Lyme disease: aetiopathogenesis, factors for disease development and control

Lyme disease is caused by infection with several genospecies from the Borrelia burgdorferi sensu lato (s.l.) complex, and is transmitted by ixodid ticks. Human disease is an infrequent sequel to infection, which suggests that multiple factors underlie disease development. Several innate immune defects modulating disease development are observed in both natural and experimental infections, and significant heterogeneity exists between B. burgdorferi s.l. spirochaetes. These factors create a panel of presentations from asymptomatic carriage to overt and variable disease. In this short review we summarise the host immune responses associated with Lyme disease in humans, domestic species and laboratory mouse strains, and discuss B. burgdorferi s.l. pathogenicity. We also describe briefly the epidemiology of Lyme disease, and current options for the treatment and prevention.