Epidemiology and clinical similarities of human spirochetal diseases.

Schmid GP

Division of Sexually Transmitted Diseases, Centers for Disease Control, Atlanta, Georgia
30333.

Lyme disease, first identified in 1975, is the most recently recognized of the seven human
spirochetal diseases; the evolving clinical picture of Lyme disease indicates it shares
many features with the other diseases. These similarities are striking in view of the
diverse epidemiology of the seven diseases, which are caused by Treponema species
(spread by human-to-human contact) or Leptospira or Borrelia species (zoonoses). These
similarities include the following: (1) skin or mucous membrane as portal of entry; (2)
spirochetemia early in the course of disease, with wide dissemination through tissue and
body fluid; and (3) one or more subsequent stages of disease, often with intervening
latent periods. Lyme disease shares with many spirochetal diseases a tropism for skin and
neurologic and cardiovascular manifestations, whereas chronic arthritis is unique to
Lyme disease. These similarities and dissimilarities offer opportunities to discover which
properties unique to the pathogenic spirochetes are responsible for clinical manifestations
and suggest that certain clinical features of patients with spirochetal diseases other than
Lyme disease may someday be recognized in patients with Lyme disease.

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