Lyme disease: a comprehensive perspective on pathogen biology, clinical aspects and epidemiology in India.

Background objectives: Lyme disease is a multisystem illness caused by the spirochaetes bacteria belonging to the genus Borrelia. It's a tick-borne disease that poses serious health concerns in major parts of the world including India. This review aims to comprehend the disease in depth encompassing its pathogen biology, clinical presentations, diagnosis, treatment strategies, epidemiology in India, and preventive measures against it.

Methods: Peer-reviewed articles, reviews, meta-analyses and clinical studies relating to the topic were searched across reliable electronic databases like PubMed, and ScienceDirect, without imposing any time restriction for up-to-date information with a focus on sources indexed in the Science Citation Index (SCI).

Results: The pathogen is a gram-negative bacterium namely Borrelia burgdorferri infesting ticks mainly belonging to the genus Ixodes. Clinical presentations vary from single Erethema Chronicum Migrans (ECM) to neurological complexities, cardiac disorders, and severe arthritic conditions. A two-tiered test recommended by CDC is currently employed to diagnose the disease. 15 out of 28 states in India have reports of Lyme disease; most of these states also have Ixodes ticks. However, the exact vector is not confirmed in India.

Interpretation conclusion: 13 of the 15 states where Lyme disease cases have been reported have also had ticks belonging to the genus Ixodes. Thus it can be assumed that vectors of Lyme disease in India are Ixodes sp., but more studies are required to confirm and validate this assumption, and find the exact species of the vector tick. As an ignored vector-borne disease in India, Lyme disease warrants more research and surveillance.