Lyme disease is an infectious disease caused by the bacterium Borrelia burgdorferi, which is transmitted through tick bites. The infection resulting from these bites causes swelling, joint pain, rash, and flu-like symptoms. The disease can affect the nervous system, as well, causing headaches, dizziness, and other symptoms.
We used data of the Belgian network of sentinel general practitioners (SGP) to study the incidence rates in Belgium, the trend over time, and the degree of compliance of the SGP. The overall Belgian incidence rates in the SGP practice in 2008-2009 were 18.65 (95% CI 17.29-20.08) per 10,000 persons for tick bites and 9.02 (95% CI 8.08-10.03) for erythema migrans.
Treat with an oral antibiotic for two weeks. Doxycycline 100 mg bd or amoxicillin 500 mg tds. Cefuroxime 500 mg bd if both are contra-indicated and there is no history of anaphylaxis with penicillins. If unable to distinguish between cellulitis and erythema migrans, use co-amoxiclav, cefuroxime or amoxicillin with flucloxacillin. For children aged over 12, use doxycycline 100 mg bd or amoxicillin 50 mg/kg/day in divided doses (maximum 500 mg per dose). For children aged under 12, use amoxicillin 50 mg/kg/day in divided doses (maximum 500 mg per dose) or cefuroxime 30 mg/kg/day in two divided doses (maximum 500 mg per dose and assuming there is no history of anaphylaxis with penicillins). For breast-feeding women, use amoxicillin or cefuroxime. For pregnant women, use amoxicillin or cefuroxime and inform an obstetrician. Lyme disease carries little direct risk to the pregnancy; however, there is a possible risk of uterine contraction following a reaction to treatment (Jarisch-Herxheimer reaction).
In recognition that a growing number of patients experience ongoing or relapsing symptoms after having been treated for Lyme disease and in recognition that diagnostic tests are plagued by both false positive and false negative results and rarely provide definitive information about the presence or absence of active infection, the mission of this center is to focus research on identifying better diagnostic assays, better treatments, and a better pathophysiologic understanding of the mechanisms of symptom persistence so as to enable the development of more effective treatments.