Holly Ahern - Lyme Disease: What You Should Know...
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Holly Ahern - Lyme Disease: What You Should Know... Presentation Transcript

  • 1. What you should know…. Holly Ahern MS, BS MT(ASCP) Associate Professor of Microbiology SUNY Adirondack, Queensbury, NY
  • 2. I say “LYME DISEASE,” you say….
  • 3. *Borrelia burgdorferi Other Borrelia Babesia Bartonella Ehrlichia Anaplasma Mycoplasma Viruses
  • 4. University of Rhode Island Tick Encounter Resource Center http://www.tickencounter.org/tick_testing
  • 5. Lyme disease is an acute infectious disease, transmitted by nymph stage deer ticks, caused by one species of a specific bacterium named Borrelia burgdorferi “Hard to catch and easy to cure”
  • 6. Tick must be attached for a minimum of 36 hours to transmit Lyme disease… Current IDSA/CDC “Standard of Care” Peer-reviewed evidence NOT included in the IDSA/CDC guidelines  Burgdorfer: transmission time for Borrelia is variable.  Other TBDs transmitted quickly; viruses in 15 min.  Borrelia may be sexually transmitted.  Borrelia, Babesia, Anaplasma are transfusion transmitted.
  • 7. Lyme disease is an acute infectious disease. Current IDSA/CDC “Standard of Care” Peer-reviewed evidence NOT included in the IDSA/CDC guidelines  Lyme disease may be an acute disease.  Lyme disease may also be a chronic disease.
  • 8. A single “FRONTAL” pathogen, Borrelia burgdorferi, is responsible for Lyme disease symptoms.  Ticks carry and transmit multiple “STEALTH” microbes.  People infected with multiple pathogens have more severe disease. Current IDSA/CDC “Standard of Care” Peer-reviewed evidence NOT included in the IDSA/CDC guidelines
  • 9. Diagnostic algorithm (ACP) includes patient history of tick bite, “bulls-eye” rash, AND “laboratory evidence” of infection (usually this means a “two-tier” system of antibody based blood tests for Borrelia burgdorferi ONLY) Current IDSA/CDC “Standard of Care” Peer-reviewed evidence NOT included in the IDSA/CDC guidelines  Current diagnostic criteria EXCLUDE any form of the disease that does not meet the ACP/CDC/IDSA algorithm  Therefore, you may not be diagnosed with Lyme disease, EVEN IF YOU HAVE IT, if:  No “bulls-eye” at tick bite site  “First tier” test doesn’t meet a threshold level  “Second-tier” test doesn’t have enough “bands”  You were infected with more than one microbe by the tick
  • 10. Most infections resolve after short-term antibiotic treatment; 5% of patients may develop post-tx sequelae that are “autoimmune.”  CDC survey - 61% require more than recommended antibiotic treatment.  30 – 50% have chronic symptoms persisting after antibiotics.  Stealth pathogens are highly adapted survivors so persistent infection may be the cause.  Reactivation of growth of spirochetes shown in most recent study. Current IDSA/CDC “Standard of Care” Peer-reviewed evidence NOT included in the IDSA/CDC guidelines
  • 11. EASY to catch and HARD to cure! Ticks may transmit some pathogens RAPIDLY Study of Lyme patients: Only 50% developed any type of rash, of those, only 10% had a “bulls-eye” Symptoms may occur at ANY TIME of the year Symptoms are highly variable and may become CHRONIC Blood tests for Lyme disease are reliably INACCURATE 2-4 weeks of antibiotics MAY NOT cure Lyme disease
  • 12. Disease New cases (annual) NIH funding (FY 2012) Hepatitis C 1,300 $112 million West Nile Virus 5,700 $29 million HIV/AIDS * 56,000 $3 billion (11% total NIH budget) Influenza * 73,000 $251 million Lyme disease 312,000 $25 million Source: http://report.nih.gov/PFSummaryTable.aspx * Considered “epidemic” by the CDC
  • 13. Financial Burden of Lyme disease, BEFORE CDC Case Estimate Revision (2012) New York State 2,590 $10,429 $27,011,110 United States 27,313 $10,429 $284,847,277 Financial Burden of Lyme disease, AFTER CDC Case Estimate Revision (2012) New York State 25,900 $10,429 $270 million United States 312,000 $10,429 $3.25 billion Financial Burden of Lyme disease, based on probable number of cases (2012) New York State 44,030 $10,429 $460 million United States 445,714 $10,429 $4.65 billion