Lyme disease is cause of recurrent facial palsy in health personnel. Three cases report

Introduction
Lyme borreliosis is the major emerging infectious disease transmitted by ticks in the world. In Mexico City, the prevalence is 3.4% and Bell’s palsy is the most common neurological manifestation of the disease in Rehabilitation clinical of IMSS. The recurrence risk of facial palsy if the treatment is not indicated is 3 times more common that in viral infection.

Methods
Cases Report. This project was registered by the Bioethics Committee in the Children Hospital. During June to November 2010 in the Service of Prevention and Health Promotion of Children Hospital, IMSS, went three workers with facial palsy. Sera samples were used to performed ELISA and WB IgM and IgG vs Borrelia burgdorferi. Confirmed case was defined by CDC: clinical manifestation of acute Lyme disease, ELISA and Western Blot IgG vs Borrelia burgdorferi positive. Analysis was with descriptive statistical.

Results
Two cases were positive and one case indeterminate. All were female of 28, 45 and 45 years old; two were exposure to tick bite and dogs infested with ticks. The exposition to tick was in Mexico City, Puebla and Cuernavaca, Morelos. Two cases presented facial palsy ten years ago and other one facial palsy recurrence in three times. The antibiotic treatment was done by four weeks and the response was good from of third week.

Discussion
Lyme disease should be integrated as differential diagnosis of facial palsy mainly in the medical primary care and prompt diagnosis an appropriate treatment and prevent the chronic stage. The health Institution in Mexico should include the surveillance of the cases.