Lyme disease prevention and vaccine prophylaxis

Lyme disease in central Europe

Lyme borreliosis is a fascinating disease, the aetiopathology of which is not yet completely known. Different subspecies of Borrelia burgdorferi sensu lato are responsible for the variable clinical course of the disease. Some new cutaneous (alopecia) and ocular (photophobia and retinal vasculitis) manisfestations have been described and the largest prospective study on erythema migrans during pregnancy was published during the last year. Optimal therapy of Lyme borreliosis is still lacking, but doxycycline, amoxicillin, penicillin, and ceftriaxone are recommended most frequently.

The prevention of Lyme disease with vaccine

Lyme disease is a potentially serious and debilitating infection caused by Borrelia burgdorferi that is endemic in North America, Europe, and Asia. Personal protective and environmental measures have not significantly impacted its increasing incidence. An adjuvanted recombinant vaccine (LYMErix) has been approved in the United States for the prevention of Lyme disease in adults, and has demonstrated both safety and efficacy. A clinical trial of over 10000 adults showed 76% efficacy following the third dose of a 0, 1, 12 schedule. Accelerated schedules demonstrate equivalent levels of protective antibody. Up to 100% of children 2-14 years of age achieve seroprotective levels of antibody. Booster doses induced protective levels of antibody in more than 96% of recipients when administered at months 12 and 24. Only mild or moderate, transient vaccine-associated adverse events have been reported after immunization. The vaccine is a safe and effective method of preventing Lyme disease.