May 23, 2018
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Developments highlight Lyme Disease Awareness Month

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Eugene Shapiro
Eugene D. Shapiro

May is recognized as Lyme Disease Awareness Month, a time for activists to bring awareness of the disease.

“I would say one of the most significant developments related to Lyme disease is that an Austrian company, Valneva, is actively developing a new vaccine to prevent Lyme disease. They are some years away from getting it licensed, but initial results are promising,” Eugene D. Shapiro, MD, professor of pediatrics and epidemiology at the Yale School of Medicine and an Infectious Disease in Children Editorial Board member, told Infectious Diseases in Children.

Shapiro added that the incidence of Lyme disease is increasing substantially in areas adjacent to traditional high-incidence areas, including northern New England (eg, Maine), the upper Hudson Valley in New York, western Pennsylvania and eastern Ohio.

"Evidence continues to accrue that antimicrobial treatment of patients with prolonged nonspecific symptoms putatively related to Lyme disease (ie, chronic Lyme disease or post-treatment Lyme disease syndrome) is of no benefit but it (and other unorthodox treatments) is associated with considerable risks of serious adverse effects and substantial extra costs,” Shapiro said.

Recent developments in Lyme diseases reported in Infectious Diseases in Children include:

Lyme disease diagnosis based on clinician suspicion often inaccurate

Clinician suspicion had minimal accuracy in differentiating between children with and without Lyme disease who presented to the ED, according to findings published in Pediatrics.

“Clinicians use clinical prediction rules to combine available demographic, clinical and laboratory factors to estimate the probability of an outcome and assist clinical decision-making. However, the considerable overlap between Lyme disease and its mimics limits the clinical applicability of these predictive models,” Lise E. Nigrovic, MD, MPH, from the division of emergency medicine at Boston Children’s Hospital, and colleagues wrote. “The ability of clinician suspicion to accurately identify children at either high or low risk for Lyme disease has not been rigorously evaluated.” Read more

Lone star tick found not to contain Lyme disease agent

Researchers have found that lone star ticks are not vectors of the Lyme disease agent, according to recently published study results.

Ellen Stromdahl, BCE, an entomologist at the U.S. Army Public Health Center, and colleagues conducted a review of 54 studies from at least 35 different research groups on 52,000 Ambyomma americanum ticks, otherwise known as lone star ticks, for Borrelia burgdorferi vectors that had been published during three decades dating back to 1983. Borrelia burgdorferi is the bacterium that causes Lyme disease. Read more

IDSA antitrust lawsuit thrusts chronic Lyme disease into health care limelight

A federal antitrust lawsuit was filed against The Infectious Diseases Society of America, eight insurance companies and seven physicians who have reportedly denied coverage for the treatment of chronic Lyme disease.

According to an article in Courthouse News, the 28 patients filing the lawsuit claim that the IDSA guidelines have prevented them from obtaining more than a month’s worth of antibiotics. The patients assert that the guidelines were created by consultants who were paid large fees by insurance companies included in the lawsuit. Read more

Vector-borne diseases more than triple in US, CDC says

The number of illnesses caused by the bite of infected mosquitoes, ticks and fleas has more than tripled in the United States, and the country is not fully prepared to handle the increased burden, CDC officials said.

According to data from a recent CDC Vital Signs report, more than 640,000 cases of vector-borne illnesses like Zika, West Nile virus and Lyme disease were reported to the National Notifiable Disease Surveillance System by state health departments from 2004 through 2016, although the actual total is thought to be much higher. Read more

Neurological symptoms do not specify Lyme disease

A familiar set of neurobehavioral symptoms often attributed to Lyme disease, such as fatigue and cognitive difficulties, is not specific to Lyme disease and is not indicative of nervous system infection or inflammation, according to researchers.

In addition, biomarkers in blood associated with these symptoms are the same whether patients have active, prior or no history of Lyme disease, they wrote in Clinical Infectious Diseases. The researchers said their work helps to illustrate the complexities of understanding the symptom complex and avoiding unnecessary antibiotic treatment. Read more

Confronting the misnomer of ‘chronic’ Lyme disease

Compounded by misinformation shared through internet forums, “chronic” Lyme disease has become a new fixture in the debate largely between patients and providers regarding medically unexplained symptoms. To explore this phenomenon and how it fits into the health care landscape, Infectious Diseases in Children spoke with several infectious disease and Lyme disease specialists about the pervasive misnomer of “chronic” Lyme disease, the furor of the Lyme community, and how physicians can better prepare themselves for treating patients with medically unexplained symptoms. Read more