Lyme Disease
Authors: Linden T. Hu
Journal: Annals of Internal Medicine (2016)

Letters1 November 2016Lyme DiseaseLinden T. Hu, MDLinden T. Hu, MDFrom Tufts University School of Medicine, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L16-0409 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:First, I agree that no study has shown the transmission time from an infected tick to a human. Estimates for the time of attachment needed to transmit infection are extrapolations from animal studies that may not accurately reflect human transmission. And, as stated, results of studies of the efficacy at preventing disease of removing feeding ticks before 24 to 48 hours have been mixed. However, early removal of attached ticks poses little downside risk.Second, recommendations for consideration of single-dose doxycycline prophylaxis are based on results of a randomized, controlled trial (1). It is not unusual for recommendations ...References1. Nadelman RB, Nowakowski J, Fish D, Falco RC, Freeman K, McKenna D, et al; Tick Bite Study Group. Prophylaxis with single-dose doxycycline for the prevention of Lyme disease after an Ixodes scapularis tick bite. N Engl J Med. 2001;345:79-84. [PMID: 11450675] CrossrefMedlineGoogle Scholar2. Johnson BJ, Pilgard MA, Russell TM. Assessment of new culture method for detection of Borrelia species from serum of Lyme disease patients. J Clin Microbiol. 2014;52:721-4. [PMID: 23946519] doi:10.1128/JCM.01674-13 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Tufts University School of Medicine, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0012. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoLyme Disease Linden T. Hu Lyme Disease Daniel Weiss and Miriam F. Weiss Metrics Cited bySpontaneous Knee Effusion in an Adolescent Soccer PlayerUnbiased Metagenomics—A New Tool for Detecting Early Lyme Disease?The Borrelia burgdorferi Adenylate Cyclase, CyaB, Is Important for Virulence Factor Production and Mammalian InfectionHost-specific functional compartmentalization within the oligopeptide transporter during the Borrelia burgdorferi enzootic cycleThe Borrelia burgdorferi infection critical BBK13 protein forms large oligomers in the spirochete membraneMechanisms of Dysregulated Antibody Response in Lyme DiseaseSpirochetal DiseasesVector-borne Diseases: An Ongoing ThreatBorrelia burgdorferi bbk13 Is Critical for Spirochete Population Expansion in the Skin during Early InfectionEpidemiology of Lyme disease among US Veterans in Long Island, New YorkIncidence of notified Lyme borreliosis in Germany, 2013–2017Kan det være Lyme-nevroborreliose? 1 November 2016Volume 165, Issue 9Page: 677KeywordsDisclosureDoxycyclineErythemaExtrapolationLyme diseaseProphylaxisRashesTicks ePublished: 1 November 2016 Issue Published: 1 November 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...