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Seven Lyme disease stories to mark Lyme Disease Awareness Month
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Tickborne diseases are on the rise in the United States, according to the CDC, which recommends that patients use repellents, check for ticks and shower after being outdoors to reduce their chances of acquiring one of the diseases.
Lyme disease, which humans can acquire through the bite of an infected blacklegged tick, is the most common tickborne illness in the U.S. Lyme disease can usually be treated with antibiotics, but left untreated, the infection can spread to the joints, heart and nervous system, according to the CDC.
To mark Lyme Disease Awareness Month this May, Infectious Disease News has compiled a list of recent stories about the illness. – by Gerard Gallagher
CDC gives $10 million to support center investigating vector-borne diseases
Lyme disease is the most common vector-borne disease in the country, but it does not occur everywhere. In fact, according to the CDC, 95% of confirmed Lyme disease cases in 2015 occurred in just 14 states, all of them in the Northeast or upper Midwest.
The CDC recently awarded $10 million to support a center managed by researchers at Cornell University who aim to better understand, prevent and treat vector-borne diseases, including Lyme disease.
The Northeast Regional Center for Excellence in Vector Borne Diseases will offer a new master’s program and develop courses for Cornell’s Master of Public Health degree to educate a team of vector biologists and public health practitioners. Story.
Climate change impacts spread of Lyme disease
In a recent cover story, Infectious Disease News explored the relationship between climate change and infectious diseases, including Lyme disease. According to Ben Beard, PhD, chief of the Bacterial Diseases Branch of the CDC’s Division of Vector-Borne Diseases, blacklegged ticks reproduce and survive better at higher temperatures. A warming climate has allowed them to migrate northward into zones that were previously too cold for their survival, expanding the threat of Lyme disease to new populations.
“We see these ticks now in areas of Canada and the northernmost parts of Wisconsin and Minnesota where we never saw them before,” Beard said in an interview. Story.
Target lesions, symptoms not always indicative of Lyme disease
Symptoms alone are not enough reason to test a patient for Lyme disease, and not every patient with Lyme disease will present with target lesions, according to a presentation at last year’s Infectious Diseases in Children Symposium.
About 80% to 90% of patients with Lyme disease have the characteristic rash erythema migrans, Eugene D. Shapiro, MD, professor of pediatrics, epidemiology and associate chair for clinical translational and educational research at Yale School of Public Health, told Infectious Diseases in Children. However, the rashes can appear differently; localized diseases in which the erythema appears in a single patch at the affected site account for 60% to 70% of clinical manifestations of Lyme, and disseminated disease — an appearance of multiple erythema on the skin — accounts for 20% to 25% of cases. Story.
Researchers identify compounds that may treat Lyme persisters more effectively
Researchers say they demonstrated that strains of Lyme disease found in California ticks are able to form persister bacteria and that several FDA–approved compounds may work better than doxycycline to inhibit these strains in vitro.
No study exists that proves viable infectious organisms persist in individuals with post-treatment Lyme disease syndrome (PTLDS), according to Jayakumar Rajadas, PhD, director of the Biomaterials and Advanced Drug Delivery Laboratory at Stanford University School of Medicine, and colleagues. PTLDS affects from 10% to 20% of Lyme disease patients who experience sustained symptoms such as chronic fatigue and fibromyalgia. There is evidence, however, that Borrelia burgdorferi persists in rodents and nonhuman primates after antibiotic treatment, the researchers said. Story.
Treatment options limited for patients with chronic Lyme disease
Over the years, many patients with unexplained medical symptoms — including chronic fatigue syndrome, irritable bowel syndrome and fibromyalgia, among a litany of others — have been diagnosed with chronic Lyme disease and treated with long-term antibiotics. This treatment, however, may not provide any clinical improvements for these patients and could lead to adverse effects, according to infectious disease specialists.
‘There is no evidence of meaningful benefit, and there is substantial evidence that such treatment is associated with frequent and significant adverse side effects,” Eugene D. Shapiro, MD, professor of pediatrics and epidemiology at Yale School of Medicine and Infectious Disease News Editorial Board member, said in an interview.
In fact, findings from a randomized clinical trial published in The New England Journal of Medicine suggest that in patients with persistent symptoms related to Lyme disease, long-term antibiotic treatment offered no additional beneficial effects on health-related quality of life compared with short-term therapy. Story.
Lyme disease possi bly underdiagnosed in Hispanics
Additional research is needed to determine if there are underlying factors explaining why Lyme disease is less frequently diagnosed in Hispanics living in the United States, despite a potentially greater risk of job-related exposure, researchers said last year.
The annual incidence of reported cases of Lyme disease among Hispanics was just 0.8 per 100,000 people compared with 4.0 cases per 100,000 among non-Hispanics, the researchers said.
According to them, inadequate health care access, language barriers, and lack of Lyme disease awareness could cause both underdiagnosis and delays in diagnosis in the Hispanic population.
Their study included 374,338 confirmed and probable cases of Lyme disease from the CDC’s National Notifiable Disease Surveillance System between 2000 and 2013. Of the 148,444 cases where ethnicity was available, 5,473 people self-identified as Hispanic. Story.
New Borrelia species causes Lyme disease in upper Midwest
Researchers said a new species of bacteria is causing Lyme disease in people bitten by ticks in the upper Midwest and cautioned that patients suspected of being infected by Borrelia mayonii likely are not being evaluated for Lyme disease because they present differently from those infected by the only other species to cause Lyme disease in North America, B. burgdorferi.
The researchers emphasized that medical and health care professionals should be aware of the new pathogen.
“The clinical range of illness must be better defined in additional patients to ensure that physicians can recognize the infection and distinguish it from other tick-borne infections,” they wrote. Story.