Lyme Disease Has So Many Similarities To Syphilis

The disease process of Lyme disease has so many similarities to syphilis, and as a microbiologist I cannot help but be fascinated by it. Although one is sexually transmitted disease (STD) and the other a zoonosis ( a disease of animals transmitted to man)  they are both caused by spirochaete bacteria and both have 3 stages of infection exhibiting similar stages. 

Though there is no link between the two infections I believe that we can gain a lot of understanding by comparing the disease process of the very ancient disease of syphilis to the more recently identified Lyme disease.

Some of the similarities and differences are tabulated below:

Feature	Syphilis	Lyme Disease
Causative Organism	Treponema pallidum A spirochete bacteria	Borrelia sp. e.g. B. burgdorferi A spirochete bacteria
Transmission	Human to Human Via Sexual Contact Congenital transmission occurs	Zoonosis Rodent to Tick to Human Congenital transmission debatable
Primary Disease	Occurs 3- 90 days after exposure Local chancre - a firm, painless, non-itchy skin ulceration. Not all patients develop or notice the initial chancre Lasts 3-6 weeks untreated	Occurs 2 days to a few weeks after exposure Local Bulls Eye Rash. Not all patients develop or notice the initial rash Lasts 1 to 4 weeks untreated
Secondary Disease	Occurs about 10 weeks after exposure Becomes disseminated and causes a diffuse rash which frequently involves the palms of the hands and soles of the feet, together with flu-like symptoms Lasts 3-6 weeks untreated	Occurs 2 days to a few weeks after exposure Becomes disseminated and causes flu-like Symptoms. May involve heart, nervous system and joints. Lasts 1 to 4 months untreated
Latent Phase	Early latent is <1 year after exposure Late latent is >1 year after exposure No symptoms are apparent, but there may be relapses in the early latent phase	Though not officially described as the latent phase Lyme disease can resurface months to years after the initial symptoms. During the this period the person may not have symptoms.
Tertiary Disease	Occurs 3 to 46 years after exposure (average 15) Invades various organs of the body and causes damage to the tissues causing gummas which are soft, tumor-like balls of inflammation which may vary considerably in size. They typically affect the skin, bone, and liver, but can occur anywhere. Also causes  neurological, or cardiac symptoms Tissue damage is irreparable	Occurs months to years  after exposure If left untreated or if inadequately treated, Lyme disease disseminates fully throughout the body and can develop into severe and chronic infection with a wide variety of symptoms affecting every organ system, including the joints, heart and brain. Can be cured with extensive log-term antibiotics
Occurs with antibiotic treatment	Occurs with antibiotic treatment	Lyme disease is also a great imitator as the wide variety of symptoms mimic other diseases.
Diagnosis	Clinical history. Early infections difficult to diagnose Serological blood tests	Clinical history early infections difficult to diagnose Serological tests
Treatment	Antibiotics – penicillin, cephalosporins, tetracyclines	Antibiotics – penicillins, cephalosporins, tetracyclines
Jarisch-Herxheimer reaction	Fever, muscle, joint pains, tachycardia etc. may occur with initial antibiotic treatment	Fever, muscle, joint pains, tachycardia etc. may occur with initial antibiotic treatment
Serological Cross Reactivity	You may get a false positive test for Lyme disease if you have syphilis	You may get a false positive test for syphilis if you have Lyme disease

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