Cases of Lyme Disease Appear to Follow Periodic Cycles Linked to Geography

We are studying the spread of Lyme disease through Wisconsin. It is important because the number of people diagnosed with Lyme Disease in the US is around 300,000, annually (CDC 2017). The CDC has collected data of reported Lyme Disease cases since 2001. When looking at the data we noticed that the trends of cases of Lyme disease followed a cyclical pattern. The cycles varied widely. We hypothesized that environmental and geographical factors could affect the main vector of Lyme Disease, Ixodes scapularis (the black-legged tick). After analyzing Lyme Disease data from the CDC and using a map making software (Paint Maps 2018), we found that geographical distribution had a marked effect on the rate at which counties cycled between up and down trends in infection rates. These findings are important because they give us more insight into possible control methods to keep the black-legged tick, and therefore Lyme Disease, at a manageable level

Lyme Disease in Fairfield County, Connecticut: The Need to Know

There has been a steady rise in number of cases reported of Lyme disease in the past 25 years. In fact, it is the 7th most common reportable infectious disease in US with an estimated over 300,000 people diagnosed and treated each year. The total medical cost attributable to Lyme disease has been estimated to be as much as $1.3 billion a year with the total cost of Lyme disease testing estimated to be$492 million. Moreover, Lyme disease is associated with higher total health care cost and more outpatient visits over a 12-month period. According to the Connecticut Department of Public Health, the most number of cases of Lyme Disease in Connecticut is in Fairfield County. Therefore, education especially awareness and prevention is crucial to decrease the number of cases of Lyme each year, keep the cost down and have a healthier patient population without Lyme Disease.https://scholarworks.uvm.edu/fmclerk/1550/thumbnail.jp

Serious Bacterial Infections Acquired During Treatment of Patients Given a Diagnosis of Chronic Lyme Disease - United States.

The term "chronic Lyme disease" is used by some health care providers as a diagnosis for various constitutional, musculoskeletal, and neuropsychiatric symptoms (1,2). Patients with a diagnosis of chronic Lyme disease have been provided a wide range of medications as treatment, including long courses of intravenous (IV) antibiotics (3,4). Studies have not shown that such treatments lead to substantial long-term improvement for patients, and they can be harmful (1,5). This report describes cases of septic shock, osteomyelitis, Clostridium difficile colitis, and paraspinal abscess resulting from treatments for chronic Lyme disease. Patients, clinicians, and public health practitioners should be aware that treatments for chronic Lyme disease can carry serious risks

A rare cause of peripheral facial paralysis in childhood in our country: lyme disease

Lyme disease is a zoonosis caused by Spirochetes called Borrelia burgdorferi, involving several areas, such as the skin, heart and central nervous system. In this case report, we present a 10-year-old male who had complaints of fever, extensive oral aphthae, perioral dried sores, rash, blurred vision and peripheral facial paralysis, and was diagnosed with Lyme disease. In this report, we want to emphasize that Lyme disease should be kept in mind for differential diagnosis in patients with fever and peripheral facial paralysis

Education on Tickborne Diseases and Prevention Strategies

Research suggests that around 300,000 people are diagnosed with Lyme disease each year and that around one billion dollars is spent on healthcare for Lyme disease alone. Vermont has the highest rate of incidences of Lyme disease per 100,000 persons in the United States. While Lyme disease is certainly a major community health issue in Berlin, VT there are many other tickborne diseases that are becoming increasingly prevalent such as Anaplasmosis, Babesiosis, Powassan virus disease, and Borrelia miyamotoi disease. An educational handout was created providing helpful information for both community members as well as healthcare providers. For community members the information focuses on tick bite prevention strategies, how to safely remove a tick and common symptoms of tickborne diseases seen in Vermont. For the providers the information focuses identification of ticks, in-depth signs and symptoms of tickborne disease, lab tests and results, diagnostic testing and appropriate treatment methods. This handout was provided to Berlin Family Medicine for distribution to patients and providers in hopes of combatting the rising incidence of tickborne diseases in Vermont.https://scholarworks.uvm.edu/fmclerk/1333/thumbnail.jp

The Emerging Role of Microbial Biofilm in Lyme Neuroborreliosis

Lyme borreliosis (LB) is the most common tick-borne disease caused by the spirochete Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia, respectively. The infection affects multiple organ systems, including the skin, joints, and the nervous system. Lyme neuroborreliosis (LNB) is the most dangerous manifestation of Lyme disease, occurring in 10-15% of infected individuals. During the course of the infection, bacteria migrate through the host tissues altering the coagulation and fibrinolysis pathways and the immune response, reaching the central nervous system (CNS) within 2 weeks after the bite of an infected tick. The early treatment with oral antimicrobials is effective in the majority of patients with LNB. Nevertheless, persistent forms of LNB are relatively common, despite targeted antibiotic therapy. It has been observed that the antibiotic resistance and the reoccurrence of Lyme disease are associated with biofilm-like aggregates in B. burgdorferi, B. afzelii, and B. garinii, both in vitro and in vivo, allowing Borrelia spp. to resist to adverse environmental conditions. Indeed, the increased tolerance to antibiotics described in the persisting forms of Borrelia spp., is strongly reminiscent of biofilm growing bacteria, suggesting a possible role of biofilm aggregates in the development of the different manifestations of Lyme disease including LNB

Science, Politics, and Values: The Politicization of Professional Practice Guidelines

The Connecticut Attorney General’s recent allegations that the Infectious Disease Society of America violated antitrust law through its treatment guidelines for Lyme disease were neither based in sound science or appropriate legal judgment. Strong scientific evidence favors IDSA’s position that chronic infection with the etiologic agent of Lyme disease does not occur in the absence of objective signs of ongoing infection and that long-term antibiotic use to treat dubious infection, recommended in the quasi-scientific guidelines put forth by the International Lyme and Associated Diseases Society (ILADS), are of no benefit. In siding with ILADS and other chronic Lyme disease advocates, ultimately forcing IDSA to settle lest it expend exorbitant legal costs, the attorney general abused science and his public trust. This case exemplifies the politicization of health policy and confuses the relative spheres inhabited by normative discourse and scientific inquiry. Science should provide the evidentiary base for normative discussions, and values and politics will always be important in deciding how science is applied for human benefit. But a wall of separation is needed between science, values, and politics, as medical science, and the patients who depend on it, is too important for political distortion

What Is the Best Predictor of Annual Lyme Disease Incidence: Weather, Mice, or Acorns?

Predicting fluctuations in annual risk of Lyme disease would be useful in focusing public health efforts. However, several competing hypotheses have been proposed that point to weather variables, acorn production, or mouse abundance as important predictors of Lyme disease risk. We compared the ability of acorn production, mouse density, and four relevant weather variables to predict annual Lyme disease incidence (detrended) between 1992 and 2002 for Dutchess County, New York, and seven states in the northeastern United States. Acorn production and mouse abundance measured in Dutchess County were the strongest predictors (r ≥ 0.78) of Dutchess County Lyme disease incidence, but the increase in mouse abundance from 1991 to 1992 was contrary to a decrease in Lyme disease in the following years. The Palmer Hydrologic Drought Index (PHDI) was a significant positive predictor of Lyme disease incidence two years later for three states (0.58 ≤ r ≤ 0.88), but summer precipitation was generally negatively correlated with Lyme disease incidence the next year (-0.79 ≤ r ≤ 0.02). Mean temperatures for the prior winter or summer showed weak or inconsistent correlations with Lyme disease incidence. In four states, no variable was a statistically significant predictor of Lyme disease incidence. Synchrony in Lyme disease incidence between pairs of states was not significantly concordant with synchrony in any weather variable that we examined (0.02 ≤ r ≤ 0.21). We found that acorns and mice were strong predictors of Dutchess County Lyme disease incidence, but their predictive power appeared to be weaker spatially. Moreover, evidence was weak for causal relationships between Lyme disease incidence and the weather variables that we tested. Reliable prediction of Lyme disease incidence may require the identification of new predictors or combinations of biotic and abiotic predictors and may be limited to local scales

Detection of Borrelia burgdorferi in historic tick samples and its relevance to the white-tailed deer population in New Hampshire

The cases of Lyme disease in New Hampshire have increased over time. There are speculations that increasing number of Lyme disease cases in New Hampshire are due to environmental factors, such as warmer climate, white-footed mouse population, white-tailed deer population, opossum population, and forestation coverage. In this study, we processed whole tick samples from 2000, 2001, and 2003 for Borrelia burgdorferi by Real-Time TaqMan PCR. In addition, we also processed homogenized tick samples from 2010, that previously tested positive for B. burgdorferi and had been stored at -80°C since 2010, for repeat B. burgdorferi testing by Real-Time TaqMan PCR. Then, the number of reported positive tick samples from the years 2000, 2001, 2003, 2009, 2010, and 2011 were correlated with white-tailed deer population and Lyme disease cases. Based on our analysis, there was an indirect relationship noted between white-tailed deer population, which is highly suggestive of the relationship between host diversity and Lyme disease cases. On the other hand, the rate of positive tick samples exhibited similar trend as Lyme disease cases. Due to poor staffing and funding issues, the NH Department of Human and Health Services were not able to obtain any tick samples in 2002, from 2004 to 2008, and from 2012 to 2017. We were unable to correlate Lyme disease cases to neither white-footed mouse population nor opossum population, since the NH Fish and Game do not keep track of these two populations. Of the 141 ticks collected in 2000, 2001, and 2003, 44 ticks tested positive for B. burgdorferi. These sample became the oldest, documented tick samples in the state of New Hampshire, which tested positive for B. burgdorferi. In addition, there were insignificant deviations noted between Ct values of the 2010 samples, which were processed in 2010 and 2018. Therefore, the unremarkable difference in Ct values suggest that cryopreservation seems to be the most optimal method of preserving DNA. It was also noted in this study, historic samples had significantly lower DNA concentration than the 2010 samples. We attributed the significant difference to time of storage and method of DNA preservation. We attempted to sequence tick samples for Next Generation Sequencing. DNA of tick samples from 2000, 2001, 2003, and 2010 were quantified in Qubit Fluorometer. However, DNA concentration of individual tick samples were insufficient for prokaryotic enrichment, thus the DNA from positive tick samples in 2010 were pooled together. The pooled DNA was reprecipitated and quantified, but the DNA concentration was still insufficient to proceed with enrichment and sequencing