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Lyme disease rates high, yet the disease remains under-reported
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NEW YORK CITY – Lyme disease is the most common vector-borne disease in North America, yet cases remain unreported, according to data presented here at the 23rd Annual Infectious Diseases in Children Symposium.
Paul M. Lantos, MD, department of pediatric infectious diseases, Duke University Medical Center, Durham, N.C., discussed during his presentation issues in Lyme disease, including clinical features; recommended therapy; appropriate use and interpretation of tests; concerns unique to pediatrics; and the controversy of chronic Lyme disease
Pediatric-specific issues included a discussion of the prevention/prophylaxis of Lyme disease and when to use doxycycline in pediatric patients, and an exploration of the controversy of a congenital Lyme syndrome.
“Doxycycline is the preferred oral drug,” said Lantos, adding that length of treatment should be 4 weeks or less.
Lantos emphasized that Lyme disease has finite, well-described manifestations; diagnostic testing should be performed judiciously; treatment is generally less than four weeks; reliable guidelines exist to assist physicians; and it is the job of the physician to educate colleagues and the public.
Diagnosis of Lyme disease is not definite, but erythema migrans (EM) does occur in 70% to 80% of patients; multiple EM is not uncommon. EM occurs more frequently in children, possibly because parents are better at inspecting their children for suspect rashes better than they check themselves, according to Lantos. However, it is important to also remember that Lyme disease is a geographical disease, which helps with the diagnosis, Lantos said during his presentation.
“Between 80% and 90% of Lyme diseases cases occur in the North East,” he said. “Most cases in other areas are imported from endemic areas.” – by Christen Cona
For more information:
- Lantos PM. Lyme Disease: When to worry? What to do?. Presented at: the 23rd Annual Infectious Diseases in Children Symposium; Nov. 20-21, 2010; New York City.
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