A newly published study conducted by SUNY Adirondack Professor Holly Ahern is providing new insights into the prevalence of Lyme disease.
In its December 2013 issue, the Journal of Microbiology Research published the peer-reviewed study entitled, “Comparison of Lyme Disease Prevalence and Disease Reporting in an Endemic Area,” conducted on the SUNY Adirondack campus, using the populations of Saratoga, Warren and Washington counties.
Ahern’s study was undertaken to evaluate the rate of “probable” Lyme disease, using the CDC’s own criteria. It found that the reporting of the disease to the CDC is far less than the actual incidence of disease, contributing to a nationwide, and possibly world-wide, matrix of misunderstanding and misinformation about it.
Lyme disease is the most commonly reported tick-borne illness in the United States. Controversy, however, plagues the diagnostic criteria and has led to claims of both under-diagnosis and over-diagnosis by physicians. While both result in errors in estimating disease risk, under-reporting of Lyme disease to public health agencies creates a serious burden on individuals and society, health officials claim.
The study resulted findings include:
1. In the study population, cases were diagnosed by physicians more frequently than cases were reported to the CDC.
2. Sixteen percent of the undiagnosed population reported signs and symptoms consistent with late-stage Lyme disease, including cardiac, rheumatologic, or neurological symptoms.
3. Only half of the diagnosed respondents reported that they remembered any tick bite.
4. Only 33 percent of diagnosed respondents reported noticing a bulls-eye rash at the site of a tick bite. (The CDC claims that 80 percent of victims experience the rash.)
5. Half of the diagnosed respondents that had been treated with antibiotics reported persisting symptoms and did not consider themselves “cured.” (The CDC maintains that only a very small percentage of victims treated with antibiotics experience persisting problems.)
Factors that might contribute to under reporting of Lyme disease, health care officials say, include:
• Misdiagnosis of Lyme disease as other disorders, such as fibromyalgia, chronic fatigue syndrome, multiple sclerosis, and many others.
• Lack of a diagnosis due to patients not presenting with either of the two CDC-accepted markers for the disease (EM rash or laboratory evidence).
• Poor recognition or understanding of the signs and symptoms of disseminated Lyme disease.
• Diagnosis of Lyme disease by physicians who then don’t report the cases.
• The case report being discounted by public health agencies as not fully meeting the CDC criteria for a case of Lyme disease.
• Reluctance on the part of the physician to report the case. A survey of primary care physicians in Connecticut, in which over half of the respondents reported uncertainty about Lyme disease diagnosis, is reflective of the problems with the current diagnosis and reporting system.
“The Lyme community has been challenging the CDC’s prevalence numbers for decades”, said Christina Fisk, a director, with Ahern, of the Lyme Action Network. “The entire system is rife with problems – from physician education to public awareness to public agencies’ responses and processing procedures. This disease is serious, and it’s everywhere.
“It is time for a comprehensive reform of public and medical policy on the subject of Lyme disease and the other devastating tick-borne illnesses. The CDC has acknowledged that their previous prevalence estimates were off the mark by a factor of ten. Now the entire support and response structure needs to be upgraded. More of the same is not an option.”
Ahern’s study can be reviewed at http://article.sapub.org/10.5923.j.microbiology.20130306.11.html#Sec5.
Photo Courtesy SUNY Adirondack