- Tick-transmitted disease caused by the spirochete Borrelia burgdorferi.
- “Borrelia burgdorferi sensu lato" is name given to the overall category. In North America there is just one genospecies variant - Borrelia burgdorferi sensu stricto. In Europe there are three categories Borrelia burgdorferi sensu stricto, B. garinii, and B. afzelii.
- B. lonestari causes a “southern tick-associated rash syndrome” in the U.S.
- In the US, occurs mostly (> 90%) in the northeast, Minnesota and Wisconsin, less common in southeast, and midwest regions.
- Ixodes scapularis, in the northeastern and north central US
- I. pacificus in the western US
- In the northeastern US from Maine to Maryland and in the north central states of Wisconsin and Minnesota
- Highly efficient, horizontal cycle of B. burgdorferi transmission occurs among larval and nymphal I. scapularis ticks and certain rodents, particularly white-footed mice and chipmunks.
- This cycle results in high rates of infection among rodents and nymphal ticks and many new cases of human Lyme disease during the late spring and early summer months.
- Nymphs are the life stage most commonly involved in transmitting B. burgdorferi to dogs and humans.
- White-tailed deer, which are not involved in the life cycle of the spirochete, are the preferred host of adult I. scapularis, Deer are not competent hosts for B. burgdorferi – their role is to maintain the ticks, not the Borrelia. Dogs, horses, cows, people, etc. are accidental victims of a hungry tick!
- Vector ecology is different in other parts of the US where prevalence is lower.
- Do not infect host until attached for 24 hours. This time is required for the bacteria to migrate from the tick midgut to the salivary glands
- Experimentally-infected dogs
- Clinical illness 2-5 months after exposure
- Inappetence, lethargy, and lymphadenopathy
- Episodic shifting leg lameness of 3-6 day duration
- Arthritis develops first in the joint closest to the tick bite
- After about 6 months, all arthritic episodes resolve
- Adult beagles do not develop the disease
- Natural disease not well characterized
- Difficult to reproduce in an experimental setting.
- Based on seroprevalence studies, only 5-10% of naturally infected dogs develop clinical signs.
- Seroprevalence in endemic areas can be as high as 90%.
- Considered a generalized, systemic infection
- Lyme disease can be seen throughout the active tick season, but it is most often diagnosed in late spring and fall, rather than in midsummer
- Develop clinical signs if experimentally-infected
- Clinical signs do not consistently develop in naturally-infected cats
- More resistant than dogs?
- Rate of seropositivity is lower than in dogs
- Most common manifestation in dogs
- May be septic or immunemediated
- Transient, respond to antibiotic therapy
- Chronic, non-erosive arthritis (persistent infection)
- Anorexia, weight loss, lethargy, lymphadenomegaly
- Protein-losing nephropathy
- Acute progressive renal failure (Lyme nephritis)
- Syndrome described in Borrelia-seropositive dogs
- Etiology not clearly established
- Unique histopathologic lesions
- Mostly in Labrador and Golden retrievers
- CNS inflammation (reported but poorly described)
- Leukocytosis with left shift, monocytosis, mild anemia
- Neutrophilic inflammation
- Clinical Signs + Serology
- Prevalence of seropositivity is much higher than prevalence of disease
- Whole cell body antibodies (ELISA or IFA)
- Should not be used anymore
- Subclinical infection is common
- Cross-reaction with vaccine
- Snout test: so Sensitive that a Negative result rules OUT the disease
- IgM cannot be used as an indicator of recent infection because IgM titers remain elevated for prolonged periods of time after infection
- Can differentiate between vaccine and natural exposure
- Some non-vaccinated dogs previously exposed to B. burgdorferi show Western-blot pattern compatible with both, vaccination and natural exposure.
- “Snap-test” or Quantitative C6
- Antibodies against C6 peptide
- Not affected by vaccination
- Detectable 3 weeks post-exposure
- May be able to use titer to gauge treatment succes
What to do with a seropositive dog?
- Asymptomatic, non-proteinuric
- Symptomatic, non-proteinuric
- Asymptomatic, proteinuric:
- Recheck proteinuria periodically. If persistent or severe
- Treat Lyme and proteinuria
- Treat Lyme and proteinuria
- Doxycycline 10 mg/kg q12h for 28 days
- Longer if nephropathy (?)
- Early treatment decreases titers and organism load
- Clearance is not complete
- Amoxicillin 20 mg/kg q8-12h for 28 days
- Ceftriaxone is used in humans with menigitis
- Bacterins + adjuvant vaccines: Reduce incidence of signs in seropositive dogs from 4.7% to 1%. Value is questionable
- Single protein vaccines (OspA): protect from infection and disease
- OspA antibodies block migration of the organism from the tick into the dog
- Do not clear infection in the dog, because the change in temperature from the low temperature tick to the high temperature dog shifts expression of OspA to OspC.
- OspC antibodies are not borrelicidal
- Vaccinate at risk dogs before the tick season
- Duration of immunity is at least 6 months
- Western-blot and C6 antigen differentiate vaccine from exposure
Vaccine X Arthritis
- Major clinical sign in human beings and dogs
- Also detected in human beings following vaccination with Borrelia OspA and in dogs with the whole cell vaccine and presumably OspA vaccine
- Arthritis is also found in animals following Borrelia vaccination with whole cell and OSPA followed by infection.
- Arthritis is seen in about 3% of naturally-infected dogs
- If prevalence of post-vaccination arthritis is assumed to be 0.04% (it is not known)
- What would be the outcome in 3 different areas? (1,000 dogs, vaccine 70% effective)
- High prevalence: 75% of dogs get infected
- Without vaccine: 23 dogs with arthritis (Lyme-induced)
- With vaccine: 11 dogs with arthritis (7 with Lyme, 4 vaccine-induced)
- Moderate prevalence: 25% of dogs get infected
- Without vaccine: 8 dogs with arthritis (Lyme-induced)
- With vaccine: 6 dogs with arthritis (2 with Lyme, 4 vaccine-induced)
- Low prevalence: 10% of dogs get infected
- Without vaccine: 3 dogs with arthritis (Lyme-induced)
- With vaccine: 5 dogs with arthritis (1 with Lyme, 4 vaccine-induced)
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