Fever, joint pain, headaches (…): these symptoms, which are as frequent as they are debilitating, can be linked to Lyme disease transmitted by ticks. The High Authority for Health has just published a guide to better guide patients.
91 cases per 100,000 inhabitants. This is the annual incidence rate of Lyme disease in France. This bacterial infection, called borreliose de Lyme “in scientific jargon, is transmitted by the bite of a tick infected with the bacteria” Borrelia burgdorferi sensu lata “. Several symptoms related to this disease should alert following a bite: for example fever, dermatological, joint, neuromeningeal signs…
disabling signs
Often persistent, generally diffuse and unexplained, these clinical signs can be particularly debilitating (article in link below). However, today, many patients are faced with medical wandering, which delays access to care. To improve the care of these patients and in view of the increase in cases, the High Authority for Health (HAS) published in March 2022 a ” Guide to the care pathway for patients with suspected Lyme borreliosis », intended for health professionals (link below). The goal? ” Define for each of the situations encountered, the action to be taken and the medical orientation of the patient » in a city-hospital care pathway distributed around the five reference centers for the management of tick-borne diseases (CR MVT) designated in 2019 by the Ministry of Health (article in link below).
Three levels of support
This guide is broken down into three levels of support, from the simplest to the most complex situation. In level 1, follow-up is provided by the attending physician who removes the tick and administers appropriate antibiotic treatment. Level 2 indicates the need for intervention by a specialist or a competence center for tick-borne diseases in the event of ” presence of other suggestive signs within six weeks of the bite “. Finally, level 3 directs towards a multidisciplinary expertise with a possible ” second line of antibiotic therapy “. The HAS also addresses the patients themselves by issuing some advice on self-monitoring and prevention. For example, immediately extract the tick using a tick puller, monitor the bitten area for at least a month and share information related to the evolution of the patient’s condition with the attending physician if necessary.
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