The number of confirmed cases of the tick-borne illness Lyme disease is on the rise in the United States and around the world. An upsurge in the amount of cases have been reported in recent times. An expert on the disease discusses why there's a surge.
Statistics from the Centers for Disease control and Prevention show that there were approximately 30,000 confirmed cases of Lyme disease in 2009 and close to 40,000 probable cases.
Throughout 2010 there has been an increase in cases of the disease. Cases have been reported in Massachusetts and Virginia, Earlier this year the New Hampshire Department of Health and Human Services advised people to take precautions to protect themselves from Lyme disease and other tick-borne diseases.
According to Wikipedia there have been reported cases of Lyme disease in 49 out of the 50 states in the United States.
Dr. Harriet Kotsoris is a neurologist and medical advisor for Time for Lyme, a non-profit research, education and advocacy group based in Greenwich, CT.
What are the symptoms of Lyme disease that people should look out for?
"Lyme disease, much like syphilis in the previous century, is a great mimicker. Symptoms are countless, but some of the most common include fatigue, waxing and waning joint pain and stiffness, muscle aches, headaches, blurred vision, concentration difficulties, sleep disturbance, imbalance, palpitations, exercise intolerance and shortness of breath. Manifestations across the pond are quite different. Europe sees a lot more in terms of cranial and spinal nerve root inflammation and pain."
How is the illness diagnosed and what are the treatments available?
"Diagnosis is a challenge. The 2-tier system (Elisa and Western blot) in place in the United States is not very reliable. Test too soon or after antibiotic use, you might obtain a false negative result. Perhaps as few as 10% of patients with actual Lyme disease fulfill the CDC (Centers for Disease Control) criteria for a positive Lyme Western blot, thus resulting in significant underreporting/underdiagnosing of the disease. There are gender differences in testing, too. Women apparently do not mount as brisk an antibody response to infection as men do."
"The mainstay of treatment is antibiotics--doxycycline by mouth, and in more complicated cases, intravenous rocephin or ceftriaxone--a third generation cephalosporin antibiotic. There are adjunctive treatments depending on the signs and symptoms manifested, as well as duration and severity of illness. IvIg (gammaglobulin) may be used in patients suffering from neuropathy or nerve damage."
Once diagnosed what is the prognosis and what are the possible complications?
"If diagnosed early, patients with Lyme disease generally do well. "Early" from an anecdotal perspective, several decades of experience in my treating patients with neurologic complications of Lyme disease, may be 6 months from time of inoculation or tick bite. Despite what is considered "adequate" early treatment, a small percentage never recover completely. This remains a mystery that is unfolding, as I answer these questions, among researchers in immunology. Perhaps there is a concurrent genetic predisposition to a chronic inflammatory state after infection in a small subset of individuals."
Why is Lyme disease on the increase?
"Lyme disease is on the increase for several reasons: reforestation of suburban developments where small critters, such as chipmunks and squirrels, act as intermediate or secondary reservoirs for the Ixodes tick vector of Lyme disease; global warming that predisposes to a preferential multiplication of the most virulent subspecies of Borrelia burgdorferi, the causative organism in Lyme disease; and the burgeoning population of deer, the primary reservoir host of the Ixodes tick."
In addition, Dr Harriet Kotsoris said:
"Lyme disease is a growing global problem of increasing complexity. Researchers are uncovering just how difficult the organism that causes Lyme disease can be with the variation of strains compounded by an expanding array of potential co-infections that vary geographically. Research efforts must step up the pace to meet the needs of this complex disease process in order to address the growing number of suffering patients around the globe.”