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Spread of tick disease is a growing problem
Every year at the start of the tick season, doctors, health authorities and associations warn of the health risks that a tick bite can entail. Because the tiny bloodsuckers often serve as transmitters of dangerous pathogens, which can, for example, cause Lyme disease or early summer meningoencephalitis (TBE).
At yesterday's launch of the annual meeting of the German Lyme Society (DBG) in 2012, the speakers emphasized the medical challenges that arise from the increasing spread of Lyme disease by ticks. Although the infectious disease has been known for a long time, diagnosis and treatment often pose considerable difficulties. According to Kurt E. Müller, chairman of the German Lyme Society, "significant progress has been made in recent years, but reliable therapy remains a major problem."
Lyme disease and TBE The tick season has started with the mild spring temperature. The small bloodsuckers become active from seven degrees Celsius and start their search for food. Human blood is just as popular here as that of birds, pets and wild animals. The tiny animals attach themselves, pierce the skin and start sucking blood. In the course of eating, the ticks swell to a multiple of their actual body size and, when they are full, fall off again on their own. This process in itself would not be a particular problem for the human organism, but the tiny bloodsuckers often transmit pathogens into the wound. The most common pathogens that can be transmitted by a tick bite include the Borrelia bacteria, which cause Lyme disease in humans. The ticks also frequently transmit TBE viruses during the sucking process, which can lead to flu-like symptoms such as fever and headache, but also to a potentially life-threatening meningitis.
Diagnostic Difficulties with Lyme Disease In tick-borne Lyme disease, one of the main problems is reliable, early diagnosis. The so-called wandering blush, which shows up as a red, growing spot on the skin (first around the puncture site, later also on other parts of the body), is a typical symptom. However, about a third of the patients do not suffer from this conspicuous disease characteristic, the experts from the DBG report. The other symptoms such as fever, muscle, joint and limb pain are also so unspecific that the suspicion of Lyme disease is often not suspected. In this way, the pathogens can often spread over weeks in the affected person's body before an examination for Lyme disease takes place. If a medical examination is carried out, it is not always guaranteed that the pathogens will be discovered. “The diagnosis is not made with sufficient certainty. Findings are often interpreted differently and it is not uncommon for them to be assessed differently when there is a Lyme disease in need of treatment, ”explained DBG Chairman Kurt E. Müller. To ensure that existing Lyme disease can be successfully detected, researchers from Innsbruck have therefore developed a method in which tissue samples can be systematically searched with the help of a microscope using a special cutting technique, Müller reported. This so-called focus-floating microscopy "makes it easier for us to find borrelia and recognize the need for treatment more reliably," emphasized the expert.
Difficult treatment of Lyme disease If Lyme disease is diagnosed after a tick bite, treatment with antibiotics usually begins immediately. In particular, if the pathogen is discovered early, the chances of a cure are very good. But here again and again the doctors reach their limits. The antibiotics do not work in the desired form and there is a risk of chronic borreliosis with late effects such as inflammation of the joints, heart muscle or nervous system. According to the DBG chairman, the difficulties in treatment also result from the pathogens' ability to "change their structure and also withdraw into a form of rest." This would make reliable treatment considerably more difficult, explained Müller. According to the expert, the individual constitution of the patient plays an important role in the treatment and should therefore be taken into account. "We have to deal with the personal characteristics even more," explained Müller at the DBG annual conference. The individual performance of the immune system should be recorded and, if necessary, measures that strengthen the immune system should be included in the therapy, the expert demanded.
Up to 400,000 new Lyme disease cases per year? According to Kurt E. Müller, it is unclear how many people in Germany actually develop Lyme disease each year after a tick bite. Regarding the number of infections and illnesses, “there are extremely contradicting numbers because there is no uniform recording,” the DBG chairman continued. For example, the National Reference Center for Borrelia in Erlangen assumes that 60,000 to 100,000 people in Germany develop new Lyme disease each year. According to Müller, however, there are also "figures that indicate that around 0.5 percent of the population is diagnosed with Lyme disease every year" - which would be around 400,000 people a year in Germany. The areas in which a particularly large number of ticks carry Borrelia include Baden-Württemberg and Bavaria, which are classified as high-risk areas in Germany. Overall, however, the spread of pathogens in the tick population is increasing across Germany, Kurt E. Müller continues. The associated health risks for the population are still too often underestimated, the expert emphasized.
Notification for Lyme Disease Some federal states have introduced a notification obligation to monitor the spread of Lyme disease, although according to the DBG chairman, the data obtained has so far only been of limited use. Although there is already an obligation to register in the eastern German federal states and Rhineland-Palatinate and the introduction is also planned in Bavaria, "it would have been better to wait and agree on a standardization of the registration criteria," explained Kurt E. With the current ones Reporting procedures “the numbers are constantly being questioned,” complained the expert. The identification of risk areas is advantageous in that the population is sensitized to the risk of Lyme disease transmission after a tick bite in the corresponding regions. People could also take appropriate protective measures when staying outdoors to minimize the risk of a tick bite.
Body-covering clothing, tight cuffs and high shoes are appropriate here. After a stay in nature, the body should be searched thoroughly for ticks. Animals that may be adhering should be removed immediately using narrow tweezers or tick pliers, and bruising the ticks should be avoided so that they do not secrete their stomach contents into the puncture wound. The trend is: the earlier the ticks are removed, the lower the risk of transmission of TBE or Lyme disease. (Fp)
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