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A number of tick-borne diseases can be transmitted by I. ricinus to a variety of mammal hosts. Dogs can be infected with Lyme disease (borreliosis), caused by the spirochaete bacteria Borrelia burgdorferi, B. afzeli and B. garnii. Cattle can become infected with redwater fever (from the protozoans Babesia divergens, B. bovis and B. ovis), Lyme disease (from Borrelia burgdorferi), sheep tick pyemia (Staphylococcus aureus), cattle tick-borne fever (Anaplasma phagocytophila), Q fever (Coxiella burnetii), Boutonneuse fever (Rickettsia conorii) and the bacterium Anaplasma marginale. Horses may be infected with Lyme disease, Anaplasma phagocytophila, and the viral infection "louping ill". Humans can become infected with Lyme disease, louping ill, Q fever and tick-borne encephalitis.
Lyme disease is the most common tick-borne disease in the Northern Hemisphere. Borrelia is transmitted to humans by the bite of infected ticks belonging to a few species of the genus Ixodes ("hard ticks"). Early symptoms may include fever, headache, fatigue, depression, and a characteristic circular skin rash called erythema migrans (EM). Left untreated, later symptoms may involve the joints, heart, and central nervous system. In most cases, the infection and its symptoms are eliminated by antibiotics, especially if the illness is treated early.
Within days to weeks after the onset of local infection, the Borrelia bacteria may begin to spread through the bloodstream. EM may develop at sites across the body that bear no relation to the original tick bite. Another skin condition that is apparently absent in North American patients, but occurs in Europe, is borrelial lymphocytoma, a purplish lump that develops on the ear lobe, nipple, or scrotum. Other discrete symptoms include migrating pain in muscles, joints, and tendons, and heart palpitations and dizziness caused by changes in heartbeat.
Various acute neurological problems, termed neuroborreliosis, appear in 10–15% of untreated patients. These include facial palsy, which is the loss of muscle tone on one or both sides of the face, as well as meningitis, which involves severe headaches, neck stiffness, and sensitivity to light. Radiculoneuritis causes shooting pains that may interfere with sleep, as well as abnormal skin sensations. Mild encephalitis may lead to memory loss, sleep disturbances, or mood changes. In addition, some case reports have described altered mental status as the only symptom seen in a few cases of early neuroborreliosis.
The disease may also have cardiac manifestations such as AV block.
Deer tick life cycle
After several months, untreated or inadequately treated patients may go on to develop severe and chronic symptoms that affect many parts of the body, including the brain, nerves, eyes, joints and heart. Many disabling symptoms can occur, including permanent paraplegia in the most extreme cases.
Chronic neurologic symptoms occur in up to 5% of untreated patients. A polyneuropathy that involves shooting pains, numbness, and tingling in the hands or feet may develop. A neurologic syndrome called Lyme encephalopathy is associated with subtle cognitive problems, such as difficulties with concentration and short-term memory. These patients may also experience profound fatigue. However, other problems, such as depression and fibromyalgia, are no more common in people who have been infected with Lyme than in the general population. Chronic encephalomyelitis, which may be progressive, can involve cognitive impairment, weakness in the legs, awkward gait, facial palsy, bladder problems, vertigo, and back pain. In rare cases untreated Lyme disease may cause frank psychosis, which has been mis-diagnosed as schizophrenia or bipolar disorder. Panic attacks and anxiety can occur; there may also be delusional behavior, including somatoform delusions, sometimes accompanied by a depersonalization or derealization syndrome, where the patients begin to feel detached from themselves or from reality.