Compare and contrast paper: Lyme disease versus influenza

Hong Anh Nguyen

AUHS, General Education

ENG101: English College Composition I

Dr. Brent M. Davis

December 03, 2022

 Abstract

Lyme disease is a bacterial infection, which is typically identified by the erythema migrans rash

and non-specific viral-like symptoms. Unfortunately, the rash is not always present, making the

disease sometimes be mistaken for other illnesses, especially influenza. This paper will provide a

closer look into Lyme disease and influenza.

Keywords: Lyme disease, influenza, common symptoms, key features

 Compare and contrast paper: Lyme disease versus influenza

Both Lyme disease and influenza are infections but offer vastly different experiences to

their hosts. By comparing and contrasting their definitions, symptoms, diagnosis, treatments, and

preventions, it will help understand how different and similar the two conditions are.

Lyme disease is known as tick-borne infection, caused by Borrelia burgdorferi bacteria and in

some cases, Borrelia mayonii bacteria (Radolf, Strle, Lemieux, & Strle, 2021). Humans acquire

the disease through the bite of an infected black tick. Once being bitten, Borrelia bacteria invade

and travel further via the bloodstream, causing either swollen lymph nodes at the bitten site or

other body areas. Without treatment, individuals with Lyme disease can undergo three stages.

Early localized infection is the first one with a duration of one to four weeks. Flu-like symptoms

and a distinctive rash called erythema migrans are noted at this stage. The rash has a bull's-eye

shape, which gradually spreads around the bitten skin. Patients may notice a red circle but no

pain or itching (Radolf, Strle, Lemieux, & Strle, 2021). Early disseminated infection comes later,

after one to four months. Patients continue to have flu-like symptoms, with increased headaches,

difficulty concentrating, pain, weakness or numbness in both upper and lower extremities, partial

facial palsy, joint swelling and heart palpitations. Late disseminated infection is the third stage,

which develops after several months or even years. Arthritis and many other neurological

problems are significantly focused during this stage (Radolf, Strle, Lemieux, & Strle, 2021).

Lyme disease is not a contagious condition, however, influenza is highly contagious. Influenza is

caused by viruses, namely, influenza A, influenza B, influenza C and influenza D. Influenza A is

the most common and noticed type in humans due to its potential pandemic nature. Scientific

studies show that influenza A virus has a mutation rate 300 times faster than influenza B

(Krammer, et al., 2018). In patients with influenza, the upper respiratory tract is attacked,
causing inflammation. The mode of transmission is through droplets from one person to another

or through touching a contaminated object (Krammer, et al., 2018). This means when a person

coughs, sneezes, or talks, droplets containing the infected virus enter the other person's mouth or

nose. Flu also occurs when touching nose or mouth with hands that have previously touched

contaminated objects.

Lyme disease sometimes is mistaken for the flu because of several common symptoms

that they share. They include chills, fever, sweats, fatigue, malaise, headache, sore throat, stiff

neck, stiff and painful joints and muscles, and swollen lymph nodes. To distinguish the two

diseases, unique characteristics of each and duration of flu-like symptoms are key. The most

obvious sign of Lyme disease is the rash- erythema migrans, which occurs at the very first stage.

On the other hand, flu patients do not have a rash but may have a runny nose, diarrhea, or a

persistent cough. Experiencing these symptoms does not rule out Lyme disease, but it does

increase the likelihood of having the flu. As in duration of flu-like symptoms, patients with

influenza reported that their symptoms went away within a short period of time. It may be after a

week or even earlier if the patients have had a flu shot. The time factor is quite different for

Lyme disease as it can last for weeks, months or even years if left untreated.

The first stage of Lyme disease can be detected clinically, based on physical symptoms

such as the rash and history of recent exposure to infected ticks. Diagnosis for stage two and

three includes laboratory tests to detect antibodies made by the human body to fight the

infection. The tests require blood samples for a two-step testing process, including an enzyme-

linked immunosorbent assay and a Western blot test (Lantos, Auwaerter, & Nelson, 2016).

Enzyme-linked immunosorbent assay is performed first. If the result is negative, patients will be

recommended to repeat the same test within the next couple of weeks to avoid false negative
results. This is because antibodies may not have been formed yet as the patients may have been

infected recently. If the assay produces a positive result, Western blot test is taken for further

confirmation. Similarly, influenza is mostly diagnosed based on the clinical presentation of the

patient. Patients will be asked if they have any symptoms of fever, chills, headaches, muscle

aches and pain, lack of energy, anorexia, cough, sore or dry throat and nasal obstruction, etc. The

diagnosis is quite accurate during seasonal influenza epidemics. However, it is important to be

alert that other respiratory pathogens can produce similar signs. Influenza can be confirmed with

specific diagnostic tests, such as virus culture, RT-PCR, rapid antigen test and rapid molecular

assay (Short, Kedzierska, & van de Sandt, 2018). Sample for testing is usually a swab from

nasopharyngeal, nasal cavity or a combination of throat and nasal cavity. To have a more

accurate result, the swab should be obtained within three days of symptom onset.

Lyme disease can be treated with antibiotics, using amoxicillin, doxycycline and

ceftriaxone. Medications can be given either orally or intravenously. For the early localized

stage, the majority of patients are cured after a short course of taking oral medicines. For the

later stages, IV medications are more preferable. Normally, antibiotic therapy will be introduced

in duration of three to four weeks. Using antibiotics for children requires special precautions. For

example, doxycycline needs to be avoided for children who are less than eight years old. Also,

antibiotic doses are adjusted based on the body weight of the child. Antibiotics, on the other

hand, do not cure influenza as it is a viral infection. The main treatments for the flu are to have

plenty of rest and fluids, nutrition and other supplements. For more severe infections, patients

will be prescribed antiviral medications, not to cure the flu but to relieve the symptoms and

shorten the duration of the illness.

 In terms of prevention, a vaccine called LYMErix was once developed in the US for the

protection against Borrelia burgdorferi bacteria. However, LYMErix's effect was reduced over

time. In 2002, the manufacturing company stopped producing it (Wormser, 2022). Currently, no

vaccine is available for this illness. Hence, Lyme disease prevention focuses on preventive

behaviors for tick bites, including wearing protective clothing, applying repellents, regularly

checking for tick bite, removing ticks immediately, and creating a tick-free zone (St Pierre,

Gould, & Lloyd, 2020). In contrast, seasonal influenza virus vaccines are available and

reformulated every year. This yearly vaccination is recommended in the United States for any

individuals over the age of six months, especially for populations with weak immune systems

and those in frequent contact with them (Qualls, et al., 2017). Nurses and other health providers

are highly recommended to have an annual flu shot. A survey is done by the National foundation

for infectious diseases (NFID) each year to better understand the public's knowledge of the flu

and their attitudes toward vaccination. According to the most recent survey (National foundation

for infectious diseases, 2022), most US residents have good knowledge about the flu, especially

those with history of previous vaccinations. Flu shots are believed to be the best defense strategy

against influenza. However, many individuals decide to not get the flu shot for the 2022-2023 flu

season. Multiple reasons are given. For instance, some worry about the effectiveness of the flu

vaccine, some do not consider influenza as a serious disease, and so on. In addition, influenza

can be prevented by non-pharmaceutical interventions (NPIs), especially during influenza

pandemics. NPI refers to staying home when sick, covering coughs and sneezes, washing hands

frequently, closing schools, avoiding mass gatherings, and regularly cleaning the frequently

touched surfaces (Short, Kedzierska, & van de Sandt, 2018). Antiviral drugs are also used as a

preventive method during the period of pandemics, when a vaccine is not yet available.
 In conclusion, for the points mentioned above, Lyme disease and influenza seem to be

unrelated, but in some cases, it is easy to confuse them because of the features they have in

common. Hence, it is important to be aware of the similarities and differences between the two

conditions. If someone notices flu-like signs that persist for a significant amount of time, gets

bitten by a tick, or develops a red rash, seeking for further medical care is needed to find out the

cause of these symptoms. Either it is Lyme disease or influenza, or the person is having both,

early detection will help with proper treatments and avoid unwanted prolonged illness.
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