connecticut

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2
Q

What was Lyme Disease first misdiagnosed as?

A

Rheumatoid arthritis
* Due to ‘polyarthritis’ symptoms

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3
Q

Borrelia burgdorferi
* Gram stain
* Shape

A
  • Gram negative
  • Spirochete
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4
Q

Describe:

Size proportions of Borrelia burgdorferi

A

Thin (~0.5 μm) and long (>10 μm)

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5
Q

Where is Borrelia found?

A

Found throughout temperate zones in the Northern Hemisphere

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6
Q

What is the main reservoir for Borrelia burgdorferi?

A

White footed mice
* Transferred to ticks

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7
Q

What ticks are the primary transmitters?

A
  • Ixodes scapularis
  • Ixodes pacifica
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8
Q

What areas do the ticks inhabit?

A
  • I. scapularis: East coast
  • I. pacifica: West coast
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9
Q

How do ticks transmit disease?

A
  • Do not fly or jump
  • Sit on grasses/shrubs and wait for a host to pass by
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10
Q

Besides humans, what else can get Lyme Disease?

A

Cat and Dogs
* Deers cannot get Lyme Disease because of their immune system

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11
Q

Can Lyme Disease transmit between person-person?

A

No evidence

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12
Q

Where are ticks bites often found?

A

Found often in ‘hard-to-see’ areas

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13
Q

Ixodes life cycle

A

3 stages
* Larvae
* Nymph
* Adult

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14
Q

Does Borrelia burgdoferi transfer between eggs and larvae?

A

No transmission between adult to egg

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15
Q

What things can carry B. burgdorferi other than lice?

A
  • Mice
  • Squirrels
  • Birds
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16
Q

How does Lyme Disease get into the host?

A

Inserts through a feeding tube with barbs

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17
Q

Why do we not feel tick bites?

A

The tick secretes a local anesthetic

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18
Q

True or False:

Transmission of Lyme disease occurs in the first 24 hrs

A

False, the transmission is not thought to occur during the first ~24 hours following bite

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19
Q

What stage of ticks normally transmit disease?

A

Nymphs

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20
Q

What should you not do when removing ticks?

A
  1. Do not squish the tick body
  2. Do not burn the tick off
  3. Do not apply petroleum jelly
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21
Q

What must Borrelia burgdorferi do to propagate through it’s life cycle?

A

Cause disseminated and persistent infection to propagate through it’s life cycle

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22
Q

What is the central event in the development of Lyme Disease?

A

Hematogenous dissemination

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23
Q

What is the migration of Borrelia burgdorferi in the skin known as?

A

Erythema migans lesion
* “Bulls eye rash”

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24
Q

How do compounds in tick saliva inhibit dendritic cells?

(4 points)

A
  1. Decreased phagocytosis
  2. Decreased maturation
  3. Decreased inflammatory mediators
  4. Decreased antigen presentation
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25
Q

How do Borrelia burgdorferi move?

A

Moves in a corkscrew like manner due to periplasmic flagella (axial filaments)

26
Q

What are axial filaments?

A

Periplasmic flagella
* Axial filaments
* Promotes movement through extracellular matrix of host tissues and invasion of vasculature

27
Q

What is unusual about the Borrelia burgdorferi outer membrane?

A
  • No LPS
  • Many surface expressed lipoproteins that can act as adhesins
28
Q

Why does Borrelia burgdorferi express so many lipoproteins?

A

To escape from the blood flow, so that it can invade the endothelium

29
Q

What is unusual about Borrelia burgdorferi genetic structure?

A
  • ‘Linear’ chromosomes
  • Multiple plasmids, some circular and some linear
30
Q

True or False:

Plasmids vary from strain to strain in Borrelia burgdorferi

A

True

31
Q

What are plasmids needed for in Borrelia burgdorferi?

A

Infection
* Have limited metabolic capability

32
Q

What are the 4 stages of Lyme Disease?

A
  1. Early (Localized) Stage
  2. Early Disseminated Stage
  3. Late Disseminated Stage
  4. Post-treatment Lyme Disease syndrome
33
Q

Signs/Symptoms:

Early (Localized) Stage

A
  • Bulls eye rash (~25% of patients do not have a rash)
  • Flu-like symptoms (fever, chills, fatigue, body aches)
34
Q

When does the Early (Localized) Stage of Lyme disease occur?

A

~1-2 weeks after tick bite

35
Q

Signs/Symptoms:

Early Disseminated Stage

A
  • Multiple rashes
  • Pain and swelling of large joints
  • Heart palpitations
  • Meningitis (severe headaches, neck stiffness)
  • Bell’s (facial) palsy
36
Q

Define:

Heart Palpitations

A

Interference with heart electrical signals

37
Q

Define:

Bell’s (facial) palsy

A

Loss of muscle tone on one or both sides of the face

38
Q

What mechanism does Borrelia burgdorferi use to traverse the BBB?

A

Paracellular travel

39
Q

How long does it take for the Early Disseminated Stage to occur?

A

Days to weeks

40
Q

Signs/Symptoms:

Late Disseminated Stage

A
  • Serious long-term disability
  • Muscle pain
  • Arthritis
  • Severe pain and swelling in large joints
  • Neurological problems (shooting pains, numbness, tingling in hands and feet, memory)
41
Q

Approximately what percentage of patients develop neurological problems in the Late Disseminated Stage?

A

~5%

42
Q

How long does it take for the Late Disseminated Stage to occur?

A

Months to years

43
Q

Signs/Symptoms:

Post-treatment Lyme disease syndrome

A
  • Fatigue
  • Muscle and joint pain
  • Cognitive defects
  • Sleep disturbances
44
Q

How well do antibiotics work in the Late Disseminated stage?

A

Work slowly

45
Q

Approximately what percentage of individuals develop Post-treatment Lyme disease syndrome?

A

10-20%

46
Q

What is the cause of Post-treatment Lyme disease syndrome?

A

Unknown
* May involve an autoimmune response
* Possibly persistent infection

47
Q

How long does it take most patients to recover from post-treatment Lyme disease syndrome?

A

After a few months
* Long-term antibiotics are not thought to help

48
Q

What is the distribution of ticks continuing to spread?

A
  • Migratory birds
  • Warmer climates
49
Q

Prevention of Lyme Disease

A
  • Avoid low lying brush, long grass, wooded areas endemic with Lyme disease
  • Stay on paths
  • Wear long pants + shirts
  • Light colored clothing
  • Repellants (containing DEET)
  • Check for ticks and remove them
50
Q

Diagnosis of Lyme Disease

A
  • Symptoms
  • Tick bite history
  • Anti-B. burgdorferi antibody tests
  • Submit tick for testing
51
Q

Why is the anti-B. burgdorferi antibody test controversial?

A

False negatives often due occurs (early testing and genetic diversity of B. burgdorferi causes this)
* Sensitivity is not very good

52
Q

Treatment for Lyme Disease

A
  • Watch for signs and symptoms
  • Antibiotic treatment (2-4 week course)
53
Q

What can happen in Lyme disease without treatment?

A
  1. Joint issues
  2. Heart issues
  3. Nervous system issues
54
Q

What is “Chronic Lyme Disease”?

A

Very controversial
1. Chronic infection by B. burgdorferi
2. Diagnosed without evidence of prior Lyme Disease

55
Q

What are signs/symptoms of “Chronic Lyme Disease”?

A
  • Fatigue
  • Headaches
  • Sleep disturbances
  • Cognitive dysfunction
  • Neurological problems
56
Q

What treatment was found to be not helpful for “Chronic Lyme Disease”?

A

Long-term antimicrobial therapy

57
Q
A
58
Q

LYMErix

A

Outer memberane protein vaccine for Lyme disease

59
Q

How effective is LYMErix in humans?

A

75% effective

60
Q

Why was the vaccine pulled from the markey (LYMErix)?

A

‘Lack of demand’
* Lawsuits and claims that vaccine caused arthritis (no evidence)

61
Q

Is the LYMErix vaccine recommended?

A

“Should be considered” for those in high risk areas

62
Q

What is the LYMErix vaccine approved for only?

A

Dogs

My Packs: (UWO) (MICROIMM 2500) (26 decks)

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