I have Lyme. I’d like to not have it anymore. I also just want cake.
It is well known in the Lyme community that a very large percentage of us never recall getting bit. But does the general population really understand this phenomenon? Before Lyme so rudely interrupted my life, it was the furthest thing from my radar. I thought ticks were these big gross bugs that would be impossible to miss, and frankly, I’d never seen one so… out of sight out of mind, right? Besides, you’re supposed to get like, immediately sick from a bite if you have Lyme so, totes hard to miss, I was sure of it. Unfortunately, this is deadly thinking. And I’m paying for it. If I could scream from the mountain top one thing to the people, it would be that TICK BITES ARE MORE ELUSIVE THAN OTHER INSECT BITES, AND YA’LL CAN BE INFECTED WITH A DEVASTATING AND USUALLY INCURABLE DISEASE AND NOT EVEN KNOW IT! I would scream it. I would. See that little guy under the dime? The one second from the right? It is a nymph tick (adolescent stage if you will), and they are ever just as hungry, pathogen-filled, and dangerous as their bigger, more adult form that we always picture in our heads when someone says “tick”. You’re more likely to notice a mosquito bite. You are. This should frighten you.
Now that my fear-mongering opening PSA is out of the way…
Let’s get sciency. Let’s talk biological things. Let’s get down and dirty with spirochetes. Let’s understand how this vicious little bacteria can go from tick belly to human brain without you ever knowing (okay so maybe a little fear mongering left in me still). This stuff is important guys. Getting a tick bite (or two or twelve or who can really say) as a child and never knowing was the single most defining act of my future destiny. It carved in stone a future illness with no cure. It started the silent ticking of a timer on a countdown to collapse.
So like, let’s say there is a human. This human likes doing some of the following normal human things that put him at risk for a vector borne illness like Lyme:
I mean, I ain’t sayin hide yo kids, hide yo wife… I won’t say don’t live your life. But live it with awareness. I know of someone who got a tick bite in a movie theater. Movie theater guys. Movie theater. Okay so back to our hypothetical human. Some teeny little nymph tick the size of a sharpie dot bites him. If only he saw it… but most don’t. If only he felt it… but most won’t…
The infection process is complex. This is where we take off the gloves and just start using a ton of big words. Que science!
To: You, With Love, From: Tick
Borrelia just chills out in the stomach of a tick by attaching itself to receptor sites ticks have in their gut for the borrelia outer surface protein A (OspA). This alone blew my mind. Ticks and borrelia are made for each other. As the tick begins to feed on our little human guy, the influx of his blood signals the Lyme bacteria to multiply and prepare to disseminate to the tick’s saliva glands. They begin to arm themselves with a big bag of tricks to avoid our immune system. To understand his tricks, you should know some basics about the immune system. There are two components: (this graphic is poor I know it’s poor)In a nutshell, your innate immune system is designed to roam the body looking for things that shouldn’t be there (whether viruses, bacteria, parasites, or even our own damaged or dead cells) and kills and/or cleans them up as best it can. It does this through inflammatory, often symptomatic processes. However, the innate immune system can not make antibodies. It’s only purpose is to “stave off the invaders” long enough to give the adaptive immune system time to be exposed to pathogen antigens (their surface proteins) and begin forming antibodies that match them. The adaptive immune system is the real key to beating infections and forming lasting resistance to those infections in the future. Those symptoms you feel when you get the flu? That’s your innate immune system throwing out inflammation bombs in action. Your symptoms subside as your adaptive system shows up and is all like “guys chill, we’re ready now we got this”. Seasonal allergies? Food allergies? Mast cell activation? These are all symptoms of a chronically over-active innate immune system. These first responders are programmed to fight until relieved by the backup. It is believed many chronic conditions are the result of a breakdown in communication between these two immune systems, i.e. the adaptive just doesn’t show up whether due to weakening, low cells counts, disease, or immune suppression…. and thus chronic innate-mediated inflammation perpetuate. All hallmark conditions associated with Lyme disease.
Now that we know that, borrelia has different tricks to evade both. Before it even leaves the tick it is preparing evasion from the innate immune system and a take-down of the adaptive system. If borrelia can successfully weaken the adaptive system enough, it knows it is home free as the innate system alone can never eliminate it. Three main stages of trickery have been discovered, and certainly there may be more. Let’s discuss them stages in order.
Borrelia (squiglies) attached to neuronal cells.
Once in the brain, however, human’s carefree and healthy days are numbered. Eventually the infection manifests and will illicit a symptomatic and damaging inflammatory response within the central nervous system. These symptoms are caused by potentially several mechanisms – direct cytotoxicity, neurotoxic mediators, or triggered autoimmune reactions.
Now finally, our human is sick. Very sick. It may be months after his bite it may be decades. There is no time frame for symptom development for Lyme. In fact, there are no rules at all. And because it’s likely he didn’t notice his bite, and his blood tests will be normal or inconclusive, and his symptoms can be any set of random things, it’s likely Lyme won’t be the first thing considered. Or the second, or seventh. Unless our human knows the facts. This is why I’m spreading the facts. I didn’t sit down today with the intention of inducing a panic attack in you, but one would be warranted, if you like. I mean… no way to notice every tick bite, no way to always know when infected, no way to prove infected, nothing but just waiting for the timer to stop and the bomb to detonate. Go on, panic, I’ll give you a minute.
Okay, time to wrap this up. I’m on a wooden chair and I just can’t.
In our world we currently have two popular opinions of bacteria, namely, 1) infections in the modern world are killed with ease using short courses of antibiotics, and 2) the really dangerous bacteria make you immediately, umistakeabley ill, and kill quickly. Lyme behaves like neither (or if it does, it’s opinion #2). And since Lyme is currently the most prevalent vector born disease in the northern hemisphere, people should take note.
To summarize, I wrote this post to establish credible scientific evidence for the following Lyme FACTS:
I didn’t talk about that last one but, I mean, it’s true and you should know it. I am living all six facts today. Check your kids after they play outside. Dress appropriately. Wear repellent. Don’t just look for the big ticks, be aware of just how tiny they can be. Don’t accept the first negative Lyme test you receive if you are mysteriously ill. Don’t “sit and see what develops” if you or your child does get a tick bite. Demand a course of antibiotics even if you need to go to several doctors to get it. Demand it!
There, I shouted from my mountain. And I’m now getting off this chair. Peace.